iHEADACHE CANNOT DIAGNOSE YOUR HEADACHES. ONLY A PHYSICIAN CAN MAKE A HEADACHE DIAGNOSIS AFTER EXAMINING YOU AND RULING OUT OTHER CAUSES OF YOUR HEADACHES. THE ADVICE BELOW ASSUMES THAT YOUR PHYSICAN HAS DIAGNOSED YOU WITH A PRIMARY HEADACHE TYPE SUCH AS MIGRAINE, TENSION, OR CLUSTER HEADACHE.

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While there are no hard and fast rules, Dr. Brian Loftus, Chief Medical Officer at BetterQOL and a neurologist in private practice at Bellaire Neurology offers the following recommendations for patients to maximize the benefit of usingiHeadache to optimize their headache care.

First of all it is important to try and enter all of your headache information at the time the headache is occurring. If you wait and enter it later you will likely forget or overlook something. At the end of the headache or the end of the day, review the headache entry and make sure the information is complete. This is particularly important for your disability time and partial disability time.

While iHeadache cannot make a headache diagnosis and all patients need their headaches evaluated and diagnosed by a physician at least once, iHeadache can provide useful information concerning the potential accuracy of your diagnosis. The system analyzes your headaches to see if the symptoms are compatible with migraine, tension, or probable migraine headache types. Cluster headaches are currently not included since there is no benefit to tracking symptoms of cluster headaches but iHeadache can still be used for headache counts and disability.

Once you have three months or more of data, take a look at your headache reports over the last three (3) months or so.

• How many days per month do you have headaches?
• How many days do you have migraines and how many days to you have probable migraines?
• How many days do you have other types of headaches?

Learn more about Headaches

Use the chart below to learn more about specific types of primary headache disease.

Chronic Migraine	Chronic migraine patients have headaches 15 days per month with at least 8 days of the headaches being actual migraines (averaged over 3 months).
Episodic Migraine	Episodic migraine patients commonly have headaches that are tension headaches and probable migraine headaches. For treatment, they can all be considered part of the migraine headache disease process.
Tension Headaches	If you have been diagnosed with tension headaches, then none of your headaches should be migraine or probable migraine. If they are, then review options with your physician for taking therapy specifically for migraines.
New Daily Persistant Headaches	Every day you have a headache and they are all tension type headaches. The headaches began on a single day and continued daily from the very first day.
Infrequent Tension Headaches	Tension headaches occuring less than once monthly on average (over one year).
Frequent Tension Headaches	Tension headaches occurring between one and 14 days per month (averaged over 3 months)
Chronic Tension Headache	Tension headaches that occur more than 15 days per month (averaged over 3 months).

Are you sure you don't have migraines?

In one study where headache experts first diagnosed patients with frequent disabling tension headaches, 30% of them proved to have migraine with real time diaries.

Think you have sinus headaches? The "SUMMIT" study analyzed over 3000 patients who presented to their primary care physician (98%) with self-diagnosed or previously physician diagnosed recurrent sinus headaches. Of these, 88% had either migraine or probable migraine. Only 8 had sinus disease. Click here to read more about sinus headaches.

Medications for treating migraines are given to patients who get disabling headaches of any type as long as some of their types of headaches are migraines. If you are not on migraine specific medications and your reports indicate significant disability from your headaches each month, then please ask your physician for this medication.

Do you need headache preventatives?

Use reports from iHeadache to determine if headache preventatives (also known as headache prophylaxis) are needed. If you have significant disability despite best efforts to treat your headaches or if your headaches are more frequent than once a week, then consider a headache preventative. Common medications used for headache prevention include Topamax® (topiramate), Inderal® (propranolol), Elavil® (amitriptylene) and others. Click here to read more about common preventatives.

Choosing appropriate prevention depends both on the headache type as well as your individual treatment preferences. You and your physician should take into account the following factors:

• Efficacy data for your headache type
• Side effects of the medication
• Cost
• Comorbid diseases (other diseases you have besides headache)
• Personal preference (types of medications you may which to avoid)

If you are already on a preventative and need to determine if it is working then use iHeadache to break reports by months, 30 days periods, etc.. Look at a period of time after the new medication is started and compare it to the time period before the preventative was started.

• Are you having fewer days with headaches?
• Are you having less disability?

If you answer no to both of these questions, then either the dose of the preventative is inadequate or the preventative needs to be changed. Typically, a good response to a preventative is a 30% reduction in the number of days you have a headache and 50% reduction in disability. A great response is more than 50% reduction in the days you have a headache and more than 75% reduction in disability.