You have been suffering with headaches for a while. Perhaps you are so used to them that you’ve never really thought about how to describe them. It could be because they occur infrequently or because they vary in characteristic. Perhaps it is because your family and friends have seen you suffering so often that you do not feel the need to bother them further with an exact headache description. Finally you’ve decided that whatever you’ve tried for these headaches simply is not working and that you would like to see a neurologist, a headache specialist to get some relief. Congratulations on taking that first step to feeling better.
Yet unlike other medical conditions for which you see a doctor such as a skin rash or facial droop, the manifestations may not be readily apparent. If someone does not describe exactly what they are feeling the doctor may not be able to tell what precisely they were suffering from.
For this reason the headache description is crucial in working with your neurologist to get the treatment you need and the better the description you can give to your neurologist for more accurate diagnosis.
So take a moment and think about your headaches and how you describe them to your doctor. Here are some of the important features that could be helpful.
- Quality of the headache. What does the headaches feel like? Is it dull, sharp, aching, pressure, throbbing or does it change in characteristics.
- Location of headache. Does not affect the whole head or only part of the head? Is it on one side or the other? Does it switch sides? Are any other parts of the body involved such as the neck? Does it affect the eyes ears teeth cheeks?
- How long does it last?
- How quickly does the headache arise?
- When during the day does the headache arise? Does it ever occur upon awakening? Is there any relationship to menstrual cycle? Are these headaches ever seasonal?
- How often are the headaches occurring? How many times per week/month?
- Associated symptoms. Are there any warning symptoms or trigger symptoms? Is there an aura (via Latin from Greek ‘breeze, breath)? Is there any sensitivity to light? Is there any sensitivity to noise? Is there any nausea? Is there any vomiting? How frequently are these associated symptoms? Is there any dizziness unsteady gait focal weakness numbness double vision speech or swallowing difficulty staggering?
- How bad do these symptoms get? How painful is the headache?
- Aggravating causes. What triggers these headaches? Are there any food triggers involved such as red wine especially Chianti, beer, nuts, chocolate, soft ripened cheeses? Does stress trigger these headaches? As a Miami Beach neurologist/Aventura neurologist Dr Raul Grosz may also interested in whether heat/humidity high hot sun or dehydration trigger these headaches.
- Alleviating factors. What makes these headaches better? Does sleep or rest help? Does lying in a dark quiet room help? What medicines have helped? What medicines do you take regularly for these headaches? What medicines have been tried but have not been helpful? Have you tried nonmedication therapy, cool compresses, soft music?
- Family history. Does anybody in the family get headaches? Siblings and parents grandparents?
- Lifestyle impact. How do these headaches affect your lifestyle? Do you miss days from work? Is work productivity reduced? How do these headaches affect family time? Do you sometimes skip family events because of a headache? Do you avoid certain venues such as loud concerts or restaurants because headaches could be triggered or worsened?
- Associated medical issues. Snore at night? Do you grind your teeth at night? Any recent head trauma? History of any brain tumor? History of any brain surgery? Anything else that can medically have an impact on your headaches. Any nasal congestion? Any association with eye or ear pain?
- Associated lifestyle issues. Do you smoke cigarettes? How much? Did you know cigarette smoking could adversely affect certain types of headaches. Alcohol use. How much and how frequently do you drink? Does this aggravate your headaches? Drug use. Any use of other stimulants or depressants. Any cause of sleep disruption? Any association of headache with sexual activity?
Not to worry if you do not relate all of this information on your first visit. Let us start with the highlights and work on getting new better today. I look forward to personally meeting you and working with you to relieve your headaches.
Dr Raul Grosz