Newswise — Todd Rozen knows you can’t just “pop a pill and deal with it.” He’s suffered from chronic migraines for more than three decades and it’s his fascination with understanding and treating this chronic condition – and the diminished quality of life that accompanies it – that led him to become a headache specialist, a relatively rare and emerging breed of doctor in America.
Dr. Rozen, who knows first-hand the devastating effects of headaches, is the director of the new Geisinger Headache Center located in Wilkes-Barre, Pennsylvania. In this role, he is committed to helping those who suffer from the number one medical complaint in America. He’s now lending a compassionate ear, providing strategic treatments, and teaching preventive measures to anyone who lands in his exam rooms.
Despite the fact that a headache is the top medical complaint of patients, it’s only been in recent years that the medical community has begun embracing the need for specialists in it. As Dr. Rozen explains, “Headache sufferers are often viewed and treated as the ‘dreaded problem patient.’ It is an extremely difficult entity to treat. It’s tough to get chronic headache sufferers better. To do so, the patient needs to have good headache health, good overall medical health and good psychiatric health. All three of these elements must line up.”
Ironically, Dr. Rozen adds there is no medical mystery when it comes to understanding headaches. “We know more about what causes headaches and migraines than we do about most other neurological conditions. We’ve developed specific therapies to treat them. We know that they are a true brain-based syndrome,” Dr. Rozen comments. “As physicians, we understand its pathogenesis. We can now go way beyond the simple treatment of an ice pack with this chronic condition.”
After a big educational push to the primary care field, from organizations like the American Headache Society, Dr. Rozen believes the medical community’s view of how to treat headache sufferers is changing. In the designated headache centers across America, doctors mostly see migraine sufferers; there are about 30 million of them. “We’ve started to recognize that migraines is a chronic illness much like diabetes or hypertension. It can emerge in a patient at a young age and they then have to cope with it the rest of their life,” Dr. Rozen comments.
And for patients who suffer from chronic daily or chronic progressive headaches, a subgroup of headache sufferers, it can be devastating to their quality of life. These are patients who miss a lot of work or family time or are completely disabled by their pain. Dr. Rozen is quick to point out that not all headache patients suffer from migraines. They could suffer from a secondary headache or a different primary headache and the treatment needs to be different. “If you miss the diagnosis, you miss the boat to recovery,” Dr. Rozen adds. “Just as you need a specialist to treat MS or a brain tumor, you need a specialist to treat headaches, which are much more common and affect your entire life.” According to a National Headache Foundation, 41 percent of migraine sufferers report headache pain five or more days in the last three months.
· Migraine is misdiagnosed as tension (a catch-all phase) or sinus headache (a relatively rare condition) almost as frequently as it is correctly diagnosed. · 39 percent of all migraine sufferers report migraine pain so severe they are forced to retreat to their beds – sometimes for days at a time.· 38 percent suffer three years or more before being diagnosed with migraine by a physician. · More than half (51 percent) of sufferers report a 50 percent or more reduction in work and/or school productivity; 66 percent report a 50 percent or more reduction in household work productivity.· 24 percent of migraine sufferers report headaches so severe that they have sought emergency room care.
So why should the rest of us care about proper headache medical treatment? Dr. Rozen adds that there are larger ramifications to our society as a whole. Beyond the pain of one person, collectively, our country loses billions of dollars in lost work productivity every year due to headaches. As Dr. Rozen puts it, “This truly is a nation-disabling phenomenon and it needs to be addressed for the economic health of our country.”
To turn this situation around, Dr. Rozen believes that headache specialists need to carefully work with headache sufferers, one by one, to clear up the confusion and frustration they’re experiencing. “From the patient’s standpoint, it can be incredibly frustrating to cope with this chronic condition; they have a real lack of understanding as to what’s going on with them and many of them keep hearing, ‘Hey, it’s just a headache, suck it up.’ The mentality of ‘you just take medicine for your pain’ has really gotten us into trouble,” Dr. Rozen comments. “In 95% of my patients who suffer from chronic daily migraines, it’s actually the overuse of medication that is now causing their headaches.”
He goes on to say, “You can’t just give a patient medicine to cope with the pain. That would be like simply giving insulin to a diabetic without teaching them the importance of how to change their diet, their exercise routines, or managing their weight. As a headache specialist, I really stress to my patients that we have to make changes in the natural history of this disorder, in their environment, in their lifestyles in order to prevent the acute attacks.”
That’s the goal of the new Geisinger Headache Center. Dr. Rozen explains that a dedicated headache center gives options to patients who are frustrated and don’t feel they’re getting the right treatment, are uncertain of a diagnosis, or are looking for a different approach. “A dedicated headache center gives patients a new avenue to get better and to improve their quality of life,” Dr. Rozen states. “A true headache center should have: 1) a fellowship-trained headache specialist, 2) aggressive treatment strategies like an outpatient infusion unit, 3) access to pain psychology to help patients cope better with the pain, 4) access to pain anesthesia for neuromodulatory blocks, and 5) access to newer treatments.”
Dr. Rozen, who is known internationally as a leader in this field, makes a promise to his patients, “They’ll get someone who listens to them here. Most doctors don’t want to hear from a headache sufferer. They’re instantly labeled as a complainer or a psych patient. But when you come to the headache center, you’ll get state of the art care and you’ll leave with better understanding of your condition than when you came. And if you’re a disabled headache patient, it won’t be same old, same old. Being a misdiagnosed migraine sufferer myself, I’m very compassionate with patients and I like to teach and help them to understand about what’s going on with them.”
When Dr. Rozen began his neurology residency at the Mayo Clinic, he never knew there was such a thing as a headache doctor, until he met two dedicated headache specialists there. He instantly took an interest in it and has never looked back. “It’s rewarding to work with pain patients; they are extremely thankful if you make an effort to get them better. And in a lot of patients, we can make them extremely better. It changes their life, their interactions and relationships. The best thing you can give a pain sufferer is hope that you’re not going to give up. When you meet a patient, and are able to make a tremendous change in their life, perhaps diagnosing something that was missed, it is very gratifying.”
As a headache physician, Dr. Rozen specializes in chronic daily headaches, cluster headaches, new daily persistent headache, and migraines. Geisinger Health System’s Neuroscience Institute is in the midst of a dramatic period of growth including the employment of more than 10 new physicians and the expansion of advanced epilepsy, neurosurgery, oncology and migraine/headache services. To learn more about headaches, visit: http://www.ninds.nih.gov/disorders/headache/headache.htm or www.headaches.org.
About Geisinger Health SystemFounded in 1915, Geisinger Health System (Danville, PA) is one of the nation’s largest integrated health services organizations. Serving more than two million residents throughout central and northeastern Pennsylvania, the physician-led organization is at the forefront of the country's rapidly emerging electronic health records movement. Geisinger is comprised of two medical center campuses, three hospitals, a 740-member group practice, a not-for-profit health insurance company and the Henry Hood Center for Health Research—dedicated to creating innovative new models for patient care, satisfaction and clinical outcomes. For more information, visit www.geisinger.org
RSS