Taking Control of Your Headache
Headache affects 18 million American women. Unfortunately, the majority of these headache sufferers have never received a formal diagnostic evaluation or treatment of their headaches, even though there are now highly effective headache treatments available. Headache warrants careful medical evaluation and treatment. There are a number of steps a woman can take to actively participate in her own healthcare and to help ensure that they receives the best available treatment.
Schedule the Appointment Specifically for Headache Evaluation
The first physician appointment should be scheduled for and dedicated to the evaluation of headache, and headache only. When headache is introduced during an office visit for other medical concerns or after an ob-gyn exam, there will not be enough time or attention to properly assess the headache.
Be Prepared to Provide the Necessary Information
The physician needs to know specific and detailed information about the headaches in order to determine the proper diagnosis and treatment plan. Women can be prepared for the interview by thinking about their symptoms and being prepared to provide information about the pain location, character, and associated symptoms (e.g., nausea, vomiting, light sensitivity). The onset and history of the headache symptoms over time will help determine any patterns. Other medical history, personal habits, prescription and over-the-counter medications, past treatments and their outcome, and family history are needed. It can be helpful to collect information about the frequency, duration, and intensity of headaches prior to their appointment in a headache calendar or diary. Often writing down information and questions prior to the visit can help ensure that the necessary information is shared.
To ensure that women are able to communicate effectively with their physician during the appointment, they should arrive early and bring notes, questions, headache calendar, medical records or other information. If possible, arrange child care so that the patient can devote full attention to the visit. Most patients feel more comfortable talking to their physician when they are wearing their street clothes. If the nurse suggests that you change into the examination gown, it is reasonable to request that the patient sit first with the physician to discuss headaches. It is important that the patient be in a comfortable environment so they interact with the physician without distractions. All women need to be sure they understand exactly what the diagnostic and treatment plans are and how the treatment plan will be evaluated over time.
Provide Reliable Feedback
The physician will be relying on the headache patient to provide feedback about the effectiveness of treatment. It is crucial to discuss the impact headache has on one's life. We know that physicians are much more likely to respond with more appropriate and aggressive treatment if patients describe the impact their headaches are having on their life. "Doctor, my headaches prevent me from working three days each month" goes further than just describing pain intensity and location. Often treatment plans have to be modified over time, and reliable information is needed. Carefully follow all treatment recommendations, and report progress back to the physician as requested. The physician (and the headache sufferer) should be interested in tracking success of treatment over time.
Headache patients need to make sure they share their treatment goals with the physician. Remember, headache is a chronic medical condition that can rarely be cured. The goal is to manage headaches, and allow the headache sufferer to function more normally. Treatment expectations need to be realistic- migraine is not a curable disorder, rather one that can be managed with a treatment plan (like diabetes, high blood pressure, and heart disease). Patients need to be educated about headaches. There is a great deal that women can do to ensure that they receive the best possible medical care.
Source: American Council for Headache Education, 2000