| NHF’S National Headache Awareness Week | |
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Each year, the National Headache Foundation (NHF) celebrates the first week of June as their Headache Awareness Week, each year with a different theme and focus. This year, the NHF has chosen “Follow the Three ‘R’s’ of Migraine Management.”
Begin by asking yourself this question: “‘R’ Migraines affecting your life?” If you answer, “Yes,” the NHF suggests the three “R’s” of Migraine management:
- Recognize Migraine symptoms.
- Respond and see a healthcare provider.
-
Relieve pain and associated symptoms.
Let’s expand a bit on each of the three “R’s
Recognize Migraine symptoms:- A Migraine attack usually lasts 4 – 72 hours.
- The pain is usually unilateral, although it can change sides or sometimes be bilateral.
- The pain is usually throbbing or pulsating.
- Migraine pain is usually aggravated by physical activity.
- A Migraine attack is almost always accompanied by at least one of the following: nausea/vomiting, phonophobia (sensitivity to sound), photophobia (sensitivity to light).
- See:
-
Anatomy of a
Migraine
When many people think “Migraine” they think only of the pain of Migraine. In reality, a Migraine episode consists of far more. The typical Migraine episode actually consists of four parts, referred to as phases or components.
-
Anatomy of a
Migraine
Respond and see a healthcare provider:
- Remember that not all doctors are trained and experienced in Migraine management.
- Educate yourself about Migraine so you can be a treatment partner with your doctor.
- If you are not getting results with your doctor, don't hesitate to seek a new doctor. It's often advisable to see a neurologist who specializes in Migraine or go to a reputable headache/Migraine clinic.
- See:
-
Headache/Migraine Care: As it
SHOULD Be
People with Migraine Disease, Cluster Headaches, and other headache disorders often encounter problems getting proper and respectful treatment. Headache specialists and clinics can be the answer. -
Time for a New Doc?
There are times when it's something to consider. If your doctor is dispensing incorrect information, your communication with him/her isn't good, or if your treatment isn't progressing, it may be time. - Guide To Visiting a New Doc
-
Headache/Migraine Care: As it
SHOULD Be
Relieve pain and associated symptoms:
- This "R" includes essential Migraine management, beginning with a definitive diagnosis, and continuing with trigger management, Migraine prevention, abortion of Migraine attacks, and pain management. Pain management here is meant in the broad sense that includes both traditional and complementary therapies — relaxation, proper breathing, medications, and other methods.
- A preventive regimen is recommended for those with frequent Migraine attacks. Preventive regimens may include vitamin/mineral/herbal supplements, exercise, and medications.
- Migraine "abortive"
medications are those used specifically for Migraine attacks to "abort" the
attack itself rather than masking the pain as pain medications do. These
medications work to relieve all Migraine related symptoms. Abortive
medications include:
- Triptans: Imitrex/Sumatriptan, Maxalt/Rizatriptan, Zomig/Zolmitriptan, Amerge/Naratriptan, and Axert/Almotriptan. Frova/Frovatriptan has been approved by the FDA and should be available by the end of June, 2002. Relpax/Elitriptan is in the final stages of the FDA approval process.
- Ergotamine Derivatives: Cafergot, DHE-45, Migranal Nasal Spray, Ergomar, Ergostat, Wigraine, Megral. These medications are dihydroergotamine, ergotamine, or ergotamine compounds that may also contain caffeine and pain relievers.
- Midrin: A compound containing Isometheptene, Dichloralphenazone, and Acetaminophen. Also produced under the names Duradin, Migquin, Amidrine, Migrend, Migrazoen, and others. Midrin is also sometimes prescribed for tension-type headaches.
- In addition to preventive and abortive medications, pain medications and antinausea medications may be prescribed.
- In addition to
pharmaceutical treatments, complementary therapies including acupuncture,
aromatherapy, and biofeedback may be recommended.
Why Migraine?
Since there are other head pain disorders, the question may be asked, "Why feature Migraine?"
Up until recent years, Migraine in the US was addressed as a somatoform disorder, but over the past decade, health advocates have worked hard to raise public awareness that Migraine is a neurological disease that affects millions of people in this country alone. Organizations offering information and support to head pain sufferers get more requests and questions from sufferers of Migraine than any other form of head pain disorder. Over the last ten years, as awareness has been on the rise, and triptans were introduced, the amount of research on Migraine has increased dramatically.
Public awareness regarding Migraine disease and headache disorders was elevated to a major public health issue at Headache 2000 in London.
At the International Headache Society's (IHS) International Congress, (of which Princess Margaret was the honorary chairperson) a groundbreaking World Health Organization (WHO) Blue Book Report acknowledged Migraine and headache disorders as a major public healthcare issue. The document produced by the Neurological Diseases and Neuroscience Unit of the WHO, Headache Disorders and Public Health: Education and Management Implications1, was distributed to governments worldwide, emphasizing that Migraine and head pain disorders are a major public health issue that need far more attention.
In December, 2001, the National Institute of Neurological Disorders and Stroke (NINDS) of the National Institutes of Health (NIH) produced a report, 21st Century Prevention and Management of Migraine Headaches.2" These documents and reaction to them produced some interesting data:
Educational Implications1:
- To include headache disorders within current WHO activities in neurology and public health (WHO divisions).
- To develop global and regional education programmes to increase public awareness of the prevalence and impact of headache disorders, and their clinical nature and presentation, and of the necessity, if burdens are to be alleviated, for appropriate disease management.
- To collaborate closely with NGOs in order to adopt sufferer-focused and sufferer-driven approaches in the campaign to increase public awareness of headache disorders.
Clinical Guidelines1:
- To promote alleviation of the disability burden of headache disorders as a key objective of management.
Eye-Opening Statistics2:
- 18% of U.S. women and 6% of U.S. men have Migraine.
- Based on those percentages, MAGNUM, the National Migraine Association, using today's population figure of 287,147,276 from the U.S. Census Bureau reports an estimated 32,379,245 Migraineurs in the United States alone. (Since there are fewer diagnosed Migraineurs under the age of five, MAGNUM excludes the 6.87% of Americans under the age of five.
- More than 112 million bedridden days per year result from Migraine.
- The annual cost of Migraine to American employers through reduced productivity and missed work is $13 billion.
A very good reason to feature Migraine is stated in the conclusion of the NINDS document:
"Despite notable advances, several obstacles have persistently undermined the prospects for optimal management of the disorder and its various comorbidities. Chief among these barriers is the widely held belief among the general population, as well as some healthcare providers, that Migraine is not a legitimate, treatable condition. Expanded educational endeavors are warranted to counter this misconception.2"
Summary
The National Headache Foundation has set forth an additional "Three R's" for us as the theme of their National Headache Awareness week. Given the impact of Migraine disease and the misconceptions still held by laymen and some healthcare professionals alike, let's brush up on our "Three R's" and pass the information along to others.
1 Headache Disorders and Public Health: Education and Management Implications. World Health Organization, Department of Mental Health and Substance Dependence, Noncommunicable Diseases and Mental Health Cluster. Published 2000.
2
Clinician, Vol. 19 No. 11, December 2001. ISSN 0264-6404.21st Century Prevention and Management of Migraine Headaches. Presented by the National Institute of Neurological Disorders and Stroke of the National Institutes of Health. Presented in cooperation with the American Academy of Neurology, the American Headache Society, and that National Headache Foundation.
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