Newsletter: Update on Office Policies

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Same day appointments:  Our office will make every effort to accommodate same day appointments upon request. However, you need to call first to allow us to see where we can fit you in. Please do not show up without an appointment. Also, keep in mind, that what we can provide for a severe headache is limited to non-narcotic injections such as Toradol or Imitrex, trigger point injections, occipital nerve blocks, and SPG blocks. We are not equipped to administer IV fluids, IV meds, or narcotics.

Prescription Refills: Please allow up to 3 business days for refills to be handled. Do not call our office to request a refill. Have your pharmacy fax us the request. In the case of an ADHD medication like Adderall, then email your request to info@ocmigraine.org. Keep in mind that in most cases, if you need a refill you probably are due for an appointment.

Appointments: All patients must be seen a minimum of every 6 months even if you are doing well: NO EXCEPTIONS.  This is Good Medicine! If you are doing well and do not feel you need to be seen this often, then consider having your primary care provider take over future prescription refills.

Completion of Forms/Letters: Keep in mind that there will be a fee to complete forms or to compose letters you request. The fee varies depending on the request and how long it will take the provider to complete. Please allow up to 2 weeks for completion. There could be an additional fee if a faster turn-around is requested. The cost will be determined and payment collected prior to the doctor fulfilling the request.

Email: We provide limited access to email. Emails take up to 5 business days to respond to so DO NOT email us with any urgent requests. Also, keep your emails short and to the point. Long emails will not be answered in full and are best handled by scheduling an office visit. For those living out of the area, phone visits are an option. Our office email is info@ocmigraine.org. If your email response requires specific personal medical information, our office will initiate a secure email protocol using Neo-Certified.  Your email will be responded to with a request to sign up with a password for Neo-certified to keep email correspondence HIPPA compliant and confidential.

After Hours Urgent Needs: Dr. Molly and Dr. Hutchinson rotate after hours coverage. If you have an urgent issue, you may call (not text) the after-hours line (949-514-4429) and the doctor covering will do their best to return your call within 1 hour. If you are experiencing a severe problem it will be better to call “911” or go to the Emergency Room.  Do NOT call the after hours line during regular business hours as it will go unanswered.  During business hours it is better to call our regular office number (949-861-8717) for urgent issues.

Office Hours: Current office hours are as follows:

Mondays: 8:30 am-5 pm

Tuesdays: 8:30 am-5 pm

Wednesdays: 8:30 am-5 pm

Thursdays: 9:30 am-5 pm

Fridays: CLOSED

Saturdays: 9 am-12: 30 pm Two Saturdays per Month (on average)

CLOSED FOR LUNCH FROM 12:30 – 1:45 PM MONDAY thru THURSDAY

 

Holiday Schedule:

Closed Wednesday Afternoon 11/22 to Monday 11/27 Morning

Closed Friday 12/22 to Tuesday 1/02/18

 

Feel free to call us if you have questions about our office policies. We look forward to continuing to provide quality care for our patients.  Suggestions, comments, and criticisms will be taken seriously.

Sincerely,

Susan Hutchinson, MD                                Molly Rossknecht, DO, MPH

 

Orange County Migraine & Headache Center

 

Can a person experience a migraine without pain?

Yes, they are not uncommon.  Typical symptoms include visual symptoms (flashing lights, zig-zag lines, or the absence of vision in all or part of the visual field).  Other symptoms can include tingling on one side of the body and/or slurred speech, or vertigo.  These types of migraines are often referred to as aura without headache (acephalgic migraine).  Symptoms may last from minutes to days.   Treatment varies but may include migraine specific medication.  These symptoms should always be evaluated by a healthcare provider for a correct diagnosis.

To make an appointment, please call 949-861-8717.

Summer Newsletter: Barometric Pressure Change & Migraine

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Many of my migraine patients tell me they don’t even need to listen to the weather report. They can tell when rainy or cloudy weather is coming due to an increase in their migraines.

Why is that?
We don’t know exactly why changes, especially drops, in barometric pressure can lead to migraines but here is what we do know: an approaching storm causes a drop in barometric pressure. This affects the pressure in the external environment including the external ear canal. This can lead to an imbalance between the pressure behind the tympanic membrane (middle ear) and the external barometric pressure. There is a certain air pressure in the sinuses, Eustachian tubes, and inner ear at any given time and if the external pressure drops, that imbalance is thought to trigger a migraine in some migraine sufferers. A change in barometric pressure of as little as .20 millibars impacts the pressure in the ear canal and can lead to migraines.

How can this be treated? 
In addition to taking the usual migraine medication, inserting a pressure regulating device (MigraineX) may be helpful. MigraineX looks like a small set of ear plugs (drug & latex free) and is designed to control the rate of barometric pressure changes in the ear canal adjacent to the ear drum (tympanic membrane). The device can be inserted preventively or at first sign of headache if a drop in barometric pressure suspected as the trigger. This product is best used in conjunction with a free App called MigraineX that can predict changes in weather and barometric pressure.

When I first learned about this device, I requested that a limited number of free samples be sent to my office for use in my patients who report that changes in barometric pressure cause migraine attacks. I have given out the first 8 devices this past week and have asked these patients to give my office feedback in coming weeks.

I am skeptical of new products that come into the marketplace promising too much especially if they are expensive. I was very pleased to see that MigraineX can be ordered online through Amazon for only $11.99. In addition, it retails for about $9.99 at CVS and does not require a prescription.

Grant O’Connell, Digital Marketing Manager, Cirrus Healthcare/MigraineX states “What separates MigraineX from other migraine relief medications is, medication-only focuses on relieving symptoms after a headache starts. The best defense against weather-related migraines is to prevent the pressure before it starts. Utilizing our app for weather event alerts will give you a step ahead to minimize the pressure using the MigraineX plugs. We are confident new customers will find MigraineX to be a great reliever from headaches.”

As I am writing this newsletter, I am wearing them and they are comfortable. They were easy to insert. Also, I easily downloaded the MigraineX app.

In a study of 36 patients who used this device in addition to their usual migraine medications, the majority felt their migraine was better treated and less likely to return. For more information, go to www.migrainex.net

For any of you who feel that changes in barometric pressure and weather are a common trigger for your migraines, I suggest you set up an appointment to review our current treatment plan and see if this new MigraineX device makes sense for you.

In summary, MigraineX may be a welcome addition to your Migraine Toolbox if changes in weather and barometric pressure are triggers for you. I welcome your feedback once you have tried this device.

 

Susan Hutchinson, MD

Director-Orange County Migraine & Headache Center

June 18, 2017

Annual John Graham Lecture Award Winner Thanks Dr. Hutchinson Among Others

Professor Gretchen Tietjen recently received the annual John Graham lecture award from Paul Rizzoli and thanked friends and collaborators including Lynne Osborn Geweke, Dawn Buse, Sheena K. Aurora and Susan Lynn Hutchinson.

“I am so happy for Dr. Gretchen Tietjen to receive this prestigious award. I was happy to be part of our Women’s Issues Section research that contributed to this award.” – Dr. Susan Hutchinson.

What type of doctor is best at treating headache?

In the past, neurologists were the most common type of doctor that patients would see for severe headaches.  Now, headache has become a specialty open to non-neurologists as well as neurologists.  Currently, there are only a little over 500 headache specialists in the United States.  Dr. Susan Hutchinson is a Board Certified Family Medicine Physician with a sub-specialty in headache.  I am a neurologist who completed a full 1 year headache fellowship. Dr. Hutchinson’s 21 years of practicing general family medicine including women’s health can help in recognizing the important role of hormones to headache and she is especially well-suited to treat menstrual migraine.  My background as a neurologist is well-suited to recognizing neurological conditions that may be associated with migraine.  Together, our practice provides an excellent comprehensive approach to the headache patient.

To make an appointment, please call 949-861-8717.

Why does a particular medication work really well for my friend with migraine but not for me?

Medications don’t work the same for everyone.  Your genes can influence the way your body responds to certain medications.  The good news is that gene testing is now available and can be as simple as a cheek swab that’s used to collect cells that contain your DNA.  We have begun using this technology to assist in optimal medication prescribing to better suit the individual patient.

To make an appointment, please call 949-861-8717.

What’s New For Migraine Prevention?

A new category of medication for prevention of migraine is in the late stages of clinical trials and is expected to be available by early 2018. This category is called CGRP Monoclonal Antibodies. It will be administered either as a monthly self-administered injection or by IV (intravenous) every 3 months. Four pharmaceutical companies (Alder, Amgen, Lilly and Teva) are all developing CGRP drugs and are competing to be the first to come to market.

The headache community is very excited about this new category of preventive treatment as it is working quite well in clinical trials. This can be a great option for Botox non-responders or others not doing well with their current treatment.

Stay tuned!

What is the difference between a migraine and a cluster headache?

molly_croppedMigraines are characterized by disabling attacks often including throbbing/pulsating pain, nausea, sensitivity to light, and the desire to be in a dark quiet room.  In contrast, cluster headaches are characterized by incredibly severe pain in and around one eye with drooping of the eyelid on the affected side, tearing, nasal congestion, and the sufferer is agitated, pacing, and may even be hitting their head against the wall.  In fact, cluster has often been referred to as the “suicide headache” due to its severity.  Migraine is much more common than cluster and it tends to be recurrent throughout the year.  In contrast, cluster, as the name implies, often clusters together during certain times of the year and may go away for months at a time.  Unlike migraine, cluster is much more common in men.  Treatment is different for migraine and cluster, so proper diagnosis and evaluation is important.  We treat both in our practice.

If you think you are suffering from one of these, call for an appointment 949-861-8717.

Dr. Susan Hutchinson Featured In FREE Live Online Migraine Event, Register Now!

The Migraine World Summit returns this April 23 – 29, 2017 to bring together over 30 top experts and doctors to provide answers, new treatments, research and best practices for migraine and chronic headache. It’s available to anyone with an internet connection.

Dr. Susan Hutchinson is one of the featured specialists.

 

UPDATE: Link has been removed as the event has passed.

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