Dr. Susan Hutchinson has written an article entitled “Menstrual Migraine: Common and Disabling” for PatientCareOnline.com
You can read it here: https://www.patientcareonline.com/view/menstrual-migraine-common-and-disabling
This past weekend, the Miles for Migraine community raised $8,885 to support local migraine research & education at the UC San Diego Health Headache Center. Top individual fundraisers were Dr. Hutchinson, Kaitlin C. and Eve H. who combined raised a total of $3,985!!
Photos from the event:
On Tuesday, October 25 at 8:00 p.m. ET, American Migraine Foundation is hosting a free “Migraine and Menopause” webinar with Headache Specialist and Founder of the Orange County Migraine & Headache Center Dr. Susan Hutchinson. Tune in from the comfort of your home to learn about the interaction between migraine and menopause and what treatments are available for people living with both.
Registration is free and so don’t wait; secure your place now!
Dr. Hutchinson recently wrote an article for KevinMD.com.
The 4th Annual Miles for Migraine Event for San Diego will be at Liberty Station Park in San Diego. Our office has formed a team called OC Migraine. Please consider joining and/or supporting our team. All proceeds go to increasing migraine awareness and funding migraine research.
Dr. Susan Hutchinson is the Team Captain. We are currently at the top of the leader board for number of team numbers and amount of money raised. We truly support any level of support you can offer including joining our team & participating in this fun event, joining our team to raise money to support this worthy cause, or donating.
For those interested in participating & learning more about this event, use the following link:
https://raceroster.com/events/2022/58354/miles-for-migraine-san-diego-2022/teams
Our practice will provide and pay for a post-event brunch for all participating with our team. Options for this event include walking a 2K, running a 5K, or simply enjoying some activities at the venue while cheering on those of us running or walking. Booths featuring treatments for migraine will provide educational value to this event.
For those interested in donating to our team or to one of us as an individual, here is the link:
https://raceroster.com/events/2022/58354/miles-for-migraine-san-diego-2022/pledge/team/387564
Thank you for any level of support you may be able to provide.
For any questions, please direct those to our office website: info@ocmigraine.org
This week’s episode of Heads UP is on the Estrogen and Migraine Controversy. Lindsay Weitzel, Ph.D. questions Susan Hutchinson, MD, Headache Specialist and author of The Woman’s Guide to Managing Migraine all about estrogen, migraine, aura, stroke risk, birth control, perimenopause, HRT, bioidenticals, etc.
The video version of Heads UP is available on: website, YouTube, Facebook. Download Heads UP on Apple Podcasts, Spotify, Stitcher, or wherever you get your podcasts.
Dr. Susan Hutchinson has contributed to the continuing education webcast “Migraine Management for the Nurse Practitioner: Acute and Preventive Therapies to Reduce Burden of Disease”. The intended audience for this activity is nurse practitioners and other health care professionals involved in the management of patients with migraines. You can learn more by visiting https://www.mycme.com/courses/migraine-management-for-the-nurse-practitioner-8009
Dr. Hutchinson recently spoke to VJ Neurology re: many aspects of migraine suffering and recent developments in treatment.
View the videos here: http://www.vjneurology.com/speaker/Susan-Hutchinson
You can follow VJ Neurology on Twitter @VJNeurology
Dr. Susan Hutchinson recently guested on the Consultant360.com podcast to discuss Oral Rimegepant in Adults With Migraine and Cardiovascular Risk Factors.
You can listen to it here.
In this video from the AAN Annual Virtual Meeting 2021, Dr. Susan Hutchinson talks about her recent study evaluating the safety and tolerability of rimegepant in adults with CV risk factors, for the prevention and treatment of migraine.
Check out Dr. Hutchinson’s recent interview on Good Day LA talking about migraine.
Click here: https://www.foxla.com/video/919404
Dr. Susan Hutchinson is a featured speaker for next Saturday’s (7/11/2020) Miles for Migraine Educational Event San Diego 2020. It is virtual and registration is free.
Link for more info and to register:
https://www.milesformigraine.org/san-diego-educational-day-2020/
Good news…. we now have 2 new medications for the acute treatment of migraine. Both are oral tablets and represent alternatives for those who have unmet acute migraine treatment needs. The triptans, first introduced in the United States in 1992, have been the mainstay of treatment for years. They include Imitrex, Maxalt, Zomig, Relpax, Axert, Amerge, and Frova. Most are generic and inexpensive. Are the new medications better? For some patients, they may be.
The goals for acute migraine treatment are to be headache free and back to full function in 2 hours after taking the acute medication like Imitrex. If your migraine treatment is not consistently bringing you to headache freedom in 2 hours you would be a candidate for Ubrelvy or Reyvow. In addition, if you are putting up with “triptan sensations” like neck/chest tightness, flushing, fatigue, nausea, or worsening of the headache before it gets better, you may tolerate Ubrelvy or Reyvow better. Lastly, if you have a contraindication to the triptans due to coronary artery disease, peripheral vascular disease, or multiple cardiac risk factors, these new medications would be safer as neither Reyvow nor Ubrelvy cause vasoconstriction.
Ubrelvy (Ubrogepant) is the first oral “gepant” to be FDA approved. It is an oral CGRP (calcitonin gene-related peptide) antagonist and works by blocking at the CGRP receptor site. In binding to this receptor site, it prevents the CGRP peptide that is released during migraine to attach and thereby, prevents the pathway of migraine. Numerous studies have shown that CGRP gets elevated during migraine. To learn more go to www.scienceofmigraine.com. Ubrelvy does not cause vasoconstriction, is very well tolerated in clinical trials, and so far, does not appear to cause medication overuse headache. It is available as a 50 mg & a 100 mg tablet and may be repeated in 2 hours. Ubrelvy comes in a package of 10 and for patients with commercial insurance, is available for $10 per 10 tablets per month. To learn more, go to www.Ubrelvy.com and to access the savings program, go to www.Ubrelvy.com/savings. If you are up-to-date on your visit with us, we may be willing to send in a Rx for Ubrelvy prior to your next visit. If interested, please email us at info@ocmigraine.org.
Reyvow (Lasmiditan) works differently than Ubrelvy. It is a 5-HT1F serotonin receptor agonist and is referred to as a “ditan” Reyvow binds to the 5-HT1F receptor activating it, which then inhibits pain pathways and inhibits release of neuropeptides like CGRP. It is not associated with vasoconstriction or medication overuse headache. However, it crosses into the central nervous system (CNS) and as such, can cause drowsiness and sedation. As a result, it is a controlled medication and is Schedule 5 by the DEA. Schedule 5 represents medications that have the least addictive potential. Reyvow comes as a 50 and 100 mg strength tablet and is dosed as 50 mg, 100 mg or 200 mg as a single dose in a 24-hour period. There is a driving restriction for 8 hours due to the potential sedation and dizziness seen in clinical trials. Reyvow may be useful as a rescue option when an individual is home for the day with a moderate to severe migraine and does not plan on driving for 8 hours. As headache specialists, we are hopeful that Reyvow can take the place of Butalbital products including Fiorinal & Fioricet as well as Hydrocodone Products such as Vicodin & Norco. To learn more go to www.Reyvow.com. Reyvow has a savings program for those with commercial insurance. Using the savings program, an individual should be able to get 8 tablets per month for zero copay. Information about the savings program is available at www.Reyvow.com. Because Reyvow is a controlled medication, please make an appointment with us if you are interested in trying. We need to carefully review the potential side effects with you.
Other medications will be coming soon including Rimegepant, another oral gepant for acute migraine. In 1-2 years, Atogepant, a 3rd oral gepant, should be available and will be for the prevention of migraine.
This is truly an exciting time in migraine. With new treatment options, comes new hope for a brighter future for all individuals with migraine.
We look forward to working with each of you to optimize your headache treatment plan.
Dr. Susan Hutchinson & Dr. Molly Rossknecht
February 12, 2020
Please join us for this fun walk/run event at beautiful De Anza Cove in the San Diego Area. You have the option of a 2-mile walk or a 5K or 10K Run. The event is to raise awareness of migraine and raise funds to advance migraine understanding and research.
The address for this event is 3000 Mission Bay Drive, San Diego, CA. It starts at 9 am. Race packets can be picked up the morning of the event or the afternoon before. For specific details on race packet pick-up, see the website.
Our office has formed a team called OC Migraine. Feel free to join our team in this inaugural event. For those joining our team, we will have logo shirts printed with our team name and we will gather together before and after our walk/run for photos. Dr. Hutchinson has signed up for the 10K and her office manager, Norma, the 2-mile walk.
The goal for our team is to raise $2000. Dr. Hutchinson and Norma have already made personal donations to our fund. Please join us & help us meet our goal.
To learn more about Miles for Migraine, the website is www.milesformigraine.org
If you are unable to participate but would like to donate the link is https://raceroster.com/events/2019/22686/miles-for-migraine-san-diego-2019/pledge/participant/15
Any size donation is appreciated. Please make a difference in lifting the burden of migraine!
For any questions, contact our office at 949-861-8717 or email us at info@ocmigraine.org
Sincerely,
Orange County Migraine & Headache Center
September 5, 2019
As many of you are aware, I was asked to go to India with a team of international headache experts to educate local providers. Each one of us on the team had a specific purpose and for me, it was to focus on the treatment of migraine in women. The need for good migraine management in India is great. With a population of over 1.3 billion, the estimated prevalence of migraine in India is over 150,000 million. By comparison, the prevalence of migraine in the United States is 38 million.
Women in India suffer from migraine disproportionally to men similar to the United States with a ratio of 3:1 beginning with puberty. To complicate the plight of women in India, many do not go for medical care without their husband or their husband’s permission. Part of my mission was to educate the need for women to have access to medical care.
Our team did educational programs in both Delhi and Kochi, India. The audience included neurologists, primary care providers, psychiatrists, nurses, and social workers. The next step is to help local providers in Kochi to open a Center of Excellence for Headache at The Amrita Hospital Center. This Center will offer a multi-disciplinary team to provide comprehensive care of the headache patient. Amrita Hospital is non-profit and provides care for everyone including those unable to pay.
Spending time on the streets of India, riding in a rickshaw in the very populated & crowded old Delhi marketplace, visiting Gandhi’s memorial, enjoying a boat ride on the backwaters of Kerala in southern India, and enjoying great food were all part of my experience. Perhaps the most memorable part of this trip was the incredible graciousness, hospitality, and kindness that I and the rest of the team experienced. Several neurologists, the hospital medical director for Amrita, and the US coordinator for our efforts hosted us. I have never experienced the level of hospitality that I did in India. The hospitality and kindness was universal from hotel staff, healthcare professionals, the Rickshaw drivers, and those in the local marketplaces.
Even the poor on the street of India exhibited a kindness and gentle spirit that is not common in the United States. I return, both grateful and humbled, by this incredible experience.
I am including a few photos from my memorable trip. I look forward to seeing many of you for follow-up now that I am back in the United States.
Sincerely,
Dr. Susan Hutchinson
Director-Orange County Migraine & Headache Center
Reader’s Digest Online has included MigraineX and Dr. Hutchinson in an article titled, “The Sneaky Warning Signs a Migraine Is Coming—and How to Stop Them.”
To read the piece, please visit: https://www.rd.com/health/conditions/warning-signs-migraine-headache/
Dr Susan Hutchinson recounts her journey as a doctor who suffers from migraine and how she has learned to manage the condition to improve her quality of life. Read her story here: https://www.mindbodygreen.com/articles/my-journey-from-debilitating-migranes-to-none
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
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.
Three New Treatments for Chronic Migraine
Dear Patients,
The official day of summer is rapidly approaching. Longer hours of daylight, days at the beach, outdoor BBQ’s, vacations, and a break from the more structured September-May time frame is welcomed by many. But for the migraine patient, the heat of the summer months can be a frequent cause of headache exacerbation. Staying well-hydrated and avoiding being out in the middle of the day are common-sense precautions. Are there some other treatments that may prove helpful for those who dread the summer months and feel “nothing is working” for them?
In this newsletter, I would like to discuss three novel treatment approaches to consider for those frustrated with their current migraine pattern.
- The Cefaly Headband: this is the first medical device approved by the FDA for the prevention of migraine headaches. It is a small, portable battery-powered headband that is worn across the forehead and fits over the ears on both sides. This device applies an electric current to the skin in the center of the forehead just above the eyes. This current is similar to that of other transcutaneous electrical nerve stimulators (TENS) that have been used for years in the treatment of pain and are frequently part of physical therapy. The electrical current of the Cefaly device stimulates branches of the trigeminal nerve, which is associated with migraine headaches. There are 3 settings for the device: one for prevention of migraine; one for acute treatment of migraine; and one for relaxation. In the patient satisfaction study of 2,313 Cefaly users in France and Belgium, more than 53% of patients were satisfied with Cefaly treatment and were willing to buy the device for continued use. The device is approximately $350 and requires a prescription to purchase. So far, in my practice, about ½ of patients who have tried the device are satisfied and happy with the results so this is consistent with the findings in the patient satisfaction study.
- Myers Cocktail IV Treatment: this is an IV treatment containing calcium gluconate, magnesium, B-vitamins, Vitamin C, and msc. Other amino acids/electrolytes administered in an IV bag of 100 cc solution. It takes about 6 minutes to go in. It is not covered by insurance and costs just under $100 for the basic IV treatment. According to a physician colleague of mine, it is recommended as a monthly treatment for maintenance. It is available at Link Medical in Newport through Dr. Garrett Wdowin who is a Naturopath MD (NMD). The phone number to schedule an appointment and/or IV treatment is 949-465-0770. My opinion is that this IV treatment may benefit some migraine patients who are frustrated with their current treatment and this treatment appears to be quite safe.
- California eyeBrain Medical Trial: For some chronic daily headache patients, there may be an imbalance between the patient’s peripheral vision and central vision. This could cause overstimulation of the Trigeminal nerve and be contributing to chronic daily headache and neck pain. For patients who have chronic daily headache (headache 15 or more days a month for over 3 months) and have dry eyes, sensitivity to light, stiffness in shoulders or neck, and/or lethargy (fatigue), then you may be a candidate for a novel treatment for your headaches. There is a clinical trial to evaluate a new treatment to address imbalance between peripheral and central vision; there is no charge to be in this trial. To see if you are a candidate for this eyeBrain free clinical trial, go to http://eyebrainmedical.com/self-evaluation website and take the self evaluation of 12 questions. This should only take about 3 minutes to complete. You will then be contacted in 24 hours to determine your eligibility for this study. The treatment involves a progression or prisms in glasses to address the imbalance contributing to the frequent headaches. The study dates in Orange County are June 23-26th. I have met with the study coordinators and was pleased with their honesty and genuine interest in helping chronic daily headache patients with their approach. Their study appears to be quite safe and non-invasive; I like the fact that patients are screened ahead of time by the on-line self-evaluation. This helps to minimize wasting anyone’s time if they are not a candidate for this study. My advice: check it out and take the on-line self-evaluation; you have nothing to lose.
In summary, I have discussed three novel treatments for migraine patients. If you feel you are a candidate for any of these treatments, please call our office and set up an appointment to discuss them further. For the Cefaly headband, a prescription is required to order the device. This could be a great time to come in and have your migraine treatment plan evaluated and improved. I look forward to seeing you in my office in the near future and in the meantime, have a wonderful summer.
Sincerely,
Susan Hutchinson, MD Director-Orange County Migraine & Headache Center