The Migraine Expert in Your Pocket

Patients want to get treated, doctors want to treat them. But one of the biggest challenges is simply telling your doctor what they need to know.

Your doctor may not have a lot of time. Or, she may not know what questions to ask. Or, you may forget something under the time constraints at the doctor’s office.

Wouldn’t it be nice if you could have a migraine expert that you could call on first, who had all the time in the world to discuss your symptoms with you? And then that expert could put the most important information into a nice, compact package and give it to your doctor?

Ah yes, in a perfect world. But actually, there is something similar that already exists.

It’s a website called BonTriage, and it was developed by migraine experts. Actually, it’s still being developed and improved, which should give you some peace of mind as our knowledge of headache disorders is growing day by day.
BonTriage
The concept is simple. You go to the website and you are asked some very specific questions about your symptoms. Very specific. Remember, the idea is to get lots of information that your doctor could easily miss, and find the information that will be most important to know.

So don’t expect to sit down for 5 minutes and answer a few simple questions. It will take some time. (Actually, there is a “short” version, but it’s worth your time to do all the steps.) Remember, this is time you’re saving in the doctor’s office.

Once you’re done, you’ll have a printable page that you can take to your doctor.

Even if you’ve already been seeing a doctor, this is a great way to breath fresh air into your conversations. Or, if you’re going to see a specialist, or a chiropractor, or another health professional, bring this along. It will give you a head start.

This is not a “perfect” solution – the computer cannot diagnose you. It is, however, a conversation starter. And if you’re willing to use it, it could be a great help.

To try it now, go to the assessment page for BonTriage here.

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New Study Questions Preventative Migraine Drugs for Kids

Just how effective are migraine drugs for kids? A new study is raising some interesting questions about whether or not we should be relying on them.

The study, published in the New England Journal of Medicine, tested topiramate and amitriptyline, both common preventatives. 328 children and adolescents were involved in the trial, which randomized, double-blind and placebo-controlled. A 24 week trial of the medications took place, and a 28 day window of results was compared – once before the medication, and once at the end of the 24 weeks.

The goal was to see a reduction of symptoms of at least 50%. So – how did the medications do?
Amitriptyline trial
As you can see, 52% of those on amitriptyline had a 50% or more reduction in symptoms. Pretty good. Let’s check out topiramate:
Topiramate trial
Even better – 54%. But here’s the problem. Being an well-designed trial, some of the patients were given a placebo – they didn’t take any medicine at all. How did these patients do?
Placebo success
That’s right, the ones who thought they might be taking medicine, but weren’t – they did the best of all.

To further complicate matters, some of the patients experienced side effects from the topiramate and amitriptyline – in some cases, quite serious ones.

Now before we completely write off preventative drugs for children and youth, there are some things to consider. First, this trial only tested one formulation and dose each of two drugs. There are a lot more options out there.

Second, it could very well be that some of these children were greatly helped by the medication who would not have been helped as much by the placebo. Remember, many patients saw a significant reduction in symptoms, and in some cases the medication may have helped with that.

But although this should not be a reason to write off preventative medications for children with migraine, it should suggest that you’ll probably want to try other treatments first – especially non-drug options. Diet, exercise, and certain complimentary treatments are excellent options for children. Take for example biofeedback, physiotherapy and certain supplements.

For more information, see the study abstract here: Trial of Amitriptyline, Topiramate, and Placebo for Pediatric Migraine

Also see: Dealing with child migraines? and Pediatric Migraine Medication

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10 Headache and Migraine News Highlights from the past 3 Months (November 2016 edition)

There’s quite a collection of most-read posts this time. Everything from treatments, to possible related conditions, to migraine theory! Here are the most popular posts from the last three months, with the most popular first. The three posts in bold received the most “likes” on Facebook.

  1. Should Doctors watch for “Cognitive” Problems in Migraine Patients?
  2. Migraine and Hypothyroidism: New Study Confirms the Connection
  3. FitBit and Migraine
  4. Helicobacter Pylori and Migraine
  5. More Research on Vagus Nerve Stimulation (and a video)
  6. Migraine: Is it really “Brain Hives”?
  7. Nerve Pain in Head: A Different Kind of Headache
  8. Botox for Migraine: One size does NOT fit all!
  9. When Taking a Shower Hurts: Migraine and Depression
  10. Approaching the Finish line: CGRP Inhibitors
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Could Listening to Your Brainwaves Fight Migraine?

The technology is called high-resolution, relational, resonance based, electroencephalic mirroring. But you may have heard more about it from the brand name – Brainwave Optimization.

Balancing Brainwaves and Fighting MigraineThe idea is this. Imagine that the functioning of your brain is like a spinning plate. The plate should spin evenly and smoothly, but sometimes it gets knocked off kilter. It continues to spin, but it’s wobbling. The two sides are no longer even.

Brainwave Optimization allows your brain waves to even-out again. The spinning plate evens out, and the imbalance lessens.

A recent study of 52 migraine patients received an average of one or two sessions a day, 90 minutes to two hours each session, over nine days. Patients reported improvements in the areas of insomnia, traumatic stress, and headache.

Researchers are also interested in potential for blood pressure and traumatic brain injury.

In each session, brain waves are translated into sound that the patient listens to. In a natural way, over time, the electrical signals in the brain become more balanced.

But as Brainwave Optimization clinics have opened around the world, doctors and researchers stress that the findings are very preliminary, the studies small, and most of the evidence anecdotal. In other words, the growth of a company and the money being exchanged is quickly overshadowing the research being done.

This isn’t unusual in many complimentary therapies. But it is a reason to be cautious about something that could quickly lighten your wallet and fill up your schedule.

Behavioural neurologist Dr. Alex Henri-Bhargava expressed concern:

It sounds intuitively sexy to people: I can rebalance my brain and that sounds like a good thing. But no real neuroscientist that I know of really thinks that their technology is actually doing that…
What is brainwave optimization?

In an investigation done in Canada, it was found that Brainwave Optimization was being sold to patients with dementia. As with migraine patients, patients with dementia and their families are often willing to fork out the money if slight hope is offered. (Dementia Patients Sold Unproven ‘Brainwave Optimization’)

We all want innovative, non-invasive treatments with limited or no side effects. But it’s important that research is done to find the best treatments, so that migraine patients can find the best help quickly, and without breaking the bank. It’s hoped that Brainwave Optimization will be studied more carefully, and that treatments like it will help many people. We look forward to learning more about the science behind these brain-balancing sessions.

For more information, visit the official Brainwave Optimization website, Brain State Technologies. For some information on recent studies, see Sound therapy may balance brain signals to reduce blood pressure, migraines. Also see the recent related KickStarter project – BRAINtellect 2, a brain optimization product you can use at home.

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Is Your Doctor a Certified Headache Specialist?

Wouldn’t it be nice to know that your doctor has at least a little advanced and current training in headache disorders? It would be nice, but it’s actually something that’s very hard to implement.

Would you want a standardized worldwide or countrywide standard, enforced by local governments? Who would decide on the qualifications? Or a standard from a group you trust? That wouldn’t be nearly as widespread, and many excellent specialists would be left out.

Certified Headache DoctorThere are those who are trying to fill the gap. Here are a couple of examples from the United States.

One is the United Council for Neurologic Subspecialties (UCNS). The UCNS is a non-profit organization that awards certification to doctors who meet certain current requirements. Headache medicine is one of their specific subspecialties. You can actually get an idea what their requirements look like by visiting their Headache Medicine Certification page.

The Migraine Research Foundation maintains a list of UCNS certified doctors in the USA, showing who specialized in which age group. Just visit Doctors Certified in Headache Medicine.

The National Headache Foundation also provides certification, called the Certificate in Added Qualification (CAQ) in Headache Medicine. This certification is also based on current knowledge, and is open not only to medical doctors but also advanced practice nurses, dentists, D.O.s, psychologists, and physician’s assistants.

If you fall into any of these categories, you can read more about CAQ here.

The National Headache Foundation has a list that includes both CAQ and UCNS certification. There are some doctors who even have both certifications. The list is maintained here: Healthcare Provider Finder.

Certification is knowledge based, and does not guarantee that you will like the doctor, or even that they will be a good doctor. However, it does help to demonstrate a basic knowledge that, unfortunately, many doctors and even specialists do not have.

Also remember, this type of certification isn’t even available everywhere. There are many excellent doctors who are not, for whatever reason, board certified in this way.

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