Home is where the head heals
Hundreds of people a week are heading to hospital with migraines or headaches in Queensland, but experts say home is the best place for most of them to recover.
Department of Health data shows 10,156 people were admitted to public and private hospitals for the conditions in 2018.
Of these, 4715 patients were diagnosed with having migraines. The remainder had headaches or other headache syndromes.
“A key red flag for a more serious headache is when the pain comes on very rapidly, instantaneously,” Royal Brisbane and Women’s Hospital neurologist Dr Claire Muller said.
“These are what we call thunderclap headaches and can be associated with bleeding in the brain or spasms of blood vessels in the brain. A thunderclap headache warrants calling an ambulance.
“Severe headache with fevers, neck stiffness, confusion, drowsiness and/or vomiting should also prompt presentation to an emergency department.
“Likewise, patients who experience significant changes in vision with a new headache and signs of swelling behind the eyes, which can be detected by GPs and optometrists, should present to emergency.
“A good general principle for migraines and headache is to seek medical advice when the symptoms are entirely new for the individual – something they’ve never experienced before – or different to headaches they’ve previously experienced.
“Many of these could initially be seen and reviewed by a GP.”
But Dr Muller said the best environment for people with migraine or headache to recover was home.
“A hospital is the best place to be treated but not the most ideal place to recover,” she said.
“The environment is bright, noisy and you won’t get a good night’s sleep.
“As soon as the migraine patient has had other more sinister problems excluded and once they can eat and drink enough without needing a drip, they should recover at home in a dark, quiet environment.
“During business hours, GP practices often have the capacity to rehydrate and treat patients suffering a severe migraine.”
The number of people seeking treatment at hospital for migraine or headache has risen in the past three years.
In 2017, 4911 people were admitted and in 2016, 4814 patients were hospitalised.
Dr Muller said prevention was key for migraine sufferers.
“The mainstay of prevention is getting good quality and quantities of sleep and staying hydrated,” she said.
“Keeping a headache diary can help identify personal triggers, be it various foods or beverages. Stress, poor sleep, poor diet and poor lifestyle habits can exacerbate migraines.
“Medication taken regularly to prevent migraines is needed for those who suffer frequent migraine attacks. Rescue medication, migraine-specific medication at the earliest signs of a migraine can prevent one from building up all together.
A Deloitte Access Economics Report released in 2018 assessed the burden of migraine, finding the economic cost of migraine to Australia is $35.7 billion, including $14.3 billion in health system costs; $16.3 billion in productivity costs; and $5.1 billion in other costs.
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