Headache and Migraine Relief with Dr. Dorlyne Brchan, Pediatric Neurologist & Headache Doctor
Dr. Dorlyne Brchan, MD Bio:
Dr. Dorlyne Brchan was born in Los Angeles, California and is a graduate of Xavier University of Louisiana. She obtained her medical degree at the University of Iowa Carver College of Medicine. Her residency was at the University of Colorado/Children’s Hospital Colorado where she completed both her residency and fellowship in Pediatric Neurology. She then moved to Fairbanks, Alaska where she served as only one of two pediatric neurologists in the state with a special interest in treating headaches in both children and adults. She decided to further her training at Children’s Mercy Kansas City where she completed her fellowship in Headache Medicine.
Dr. Brchan is a member of the American Headache Society and the Child Neurology Society. She was also awarded a delegate of the International Headache Academy in 2021. Furthermore, she has had the privilege of providing education and promoting advocacy to families and parents through Miles for Migraine. She is board-certified by both the American Board of Psychiatry and Neurology and the United Council for Neurologic Subspecialties. She has a special interest in adolescent care, complimentary and integrative management, as well as procedures in headache medicine.
Dr. Brchan also serves her family as a devoted Army wife and mother of two young daughters. She has had the unique privilege of traveling the United States and, therefore, gaining diverse experiences in medical organizations and communities. She is a Christian which forms the foundation and backbone to all her values, goals, and pursuits. She deeply loves and cares for all those she has the privilege to know and serve.
1. Why do we get migraines?
· The most common type of headache is generally tension-type headache, at least in the pediatric population. However, the most common primary headache disorder prompting medical care, is migraine. Migraine is a very specific type of headache that involves much more than pain in and around the head. It often involves nausea and/or vomiting, light/sound sensitivity, worsened pain with movement, sensation, or movement problems, and more.
· Very common:
o According to the 2017 Global Burden of Disease Study, migraine is the 2nd most common disease globally and can affect quality of life as much as cancer, diabetes, and arthritis.
o 1st leading cause of disability in people < 50 years old
o Just a decade ago, migraine cost the United States almost $20 billion annually. So it is critical to approach this aggressively and with the best treatment approaches we have available.
· Numerous causes (influenced by nervous system and other systems – endocrine, reproductive, cardiovascular, immune, and GI system)
o Genetics, environment, comorbidities, hormonal changes, prior pain experiences
o Lifestyle (sleep, hydration, stress, exercise, diet)
o Medications
2. Top methods of treatment (preventative vs abortive)
a. Abortive/rescue medications are used to treat a headache in the moment and involves a wide range of options today including oral tablets, dissolving tablets, nasal sprays, injections, neuromodulation therapies which don’t involve traditional medication at all, acupuncture, and more. For many OTC analgesics can suffice- namely NSAIDs like ibuprofen and naproxen, acetaminophen for some and/or triptans. All of these can be combined with other cocktail medications that treat the headache also as well as associated symptoms like nausea/vomiting.
b. Preventative medications are used to decrease the intensity and frequency of headaches over time. This is a critical treatment approach because many migraine sufferers have more than 4-6 headache days per month, migraine-related disability, and/or overuse pain medications which is the criteria for needing a preventative medication. More than ever before, treatment options for prevention are lengthy and diverse and can be tailored for each individual patient. It includes medications in the seizure class, antidepressant class, blood pressure or antihistamine categories. Our newer class of CGRP therapies are very migraine-specific and can include tablet, mostly monthly injections or Q3 monthly infusions. Botox is a well-established treatment as well given every 3 months. We can also use nerve blocks, acupuncture, and neuromodulation devices for prevention. Even more potential therapies are likely to come as well.
3. Nutrition and the microbiome-gut-brain-axis
a. Wow, this is a BIG topic and can be quite controversial also. The big picture is that our body can be WELL equipped to heal and treat itself, including pain. Many of the nonmedication options we use is to high-jack our bodies OWN pain-fighting mechanisms to treat our headaches. For the same reason your car runs better when you get regular maintenance, proper oil and gas; if we do not give our body the right things, it cannot work as well for us. Now certainly there are many healthy people who still suffer from debilitating pain so we know that there are other factors involved such as autoimmune conditions or cancer when some of our body systems go haywire and start attacking itself. That could also be why migraines are so much more strongly associated in individuals who have autoimmune conditions. There are also pro-inflammatory conditions such as obesity and stroke that adversely affect our body’s ability to manage pain. So if we really want to treat headaches from all angles, we MUST also treat properly screen for/diagnose and treat autoimmune or other health problems, and optimize our health as much as we can. This is the overarching theme of the microbiome-gut-brain axis. Also our mitochondria is the energy center of our cells and many of our medications work on the mitochondria, improving it’s efficiency and help protect against oxidative stress
b. Statistically obesity increases risk of migraine by 50%, similar to that seen in heart disease. In fact, patients with a BMI > 40 have a 3-fold higher risk (275%) of having migraine. Also, lack of exercise increase migraine attack risk by 21% in adults and 50% in adolescents. Obese migraine sufferers are also more likely to have a chronic migraine pattern which is > 15 headache days per month.
4. Non-medical side to pain (biblical worldview) – see above.
a. First off, it’s important to talk about the root of this question. And that is why we have disease at all, right? Genesis 1:27 and James 3:9 state that we are made in God’s image. So, does that mean that we are meant to have pain? Well, no – that was not God’s intent for us. Pain and death was introduced as a result of sin. Adam and Eve sinned in the garden and introduced pain and death into the world. That fall did not remove God’s image from us, but certainly distorted it. That’s the bad news. The good news is that God had a redemptive plan to redeem us and we can look forward to a future where we are fully restored to Him. Revelation 21:4 says “and God shall wipe away all tears from their eyes; and there shall be no more death, neither sorrow, nor crying, neither shall there be any more pain: for the former things are passed away.”
b. Headaches, and frankly any kind of pain, is not just a physical reality. The physical is a bit part of it, sure. But it pain is in the BRAIN which comes down to a processing reality. Pain is also greatly impacted by how we view/perceive our pain and our spirit (namely how we view ourselves – the big picture). In order to properly treat headaches, we address the physical as we’ve discussed so far. But we also address these other areas as well. I would argue that understanding the big picture of pain is most important of all in order to improve function and give purpose to our lives.
c. There’s a treatment strategy used often in headache management termed behavioral headache management. It includes things like hypnosis, relaxation, mindfulness, biofeedback and something called cognitive reframing – a part of cognitive behavioral therapy. There is good evidence supporting these interventions for headache relief and involves a person’s perception about the pain experience and how that directly influences the experience of pain. A lot of the psychological approach to this, though involves the SELF such as “Have I gotten through this before?” or focusing on self-worth, self empowerment, etc… These approaches can feel good in the moment or for a little while but must be pulled out often and are incredibly dependent on feeling and putting a lot of faith/focus in ourselves. This is going to sound very abrasive and radical but as Christians, that is really the opposite of Biblical truth. True empowerment, worth, and purpose is in our POSITION through what Jesus Christ has done for us. It is completely independent of a feeling or effort on our part. When we let ourselves down, which we DO, we don’t lose ground because our faith/hope is not in our perception of ourselves but in WHO we belong to. THAT is ultimate freedom, peace and joy. There are, to my knowledge, no treatment approaches that approach headache cognitive reframing from a biblical perspective; and many Christian migraine sufferers or Christians with any degree of pain/suffering miss this and struggle finding purpose/function that can be life-giving for them. And that is one of the goals I have, Lord-willing, for my patients and for a headache coaching program.
Schedule a call with Dr. Brchan, MD or me, Dr. Anna, MD to learn more about the program! Just a few minutes with us to see if we’re a good fit. Totally judgement and commitment-free!
Email us: Hello@healthispowher.com
Or Sign Up For a Free Call Here: https://calendly.com/healthispowher/15min
Headache coaching program:
- 8 weeks long
- 8 weekly calls with group + 1-2 fifteen minute touch-base sessions; then 1:1 session
- Teach neuroscience of pain
- Pain re-processing therapy (Cognitive reframing from Biblical worldview); negative thoughts to become aware and focus on positive; mindset; growth from stagnant using neurolinguistic programming
- Gut health and nutrition; immune health, sleep, mind-body therapies, relaxation, meditation, and more.
Because this is a Biblical approach method, it is quite contrary to current secular treatment approaches, we’re trying to provide this treatment approach ourselves without the ability to have financial backing of a specific medical organization. Our goal is to make it as affordable as possible and are praying about what God may do in the future to make this treatment approach even more accessible over time. We are trusting Him to provide the means for this to not only provide physical healing options but; most importantly bring our patients to the ultimate healer of all, Jesus Christ and tend to the proper nourishment of our relationship with Him and who we are in Him.
Disclaimer:
Anna Esparham, M.D.is a medical doctor, but she is not your doctor, and she is not offering medical advice on this podcast. If you are in need of professional advice or medical care, you must seek out the services of your own doctor or health care professional.
This podcast provides information only, and does not provide any financial, legal, medical or psychological services or advice. None of the content on this podcast prevents, cures or treats any mental or medical condition. You are responsible for your own physical, mental and emotional well-being, decisions, choices, actions and results. Health Is PowHer, LLC disclaims any liability for your reliance on any opinions or advice contained in this podcast.