THE FOLLOWING IS AN INTERVIEW WITH NANCY VAN VESSEM, M.D., THE CHIEF MEDICAL OFFICER AT CAPITAL HEALTH PLAN:
ANGELA: What is Headache?
NANCY: Headache refers to any pain that occurs in the head region. It may be due to structures in the head, but not the brain since the brain does not have pain receptors, or pain that radiates from other areas, usually the neck. It is not uncommon for an individual to have multiple types of headaches so one person could have a migraine on Monday, a sinus headache on Wednesday and a tension headache on Friday. That can cause confusion in the diagnosis and treatment since the best treatment varies depending on the type of headache.
ANGELA: What is the best way to sort through headache symptoms?
NANCY: Prepare before your visit to your primary care physicians by keeping a headache diary for a month. There are a number of headache diary forms on line that can help you get organized. What you want to do is identify the characteristics of your headaches.
When a headache occurs, write down:
• The date and time the headache began
• What you ate for the past 24 hours
• How long you slept the night before
• What you were doing and thinking about just before the headache started
• Any stress in your life
• How long the headache lasted
• What you did to make it stop
After a period of time, you may begin to see a pattern. The goal is for the individual to be able to identify the types of headaches they have so they can apply the best treatment for each headache.
The usual impulse is to take pain reliving medication for all types of headaches. Usually that is not the best course of action over the long term. If medications such as Tylenol or ibuprofen are used frequently a problem can occur called “rebound headache” which is a headache caused when the pain medication wears off. Then more pain medication is taken leading to escalation in the frequency of headaches which can be difficult to treat.
ANGELA: What are some danger signs?
NANCY: A sudden, severe headache or sudden headache associated with a stiff neck, headaches associated with high fever, convulsions or accompanied by confusion or loss of consciousness, headaches following a blow to the head or associated with pain in the ear or eye, headaches in people who were previously headache free and recurrent headaches in children. If this occurs, you should seek help as soon as possible.
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