Selected Podcast
Is It A Headache Or A Migraine?
Have you ever had a pounding headache and wonder if it's a migraine? How can you tell the difference between a headache and a migraine? Listen as Dr. Even Wang shares information on the two conditions and how to treat them.
Featuring:
Even Wang, M.D.
Even Wang, M.D., specializes in neurology with the Genesis Neurology Group. He completed his doctor of medicine at St. George’s University School of Medicine in Grenada, West Indies. He completed a residency in neurology at The Ohio State University Wexner Medical Center and Nationwide Children’s Hospital in Columbus. Dr. Wang also completed an advanced medical fellowship in neurophysiology, electromyography and neuromuscular medicine at The Ohio State University Wexner Medical Center. Dr. Wang treats neurology diagnoses including, but not limited to, neuropathy, syncope, dizziness/vertigo, headaches/migraines, seizures, stroke, tremors, dementia and multiple sclerosis. He holds board certifications from the American Board of Neurology and Psychiatry, and the American Board of Clinical Neurophysiology. He is an active member of the American Academy of Neurology Physicians and the American Medical Association. Transcription:
Scott Webb: Headaches are a real headache, right?
Scott Webb (Host): And when it comes to migraines, there are a variety of treatment options, including medications, Botox, and more. And joining me today to discuss the signs and symptoms of migraines and how we can help folks not to suffer is Dr. Even Wong. He's a neurologist with the Genesis neurology group.
Scott Webb: This is Sounds of Good Health with Genesis, brought to you by Genesis Healthcare System. I'm Scott Webb. Dr. Wang, it's so great to speak with you. We're going to talk about migraines today. And I was just kind of mentioning that most of us have had headaches before. Some people maybe even had migraines or thought they had migraines, but it's great to have an expert on to tell us exactly what is a migraine, can we prevent it, how do you treat it, and so on. So as we get rolling here, what is a migraine exactly?
Dr. Evan Wang: People with migraines, usually describe their symptoms as a very pounding headache. Throbbing headache. It can be, both sides of the head. It can be one side of the head sometime they'll have a lot of licenses, city associated with the headaches. Sometimes it can make them nauseous. Typically people say they will have to go lay down a dark room and sometime the headaches can be very debilitating.
Now the exact etiology of the headaches, like exactly why does it happen? What causes it? We don't really fully understand. the pathophysiology of the migraine. But we think he may be associated with some of the ion channels within the brain on the cells where, the electric charges the cells.
Maybe some of those channels may be mutated in some people with migraines. Not that they have some severe disease, but it can cause these type of.
Scott Webb: How can we tell the difference between a regular headache, run of.
the mill headache and a migraine.
Dr. Evan Wang: I think people are concerned that, okay, am I getting something really way bad? Am I going to have some kind of horrible outcome from this headache? Or is this just something that's going to go away?
And then, it's going to feel really bad right now. But I'm going to be okay in 24 hours. But how do you tell the difference between that and something really bad? I tell people is that typically, if you have had headaches for 10 years and you have a severe headaches and it's the same headaches that you usually have you don't have to worry too much.
Okay. So if you're somebody that never has headaches and then boom, suddenly you have a very severe. And that puts you down, then you should be more concerned then come to the hospital to make sure it's not a bleeding or it's not like an infection or, it's not a tumor that's causing the headaches.
So it's a little bit counterintuitive. So for people who suffer from headaches a lot, you have a severe headache. That's less worrisome than somebody who has never had a headache and just starting. Intractable headaches.
Scott Webb: when we're suffering from a headache that we think might be a migraine, what would be sort of our first level of treatment for ourselves? If we want to go to the store and buy some.
Dr. Evan Wang: Yeah, you can try the over the counter, et cetera, migraine with Tylenol. If those things don't work, there are prescriptions, your family doctor can prescribe to you such as sumatriptan or rizatriptan Maxalt. So those are the entry level medications for migraine, and they do work, also rest Canada.
Decrease the headache. And people typically find that maybe they don't get enough sleep, or if they drink too much caffeine, that can trigger them to have a headache. So the remedy for that would be, taking any more fluids because caffeine does dehydrate you. And then also getting more.
Scott Webb: Yeah, it does seem like a lot of it is just a behavior and lifestyle, right. if you're somebody who has like myself, a couple of cups of coffee every day, and maybe he didn't sleep well the night before, and maybe he didn't eat well and you're not hydrating enough is like, I always feel like it's our body's way of telling us you're doing it wrong. You need to be better rested and better hydrated and stop drinking so much coffee like that. I feel like That's my body talking to me. Is there anything to that?
Dr. Evan Wang: That's exactly right. You'd be surprised. Like I just had a patient today. He was having headaches every single day, but he was drinking like, five months and a day he was getting, maybe five or six hours of sleep at night. Last time I told him, six weeks ago, I told him, Hey, let's cut down on the mountain, Dew, make sure you sleep eight hours a night.
And then he came back this time. Didn't really need any medication. You know, His headaches cut down by 90%. So you're exactly right. It makes a huge difference. With.
Scott Webb: Yeah, and we just all need to be really better probably at listening to our bodies and, if we're having daily headaches, First of all, we don't have to suffer every day. Like we can reach out, talk to our family or, primary doctors and then see a specialist like yourself.
And you might just say, Hey, once you cut down on the mountain, do bro, you'll feel a lot better, maybe sleep a little bit more. So just a great advice. And it just seems so obvious, but we need sometimes professionals to tell us these things to really drive them home. And so when we think about somebody in your office, doctor who's, reached out to their primary, they ended up in the room with.
you.
How do you diagnose a migraine? How do we know it's a migraine and not something else?
Dr. Evan Wang: Yeah. Typically when somebody has headaches for a long time, that the diagnosis is really based on patient's history. If they tell me that they have a pounding headache, they have licensed activity. They've had it since they were 12 years old. It's a typical headache that they always have the most likely it's a migraine.
I usually people will have a family history of headaches as well. If they come in with more concerning history, such as, you know, we already talked about, they never used to have headaches. Now they have sudden headaches or they have other, perhaps local and neurological symptoms like numbness and weakness.
Or trouble speaking that we can do MRI to route, tumors or bleeding or some other things in the brain or infection. But most of the diagnosis is based on, the history. That's a pretty typical story that patients tell me why don't we diagnose somebody with migraine a lot of times, It is migraines or it could be stress-related.
Scott Webb: I think you're so right. what would be your final takeaways doctor? When we think about folks who, you know, kind of suffer on an almost daily basis with things that they don't have to suffer from, right? So if they have headaches every day, that may be normal or typical for them, but they don't have to suffer.
And for anyone who's getting migraines on a regular basis and the OTCs only sort of work, what would be your best advice. And when you want them to really reach out to someone like. Yeah.
Dr. Evan Wang: Yeah, I will say, if you try over the counter remedies that doesn't work or you try it, the typical sumatriptan or rizatriptan that doesn't work, or you try it to get more sleep, you try lifestyle change. If that doesn't work, then you'll probably have, true migraines. And at that time, you really should reach out to our office.
We can set up an employment. There are a lot of medication new medicines nowadays. And some medicines just came out over the past few years that can really make a dramatic difference in people's quality of life. That's where we can really.
Scott Webb: Yeah, they really can. And I know a number of people who, you know, Migraines. And they went to the doctor 10 years ago, 15 years ago, and whatever was prescribed didn't work. And they went, oh, it didn't work for me. So I'm just stuck with these migraines, but that's, what's so cool about medicine and science is things are always progressing and evolving and changing, and there's always new meds to try.
And we have experts like yourself to help us through all of this. So.
Dr. Evan Wang: Also, I would like to add, the treatment options we have nowadays. We can do Botox injections. We have this new class of medication called CGRP inhibitors. CGRP stands for calcitonin gene related peptides. It's a molecule that's implicated in migraines and there are these CGRP inhibitors that blocks the function of the CGRP.
And that can really stop the migraines in his tracks. And we have different forms of this new type of medication such as monthly injections. We have three of those. We have daily pills that work in the same way. We have, a board of medications a boarded means, somebody has a severe migraine.
They really got to stop it in its tracks like there, and now we have new medications for that. So I really think patients should reach out if they're suffering from headaches and, try these newer options.
Scott Webb: Migraines are still a bit of a mystery in terms of what actually. Causes them, like, why do people get migraines? But in the final analysis, there's so many options from over the counter options where we can go to the local, drug store ourselves.
But the stuff that you're talking about here, the evolution and the science of treating migraines has come so far and people just don't need to suffer. So we really do hope they reach out thanks again.
And for more information, go to genesishcs.org. And thanks for listening to Sounds of Good Health with Genesis, brought to you by Genesis Healthcare System. If you found this podcast to be helpful, please be sure to tell a friend and subscribe, rate and review this podcast and check out the entire podcast library for additional topics of interest. I'm Scott Webb. Stay well.
Scott Webb: Headaches are a real headache, right?
Scott Webb (Host): And when it comes to migraines, there are a variety of treatment options, including medications, Botox, and more. And joining me today to discuss the signs and symptoms of migraines and how we can help folks not to suffer is Dr. Even Wong. He's a neurologist with the Genesis neurology group.
Scott Webb: This is Sounds of Good Health with Genesis, brought to you by Genesis Healthcare System. I'm Scott Webb. Dr. Wang, it's so great to speak with you. We're going to talk about migraines today. And I was just kind of mentioning that most of us have had headaches before. Some people maybe even had migraines or thought they had migraines, but it's great to have an expert on to tell us exactly what is a migraine, can we prevent it, how do you treat it, and so on. So as we get rolling here, what is a migraine exactly?
Dr. Evan Wang: People with migraines, usually describe their symptoms as a very pounding headache. Throbbing headache. It can be, both sides of the head. It can be one side of the head sometime they'll have a lot of licenses, city associated with the headaches. Sometimes it can make them nauseous. Typically people say they will have to go lay down a dark room and sometime the headaches can be very debilitating.
Now the exact etiology of the headaches, like exactly why does it happen? What causes it? We don't really fully understand. the pathophysiology of the migraine. But we think he may be associated with some of the ion channels within the brain on the cells where, the electric charges the cells.
Maybe some of those channels may be mutated in some people with migraines. Not that they have some severe disease, but it can cause these type of.
Scott Webb: How can we tell the difference between a regular headache, run of.
the mill headache and a migraine.
Dr. Evan Wang: I think people are concerned that, okay, am I getting something really way bad? Am I going to have some kind of horrible outcome from this headache? Or is this just something that's going to go away?
And then, it's going to feel really bad right now. But I'm going to be okay in 24 hours. But how do you tell the difference between that and something really bad? I tell people is that typically, if you have had headaches for 10 years and you have a severe headaches and it's the same headaches that you usually have you don't have to worry too much.
Okay. So if you're somebody that never has headaches and then boom, suddenly you have a very severe. And that puts you down, then you should be more concerned then come to the hospital to make sure it's not a bleeding or it's not like an infection or, it's not a tumor that's causing the headaches.
So it's a little bit counterintuitive. So for people who suffer from headaches a lot, you have a severe headache. That's less worrisome than somebody who has never had a headache and just starting. Intractable headaches.
Scott Webb: when we're suffering from a headache that we think might be a migraine, what would be sort of our first level of treatment for ourselves? If we want to go to the store and buy some.
Dr. Evan Wang: Yeah, you can try the over the counter, et cetera, migraine with Tylenol. If those things don't work, there are prescriptions, your family doctor can prescribe to you such as sumatriptan or rizatriptan Maxalt. So those are the entry level medications for migraine, and they do work, also rest Canada.
Decrease the headache. And people typically find that maybe they don't get enough sleep, or if they drink too much caffeine, that can trigger them to have a headache. So the remedy for that would be, taking any more fluids because caffeine does dehydrate you. And then also getting more.
Scott Webb: Yeah, it does seem like a lot of it is just a behavior and lifestyle, right. if you're somebody who has like myself, a couple of cups of coffee every day, and maybe he didn't sleep well the night before, and maybe he didn't eat well and you're not hydrating enough is like, I always feel like it's our body's way of telling us you're doing it wrong. You need to be better rested and better hydrated and stop drinking so much coffee like that. I feel like That's my body talking to me. Is there anything to that?
Dr. Evan Wang: That's exactly right. You'd be surprised. Like I just had a patient today. He was having headaches every single day, but he was drinking like, five months and a day he was getting, maybe five or six hours of sleep at night. Last time I told him, six weeks ago, I told him, Hey, let's cut down on the mountain, Dew, make sure you sleep eight hours a night.
And then he came back this time. Didn't really need any medication. You know, His headaches cut down by 90%. So you're exactly right. It makes a huge difference. With.
Scott Webb: Yeah, and we just all need to be really better probably at listening to our bodies and, if we're having daily headaches, First of all, we don't have to suffer every day. Like we can reach out, talk to our family or, primary doctors and then see a specialist like yourself.
And you might just say, Hey, once you cut down on the mountain, do bro, you'll feel a lot better, maybe sleep a little bit more. So just a great advice. And it just seems so obvious, but we need sometimes professionals to tell us these things to really drive them home. And so when we think about somebody in your office, doctor who's, reached out to their primary, they ended up in the room with.
you.
How do you diagnose a migraine? How do we know it's a migraine and not something else?
Dr. Evan Wang: Yeah. Typically when somebody has headaches for a long time, that the diagnosis is really based on patient's history. If they tell me that they have a pounding headache, they have licensed activity. They've had it since they were 12 years old. It's a typical headache that they always have the most likely it's a migraine.
I usually people will have a family history of headaches as well. If they come in with more concerning history, such as, you know, we already talked about, they never used to have headaches. Now they have sudden headaches or they have other, perhaps local and neurological symptoms like numbness and weakness.
Or trouble speaking that we can do MRI to route, tumors or bleeding or some other things in the brain or infection. But most of the diagnosis is based on, the history. That's a pretty typical story that patients tell me why don't we diagnose somebody with migraine a lot of times, It is migraines or it could be stress-related.
Scott Webb: I think you're so right. what would be your final takeaways doctor? When we think about folks who, you know, kind of suffer on an almost daily basis with things that they don't have to suffer from, right? So if they have headaches every day, that may be normal or typical for them, but they don't have to suffer.
And for anyone who's getting migraines on a regular basis and the OTCs only sort of work, what would be your best advice. And when you want them to really reach out to someone like. Yeah.
Dr. Evan Wang: Yeah, I will say, if you try over the counter remedies that doesn't work or you try it, the typical sumatriptan or rizatriptan that doesn't work, or you try it to get more sleep, you try lifestyle change. If that doesn't work, then you'll probably have, true migraines. And at that time, you really should reach out to our office.
We can set up an employment. There are a lot of medication new medicines nowadays. And some medicines just came out over the past few years that can really make a dramatic difference in people's quality of life. That's where we can really.
Scott Webb: Yeah, they really can. And I know a number of people who, you know, Migraines. And they went to the doctor 10 years ago, 15 years ago, and whatever was prescribed didn't work. And they went, oh, it didn't work for me. So I'm just stuck with these migraines, but that's, what's so cool about medicine and science is things are always progressing and evolving and changing, and there's always new meds to try.
And we have experts like yourself to help us through all of this. So.
Dr. Evan Wang: Also, I would like to add, the treatment options we have nowadays. We can do Botox injections. We have this new class of medication called CGRP inhibitors. CGRP stands for calcitonin gene related peptides. It's a molecule that's implicated in migraines and there are these CGRP inhibitors that blocks the function of the CGRP.
And that can really stop the migraines in his tracks. And we have different forms of this new type of medication such as monthly injections. We have three of those. We have daily pills that work in the same way. We have, a board of medications a boarded means, somebody has a severe migraine.
They really got to stop it in its tracks like there, and now we have new medications for that. So I really think patients should reach out if they're suffering from headaches and, try these newer options.
Scott Webb: Migraines are still a bit of a mystery in terms of what actually. Causes them, like, why do people get migraines? But in the final analysis, there's so many options from over the counter options where we can go to the local, drug store ourselves.
But the stuff that you're talking about here, the evolution and the science of treating migraines has come so far and people just don't need to suffer. So we really do hope they reach out thanks again.
And for more information, go to genesishcs.org. And thanks for listening to Sounds of Good Health with Genesis, brought to you by Genesis Healthcare System. If you found this podcast to be helpful, please be sure to tell a friend and subscribe, rate and review this podcast and check out the entire podcast library for additional topics of interest. I'm Scott Webb. Stay well.