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Marcy Yonker, MD, once saw a 17-year-old patient who'd suffered migraine headaches every day for nearly five years. They'd wrecked her life. She'd written an essay about it for her English class, about the guilt she carried around, the burden she'd been on her family, events canceled, plans abandoned.
"This girl had basically given up," says Dr. Yonker. "It was hard to read."
Migraine headaches can be painful — very painful — but the pain is not what makes them migraines.
"It's associated with other symptoms," says Dr. Yonker. "Light and sound sensitivity, nausea, often vomiting. Sometimes there's an aura, blind spots, changes in sound and vision or tingling in the hands or limbs, but not always. It's usually made worse by doing daily activities."
That last part is the kicker. A tension headache, while uncomfortable, is usually bearable and often preventable. It's not possible to pinpoint the exact reason for every tension headache, but healthy habits help: good hydration, adequate sleep, and a little relaxation to minimize stress.
Not so with migraine, which is almost always a genetic condition: Sufferers have to stop what they're doing, and not necessarily because of the pain. Often, the other symptoms are worse.
Migraine is the most common neurologic problem in humans — nearly 10 percent of kids get them, and that figure increases in adulthood, especially in women, to about 20 percent. Yet less than half of people who experience migraine, Dr. Yonker estimates, get accurately diagnosed.
"If we treated asthma like we treat migraine, and migraine is just as prevalent," says Dr. Yonker, "we'd have a real problem."
For a condition like asthma, care pathways — the decision trees that inform the course of treatment — are well established and continually refined. Researchers study it. Donors fund it. Doctors know how to recognize it and prescribe the medications and lifestyle changes that can help.
Less so with migraine — a fact Dr. Yonker and her team of clinicians and scientists at Children's Colorado's Headache Program, one of just a handful like it in the country, are trying to change.
Dr. Yonker's team has made a lot of progress since she started treating headaches 20 years ago. They use an array of medications from anti-depressants to blood pressure reducers, as well as newer methods like biofeedback. Each patient gets a personalized treatment plan based on their individual condition and needs.
"We know for certain that levels of a chemical called CGRP are elevated during migraine attacks," says Dr. Yonker. "There's a new group of meds coming out that target CGRP. It's the first treatment ever developed specifically to target what's going on in migraine. It's potentially revolutionary."
The treatment is approved in adults, and Dr. Yonker's team will soon begin studying the effectiveness and side effects of applying it in kids. So far her hopes are high.
Not that there isn't plenty of hope already for the patients she sees today. In fact, she says, for that 17-year-old patient, the relief was almost immediate.
"The first med we put her on decreased her symptoms by 75 percent."
Migraines are common, but not everyone gets them. For the rest of us, there's the tension headache: that annoying, clamping discomfort around the head — and yes, kids get them too. The reasons for them vary and are often impossible to pinpoint, but there are some proven ways to ward them off, or at least get them less often.
Water is the stuff of life, and not getting enough of it can cause tension headaches, among other unpleasant symptoms. Have kids carry around a water bottle so it's always on hand (why not do the same yourself?).
Everyone knows infants need a lot of sleep — about 15 hours a day — but even teens do best with a solid 10 hours per 24. A well-rested kid is a happy one, and they'll be far less likely to get headaches.
Kids need it too, especially in this age of overscheduling. Sports, clubs and activities can be great for kids, but too little downtime can stress them — and contribute to lack of sleep, both of which contribute to more headaches.