Friday, November 22, 2013

Tests to question if you are a headache patient

Recently, a friend wrote me that her mother was in the hospital and she and her siblings were having a hard time deciding what procedures to approve.

Been there.

In our family, one rule we have is if a test would indicated a surgery or drug we would not have or take, why get the test?

But The Choosing Wisely campaign (I have written on this before, you are not losing it), a product of the ABIM Foundation, tries to get docs to identify tests that may not be needed for certain ailments.

This time, the American Headache Society has five recommendations that can at least be conversation starters between you and your headache doctor.

--First, patients with stable headaches that are clearly migraines do not need neuroimaging.

--MRI is preferable to CT, except in emergency settings. CT=radiation, MRI=spendy.

--Surgical deactivation of migraine trigger points is not advised unless it's a clinical trial.

--Opioid or butalbital meds are not first-line treatment for recurrent headaches.

--And--prolonged use of over-the-counter pain medications is not a good idea.

For more Choosing Wisely recommendations, go to www.choosingwisely.org. Many more lists are coming out.

Pretty soon, I fear, the feds will try to decide all this for us...

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