Hartford HealthCare Podcast
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Hartford HealthCare Podcast
Splitting Headaches: Episode 1 with Dr. Nicole Gill
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Dr. Nicole Gill, a headache specialist with Hartford HealthCare Ayer Neuroscience Headache Center in Cheshire, Connecticut, talks about the triggers of migraine, how they can affect our families, friends and careers, and how certain lifestyle changes might just relieve your pain.
Listen to episode 2 featuring Dr. Joe Casaly for some promising new headache treatment and devices on the market.
Many patients suffering from migraines and headaches have been made to feel like they're either not doing something right, the pain is just in their head, they're being dramatic, that you know, it's just suck it up, it's just a headache. You know, a lot of the stigma that's around migraines can be really hurtful and prevent people from actually getting better.
SPEAKER_03Welcome to more life. I'm Enron De Pierre. Our guest today in episode one of our two-part headache series is Dr. Nicole Gill, a headache specialist with Hartford Healthcare's IR Neuroscience Headache Center in Cheshire, Connecticut. Welcome, Dr. Gill. Can you first tell us a bit about yourself?
SPEAKER_00I'm an osteopathic physician. I grew up in Massachusetts. For the past five and a half years, I was in private practice in Durham, North Carolina at a headache clinic and just moved up here to Connecticut and became part of the Hartford Healthcare Headache Center and am working in the Cheshire office.
SPEAKER_03Oh so you made the big move back, East Welcome to Connecticut.
SPEAKER_00Thank you.
SPEAKER_03So let's talk migraines. First of all, who or what inspired you to pursue neurology and the field of uh headaches in particular?
SPEAKER_00Well, I think it was actually my interest in headache medicine that pushed me into looking at neurology. Um I felt that that was the best way of having a career in headache medicine. And what really inspired me about headache patients is dealing with the whole person. So I went to osteopathic school and our theory is you treat the whole person, not just the illness. And I found that in headache medicine that was one of the best areas that it could really use that philosophy significantly in looking at the whole person, lifestyle, exercise diet, sleep, as well as the disease process.
SPEAKER_03Migraines affect one in ten Americans. Now, for those of us who suffer or know someone who does, they can be absolutely debilitating. Are you seeing a lot of patients suffering from migraines?
SPEAKER_00Yeah, I would say that I mean previously in my old practice, my population was probably about 80% migraine. So for me, being at a headache clinic, we see migraine and some other primary as well as secondary headache disorders. Um, but migraine is extremely prevalent, and we're just seeing a drop in the bucket of how many people are actually out there suffering with migraines. I think the current number is I think over 37 million people in America every year have migraine.
SPEAKER_03Now, are those numbers going up? Have you seen an uptick?
SPEAKER_00I think they are. It it's hard to say that as migraine awareness is happening more and more, which is great to see, is are there just more people actually getting diagnosed versus are there more people actually having them? Um obviously our population is going up too, so it's I'm not sure if overall burden of migraine has changed or if it's just how we look at it and what people are if they're actually aware of their migraines. I think some people have gotten so used to just saying, oh, I have these bad headaches, it ran on my family, and it is what it is, and never even bring it up to their doctor or um any of their practitioners to actually get diagnosed and possibly get treated.
SPEAKER_03Oh, that's interesting. So perhaps more people are actually seeking treatment and hearing, you know, more about it out there because in the field of migraine, we have made progress over the past decade or so, correct?
SPEAKER_00Uh yes, significantly in lots of areas. One is awareness. I think there are more and more uh awareness groups that are starting to form and actually hit, you know, whether it's news channels or forums or blogs, and it's been great for patients because, you know, migraine is such an isolating disorder. A lot of people retreat and don't have a lot of social interaction due to their headache disorder. Uh so finding another way and realizing that they're not alone, I think, has been huge. In addition, we've had a lot of advances in the science of migraine and our ability to treat it from new medications, new devices, which is kind of new for the world of migraine. I think it was there's been one class of medications that has come out ever for the treatment of migraine or that was specific to treatment of migraine, and those are the tryptan medications in the early 90s. Uh, since then, you know, the it's been lacking, so it's exciting to see all the new advances that are are coming and are available to patients.
SPEAKER_03For those of us who are fortunate enough to have never experienced a migraine headache, can you tell us how your patients describe it?
SPEAKER_00Yeah, I can tell you how my patients describe it. I've never had one personally, so I can't comment on a personal experience. However, you know, migraine is typically moderate to severe pain, but does not have to be. Typically it's one-sided, but not always. Um we often see that patients become really sensitive to the light, to sound, to smells. They can become really nauseous. Oftentimes they don't want to move. Movement, standing up, any of those things can really exacerbate the pain. So often patients are retreating to you know a dark, quiet room when possible. They also typically experience a throbbing type pain. But with all that being said, it is very variable in how how each individual has their disorder. So some people it's more in the front of their head, some more in the back, some on one-sided, or some are both, sometimes the whole head. So it can be variable, and I think that's one of the difficult points with migraine. One of the biggest things is that it it's not just head pain itself, that it actually is almost like a whole body experience with migraine versus just, oh, it's just a headache, but it's really so much more than that.
SPEAKER_03It completely takes you over.
SPEAKER_00Or can it does, and I often describe it as the difference between having, you know, the common head cold versus having flu. So even though, you know, you list off some of the symptoms and they sound similar, but when you experience it, it is a very different animal.
SPEAKER_03Right, and can really knock you out.
SPEAKER_00Yeah.
SPEAKER_03I'm curious, in diagnosing migraine, is this something that can be seen on an MRI? Are there diagnostic tools?
SPEAKER_00Not really. The true diagnosis of migraine is via uh, you know, history only. What we do is depending on symptoms and onset, we may do imaging or check labs or check other things to rule out secondary causes of headache, things that you know may mimic a migraine. Um but usually there's nothing that we can see on a picture or anything that will tell us if it's migraine or not. We rule out some of the bad things, and if there's nothing else there and the history fits and meets criteria for migraine, then it's migraine.
SPEAKER_03Dr. Gill, can you tell us who's most at risk of migraines?
SPEAKER_00So as far as risk, I mean typically it's more common in females, so it's a three to one ratio between females to males who get migraine. Um, it's often affecting females at a younger age, so looking at teens, twenties, and sometimes early 30s, that it starts to present itself. We see it more often in the Caucasian population. And it also seems to run in families. So if you really delve into it, usually there's somebody else in the family that has either migraines or some type of headache disorder, and we'll see that persistently through families, uh, especially on the maternal side.
SPEAKER_03So you mentioned women and a particular age group. Do they tend to get into that risk factor when hormones kick in?
SPEAKER_00Yeah, so prior to puberty, the ratio of migraine prior to our preprecent age is equivalent male to female. So we see just as many migraines in females as we do males, and as they start to hit puberty, it certainly becomes a lot more common in females. We think it is hormonally related as we know there's a lot of estrogen receptors in the brain, and especially on the nerve in the brain called the trigeminal nerve, which is our pain-sensitive nerve in our head and face, and we often refer to it as the migraine nerve. So we know that there's a role of hormones and it's consistent with that change in life. And on the flip side, some women actually do better after they hit menopause. So their migraines can sometimes go away after they hit menopause.
SPEAKER_03Okay. One upside to menopause. Yeah, there's not many, but that is one. Dr. Gill, we discussed the personal struggle with migraine, but describe the ripple effect, the toll it can take on family members, friends, colleagues, and even beyond.
SPEAKER_00So for each individual, uh migraine can be extremely debilitating and it it does boil down to how frequently the attacks come, how predictable they are. Uh for some people uh during a migraine attack, they can be completely dysfunctional. They're bedridden, they like I said, they retreat to a dark, quiet room. Um and given the nature that it can occur at any time, uh somebody who even has three or four migraines a month can I mean if those d days occur when they are at work or, you know, a primary caregiver to uh young children, uh it can cause extreme uh dysfunction in their life. Um oftentimes people will avoid making plans because they don't know when that migraine is coming and then they have to they get sick of canceling on their friends and family and always needing a backup. Uh oftentimes it puts a lot of stress on them at work because their coworkers are constantly dealing with them, either missing work or not being present at work. So sometimes people have what we call presenteism where they're actually there, but due to the migraine, they're not actually there, they're not functioning, they're just physically at work. The other big thing with migraine is the time that it actually hits. So versus, you know, things like strokes, which are very debilitating and can cause a lot of dysfunction. The difference with migraine is that it happens, you know, typically earlier on. So, you know, if we talk about that age twenty to thirty, this is a huge time frame when people are going to college and higher education, uh, starting their careers, starting their families, and where we're supposed to be the most productive times of our lives, and oftentimes people are, you know, having the debility of migraine really sets them back. And if we look at it worldwide, it's actually the second leading cause of years lived with disability around the world. So that means that maybe it's not as disabling as maybe another condition. However, when you look at the the longevity of it over time and the amount of it, it is the second leading cause. Back pain would be number one, um, but when we look at, you know, those are two big pain disorders that wear are way at the top of the list. The other impact is financially. So if you look at how does that affect a family or um an individual as to their income, how does that affect, you know, the employer as far as missed days of work and what they're paying out? So there's a huge financial burden both on the individual, the family, as well as the economy in general due to the disability that migraines cause.
SPEAKER_03Such a toll it takes on so many different levels. You know, the spouse or young children who uh migraine sufferer might be caring for, as you said.
SPEAKER_00Yeah, it it is very it is very tough because often the spouse or family members are are picking up, for lack of a better term, the slack that the person's not able to accomplish the same tasks that they normally would. And, you know, even the interaction, you know, so many people come in and they say that they're unable to attend their child's sporting event or play that they're involved in, or if they are home watching, you know, the kids in general, they're not very present. You know, they may be laying on the couch and just trying to tell the kids to be quiet. And that's really it does take an impact on the especially the relationships and oftentimes children are having to do more than there should have to at whatever age they are to help out around the with the family.
SPEAKER_03So what can someone suffering like this do? What's the first step they can take in getting their migraines diagnosed and hopefully treated?
SPEAKER_00Well, you're exactly right. The first step is to get diagnosed. So you may or the primary care provider um or a general neurologist or even um here in Connecticut, you can easily get in with one of our multiple locations of with the headache center to get diagnosed appropriately, whether this is migraine or another headache disorder, um, or is this secondary to something else? And you know, when we see a patient here, we're again looking at more than just the diagnosis of migraine, but what may be contributing. So we'll look at things like sleep, diet, exercise, hydration, caffeine intake, mood disturbance if people have some underlying depression, anxiety, or any other mood disorder. All of these are important to be addressed so that you know we're taking away from what may contribute to migraine. The other big piece of the puzzle is looking at hormones. So for females, we do really like to identify whether their headaches are at all related to their cycle and when they are, you know, addressing those separately because they're often more difficult to treat than your migraine that may occur outside of your menstrual cycle.
SPEAKER_03Right. And do you see an increase in migraine perhaps during pregnancy or postpartum?
SPEAKER_00So the one good thing is actually during pregnancy, 70 to 80 percent of women um their migraines decrease or stop. So the first trimester sometimes that they're still there, but usually by second trimester, um the migraines have stopped, which is really great because many women that suffer from migraines are very nervous to get pregnant based on the amount of medications that they take and that they don't want to expose a baby to that as as they're pregnant. Postpartum, typically we see very quickly that the headaches return to their previous baseline. You know, and it's you're battling a couple of things. Some women do a little bit better during breastfeeding, but most women are go are starting to get back into their pattern on top of just the stress and sleep deprivation. Sleep deprivation, yeah, that happens um, you know, with a newborn. And that that obviously can exacerbate headaches as well. But certainly, you know, some women still have headaches through pregnancy, and regardless that there are treatments available, you know, even though it's limited, it's more limited during that time, there are treatments available and uh people should still seek help from whether it's a neurologist or headache specialist.
SPEAKER_03Okay, and hopefully if you're suffering from migraine, hopefully you've come forward, you're getting diagnosed. You touched on lifestyle changes. We were talking a little bit off the air, and you mentioned you really like looking at that holistic approach. What are some other tips maybe you could share with us about preventing migraine?
SPEAKER_00So there's two main courses of action with migraine. There's abortive treatments and then there's preventative treatments. And preventative, you can look at medication or supplements, and you can also look at lifestyle. And I think it's important to address kind of all those three pillars. And lifestyle, I think, is one of the most meaningful changes that people can make because you're looking at the overall health of a person. So caffeine is probably one big thing. You know, caffeine can certainly help with headaches, but frequent caffeine use can actually cause headaches to be more frequent and sometimes more refractory.
SPEAKER_03Could I pause you there just for a moment? Because I know some of the over-the-counter migraine labeled migraine medicine contains caffeine, correct? Yes. Okay. So maybe a heavy coffee drinker may want to take caution with that. You you don't want to overdo it with the caffeine, that's not necessarily going to help you stave off that migraine or help the pain.
SPEAKER_00Yeah, so the the American Headache Society recommends 200 milligrams or less of caffeine daily, which is about two strong cups of coffee. However, my my personal take on it is that some people, it's a very individual basis. So my kind of rule of thumb is if you miss your daily dose of caffeine and it causes a headache, that's probably too much for your brain. Your brain is becoming hypersensitized to the caffeine and requiring it to maintain just almost like a sense of normalcy without pain. With the over-the-counter caffeinated products, we do know that caffeine can help treat a migraine. And for somebody who is having infrequent migraines, you know, a couple times a month or less, those products, if they work, are perfectly fine given that they're not having too much caffeine in their daily diet. But oftentimes what happens is the the headaches are becoming more and more frequent. You start taking the medicine more and more frequent, and you get into the point where you're actually getting into a caffeine overuse situation and the headaches are now that you're requiring you're now requiring that medication, otherwise you develop a headache.
SPEAKER_03Okay. Just like becoming dependent on coffee, because I am one of those people. I drink a lot of coffee and and if I don't, I do not suffer from migraines. But if I don't have coffee, I do get a headache. Would you suggest people who experience that maybe try and taper back on the caffeine a bit?
SPEAKER_00Yeah, um, it's something that I noticed in myself. I was not a caffeine drinker and residency kind of put me through the ringer and I started drinking a day just one daily cup of coffee and realized if I didn't have it on the weekends, I would get headaches. And I kept, you know, trying to figure out why, and I realized as soon as I stopped the caffeine, yeah, I had a couple days of headache and I don't have migraine, so it wasn't unbearable. But then I stopped getting frequent headaches. And I do think that everybody's an individual, so some people experience that more, and some people it's not a problem. They can drink two pots of coffee a day and they have no problems whatsoever.
SPEAKER_03So getting back to some more preventative tips and lifestyle changes, can you lend some more insight for us there?
SPEAKER_00Yes, hydration is huge. So dehydration is the number one cause of headache worldwide. So certainly we notice that if people are not taking inappropriate fluids, specifically water, that you know they may be more prone to headache, especially somebody who is already prone to migraine. Their hydration is really important. And, you know, I often recommend that people don't try to fill that in with any sugary beverages. And certainly, actually, caffeine will inevitably dehydrate you more than it will hydrate you. So the more caffeine you drink, the more water you need to drink to compensate for that. And the next big problem is sleep. So oftentimes people are just, especially in in our world now, people are just not getting enough of it. So we really need to get that seven to eight hours of quality sleep. And this can be a huge difficult hurdle for a lot of people to overcome because of a lot of things that can affect the sleep. But the simple things that people can do on their own is really develop appropriate sleep hygiene. Sleep hygiene entails having kind of a strict routine for going to bed and taking away things that negatively affect sleep. So I always recommend people eight hours a night, that your head is on the pillow from start to finish, that you have a routine where you start turning off electronic devices, dimming lights, cooling down the home, you know, up to an hour before your desired sleep time. And have that routine of how you get ready for bed, whether you're shower at night or you know, brush your teeth, or get ready for the next day. And that way when your head hits the pillow, your your brain starts relating that to sleep. Also, one of the big problems in today's society is screens. So the the screens have a lot of uh blue light to them, and that blue light is very activating to the brain, and the more that's activating, the harder it is to get to sleep. You know, our brain goes through different rhythms, and when we sleep, it goes into a very slow rhythm, and that is the opposite of what blue light does. So that light will, you know, whether it's from a tablet, computer, phone, TV, often really interrupts that sleep. Does that mean that everybody should avoid screens before bed? Probably not. Some people do just fine, but if you are having difficulty with sleep, really turning those screens off and getting the TV out of the bedroom. You know, I recommend no TV in the bedroom, putting your phone across the room or another room, and using a regular alarm clock if you need one and kind of allowing that brain to kind of quiet down. For some people, they like the noise of the TV, in which case, you know, I recommend just a white, white noise. You know, the noise of the TV goes up and down. Again, that's very activating to the brain. So sleep hygiene can be really, really huge for a lot of people. And that is actually what we find is number one treatment in regards to insomnia and sleep disorders.
SPEAKER_03And would you say that is one of the top triggers of migraine, lack of sleep? Or you you mentioned dehydration too. That's a big one.
SPEAKER_00Dehydration is huge, but yeah, sleep disturbance or or not getting in a sleep is huge. The one thing that is kind of confounding to that is that we also know that as somebody is developing, as their brain is starting to go into that process of having a migraine, that alone can cause sleep disturbance. So I think it's different between, you know, the sleep disturbance, what's part of the migraine versus the sleep disturbance of just our routine life. You know, you know, some people coming in that routinely only got four to five hours of sleep. It's different times of the day. You know, they're drinking coffee before bed. Those types of things, I think there's a difference. So I think having a good sleep hygiene can be a great preventative change to decrease the frequency of having your of having migraines or just headaches in general.
SPEAKER_03Is there a benefit to keeping a diary if you do suffer from headaches or migraine? Does that help you, the physician, help maybe determine some triggers?
SPEAKER_00Yes and no. So there's two pieces to this. Certainly keeping a diary of how many headaches you're having helps with us to diagnose what type of migraine you're having as well as you know when making whether it's a lifestyle change or or starting on treatment, whether it's working to see the difference in the numbers of headaches and and whether how s significant they are. As far as triggers I think if you ask multiple headache professionals you're going to get a couple different answers. There's the piece that some some folks actually become overly obsessed with triggers and they start documenting everything and they start analyzing everything they do in life and almost put themselves down because of the simple things that they're doing they feel are triggering their migraines. So there's two pieces to that in regards to they end up spending a lot of time documenting and not enough time living. And then the anxiety around that can actually then lead to you know they becoming obsessed over those things can actually worsen headache. But there is a piece to it that's true. If we can get a good sense of what triggers are and ones that are easily modified or avoidable it can be helpful. So I think there's a healthy balance between that. The other thing is there will be some people in the headache community that will argue that some triggers are not necessarily triggers that they're actually the changes that are happening in the brain before migraine cause you to have different symptoms, one of which is certain food cravings or you know like we I mentioned before sleep disturbance. So things that we typically thought were triggers maybe are actually just part of the process of migraine in and of itself.
SPEAKER_03Explain that a little bit are you saying that if you tend to crave a certain food before a migraine sets in?
SPEAKER_00Yeah so there's a huge debate about this that is it so we know that prior to actually having the pain or symptoms that people normally relate to migraine that there are certain areas of the brain that start to become overactive. One of which is the hypothalamus and the hypothalamus controls food cravings, it controls urinations and some of our sleep wake cycle is part of are part of that. So there is a big debate is are the food cravings that people have due to the activation of the hypothalamus or is it that they eat said food and get a migraine and I think as as they've looked at it closer, I think more and more people are starting to realize that some of those food triggers may not actually be triggers, that they're food cravings. So you crave the food, you eat it, you get a migraine but it's a it's a definitely a difficult thing to differentiate between the two that there are some true triggers for some people and some of the more common ones are MSG nitrates, uh red wine some of those things I think are common. Chocolates I think in the debate as to whether you get a craving or not and there is some sometimes there are ways to to really look at that and but it can be really difficult to do.
SPEAKER_03So now that makes me wonder could such cravings be a benefit if you feel one of those cravings coming on could that be a signal to take action to perhaps stave off that oncoming migraine?
SPEAKER_00Yeah so the the phase that we're talking about is called the premonitory phase of migraine or prodrome and some people have very profound changes. It can also be mood, yawning, increased urination as well as food cravings and when that prodrome hits some people once they become aware of it can really identify that you know my migraine is going to start within hours or for some people it's a couple of days and they can start making changes. There's not a lot of research yet as into what can we do in that phase. I think it's it's it's something that has intrigued a lot of folks and we're starting to look at it more but I don't think we have any evidence. But it may be time that we could initiate whether it's a medication or some type of treatment during that phase that will stop the migraine before you actually get the full blown symptoms of the headache and all the other symptoms that go with it.
SPEAKER_03Okay. And can you talk a little bit about the aura headache? Is that something different or is it a s is it a type of migraine?
SPEAKER_00So it is different than the prodrome about 20 to 30% of people and more commonly females experience some type of migraine aura. For most people for 90% of the time it's a visual aura so usually it's flashing lights or zigzaggy lines or different colors or spots in their vision. For some people it can be loss of vision. Other people will have sensory changes or speech changes. Rarely people will get motor changes. Typically with aura we see it occurring just prior to the head pain so usually five to sixty minutes before the actual headache starts but it can actually occur during the migraine itself so it can be difficult. There are slightly different risk factors with migraine with aura than there is with migraine without aura so migraine with aura does increase the risk of a stroke a small amount and also you know so we may question of whether to use hormonal therapy for those women if they have migraine with aura but that's certainly a discussion to be had with your physician.
SPEAKER_03Can you talk a little bit about treatment options now? Every few years I seem to come across a new option Botox injections for example what are you looking at?
SPEAKER_00Preventative treatment deals with the fact that you either take something every day or do something on a routine basis to decrease the chances of you getting headache. Some of our mainstays are certain medications or supplements like magnesium, riboflavin. We'll also use anti-seizure drugs like toparamate or zonisamide. We also use blood pressure medications, mood medications, and these are kind of some of the older treatments that we've used and in the last few years is when we've started to get some more treatments that deal with more migraine specific modalities. So these are new injections that you do once a month to help prevent the migraine. Botox is has been around for a very long time and was used in headache I think as early as the 80s or 90s but did not gain FDA approval I think until it was either 2010 or 2011 that we were actually able to use Botox as a preventative treatment on label that was you know FDA approved for the prevention of migraine. With Botox we can only use it for chronic migraine which the difference between epathotic migraine and chronic migraine is just whether or not you know how frequent the headaches are occurring. So chronic is typically happening 15 days a month or more versus epithodic which is less than 15 days a month. And Botox can be a great option for many people and with injections that we do every 12 weeks and can really bring down the overall sensitivity to the brain and allow the migraines to be less frequent and or less severe. Overall that's our goal for prevention in general is decrease the severity of the migraines they do get, decrease the frequency as they come and hopefully when they do have one allow their acute medications to work a lot faster.
SPEAKER_03You had touched on magnesium before are there supplements that someone suffering from migraine should consider taking more of is that something they need a doctor to really go over with them?
SPEAKER_00As far as supplements there are a few that actually have been found to have benefit for people with migraine so magnesium, riboflavin which is vitamin B2, CoQ10, fever few, and butterbur have all had at least some level of evidence in headache. I think it's always recommended to at least discuss it with your doctor some of them specifically the butterbur can have health complications and or side effects in themselves. So I think you know even though there's stuff that you can get on your own I think it is always good to have the conversation with your doctor with the supplements and they are things that we always want people to take for at least a few months to determine whether it's helping once again we are talking to Dr.
SPEAKER_03Nicole Gill, a headache specialist with Hartford Healthcare's IR Neuroscience Headache Center in Cheshire, Connecticut and this is our episode one in a two part series in part two we will be getting into a lot more detail about preventative and acute treatment for migraine including some exciting new medical devices on the market with one of Dr. Gill's colleagues neurologist Dr. Joe Cassley So Dr. Gill you have a passion for migraine and headache disorder and raising awareness about it. Can you tell us a bit about your role there?
SPEAKER_00So I'm part of the the Alliance for headache disorder association. So we go every year to uh Washington DC to lobby for something to do with you know whatever the topics may be that year looking for increased funding for headache disorders because that's one of the big problems is the lack of funding that headache has received in the past from the NIH. They may be also asking for looking at revamping the disability criteria for migraine oxygen for cluster headaches. So there's there's kind of a team of people that sit down and kind of decide what are even though we need a lot of things what are the top one, two or three things we really need to ask Congress for.
SPEAKER_03Okay.
SPEAKER_00So a part of that and then there's the migraine summit that is really trying to promote educating patients and families. There's things like miles from migraine which our clinic has was going to take part in kind of did this May but COVID kind of put a kibosh on it that help raise money for headache education specifically more for practitioners to learn more about headache. And then there's multiple associations that are developing that help with patient friendly information. CHAMP is a great group that they kind of bring together all of the different resources for headache disorder. So there's different websites on there and stuff like that. And so there's more and more people joining groups like this to get information. A couple other really good resources um the National Headache foundation has a lot of resources that are great for for patients. So a lot of this brings just more knowledge to people about migraine and headache disorder and then there are some groups that are more um about bringing people together. Shades for migraine an association that's really trying to raise awareness. It's really refreshing to see more of these groups getting out there and touching more and more people so that people realize they're not alone and that they're not crazy. I think that's one big problem is that uh many patients suffering from migraines and headaches have been made to feel like they're either not doing something right, the pain is just in their head, or they're being dramatic.
SPEAKER_03Yeah.
SPEAKER_00Yeah that they're being dramatic, that you know let's just suck it up, it's just a headache, you know, a lot of the stigma that's around migraine can be really hurtful and prevent people from actually getting better. So it's just getting to be more and more wonderful resources for people to learn about it. There's some great folks out there that are that are putting their their stories in their life online through blog posts and stuff or on social media to bring awareness of what their day-to-day life is like that they have good days, they have bad days and what those bad days are and what it is like. I think it really empowers people to see other people suffering and having similar symptoms that they may have and to hear how some people have overcome that or how some people are working through that and learning to still live a positive life and that that is possible.
SPEAKER_03Thank you, Dr. Gill. The team of specialists with the Hartford Healthcare IR Neuroscience Headache center see patients in West Hartford, Cheshire Mystic, Norwich and Stamford for more information go to Hartfordhealthcare.org slash headache or call for 860 6962925. Also be sure to listen to episode two in our two-part headache series featuring Dr.
SPEAKER_01Joe Casley we'll talk about headache treatment, cluster headaches, new wearable devices on the market, and more don't forget to hit the subscribe button thanks for listening to more likes on ready to be a little bit