Your Health: Headaches (Part Two)

Yeah.

Last week we talked about kind of the primary versus secondary headaches, primary being like the headaches, so tension-type headaches, migraines, cluster headaches fall in there.

And then secondary would be temporal arteritis that's secondary to an inflammatory process.

Or if you have a sinus headache, those would be more secondary-

Or you grind your teeth at night

... headaches.

Right, causing some issue.

So-

Okay

...

when we think about tension type headaches, what...

And you think about conventional type treatments, what do we do? We will use nonsteroidal anti-inflammatories, so ibuprofen, naproxen, sometimes Tylenol.

We'll use muscle relaxants.

When we're looking at migraine, uh, meds, we're often using abortive medications, so the triptan class of drugs, CGRP antagonists, antiemetic.

Like, a lot of times in the emergency room many years ago, I would often use an anti-inflammatory, so an NSAID, and also basically an antiemetic, whether it be Zofran or Compazine or something like that.

And a lot of times if I could give somebody early in the process of a migraine a liter of fluid, some medicine so that they won't vomit, and an anti-inflammatory, the vast majority of people could leave the ER when I was there without a headache then-

Wow

... and feel better.

Mm-hmm.

So I often will find, yeah, having anti-nausea medicine, 'cause the number one thing that's gonna happen is if you get a really bad migraine and you're prone to throwing up, once that happens, now you're gonna get dehydrated, and it's just gonna get worse.

[laughs] So sometimes if you can jump on that right away, that can be really helpful for people.

So the liquid anti-vomit medication and then the migraine medication-

Yeah

... that combination solves all those problems.

That's great, Dr. Jill.