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Children and Young Adult Headache & Research Program
Dr. Sharoon Qaiser discusses the Children and Young Adult Headache & Research Program.
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Learn more about Dr. Sharoon Qaiser
Sharoon Qaiser, MD, MBBS
Dr. Sharoon Qaiser is a graduate of King Edward Medical College in Lahore, Pakistan. He completed a residency in pediatrics and child neurology at the University of Kentucky and a pediatric headache fellowship at Cincinnati Children’s Hospital and Medical Center, the largest pediatric headache program in the world.Learn more about Dr. Sharoon Qaiser
Transcription:
Children and Young Adult Headache & Research Program
Introduction: Another informational resource from UK Healthcare. This is UK HealthCast. Featuring conversations with our physicians and other healthcare providers. Here's Melanie Cole.
Melanie Cole: Welcome to UK HealthCast with the University of Kentucky Healthcare. I'm Melanie Cole, and I invite you to listen in, as we discuss children and young adult headache and research program at UK Healthcare. Joining me is Dr. Sharoon Qaiser. He's the Director of the Children and Young Adult Headache and Research Program at UK Healthcare. Dr. Qaiser, it's a pleasure to have you join us again. What a great topic headaches are so pervasive. They can affect your quality of life. Indeed, your ability to function. Do we know why we even get headaches? Do we even know what they are or what causes them?
Dr. Qaiser: This is a very interesting question because probably we are not the only one who has been asking this question. I think people a few thousand years ago when we were trying to do bur holes in the skull to find out where headache lives. We're asking the same question. Yeah. That's interesting questions, with our recent genetic models and studies. I think we started to get a little bit of a better picture about pathogenesis of headaches in children, especially migraine type headaches. And I think it's a combination of genetic factors and environmental factors. That's a thing what would cause headaches, but still lot of things to know. So we don't have a great answer yet.
Host: Thank you for that. They are mysterious. So tell us the difference between a normal headache that people might get and a migraine?
Dr. Qaiser: So, here's my take on that. So pain is one of the most subjective things. And the problem is when we try to look subjective things using an objective lens. So when we divide different types of headaches or sub headaches or different subgroups, so we forget one basic principle that a child in the pain at that time, it doesn't matter whether the child has migraine defining headache or tension type headache, or what we call simple headache. At that time, the most important thing is for a child is, Oh, I have a headache and I just can't function. So the way I look at headaches is how much it affects you. So the quality of life scores and the morbidity associated with that, or little Johnny can't go to school because his head hurts or a little girl, she missed the school because her tummy hurts. And surprisingly headaches may not only be in the head only, they could be in your tummy. They could be in other parts of the body as well. So that's how I, in my clinic practice divide different headaches. But of course the more scientific way or more objective way of defining headaches are that we call them primary headache. If we don't really know what's the cause, or we call it secondary headache if we think there is an underlying cause any kind of infection or mass or tumor or increased pressure, things like that. But the most common headaches are the prime time headaches in children.
Host: Dr. Qaiser, you opened the new Children and Young Adult Headache and Research Program at UK Healthcare. Tell us how this came about and why did you see a need for a program like this?
Dr. Qaiser: When I was resident, I saw that unmet need and I saw the pattern that something as simple as headache is plagued with familiarity. So although one of the most common complaint in the community, in the neurology clinic, but really it was just considered as it's just a headache. And then we talk about other bigger, important things. So I saw that unmet need. And then I started working on that, then I started working on different inpatient, headache protocols, simple things to address. And then I started building my career on that. And that leads me to a formal fellowship program at Cincinnati Children's where I was trained to treat headache, especially in a younger kids. And that's how it all started
Host: And speak about some of the treatment options that you have available. And if someone is in an acute phase for parents listening, is it important that they get into a quiet calming environment during the time when being loud or in a place where it's not so calming can exacerbate that headache? I'd like you to speak about some of the treatments that you offer and some of the triggers so that parents listening can help their child avoid some of those.
Dr. Qaiser: I think this is beautiful question and really the cure lies in simple things. Most of the time, it's the simple things, how well you're hydrated. There was a CDC survey back in 2013. And they found out that only 14, one four, 14 person adolescents were properly hydrated, which means most of our adolescents are in perpetual state of being dehydrated and being dehydrated maybe one of the most common external trigger for many people, especially if they have migraine type headaches, then sleep and wake cycle. It's a very common thing. Now, not many kids get eight to 10 hours of sleep every day because of different reasons, eating patterns, skipping meals. So all these simple things that may seem simple, they constitute what we call lifestyle changes and all these things are more important and more common trigger factors. And since they are more common, they are easy to fix as well.
And I have seen great response in my patients when they start working on improving the quality of life by years, they keep good hydration status. They don't skip meals. They start eating things that are rich in a few vitamins that are thought to be helpful in headaches, especially migraine, they exercise well. And when they do all those things, they do well. And I think the role of treatment is addressing these simple layers don't help you. Then you may need to have some other extra treatment options as well. And in our clinic, we have a different ways. The way we treat different patients, basically it's a multi-disciplinary clinic. So we address the behavioral health aspects, the nutrition aspects, and then we have different tiers of treatment options starting from oral therapies, injectables, and some Botox injections for chronic migraine for ages 12 and above, and then some other things as well.
Host: So, I'd like you to expand a little bit on the services and that multidisciplinary approach that you mentioned, Dr. Qaiser, what makes this program stand apart and tell us your philosophy of care when you're treating these young patients, when headaches can, as we said, be so debilitating, these kids must be fairly unhappy and in pain, tell us how you care for them?
Dr. Qaiser: So, philosophy of my clinic is that there's so much headache out there. I can't reach out to everyone, but what I can do, I can use every opportunity as opportunity to teach. So educate my patients. I educate the caregivers. I educate the referring providers and many, a times my patients have told me that when they go back home, they educate their siblings because of such a strong genetic competent. So I don't get surprised when I see multiple family members on the same day because of the strong genetic competent of headaches. So they become advocates and then they teach other people about simple things, you need to hydrate yourself. You need to eat your dog greens because my doctor told me there was a special vitamin that helps with headache in dark greens, simple things. So philosophy is to educate. And I spent a lot of time in going back and forth and explaining the different things about headache, and even as simple advice or a healthy advice, what is the logic behind that and why I am telling you. And I always give my patients option to pick medicines and whichever they pick, I explain always the benefits, the side effect, and then I let them make a decision. And most of the time they feel empowered and then they have better compliance and they do well.
Host: It's such an interesting topic, Dr. Qaiser. And as we said, mysterious, tell us how this new program will benefit the kids of Kentucky and some of the special things that your team does to go above and beyond?
Dr. Qaiser: So, we are the only multi-disciplinary program, specifically designed for children and young adults in Central Kentucky. And we offer different things. For example, behavioral health is a big confident. So we work in close collaboration with our adolescent medicine and the pain psychologist, because according to multiple studies, if you have frequent headaches, more likely you have other stressors as well, or it causes anxiety, or those children who have migraine have a very high prevalence of different psychological concerns, including depression, anxiety, and some other things. So if I only offered them the headache competent of the management, I am only addressing only half of the thing and I'm really not helping my patient. So what we offer is a total multi-disciplinary approach. Then we work in collaboration with the nutritionist because that's one of the things we really have a challenge, a great challenge because of different dietary habits and the role of different diets in migraine and other headache disorders. So these are the things, what we offer. And I think we are the only true multi-disciplinary clinic in Central Kentucky who see a younger patient groups.
Host: As we wrap up Dr. Qaiser, tell us how patients can go about making an appointment with the clinic and please offer your best advice for every single person listening out there on ways to possibly prevent headaches. And maybe we're not talking specifically about migraines, but really headaches in general. And what would you like us to know about these insidious things?
Dr. Qaiser: To answer the first part of the question, how to make the appointment, any healthcare provider can make a referral to our patient access center. And I always encourage my colleagues in community, other providers, that if you are super worried, don't hesitate to reach out to me. My email address is on our headache page. It's public information. You can just access the website. And if you're worried about your patient, just drop me an email. I am more than happy to discuss over the phone or whichever way I can help, but for now any primary provider can make a referral. And the next question is when is the best time to see me? I think it depends on the comfort level. If caregivers are worried, I am worried, if a physician is worried, I am worried. Referring provider is worried. I am worried. So whenever you want to see me, I'm more than happy to help and see you. And what one advice, drink well, eat well, exercise, sleep well and enjoy your life. And the more likely you're going to have less headaches.
Host: That's great advice. We can all certainly heed all of that advice. So thank you so much, Dr. Qaiser for joining us today and to learn more about our Pediatric Headache Program, please visit the website at ukhealthcare.uky.edu to get connected with one of our providers. That concludes another episode of UK Health Cast with the University of Kentucky Healthcare. Please remember to subscribe, rate, and review this podcast and all the other University of Kentucky Healthcare podcasts. I'm Melanie Cole.
Children and Young Adult Headache & Research Program
Introduction: Another informational resource from UK Healthcare. This is UK HealthCast. Featuring conversations with our physicians and other healthcare providers. Here's Melanie Cole.
Melanie Cole: Welcome to UK HealthCast with the University of Kentucky Healthcare. I'm Melanie Cole, and I invite you to listen in, as we discuss children and young adult headache and research program at UK Healthcare. Joining me is Dr. Sharoon Qaiser. He's the Director of the Children and Young Adult Headache and Research Program at UK Healthcare. Dr. Qaiser, it's a pleasure to have you join us again. What a great topic headaches are so pervasive. They can affect your quality of life. Indeed, your ability to function. Do we know why we even get headaches? Do we even know what they are or what causes them?
Dr. Qaiser: This is a very interesting question because probably we are not the only one who has been asking this question. I think people a few thousand years ago when we were trying to do bur holes in the skull to find out where headache lives. We're asking the same question. Yeah. That's interesting questions, with our recent genetic models and studies. I think we started to get a little bit of a better picture about pathogenesis of headaches in children, especially migraine type headaches. And I think it's a combination of genetic factors and environmental factors. That's a thing what would cause headaches, but still lot of things to know. So we don't have a great answer yet.
Host: Thank you for that. They are mysterious. So tell us the difference between a normal headache that people might get and a migraine?
Dr. Qaiser: So, here's my take on that. So pain is one of the most subjective things. And the problem is when we try to look subjective things using an objective lens. So when we divide different types of headaches or sub headaches or different subgroups, so we forget one basic principle that a child in the pain at that time, it doesn't matter whether the child has migraine defining headache or tension type headache, or what we call simple headache. At that time, the most important thing is for a child is, Oh, I have a headache and I just can't function. So the way I look at headaches is how much it affects you. So the quality of life scores and the morbidity associated with that, or little Johnny can't go to school because his head hurts or a little girl, she missed the school because her tummy hurts. And surprisingly headaches may not only be in the head only, they could be in your tummy. They could be in other parts of the body as well. So that's how I, in my clinic practice divide different headaches. But of course the more scientific way or more objective way of defining headaches are that we call them primary headache. If we don't really know what's the cause, or we call it secondary headache if we think there is an underlying cause any kind of infection or mass or tumor or increased pressure, things like that. But the most common headaches are the prime time headaches in children.
Host: Dr. Qaiser, you opened the new Children and Young Adult Headache and Research Program at UK Healthcare. Tell us how this came about and why did you see a need for a program like this?
Dr. Qaiser: When I was resident, I saw that unmet need and I saw the pattern that something as simple as headache is plagued with familiarity. So although one of the most common complaint in the community, in the neurology clinic, but really it was just considered as it's just a headache. And then we talk about other bigger, important things. So I saw that unmet need. And then I started working on that, then I started working on different inpatient, headache protocols, simple things to address. And then I started building my career on that. And that leads me to a formal fellowship program at Cincinnati Children's where I was trained to treat headache, especially in a younger kids. And that's how it all started
Host: And speak about some of the treatment options that you have available. And if someone is in an acute phase for parents listening, is it important that they get into a quiet calming environment during the time when being loud or in a place where it's not so calming can exacerbate that headache? I'd like you to speak about some of the treatments that you offer and some of the triggers so that parents listening can help their child avoid some of those.
Dr. Qaiser: I think this is beautiful question and really the cure lies in simple things. Most of the time, it's the simple things, how well you're hydrated. There was a CDC survey back in 2013. And they found out that only 14, one four, 14 person adolescents were properly hydrated, which means most of our adolescents are in perpetual state of being dehydrated and being dehydrated maybe one of the most common external trigger for many people, especially if they have migraine type headaches, then sleep and wake cycle. It's a very common thing. Now, not many kids get eight to 10 hours of sleep every day because of different reasons, eating patterns, skipping meals. So all these simple things that may seem simple, they constitute what we call lifestyle changes and all these things are more important and more common trigger factors. And since they are more common, they are easy to fix as well.
And I have seen great response in my patients when they start working on improving the quality of life by years, they keep good hydration status. They don't skip meals. They start eating things that are rich in a few vitamins that are thought to be helpful in headaches, especially migraine, they exercise well. And when they do all those things, they do well. And I think the role of treatment is addressing these simple layers don't help you. Then you may need to have some other extra treatment options as well. And in our clinic, we have a different ways. The way we treat different patients, basically it's a multi-disciplinary clinic. So we address the behavioral health aspects, the nutrition aspects, and then we have different tiers of treatment options starting from oral therapies, injectables, and some Botox injections for chronic migraine for ages 12 and above, and then some other things as well.
Host: So, I'd like you to expand a little bit on the services and that multidisciplinary approach that you mentioned, Dr. Qaiser, what makes this program stand apart and tell us your philosophy of care when you're treating these young patients, when headaches can, as we said, be so debilitating, these kids must be fairly unhappy and in pain, tell us how you care for them?
Dr. Qaiser: So, philosophy of my clinic is that there's so much headache out there. I can't reach out to everyone, but what I can do, I can use every opportunity as opportunity to teach. So educate my patients. I educate the caregivers. I educate the referring providers and many, a times my patients have told me that when they go back home, they educate their siblings because of such a strong genetic competent. So I don't get surprised when I see multiple family members on the same day because of the strong genetic competent of headaches. So they become advocates and then they teach other people about simple things, you need to hydrate yourself. You need to eat your dog greens because my doctor told me there was a special vitamin that helps with headache in dark greens, simple things. So philosophy is to educate. And I spent a lot of time in going back and forth and explaining the different things about headache, and even as simple advice or a healthy advice, what is the logic behind that and why I am telling you. And I always give my patients option to pick medicines and whichever they pick, I explain always the benefits, the side effect, and then I let them make a decision. And most of the time they feel empowered and then they have better compliance and they do well.
Host: It's such an interesting topic, Dr. Qaiser. And as we said, mysterious, tell us how this new program will benefit the kids of Kentucky and some of the special things that your team does to go above and beyond?
Dr. Qaiser: So, we are the only multi-disciplinary program, specifically designed for children and young adults in Central Kentucky. And we offer different things. For example, behavioral health is a big confident. So we work in close collaboration with our adolescent medicine and the pain psychologist, because according to multiple studies, if you have frequent headaches, more likely you have other stressors as well, or it causes anxiety, or those children who have migraine have a very high prevalence of different psychological concerns, including depression, anxiety, and some other things. So if I only offered them the headache competent of the management, I am only addressing only half of the thing and I'm really not helping my patient. So what we offer is a total multi-disciplinary approach. Then we work in collaboration with the nutritionist because that's one of the things we really have a challenge, a great challenge because of different dietary habits and the role of different diets in migraine and other headache disorders. So these are the things, what we offer. And I think we are the only true multi-disciplinary clinic in Central Kentucky who see a younger patient groups.
Host: As we wrap up Dr. Qaiser, tell us how patients can go about making an appointment with the clinic and please offer your best advice for every single person listening out there on ways to possibly prevent headaches. And maybe we're not talking specifically about migraines, but really headaches in general. And what would you like us to know about these insidious things?
Dr. Qaiser: To answer the first part of the question, how to make the appointment, any healthcare provider can make a referral to our patient access center. And I always encourage my colleagues in community, other providers, that if you are super worried, don't hesitate to reach out to me. My email address is on our headache page. It's public information. You can just access the website. And if you're worried about your patient, just drop me an email. I am more than happy to discuss over the phone or whichever way I can help, but for now any primary provider can make a referral. And the next question is when is the best time to see me? I think it depends on the comfort level. If caregivers are worried, I am worried, if a physician is worried, I am worried. Referring provider is worried. I am worried. So whenever you want to see me, I'm more than happy to help and see you. And what one advice, drink well, eat well, exercise, sleep well and enjoy your life. And the more likely you're going to have less headaches.
Host: That's great advice. We can all certainly heed all of that advice. So thank you so much, Dr. Qaiser for joining us today and to learn more about our Pediatric Headache Program, please visit the website at ukhealthcare.uky.edu to get connected with one of our providers. That concludes another episode of UK Health Cast with the University of Kentucky Healthcare. Please remember to subscribe, rate, and review this podcast and all the other University of Kentucky Healthcare podcasts. I'm Melanie Cole.