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Headaches: What You need to know!

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Headaches, What YOU need to know!

This week we sat down with Dr. Wise.  She is currently practicing at the Alcona Health Center - Community Health Center of Northern Michigan in Harbor Springs.  Dr. Wise provides acute care and chronic disease management.  We discussed the signs and symptoms of suffering from headaches.

1.     What is your medical background?
I am a board certified family medicine physician.  I provide primary care for all age groups.

2.    If a person has been having headaches, at what point should they consult their physician?
If a person begins to experience frequent or severe headaches and he or she does not have a history of headaches, I would encourage them to consult with their physician.  Frequent headaches occur more than 2-3 per week.  Severe headaches will limit and/or interfere with daily activities and may not respond to over the counter medication such as Tylenol or ibuprofen.  If a person with a history of headaches notices a change in the quality or pattern of their headaches, they should also discuss this with their doctor.  Some headaches require immediate medical attention.  “Red flags” including any headaches with mental status or personality changes, neck stiffness, recent head trauma, or neurological signs such as numbness, weakness, vision changes, or dizziness.  A sudden onset headache described as a “thunderclap” sensation” which builds to severe intensity over seconds or also described as “the worst headache of my life” should also be immediately evaluated.

3.    When a patient decides to consult their physician about their headaches, what kind of information is most helpful to bring to that first appointment?
It is important to be able to describe the quality of the headache:  Is it sharp, dull, aching, burning, throbbing, etc?  The location can also help with the diagnosis: Is it one-sided or both-sided? Is it along the back of the head, the temples, or the forehead?  Does the pain radiate anywhere?  I also need to know what makes the headache better and what makes it worse.  It is extremely helpful if patients identify headache triggers such as stress, hormonal cycles, certain foods or beverages, environmental allergies, lack of sleep, etc.  Keeping a headache log or journal can help identify triggers or patterns.  It is also important to note any accompanying symptoms such as nausea, light/noise sensitivity, or eye/nasal symptoms.  Family history of headaches is also important to know.

4.    What are some different types of headaches people can experience?
There are many different types of headaches. Primary headaches include tension headaches, migraines, and cluster headaches.  These headaches can vary in quality and location.  For example, tension headaches are often described as a band of pressure around both sides of the head whereas a migraine is described as a pulsing or throbbing sensation on one side of the head.  Secondary headaches are headaches due to other causes such as allergies or sinus problems, head trauma, infections, or vascular diseases.  Medication overuse or rebound headache is a common secondary headache which happens when the medication used to relieve headaches is used in excess.  This can happen with many of the over the counter pain relievers.

5.    What are some treatment options for someone experiencing severe and/or frequent headaches?
Treatment options will vary depending on the type and cause of the headache.  For primary headaches, medication is the most common type of treatment.  Medication is classified as either abortive or prophylactic.  Abortive medication is taken only as needed when the headache occurs and prophylactic medications are taken every day to prevent the headache from even occurring.  Common abortive agents include NSAIDs such as naproxen as well as the prescription class of medication called triptans.  Certain anti-seizure medications, antidepressants, and blood pressure medications can all work to prevent headaches.  Physical therapy can also help decrease headache intensity and frequency.  Botox injections are an option to control chronic migraines.  Studies have also shown that biofeedback, acupuncture, and meditation can also help relieve and prevent headaches.  And certainly trying to avoid headache triggers is essential.  

Dr. Wise is originally from the Detroit area.  She received her medical degree from Michigan State University College of Human Medicine in 2001. Prior to relocating to Petoskey with her family in 2012, Dr. Wise was a family physician with Bronson Methodist Hospital in Kalamazoo, Michigan for almost 10 years.  She is currently practicing at the Alcona Health Center - Community Health Center of Northern Michigan in Harbor Springs.  She provides acute care and chronic disease management for all age groups.

Image courtesy of wholistichealthcare.ca

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