Key Questions
- When did your migraine journey begin as a child?
- What happened after your diagnosis?
- What was it like having migraine in school?
- How did your migraine condition change throughout the years?
- Was it sudden or gradual?
- What treatments have you been given?
- As a wife and mother, how do you deal with the guilt that comes with not being able to fully function in these roles at times?
- How did migraine eventually lead to fibromyalgia, depression, and anxiety?
- How did you cope with these comorbidities that often come with migraine disease?
- What have you learned from a naturopath that you wouldn’t necessarily learn from a headache specialist or neurologist?
- Has using a more holistic, naturopathic approach improved your health?
- What led to your advocacy work, and what have you been working on in that area?
Interview Notes
Find more about Jaime Sanders and her work here:
Key Questions
- How do you fight the stigma that people with migraine are weak or lazy or even faking it?
- How does presenteeism come into play with migraine?
- Why should an employee tell an employer about a migraine condition?
- When is the best time to inform your employer that you suffer with migraine?
- What is the Americans with Disabilities Act (ADA)?
- Does migraine qualify as a disability under the ADA?
- What is a “qualified individual” with disability?
- What is required for people with migraine to be considered for disability under the ADA?
- How can people with migraine benefit from accommodations in the workplace?
- If you experience migraine, are you allowed to ask your employer for a flexible work schedule?
- What should you do if your employer is not willing to make accommodations for you in the workplace setting?
- What is the FMLA and how does it apply to migraine in the workplace?
- Can your employer legally terminate you if you are missing work because of migraine?
Interview Notes
Find more about Stacey Worthy JD and her work here:
Key Questions
- How are new drugs developed and approved?
- Why do insurance companies make drug development and approval even more complicated in the United States?
- What are the biggest concerns that doctors and patient advocates have about newly released medications?
- How would you describe patient expectations for anti-CGRP medications before they were approved?
- And now that the first few have been approved?
- What were some of the biggest challenges going on behind the scenes to get CGRP therapies into people’s hands?
- What programs have manufacturers created to make CGRP medications affordable and accessible?
- What big access challenges are coming soon?
- What happens if we do nothing?
- What do terms like co-pay, forced choice, and layered therapies refer to and how might they affect people with migraine?
- What is CHAMP, and how did it come to exist?
- How is CHAMP training and empowering a new level of advocacy in migraine?
- What are some of the ways people can support CHAMP’s work?
- What is your role and challenges as a caregiver for someone with migraine?
Interview Notes
Find more about Kevin Lenaburg and his work here:
Key Questions
- Can you tell us about your first hemiplegic attack?
- What happened after your diagnosis?
- How did it affect your life at the time?
- What are the telltale signs of a hemiplegic migraine attack?
- What is the difference between the two main types of hemiplegic migraine?
- Can genetic testing identify a certain type of hemiplegic migraine?
- Are there specific treatments for people with hemiplegic migraine?
- Is it common for people with hemiplegic migraine to have one of the more common migraine types, as well?
- How is your migraine condition today? What do you do for it?
- How did you get into health-advocacy work, and what was your journey to migraine advocacy in particular?
- What is the American Migraine Foundation (AMF)?
- What is AMF’s biggest challenge and opportunity?
- How can people with migraine get involved with AMF?
Interview Notes
Find more about Nim Lalvani and her work here:
Key Questions
- How does migraine progress from episodic to chronic, and then to refractory headache?
- When changes occur, why is it important to keep a record of the number of days with migraine and the use of acute drugs?
- Why will CGRP antagonists be important in the treatment of refractory migraine?
- How is refractory migraine defined?
- How could incorrect use of onobotulinumtoxinA lead to refractory headache?
- Is inpatient treatment necessary for the refractory migraine patient?
- Why is it so important to be treated by a migraine specialist?
- How will more physicians be trained to treat migraine patients?
Interview Notes
Find more about Paolo Martelletti, MD and his work here:
Key Questions
- Can you can describe several patient case studies that represent different patients in your clinic?
- What do you do with them?
- What is their biggest need?
- What was prescribed? Why?
- How do you develop management strategies for your patients with migraine?
- What are some common themes across these case studies?
- Can stubborn migraine be managed and controlled?
- What role does the doctor need to play in migraine management?
- What role and responsibilities does the patient have in their own migraine management?
- How do you measure success for acute treatments?
- How do you measure success for chronic migraine patients?
Interview Notes
Find more about Rashmi Halker Singh, MD and her work here:
Key Questions
- What is cluster headache?
- How are cluster headache and migraine differentiated?
- For what other conditions is cluster headache often misdiagnosed?
- How are episodic cluster headache and chronic cluster headache different?
- What are cluster cycles?
- What does timing of attacks reveal about the involvement of the hypothalamus in cluster headache and what implications does that have?
- What associations exist between lifestyle factors — such as sleep and alcohol use — and cluster headache?
- What health care provider should treat cluster headache?
- What medications and therapies can be used acutely and preventively in cluster headache?
- Can neuromodulation therapy be helpful in cluster headache management?
- How are grassroots efforts exploring the use of psilocybin in cluster headache?
- What research is in progress in cluster headache?
Interview Notes
Find more about Christopher Gottschalk, MD and his work here:
Treatments Mentioned
- Beta blockers
- CGRP monoclonal antibodies
- CGRP oral treatments (list in online speaker page and summary sheet but not Treatment Directory as these are gepants)
- Depakote
- Eptinezumab (Vyepti)
- Lithium
- Nasal sprays (list in online speaker page and summary sheet but not Treatment Directory)
- Nerve blocks
- Oxygen
- Psilocybin
- Steroids
- Sumatriptan injections
- Topamax
- Vagal nerve stimulator (neuromodulation device)
- Verapamil
- Zolmitriptan nasal sprays
Key Questions
- What makes chronic migraine a different beast than episodic migraine
- What is central sensitization and how does it relate to chronic and episodic migraine?
- How do you treat someone who says they have already tried everything?
- How do you treat someone who is never pain-free?
- What are the risk factors that lead people to develop chronic migraine?
- Why do some people recover from chronic migraine spontaneously?
- What types of migraine improve with age?
- Why do some people’s chronic migraine get better at younger ages?
- How can I participate in migraine research studies?
- How should I keep track of migraine triggers when my symptoms are constant?
- How can migraine triggers be made irrelevant?
- When should someone be hospitalized because of chronic migraine?
- What percentage of people do not get better with adequate treatment, and how do I know if I’m one of them?
- Why are some doctors still unaware of chronic migraine, and how can this problem be addressed?
Interview Notes
Find more about David Dodick, MD and his work here:
Key Questions
- Why are governments and health regulators changing laws and legalizing marijuana?
- Is there a legitimate therapeutic or health benefit of cannabis?
- What obstacles are there for doing research on cannabis, so that we know whether it will work for migraine?
- If marijuana has a legitimate role in medicine, why has it been illegal for so long?
- What is cannabis?
- How is it different or similar to marijuana?
- What is THC and CBD?
- What are endocannabinoids?
- What are common strains of cannabis?
- How might cannabis address migraine symptoms or comorbidities (nausea/vomiting, etc.)?
- Which strains or formulations of medical cannabis seem to be the most effective for migraine relief?
- How is medical cannabis different to “street” cannabis?
- What risks are involved?
- What should we expect in the future?
Interview Notes
Find more about Eric Baron, DO and his work here:
Key Questions
- What is a ditan?
- Is a ditan used for prevention or acute migraine treatment?
- How will ditans be administered?
- How do ditans differ from triptans?
- What is a gepant?
- Is a gepant used for prevention or acute migraine treatment?
- How are these treatments different from existing medications?
- Will they require a prescription?
- How expensive are they likely to be?
- Who is ideally suited to try these new drugs?
- What side effects do ditans and gepants cause?
- When will these new medications be available?
Interview Notes
Find more about Uwe Reuter, MD, PhD, MBA and his work here:
Key Questions
- Isn’t Botox mainly a beauty treatment?
- What exactly is Botox made of and is it dangerous?
- Are people who are using Botox for chronic migraine also getting cosmetic benefits?
- How strong is the evidence supporting Botox?
- How much does Botox cost?
- How common are unwanted side effects of Botox?
- Should I be concerned about the possibility of “frozen forehead?”
- Is Botox treatment painful?
- If I’m scheduled for a Botox treatment and I am having a severe migraine attack, should I still receive a treatment or wait until after my attack has passed?
- If you begin showing improvement after receiving Botox, how long should you continue receiving additional treatments?
- If I don’t see positive effects after the initial round of Botox, should I discontinue use?
- Can Botox lead to depression or anxiety?
- How do you know if your doctor is properly trained in giving Botox injections?
Interview Notes
Find more about Andrew Blumenfeld, MD and his work here:
Key Questions
- What non-invasive neuromodulation devices have been approved by the FDA for the treatment of migraine?
- Are neuromodulation devices safe?
- Does insurance cover neuromodulation devices?
- Do you need a prescription for neuromodulation devices, and if so, does it have to be from a headache specialist or can it be from a primary care provider?
- Do these devices hurt when you use them?
- Can they be used for both acute and preventive treatment of migraine?
- How do I know if I’m a good candidate for a neuromodulation device?
- Can any of these devices be used for cluster headache?
- Are there any side effects from using these devices?
- Are there any new devices due to be released soon?
Interview Notes
Find more about Amaal Starling, MD and his work here:
