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Woman putting her hands up due to stress and headaches

 

Too much of a good thing is actually a bad thing

 

Your workday feels like it has gone on for-ev-er, but it is only 9 AM.  You didn’t eat breakfast and lunch isn’t looking like it is going to happen either.  You can’t remember what a beverage even looks like, let alone be able to drink one.  What is that twinge in your head?  Oh, no.  Not a migraine.  Not today, but you know what to do to kick its butt.  You grab your triptan rescue and attack.  A few minutes later you feel relief start to sweep over you.  Ahhhh.  Now if you can just make work go away that fast.

A few hours later, the workday is almost done.  You can see the light at the end of the tunnel.  Wait, what is that feeling?  Aw, come on.  Your headache is coming back, but you thought you did everything right.  Well, the medication worked the first time so why not again?  You take another dose and feel better.   While you get ready for bed, it starts coming back.  So, you repeat the ritual of medicating yet again.  This can go on and on.  For some patients, this can go on for days, even weeks.  It is an easy trap to fall into.  What patients don’t get is that the medication really isn’t working.  It is only providing partial relief.  It helps the headache go away but is not doing its job of keeping it away.

The worst part is that this mistake can be costly and make your problem far worse than it was before.  You now have what is called Medication Overuse Headache or MOH.  You are actually having a headache from the medicine itself.  So, now you have even more headaches than before and the exact thing you think is trying to help it is making it worse.  The ultimate treatment is that you have to stop taking your rescue medication.   So, personally, I do my best to educate patients so that we never get to MOH.

It takes a lot of patience and education to avoid such a situation.  It is best to pair up with a headache specialist who has extra training in dealing with these sorts of complicated situations.  You may need daily medication to help with the taper off of the rescue therapy and hopefully decrease the need for rescue therapy in the future.  It is possible that you can find relief with a variety of nerve blocks as well to bridge the therapy.  These are all options that your headache specialist can discuss with you.  The key is to avoid taking rescue therapy daily.  Don’t settle for quick relief with an urgent online appointment when the long-term consequence is MOH.  A quick solution is not the answer no matter what commercials and social media tell you.  You don’t want to take a prescription-level rescue more than 2-3 times a week and over-the-counter more than 3-4 times a week.  If you are finding that you are using medications more often than this, call your headache specialist or find one to help get you out of the hamster wheel.

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Address: 2500-B Gaskins Road, Richmond VA 23238

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