HeadWise HeadWise: Volume 6, Issue 2 - Page 3

Throughout my many years of practice, I adhered to the principle of a continuity of care. I learned this concept during my years in Family Practice, and continued it through my work with headache patients. Eventually, this was the guiding principle at the Diamond Headache Clinic by the entire staff. It is essential that when managing headache patients, the health care practitioner is aware of the entire individual – and not just focusing on the headache complaint. Coexisting conditions may impact on both the diagnosis and treatment choices. In this issue, two articles reflect the need for continuity of care. Asthma and migraine not only can occur together in the same patient, but a recent study at the University of Cincinnati recognized a possible link between asthma and the evolution of chronic migraine. Therapeutic options for both disorders are influenced by the presence of both conditions. In older patients, some migraine symptoms may suggest a serious neurological condition, such as stroke. These late-life migraine accompaniments highlight the need for a thorough headache history as well as complete neurological examination for migraine patients. The treatment of migraine and other headache conditions in older patients present a complex situation in which many therapeutic options must be considered. Continuity of care also indicates the need for appropriate follow-up care. The evaluation of headache patients cannot be limited to a one-time consultation. Return visits should be scheduled in order to assess the impact of therapy, and discuss the results of testing (if needed). All of these visits provide an opportunity to enhance patient education and supply the patient with tools to advocate for themselves. The principle of Continuity of Care establishes a feeling of caring for the patient by the physician. Without this approach, management of any medical problem – whether headache, asthma, hypertension, etc – is at a disadvantage. Seymour Diamond, M.D. Chicago, Illinois www.headaches.org | National Headache Foundation 3