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Principles of Chronic Disease ManagementPrinciple 1: Chronic MedicationPrinciple 2: Any Disturbance create flares Principle 3: MeasurePrinciple 4: AnticipateSpecial Note - Recognizing Red FlagsLifestyle considerations in Migraine ManagementResources
Principles of Chronic Disease Management
Applies to all disease that are chronic in nature
Migraine, Epilepsy, MS, UC, Crohn's disease
Principle 1: Chronic Medication
- If prescribed daily medication take it on time daily
- Do NOT Forget
- Medical Adherence is key
Chronic Medication Selection
- It is a process
- Trial & Error
- First Line > Second > Third
- Max out and then combination
Principle 2: Any Disturbance create flares
Routine, Routine, Routine
Consistency, Consistency, Consistency
General Good Hygiene measures
Any Disturbance late nights, mild flus can trigger a flare
Principle 3: Measure
If you can't measure you can't improve
Create your own spread sheet "Date, Time, Symptoms"
There is an app for that
Headache Diary App for Migraine Patients
Principle 4: Anticipate
- Anticipate Flare
- Be Proactive
- Season of Asthma, Days of the month for Migraine
Special Note - Recognizing Red Flags
It is important to differentiate between your Flare up and other "Red Flags"
You can still have other new diagnosis other than your regular headaches.
This brings the importance of Logging
Infection (Fever, Chills, Weight loss)
New Neurological Symptoms
Lifestyle considerations in Migraine Management
- Sleep Hygiene
- Priority
- Food 3-4 hours before going to bed
- Avoid Benzodiazepines
- Bedroom for sleep and sex only
- Only a book or kindle is allowed
- Ditch the phone and TV.
- If need a phone which to night mode
- Special Note: Sleep Apnea
- I have treated headaches with CPAP
I can't treat your headache if you do not get enough good sleep
- Hydration
- Hydrate, Hydrate & Hydrate
- There is an app for that
- Exercise
- 10 min brisk walk daily preferably outdoors
People who do not find time to exercise will have to find time for illness
- De-Stress
- Yoga
- Meditation
- Support Groups
- Breathing Technique
- Sleep, Hydration, Exercise
- Anticipate
- If you know you will have to engage an avoidable situation
- Have a plan for acute headache abortive therapy ready
Resources
American Migraine Foundation - Patient Guides