Dr. Loftus treats patients everyday who have frequent headaches. Many physicians, including some neurologists, do not like to care for this kind of patient. Dr. Loftus recommends you ask your neurologist's office if they enjoy treating patients with frequent headaches. See what our patient's say about our office.
Frequent or recurrent headaches can ruin a patient’s life. It can interfere with their ability to work, resulting in lost wages. It can interfere with their ability to keep social plans, resulting in loss of enjoyment and relationships. Fortunately, much research and progress has been made in headache treatment in the last decade or two. Sadly, it has also become increasingly clear there is a large gap in headache treatment and its application to patients. Many patients are unaware of new therapies now available and many physicians are unwilling to take the time to classify their patients' headaches in order to prescribe the best therapies available.
Recent studies on migraine headache found that only 50% of patients who have migraine headaches know this is their diagnosis and among that group of patients, optimum therapy is being given to only about half of those patients. The net result; a small minority of patients are receiving the most beneficial therapy. There have been several studies on migraine treatment cost and the most beneficial treatments are also some of the most cost effective. Many patients with frequent headaches thinking they have had "everything" have not even had a single preventative treatment. In addition, many patients have numerous of injections and blocks before taking simple preventatives.
Dr. Loftus hopes to fill some of the gap between headache therapy and its application to patients by helping patients better educate themselves about headaches and determining what their best treatment options are. With this information the patient can approach their physician and ask for the correct type of treatment which will result in a better outcome for patients.
What type of headache do I have?
Neurologists utilize a system to classify headaches known as the International Headache Society Criteria or I.H.S. Criteria {Cephalgia 2004;24 (Suppl 1)}. This criteria recognizes four types of primary headache. A primary headache is a headache which is not caused by another disease. The primary headache types are cluster headaches, migraine headaches, tension headaches, and "other headaches not otherwise explained." In order to best treat a patient, the physician must classify the patient's type of headache correctly. To give you an idea of the importantance of proper headache classification, studies of groups of patients and their headache classification has led to major treatment developments.
- If you are unsure which type of headache you have and they are moderate or worse in severity, then you should begin reading the migraine headache section. Migraine headaches are very common are much more likely than other types of headaches to be moderate or worse.
- If you do not fit the migraine definition, then read the cluster headache section.
- Read the tension headache section if you have frequent headaches but they are not debilitating, do not throb and are not associated with nausea.
- A section on sinus headache is included because this is the most commonly misdiagnosed of all headache types and the largest group of patients that potentially will benefit from a proper diagnosis.
- If your headache is not severe but rather you have a sharp, stabbing or electric type pain that happens to be on your face or head, then read the trigeminal neuralgia page.
Could my headache be an emergency?
This website is geared to educate patients who suffer from recurrent headaches and are not getting adequate treatment from their current therapy.
New onset headaches, headaches that have started in the last few months, or headaches that are brand new should be immediately evaluated by a physician. Headaches that are intense and begin abruptly also require emergency evaluation. If you are reading this after the new onset of a horrible headache that began suddenly, stop reading and go to an emergency room.
The onset of any new headache in patients with compromised immune systems (such as patients with HIV, cancer, leukemia or lymphoma) or on immunosuppressive therapies (such as steroids, cytoxan, or chemotherapy) should be promptly evaluated by a physician.
Primary headaches are less common in older patients therefore all headaches in patients over the age of 50 should also be evaluated promptly by a physician. Headaches that are associated with other illnesses such as fever or severe neck pain, also require prompt medical and sometimes emergency attention.
Dr. Loftus feels all headaches should be evaluated by a physician at least once.
What can I do to better prepare for my physician visits?
Ofter there is a disconnect between the patient's degree of disability and the physician understanding of this disability. Physicians need to know number of headaches over time, severity, the amount of partial disabilty and full disability and what medication is being taken. Dr. Loftus designed an iPhone and iPod Touch app called iHeadache which gathers this information.
When seeing a doctor for the first time it is important to bring prior head scans (whether they are MRI or CT) to your visit and a list of medications you take (along with dosing) and no longer take. Divide the list into medications that you take daily to prevent headaches and those that you took/take when you had a headache.