Latest News

Posted on September 6, 2016

I wish that I was coming here to announce some major breakthrough in headache treatment. The advances are far too slow for all of us. I will be attending the International Congress on Migraine and Headache next week in Glasgow. … Continue reading

Insurance and Migraine Medications

Posted on August 17, 2016

I thought this was a good resource for figuring this out: Go Here

Can Daith Piercings Stop Migraines

Posted on August 10, 2016

Suddenly one day, about a year ago, patients started to come in saying they had  heard about a new ear piercing that cures migraines. It was all over Facebook and even (from what I’ve heard) Dr. Oz talked about it. … Continue reading

The Marginalization of the Headache Sufferer

Posted on August 5, 2016

Today I learned of yet another major headache clinic, this time in the Midwest, closing its doors for good. There are several reasons for this. From what I have heard, the director took a job with the pharmacological industry and … Continue reading

News from Headache Research

Posted on July 26, 2016

There is nothing earth-shattering that has been published in the last month. I will summarize what I have seen. The CGRP antagonist (the so-called “migraine vaccine”) studies are still looking promising. We hope that something would be on the market … Continue reading

Health Care Policy and the Future of Headache Treatment

Posted on July 8, 2016

I often get on a soapbox regarding the complexities of trying to give good care to headache sufferers. The first obstacle is the fact that, at least at the level we deal with, it is a dreadful illness that is … Continue reading

Migraines and Genetics

Posted on July 5, 2016

The most recent issue of Cephalalgia (the journal of the International Headache Society) had a focus on genetics and migraine. I often tell my patients that I foresee a day when, on the first visit, a patient is genetically tested … Continue reading

Migraineur: The Unsung Heroine / Hero

Posted on June 23, 2016

It may be hard for the typical sufferer of migraine and other headache disorders to see themselves as heroines or heroes. It is society that seems—although subliminally—to be saying that they are anything but that. They are weak, unreliable, irritable, … Continue reading

Choosing Wisely in Headache Treatment–Things Patients Should Question According to Headache Specialists

Posted on June 15, 2016

Choosing Wisely in Medical Care The American Board of Internal Medicine Foundation started a program looking for things in each branch of medicine that was, based on clinical trials, had no or little value in helping patients get better. The … Continue reading

Headache Treatment in 2026

Posted on June 8, 2016

Patients often ask what does the future of headache treatment look like. For many of them, the future will be too late. This is not just a negative thought (meaning that they will not live long enough to see these … Continue reading

June News Updates

Posted on June 1, 2016

I have been out of town and have not posted in the past 10 days. I did have the chance to visit my old stomping grounds at Mayo Clinic in Rochester, MN last week. I have reviewed several two journals … Continue reading

News from Headache Research 5/18/16

Posted on May 18, 2016

Breaking News Items Is Chronic Migraine (CM) totally different from Episodic Migraine (EM)? At this present time, the definition of CM is simply based on frequency. If you have headaches more than 14 days per month it is called CM … Continue reading

Loss in the Quality of Life, Intrinsic and Imposed

Posted on May 16, 2016

Intrinsic Factors Impacting the Quality of Life In my previous post, I alluded to one study, titled Quality of Life in Primary Headache Disorders. It appeared in the January issue of the journal Cephalalgia, An International Journal of Headache. The … Continue reading

News from Headache Research

Posted on May 11, 2016

I had two no-shows  yesterday, (which I find perplexing in itself), but that did give me the opportunity to catch up on reading three issues of Cephalalgia, the international journal of headache research. While the journals were full of reports … Continue reading

A New, Non-Drug Option for Treating and Preventing Headaches

Posted on May 6, 2016

I have spoken for awhile about the Spring TMS. This is a device that delivers a powerful magnetic impulse to the brain, interrupting the bad signals that are starting a migraine attack. It is FDA approved  to stop a migraine … Continue reading

A Lesson from Prince?

Posted on May 5, 2016

It is a little early to speak and the official report of the cause of death for Prince has not been released. However, at this juncture, there are strong indications that prescription narcotics may have been part of the problem. … Continue reading

Latest News from Cascade Neurologic Headache Clinic and the World of Headache

Posted on May 3, 2016

I want to do an update weekly, as time permits. This week: Cefaly Money Back Guarantee I’ve had many patients want to try the Cefaly device but were afraid that they would pay $250 for the device and then it … Continue reading

The New Headache Clinic at Cascade Neurologic

Posted on April 29, 2016

The dust is starting to clear and I have time to come up for air, long enough to start posting again. As many know, on December 31, the Pacific Rim Headache Center had to cease to exist. It was meant … Continue reading

Tis the Season for Insurance Enrollments. What the Headache Sufferer Should Know

Posted on December 31, 2015

There is no illusion here that there is a good insurance plan for the headache sufferer. The headache sufferer will be discriminated by all insurance plans. But the real question is which one does it the least? I will say … Continue reading

Headache Patients in Urgent Care or ER — A Response

Posted on December 24, 2015

I often hear from my colleagues who work in the emergency room or urgent care how they hate seeing headache patients there because it is so “inappropriate.”  I had such a statement from a ER medical provider on a private … Continue reading

Some More Good News For Headache Sufferers . . . for a Change

Posted on December 18, 2015

For about twenty years researchers have been looking at “neuromodulation” as a novel and exciting way to prevent and stop headaches without medication. What we mean by neuromodulation is affecting the misbehaving neurons, which are causing the headaches.  This could … Continue reading

Good News for Headache Sufferers

Posted on December 17, 2015

A very large Norwegian study (called the HUNT study) looked at risk factors for death for almost 51,000 patients over the period from 1995 until 2011.  In this study they found that having either migraine with aura (neurological symptoms) or … Continue reading

Our Merger and What this Means for You

Posted on December 9, 2015

I have described previously that we must merge with Cascade Neurologic in Mount Vernon for the sake of financial survival. As of December 31st, the Anacortes office and the Bellingham offices of Pacific Rim Headache Center will be closed.  I … Continue reading

Pacific Rim Headache Center will be Merging with Cascade Neurologic–Mount Vernon–The Anacortes Office Must Close

Posted on December 5, 2015

Today it became final that Pacific Rim Headache Center will merge with Cascade Neurologic in Mount Vernon. This merger will begin on January 1st 2016. It may take several weeks to complete. This means that our beautiful Anacortes office must … Continue reading

What My Personal Headaches Have Taught Me

Posted on December 1, 2015

I am not a headache sufferer . . . nowhere to the extent of my patients at least. My mother and sister, both suffered from migraine with aura.  I have had episodic migraines that, while severe, are rare.  Each time … Continue reading

Children with Headaches

Posted on November 27, 2015

Maybe, because it is now officially Christmas season and, for me at least, Christmas always makes me think of children. It reminds me, not only, of my own childhood, but that of my children and the present children (grandsons included) … Continue reading

Please Be Patient as Our Phones / Internet has Been Spotty

Posted on November 25, 2015

Due to high winds yesterday we had spotty power outages. Due to the complexities of the electronic world this has caused disruptions in our phone / fax and at times our Internet services.  We regret this and the frustration it … Continue reading

This Should Worry Us All

Posted on November 23, 2015

A study published today in the Journal of the American Headache Society shows a grim future for headache specialists and therefore headache sufferers.  This  growing lack of specialists or lack of interest in headache specialization will be the greatest challenge … Continue reading

Five Reasons Some Headache Patients Don’t Get Better–Part II

Posted on November 22, 2015

3. Unrealistic Expectations. At Pacific Rim Headache we see some of the most complex headache patients in the world. We have many patients who have spent years struggling with their headaches, traveling the country, seeing many different types of experts, … Continue reading

Evidence for Chiropractic Care Helping? . . . Maybe.

Posted on November 10, 2015

I will be back to the five reasons some people don’t get better for Part II in a few days.  This morning the most recent headache studies were published and one (out of about 20) caught my eye and I … Continue reading

Five Reasons Why Some Headache Patients Don’t Get Better- Part I

Posted on November 8, 2015

(Sorry for the typos as I only had time to type this quickly without proof-reading) 1. Bad Disease. Most headache disorders result from a combination of genetic influences and acquired injuries to the sensitive headache alarm system in the brain. … Continue reading

Please Plan Ahead–The Future of PRHC–An Update

Posted on November 3, 2015

We sent out a newsletter to most of our patients in September and I also posted that newsletter here.  To avoid redundancy, I will summarize the situation in a nutshell. Every small, independent medical practice in America is struggling to … Continue reading

Latest Research on Acupuncture and Migraine Prevention

Posted on October 31, 2015

Adding non-drug modalities to migraine treatment is always of value, when they work.  It has always been difficult to study acupuncture from a scientific perspective, because you can’t compare it to a real placebo. Here is the latest report on two … Continue reading

News From Research–The Best Headache Diets and Supplements

Posted on October 28, 2015

I had a 90 minute no-show patient today and gave me a moment to catch my breath and to read up on world headache research, which I may had missed earlier. I know that here, in the Pacific Northwest, there is … Continue reading

Michael Jones Receives Certificate of Added Qualification in Headache Medicine

Posted on October 28, 2015

We congratulate Michael Jones as having passed the National Headache Foundation’s board exams in CAQ (Certificate of Added Qualification in Headache Medicine).  Michael was one of the first to sit for this new exam.  Passing this exam clarifies that he … Continue reading

Cefaly® a Microcosm of what’s Wrong in Headache Treatment

Posted on October 26, 2015

The Cefaly® , if you are not familiar with it, is a device that delivers a very well controlled electrical stimulation to precise locations of the Trigeminal Nerve.  For decades (even centuries if you include acupuncture) we have know that if … Continue reading

A Blood Test for Migraine?

Posted on October 21, 2015

Patients often ask why we don’t do blood tests for the diagnosis of their headaches. The truth is, after forty years of research into headache disorders, the science (not popular beliefs, fads or what snake oil salesmen say) clearly state … Continue reading

A List of Little-known Headache Facts–Part II

Posted on October 18, 2015

23 Million Americans suffer from migraine. Of the 23 million migraine sufferers, over 2 million require the expertise of a headache specialist to find optimal care and the highest quality of care. Presently, less than 23,000 migraine sufferers have access … Continue reading

A List of Little-known Headache Facts-Part I

Posted on October 15, 2015

I am getting ready to take another board exam in Headache Medicine this Friday. I thought I could pass it in my sleep, but I decided to do some reviewing to be safe.  I have reviewed a lot of facts … Continue reading

Reaching the Masses of with Top Quality Virtual Headache Visits

Posted on September 30, 2015

Those Who Come from a Distance Headache disorders are among the most underserved medical problems in the world.  The state of Washington has one of the worst served populations in the country with a ratio of 1  headache specialist to … Continue reading

The Difference between Asking Good Questions . . . and Arguing

Posted on September 29, 2015

Several things happened this week that had me thinking about this question.  The first thing was hearing about the release of a new study that looked at medical misdiagnoses.  It appears that one out of ten people will have a … Continue reading

Curbside Consult–Free Beta Testing

Posted on September 22, 2015

NOTE: THE OFFER BELOW IS NOW COMPLETE AND WE WILL NOT NEED ANY OTHER BETA TESTERS. THANKS   Headache sufferers have fewer resources than sufferers of any other medical disorder. We hope that this is changing. In our state alone, there … Continue reading

This is a Piece of the Puzzle

Posted on September 15, 2015

In recent years patients have seen their health insurance premiums go way up as well as their deductibles.  We small independent practices have seen increase costly regulations, quickly diminishing payments and a labyrinth of obstacles to go through to get … Continue reading

Breaking News Pacific Rim Headache Center – Summary

Posted on September 10, 2015

We are going through some major changes here, hopefully to secure our future for our patients and to bring better and more convenient care. Some of this vital information may have been missed if you have not read our newsletter … Continue reading

A Great Video to Share with All Your Friends

Posted on September 9, 2015


2015 Summer/Fall Patient Newsletter

Posted on September 3, 2015

Here is our summer newsletter. 2015 Summer/Fall Patient Newsletter There are some big changes coming  as we try to weather the economic storms of the present healthcare system. As a practice, we are determined to keep our focus on providing … Continue reading

Why Some Sufferers Don’t Get Better–The Psychosocial Barriers–Part III- Professional Stigma

Posted on August 18, 2015

As I mentioned in previous posts, one of the reasons that patients don’t get better is that the present treatments are generally mediocre.  This is due to lack of research over the past century. Things are getting better in that … Continue reading

Why Some Sufferers Don’t Get Better–The Psychosocial Barriers–Part II Social Stigma

Posted on July 29, 2015

Yesterday, I was speaking to a physician, and when I told him I have a headache clinic he immediately assumed that I was either a psychologist or someone who pushes narcotics.  This happens all the time.  If you are a … Continue reading

What Some Headache Sufferers Don’t Get Better – Psychosocial Barriers

Posted on July 24, 2015

I usually come here to write about new research into headache prevention and treatment. I will continue to do that after I finish this series.  Despite how disappointed we all are in the snail’s pace of bringing new and better … Continue reading

IV Infusions for Pediatric Headache Sufferers

Posted on July 6, 2015

It has long been established that IV infusions have the greatest effect is shutting down a severe and /or prolonged headache in the adult population. A study presented at the recent American Headache Society’s scientific meeting in Washington DC showed … Continue reading

Chronic MIgraine (patients with 15 days a month or more of headache) Can Now Be Diagnosed Via MRI — Almost

Posted on July 1, 2015

A study presented in the June issue of Headache showed highly accurate MRI differences between the brains of normal subjects and those with chronic migraine.  These markers were thickening in some areas of the brain’s cortex, the surface area of … Continue reading

A Word of Gratitude to Our Patients

Posted on June 29, 2015

Over the past year Pacific Rim Headache Center has had no choice but to apply several new austerity measures in order to stay in business. This is despite the overwhelming demand for our services and us working extremely hard to … Continue reading

Update in Migraine Research from Valencia, Spain and Washington D.C.

Posted on June 28, 2015

This year I attended the International Headache Congress in Valencia, Spain. This is where the greatest minds in headache research in the world come together every two years to discuss their findings.  I have shared a few thoughts from that … Continue reading

News from the Scientific Meeting of the American Headache Society

Posted on June 25, 2015

Having Bad Headaches Negatively Influences Parenting.  This should be a no-brainer, but research now supports this. See the study here. This does not mean that you are a bad parent. A bad parent is a parent who does a bad … Continue reading

No Longer Doing Botox for Medicare Patients

Posted on June 23, 2015

  We love our patients and we love helping them to get well. In this present time of health care in America, it is becoming almost impossible for small independent practices to stay in business. The amount of overhead keeps … Continue reading

Email Limits

Posted on May 20, 2015

In the past we have allowed patients to communicate with us via secure e-mail account connected with our web page.  After discussing this with our legal advisers, they suggest that we close that account for established patients due to their interpretation … Continue reading

News from the International Headache Congress

Posted on May 20, 2015

I mentioned in a previous post, I just returned from the International Headache Congress in Spain. This is a meeting held every two years and is an assembly of the brightest minds in headache research from around the world.  The … Continue reading

New Research on Migraine

Posted on May 19, 2015

I mentioned in the post yesterday that I just returned from the International Headache Congress.  There are several items of importance for migraine sufferers that I want to share. I will ty to do one post every few days to … Continue reading

International Headache Congress, Valencia, Spain

Posted on May 18, 2015

I just returned from this meeting, which is held every two years, where the top headache researchers in the world assemble and discuss their work. I’m not sure how many were in attendance, but I guess it was over two … Continue reading

We Will Be Closed May 11 – 14

Posted on May 4, 2015

The Pacific Rim Headache Center will be closed for seeing patients from May 9th until May 14th.  Dr. Moren will be seeing patients in Bellingham on May 15. We are sorry about any inconvenience that this may cause our patients.  … Continue reading

Headache – The Rodney Dangerfield of Maladies, PART I

Posted on April 7, 2015

I know by now many of you don’t remember Mr. Dangerfield. He was a comedian who was born in 1921 and passed away in 2004. The life-long theme to his comedy was his catch phrase, “I don’t get no respect.”  … Continue reading

Updates from Headache Research

Posted on March 11, 2015

Magnetic Gun to Stop Migraine Attacks In December 2013, the FDA approved the use of a powerful magnetic pulse generator (Cerena TMS®) gun to stop a developing migraine.  It was shown to be as effective as many of our present … Continue reading

Children and Headache

Posted on March 3, 2015

Here is a great article about children in headache from the American Migraine Foundation. If you have children with headaches it is worth the read.

A Word of Thanks / Group Health Update

Posted on March 3, 2015

I wanted to come back and finish part II of the role of pharmacophobia (the irrational fear of medications) and the hope of getting well.  However, we are facing an unprecedented demand from patients and we are working as hard … Continue reading

Refractory Migraine in a “Just World”

Posted on January 27, 2015

Here is an article that Michael Jones had published in the Headache Journal today.  It shines the light on the process where patients with bad headache disease are often unfairly blamed for their disease. Refractry Migraine in a Just World

Anticholinergic Medications Possible Linked to Dementia

Posted on January 27, 2015

A study in Seattle released this week suggested that the high use of anticholinergic medications by people over the age of 65 may be linked to developing dementia. This associated is not clear and all agree that the relationship is not just … Continue reading

Pharmacophobia as as Obstacle to Good Care Part I

Posted on January 22, 2015

I recently had an experience that got me thinking about one of the major obstacles that we face here in the Pacific Northwest in helping patients get well and that is pharmacophobia.  I say that it is most prominent in … Continue reading

American Migraine Foundation

Posted on January 21, 2015

Below is a statement from the American Migraine Foundation.  It is a grassroots migraine sufferer advocacy group.  It is time that headache sufferers come together to demand the better care that they deserve. This organization is fighting for better research … Continue reading

Latest News on the Magnetic Stimulator to Abort and Possibly Prevent Migraines

Posted on January 14, 2015

Follow this link to the Neurology News source.

Introducing Ketziah Moffitt

Posted on January 5, 2015

You may hear a new voice on the phone. We have added a new MA to our staff starting last week and that is Ketziah Moffitt. She says it is okay to call her “Kat” for short. She will be … Continue reading

Newsletter Correction

Posted on December 19, 2014

In our newsletter there was a statement that we need to correct. In the news about our clinic it said that we are now board-certified in headache medicine and we are the only board certified clinic in the state of … Continue reading

Rebound Headache is Probably Over-diagnosed.

Posted on December 17, 2014

I was lucky enough to work for Dr. Joel Saper in the 1980s. He is still considered the top headache clinician in the world by most people who work in headache medicine.  He was the first in the world to … Continue reading

Prior Authorizations for Medications

Posted on December 15, 2014

For the last 15 or 20 years, insurance companies have required prior authorizations before they would pay for certain, expensive medications. In the past couple of years the trend for the “apple” plans, (those low-cost commercial plans that represent Medicaid), … Continue reading

Why Headache Treatment is Behind Other Disorders

Posted on December 11, 2014

I often talk to patients about the societal discrimination against headache sufferers.  It is unfair and we must change that. There is much to talk about the why, but for now I wanted to share a quote from the American … Continue reading

We Are Now Board Certified in Headache Medicine!

Posted on December 10, 2014

We were notified today that Dr. Moren has passed the headache board exams. This was the last step in an long process making us the fourth medical practice in the state of Washington that is board certified in headache medicine … Continue reading

Obesity and Anxiety Roles in Headache Treatment

Posted on December 8, 2014

Regarding Obesity and Headaches Over the last thirty years there has been an observation that there are more obese people with bad headaches than obese people in the general population.  The cause and effect has not been so clear. Some studies have … Continue reading

More from the Scottsdale Headache Meeting

Posted on December 2, 2014

If this year’s meeting had a keynote address, it was around the inventor of the magnetic pulse generator for neuro-modulation.  In laymen’s terms, this means using a pulse of very strong magnetic energy to cause neurons to fire (or in … Continue reading

Phone Policy Update

Posted on December 1, 2014

We have witnessed a huge demand for our services in the past six months. The corresponding phone calls have risen to an unmanageable level.  After being gone for a week to a headache meeting we came back to 46 phone … Continue reading

Scottsdale Symposium Update

Posted on December 1, 2014

I wanted to come here each day and bring some breaking news in headache research from our recent symposium. However, combined with us being gone for a week to the meeting, then coming back for three days before the holidays, … Continue reading

We Will No Longer be Recommending Butterbur (Petasitidis hybridus)

Posted on November 24, 2014

We just returned from an annual meeting with the American Headache Society. This is a very large meeting that draws about 400 headache specialists and researchers from around the world.  I will be back with more breaking news of headache … Continue reading

We Will No Longer Be Accepting New Molina Insurance Patients

Posted on November 14, 2014

It is always a difficult decision to turn away any person who suffers from a headache disorder.  We have come to an impasse with Molina insurance. Our mission is to provide the best possible care to the most patients with … Continue reading

We Are Overwhelmed . . . Please be Patient

Posted on November 10, 2014

We have been overwhelmed with demand for patient appointments over the past few weeks.  The reason for this has been the combination of several factors.  For one, the word is getting out among headache sufferers that we do offer good … Continue reading

News From the World of Headache Research

Posted on November 4, 2014

I read several journals and listen to many lectures each month on the cutting edge of headache research. I try to provide brief summaries of the most pertinent findings here. 1) Will Chronic Migraine Last Forever? A look at remission … Continue reading

Study Predicts Who Responds to Botox®

Posted on October 22, 2014

We know that most chronic migraine sufferers respond to Botox® treatments, but not all.  Several markers have been looked at and none of them were able to predict who responed.  That may be changing. A recent study found that the … Continue reading

News from the World of Headache

Posted on October 20, 2014

Cluster Headaches: An interesting study presented last week showed that a hand-held electrical stimulator, called the gammaCore®, is used twice a day, the number of cluster attacks per week are reduced by eight.  For those with three or more attacks … Continue reading

How You Can Help—Headache Sufferers

Posted on October 9, 2014

Here are two very tangible ways that you can get involved in helping us help headache sufferers.  As we all know, sufferers of headache disorders are the most discriminated sufferer of any type of chronic illnesses simply because headaches are … Continue reading

Latest Headache Research on Headache

Posted on September 23, 2014

Reviewing headache literature today I came across several stories that patients might find interesting. A New Herbal for Migraine Prevention? Eric Eross, a headache neurologist that I worked with at Mayo Clinic a number of years ago, went on a … Continue reading

A Potential New Non-Drug Way to Treat an Acute Headache

Posted on September 15, 2014

We are always looking for non-pharmacological ways to manage headaches.  A study published today, although small, did have convincing evidence that a cold head bath is quite effective in stopping a new headache.  The secret is starting with a lukewarm … Continue reading

Patients with Difficult Headaches in an Otherwise “Just World”- Commentary

Posted on August 11, 2014

This is a commentary piece that I just had accepted for publication in a major headache journal.  The patient mentioned here is a collage of three patients so that no one’s identity can be exposed.  But, as we all know, … Continue reading

American Headache Society Scientific Meeting Part II

Posted on July 7, 2014

This is a continuation of my review of the highlights of the annual headache research meeting, which was held in Los Angles in late June. 1) A Dutch study looked how children with headaches were treated by their family physicians. … Continue reading

American Headache Society Scientific Meeting: Part I

Posted on July 1, 2014

This year is the first time I’ve missed the annual scientific meeting of the American Headache Society in years and it was due to a family emergency.  I have had time to review all the presentations and I wanted to … Continue reading

PRHC Closed from June 20th – June 30th

Posted on June 18, 2014

This is the week for the annual scientific meeting for the American and International Headache Societies.  I’ve had the opportunity to attend these invaluable meetings for most of the past thirty years. It is where cutting edge research in headache … Continue reading

Road Construction

Posted on June 16, 2014

This week the city of Anacortes is re-paving R Ave., which runs in front of our building. Yes, we are open and our road is open.  I talked to the construction crew this morning and they say that they would … Continue reading

SphenoCath a new Innovation for Headache and Face Pain Management

Posted on May 30, 2014

We are now offering an innovative and non-invasive treatment to help the sufferers of chronic face pain and headaches.  We will offer this treatment for selected patients, for whom we think there could be significant benefit. For details about the … Continue reading

The Word has Gotten Out so We are Now Overwhelmed. Please be Patient.

Posted on May 11, 2014

Apparently the word has gotten out to the wider public about the unique care we have for headache sufferers.  We appreciate our present patients who have made this possible.  We are now overwhelmed with demand. Therefore, please be patient if … Continue reading

A Great Source for Cutting Edge News about Headache

Posted on May 11, 2014

Sometimes there is so much chatter and clutter on the Internet it is hard to know what is the best information about headache disorders.  Patients often bring me articles that they have copied from blogs and discussion groups.  I would … Continue reading

A More Detailed Report about the CGRP Antagonist and Migraine

Posted on April 28, 2014

I recently posted about this under the “Migraine Vaccine” title.  The article below goes into a bit more detail. If you read these studies carefully, you will see that the treatment group was only about 10-15% better than the placebo … Continue reading

Update on the Migraine “Vaccine”

Posted on April 24, 2014

I spoke about this a year ago, but now that the first results of the studies are being revealed, it is time to update the story. First of all, it is not a real vaccine, but that is a over-simplified … Continue reading

So, You Think You Have Tried Everything? Think Again Part I

Posted on April 8, 2014

I recently heard a patient say that she was thinking about giving up on finding a solution for her headaches.  It wasn’t as if her headaches were a minor problem either.  Her headaches were ruining her life. But she felt … Continue reading

So You Think You Have Tried Everything? Then Think Again- Part II

Posted on April 8, 2014

We will move on to treatments that are available in Tier II.  You don’t move on to Tier II until those things in Tier I have failed. This means that the supplements should have been tried for three months and … Continue reading

So You Think You Have Tried Everything, Do You? Then Think Again. Part III

Posted on April 8, 2014

When everything in Tiers I and II have failed, we are halfway there.  Here are some of the things to try at this next level. Abortive / Symptomatic-Pharmacological Treatment Tier III Remaining Triptans 1)      Frovatriptan, 2)      Almotriptan, 3)      Zolmatriptan oral … Continue reading

So You Think You Have Tried Everything, Do You? Then Think Again. Part IV

Posted on April 8, 2014

When everything in Tiers I and II have failed, we are halfway there.  Here are some of the things to try at this next level. Abortive / Symptomatic-Pharmacological Treatment Tier IV Intravenous Infusions  The role for IV therapy in headache … Continue reading

Group Health Contract

Posted on March 25, 2014

I hope this will be the last of our updates about our contracting situation with Group Health.  This has been a three-year  ordeal that I would not wish on my worst enemy. We had signed a contract with GH eleven … Continue reading

Cefaly® – the New Wearable Electrical Stimulator to Prevent Migraines, The Latest Update

Posted on March 25, 2014

Cefaly approved by the FDA needs a medical prescription. It can be ordered on the Cefaly US website: It must have a valid prescription sent to them by your headache provider.  We can do that for our patients who … Continue reading

Cefaly® – the New Wearable Electrical Stimulator to Prevent Migraines

Posted on March 12, 2014

Apparently an announcement was made recently that Ceflay®, a device that stimulates the nerves around the head using electricity, has been approved in the US for the prevention of migraine. This device has been around for a couple of years … Continue reading

So You Think You Have Tried Everything, Do You? Then Think Again. Part I

Posted on March 9, 2014

(This will part I of  4 part series. I will try to post a new part each week) I recently heard a patient say that she was thinking about giving up on finding a solution for her headaches.  It wasn’t … Continue reading

Children and Headaches Part II

Posted on February 18, 2014

The Reality of Treatment Migraine and other headache disorders are often not respected as real and profoundly disruptive medical conditions in themselves.  The feeling is that a headache is simple and therefore the solution should be simple.  Sometimes it is, … Continue reading

Children and Headaches Part I

Posted on February 15, 2014

Finding good headache care for adults is very difficult, since trained specialists are few and far between.  Finding good headache care for children is even harder, as most headache clinics don’t see anyone under the age of 18. We, at … Continue reading

The Latest News from PRHC

Posted on February 10, 2014

I wish I were reporting a major breakthrough in headache research. But once again, 2013 was a dismal year for new breakthroughs.  The future does look very bright with many exciting studies underway and 2014 might be the pivotal year. … Continue reading


Posted on January 29, 2014

PRHC is undergoing some major growth.  I have mentioned before that we are upgrading our entire electronic medical management environment.  What this will mean for patients is that we will not have to type while you talk (maybe a few … Continue reading

Group Health Providers, the Timing Finally Clarified

Posted on January 25, 2014

After three long years, it appears that the light at the end of the tunnel is near, or at least we have a time frame.  It has been frustrating experience for our potential Group Health patients . . . as … Continue reading

FDA Approves Magnetic Migraine “Zapper”

Posted on January 2, 2014

After almost ten years of research, the FDA on December 13th approved the Cerena TMS (TMS=trans-cranial magnetic stimulation).  This is the first device ever approved for the treatment of migraine. This magnetic gun is different from the “snail-oil” magnetic and … Continue reading

Surgery for Migraine . . . and Other Hot Topics

Posted on October 23, 2013

Not a day goes by when at least 2-3 patients bring in new articles or simply comments from someone who claims they can cure migraine.  Yesterday someone asked me why we don’t just do acupuncture because “studies show it is … Continue reading

The Latest from Headache Research

Posted on October 15, 2013

I always wish I could come to you announcing that a cure for headaches has been found. But, because headache disorders are some of the most complex and multifactorial human maladies, it will never happen that way.  But progress will … Continue reading

Pacific Rim Headache Center – Summer Newsletter

Posted on August 1, 2013

Here is a copy of our newsletter, which is going out this week to our patients.   Pacific Rim Headache Center Breaking News / Summer 2013   Group Health has Invited Us to be Part of Their Network! We have … Continue reading

Headache Poster

Posted on July 16, 2013

Here is our new poster we created for our office. migraine poster

Provider News Letter

Posted on July 16, 2013

Pacific Rim Headache Center News Letter-Final

International Headache Congress Report

Posted on July 7, 2013

Every two years the American and International Headache Societies combine to have the world’s most important symposium on headache research.  It is always exciting to attend these meetings with 500 headache experts from every continent of the world.  This year, … Continue reading

Our Electronic Health Records . . . You Love Them and Hate Them

Posted on July 5, 2013

Once again I want to apologize for our office being hard to reach this week. After being closed for 10 days, while I attended and presented at the International Headache Congress, the second day back our electronic environment collapsed.  We … Continue reading

World Headache Congress

Posted on June 20, 2013

Next week we will be closed as I will be attending and presenting at the World Headache Congress. This is a very important meeting that occurs only once every four years.  Here is a brief agenda from the International Headache … Continue reading

The Migraine Vaccine?

Posted on June 17, 2013

On the scientific front, the past two years have been dismal when it comes to breakthroughs in migraine treatment. It isn’t due to the lack of trying.  We have learned much more about migraine and other headache disorders than we … Continue reading

International Headache Congress

Posted on June 12, 2013

Next week I will have the privilege of attending the International Headache Congress.  This is the biggest headache research meeting in the world and occurs about once every four years. This will be the forth one I’ve attended, while I … Continue reading

Pacific Rim Headache Clinic Has the Highest Patient Satisfaction Level Ever Reported for a Headache Clinic

Posted on June 3, 2013

Many of you were asked to complete a survey about your attitudes and satisfaction level after visiting our clinic.  I wanted to thank all who did participate, some did so despite having a headache.  This was very important work and … Continue reading

The State of Headache Care in America – A Report to Congress

Posted on May 19, 2013

Attached below is a fantastic summary of what is wrong with headache care in America. This report was given to Congress in Feb 2012.  I think it is so important in understanding the problem that I must post it here: … Continue reading

From Our Billing Department

Posted on May 16, 2013

  It would be an understatement to say that billing has been our biggest nightmare.  A big part of the problem is the fact that working with insurers has become so complex that a rocket scientist would be pulling his hair out even to … Continue reading

Treating Migraine in Breast-Feeding Women

Posted on May 1, 2013

Migraine is a disorder that is most common in women during their reproductive years. This does create many dilemmas for the patients and us who are treating them. Many medications (and other treatments) are not safe during pregnancy and if … Continue reading

Good News for Headache Sufferers . . . No Lasting Brain Effects

Posted on April 29, 2013

It has been observed for some time that people with frequent headaches, namely migraine, have a much higher rate of what we call “deep white matter brain disease” as revealed on MRIs. A recent study looked at this effect over … Continue reading

Migranal (nasal dihydroergotamine) Goes Generic!

Posted on April 28, 2013

I really like dihydroergotamine as a migraine abortive for several reasons. For one, it actually is a natural product. It is extracted from the ergot fungus pod grown in the lab and purified. Secondly, if it can get into your … Continue reading

Latest from Headache Research – More Truth about Triggers

Posted on April 25, 2013

We who have been around headache treatment for a while often find ourselves in this strange dilemma. There are many so-called “truths” about headache that are promoted in pop-culture, repeated by some physicians or other practitioners, but was somewhat dis-proven … Continue reading

What Kind of Headache Do You Have?

Posted on April 15, 2013

I often have patients reading things on line and making a self-diagnoses.  The web and other sources of hearsay (what aunt Mildred thought) are notorious for not being very reliable.  For example, there is no-longer such a thing as “tension headaches” or … Continue reading

More on Electrical Procedures for Migraine Prevention — a Candid Discussion

Posted on April 12, 2013

A couple of posts ago I discussed plastic surgery for migraine treatment, the pros and cons.  I want to discuss (again) a new wave of procedures for migraine prevention that, while holding great promise, must be discussed honestly. I also … Continue reading

For the First Time . . . You Can See Pain

Posted on April 11, 2013

I’ve had ridiculous calls from ER providers telling me that “your headache patient is in our ER and they want something for pain, but they don’t look like they are in pain to me.” No human being can look at … Continue reading

Plastic Surgery for Migraine Prevention? The Pros and Cons.

Posted on April 6, 2013

I was responding to a patient’s e-mail inquiry about this procedure tonight and I thought I would carry that thought here to our web page. Background: To make a long story short, and I may have a couple of the facts incorrect … Continue reading

Genetics and Migraine

Posted on April 5, 2013

All fingers are pointing to genetic predisposition as the major reason that people have bad headaches.  If you want to follow this story, here is a web site that can keep you up to date. I’m sorry but the genetics … Continue reading

100 Million for Brain Research . . . Why This is Good for Headache Sufferers

Posted on April 2, 2013

The Obama administration announced that they are taking a big initiative towards brain research. While this sounds like a lot of money, once it gets divided between the interests (all the neurological branches) it will not amount to that much. … Continue reading

Latest News from the World of Headache Research

Posted on April 1, 2013

The best places in the world to get the latest information on headache research are the journals Headache,  Cephalalgia (Latin for “headache”), then maybe the Green Journal of Neurology and the NIH (which can be found on the Internet and I’ve … Continue reading

The “Real Reason” that You Have Headaches and the Lure of the Quick Fix

Posted on March 28, 2013

Several things lately have brought this concept once again to the forefront. The first set of reasons has to do with encounters with five particular patients over the last week. The other thing was a bogus ad that got sent … Continue reading

Marijuana for Migraine, LSD for Cluster Headaches, Gluten Free Diets and Other News

Posted on March 26, 2013

The internet is an interesting place, sometimes for good and sometimes misleading. The hottest internet topics on headache lately have been those mentioned in the title above. The Headache Journal, the premier research on finding the truth about headaches, has … Continue reading

Virtual Visits Available Now and More in the Works!

Posted on March 23, 2013

In the U. S. it is estimated that there is one headache specialist (defined by specific training in headache medicine) per 300,000 people. This means that there is one headache specialist per every 45,000 migraine sufferers (not to mention the … Continue reading

Medicare to Pay ( a little) for Complex Care of Chronic Illinesses

Posted on March 13, 2013

On Jan, 1st of this year, Medicare agreed to pay for the time (in excess of one hour per month) outside of the typical office visit, that medical practices spend coordinating care for patients with complex problems. It is not … Continue reading

Supplements for Migraine Prevention

Posted on February 20, 2013

I wish, more than anyone, that we had a cheap, natural supplement that would prevent most headaches from coming. However, no such thing exists at this time.  There are a few supplements that have shown some modest improvement in headache … Continue reading

Please Be Patient with Phone Calls

Posted on February 19, 2013

Our office was closed last week. We do have our personal lives and not just work. Kaaren took a vacation and I went to Florida to check on my 91 year old mother (I just get to see her once a year … Continue reading

Why Some Headache Sufferers Don’t Get Better

Posted on February 5, 2013

This is a rough draft of a new handout that I’m working on. I hope to edit it more and even shorten it a bit. But I think this is very important information for patients to have so I’m publishing … Continue reading

Office Closed from Feb 11 – 15

Posted on February 2, 2013

Please be aware that our office will be closed during the dates listed above. Because we are a small office, with just two full time staff, it makes the most sense that we are both gone at the same time. … Continue reading

A Disappointing Year for Headache Research – But Hope Still Triumphs

Posted on January 24, 2013

It was just a few years ago, after some major breakthroughs in our understanding of headache, that there seemed to be a flurry of new headache research.  We were optimistic that we were on the threshold of a whole new … Continue reading

Greater Occipital Nerve Stimulators and Intractable Migraine

Posted on January 22, 2013

Today marks a new point for Pacific Rim Headache Center, in that one of our patients is getting an occipital nerve stimulator for refractory chronic migraine.  She was the ideal candidate simply because she has exhausted all other treatments. She had … Continue reading

Zecuity Approved for Acute Migraine

Posted on January 18, 2013

Zecuity, is a sumatriptan (what’s in Imitrex) patch that uses electricity to push the medication through the skin and into the blood stream, thus bypassing the stomach. It gives a continuous does of sumatriptan for four hours. For more information go to their website … Continue reading

Migraine with Aura, Associated with Heart Attacks, Strokes and Blood Clots

Posted on January 16, 2013

Two studies will be presented at the annual meeting of the American Academy of Neurology in San Diego during the third week of March. The first study was done in France and looked at the risk factors for heart attacks … Continue reading

Maxalt is Now Generic

Posted on January 15, 2013

We knew that this was coming soon, but now it is here.  Mylan (generic manufacturer) has announced that it is now available as a oral dissolving tablet that is similar to Maxalt MLT.  The generic is called rizatriptan benzoate ODT.  They … Continue reading

The Headache Diet

Posted on January 12, 2013

Twice in as many weeks I’ve had patients ask me why I don’t put them on a headache diet.  One of those patients even suggested that maybe I’ve had never even heard of such diets, which they had read about … Continue reading

A New Study on the Simplified Approach to Detoxing Patients with Medication Overuse Headache

Posted on January 11, 2013

In a large European + Latin American study, they tried a simple approach of getting patients off rebounding medications (medications taken more than three days per week that causes the headaches to get worse over time).  Typically, the standard as been admission … Continue reading

More Good News About Beta Blockers

Posted on January 8, 2013

Beta Blockers, such as propranolol or nadolol are one of the first steps in using medications in migraine prevention. I like to start with them first, not only because they are effective and have low side effects, but they also … Continue reading

New Research Links Genetic Flaws for Both Migraine and Seizures

Posted on January 7, 2013

Headache research has taken us a long ways in the past decade. We now think that most common headache types are genetic based and indeed five specific migraine genes have been found so far.  In this study (linked here) for … Continue reading

The Cause of Headaches from an Evidence-based Medicine Perspective

Posted on January 6, 2013

I wanted to share here our latest handout: What “Causes” Headaches from an Evidence-based Medicine Perspective Evidence-based, or what some people call “Western medicine” is simply what the name implies, we do not make statements that are not backed up … Continue reading

Why We Hate Having to Type on a Laptop When We See Patients . . . and, Do You Have Any Better Ideas?

Posted on January 2, 2013

We often get letters of gratitude and thanks. It is very rewarding to diagnose an obscure headache disorder that is an easy fix that changes someone’s life. However, today we got the first critical letter that we have received since … Continue reading

No Relationship Between Vitamin D Deficiency and Migraine

Posted on December 21, 2012

When you have been around medicine, especially headache medicine, as long as I have, you see fads come and go like Christmas mornings.  One of the latest ones is that headaches are caused by Vitamin D deficiency. Just this week I … Continue reading

Headache . . . is NOT a Mental Illness

Posted on December 4, 2012

I know of no other disease that has such a stigma as headache disorders.  I suspect that the major reason is there has always always been a mystery around headache causes, that it was assumed to be a mental health … Continue reading

Anatomy of a Migraine . . . From the Inside Out

Posted on November 23, 2012

People often ask me if I went into headache work because I have migraines.  No, that wasn’t the reason. But it wasn’t like I hadn’t witnessed migraine throughout my life as both my mother and my sister had migraine with … Continue reading

The Real Cure for Migraine

Posted on November 13, 2012

Many claims are made for curing migraine.  All of course are false.  However, migraine is a very treatable disease and, unlike most chronic illnesses, can cure itself and just get better or go away. But some day there will be a … Continue reading

New Migraine Gun . . . Could Mean Medication-less Relief for Many Migraine Sufferers

Posted on November 3, 2012

For the past 8-9 years there has been work on a gun that can stop a migraine in its tracks. It is a long story how this idea came about.  But in summary, it is a gun that shoots a … Continue reading

Is it Worth the Drive from Seattle?

Posted on October 21, 2012

The headache treatment world is a small community.  In our region, we have had two major headache practitioners leave their perspective headache clinics in the past three months, Dr. Aurora at the Swedish Headache Department and Dr. Steven Singer in … Continue reading

Why Follow Up Appointments Are Necessary

Posted on October 14, 2012

A study was presented last year at the headache scientific meeting that showed that almost 50% of patients who came to headache centers didn’t return for their follow ups.  I’m sure that there are many reasons for that and I … Continue reading

Headache Cyber-Medicine is it Possible?

Posted on October 11, 2012

We have had an increasing demand for our services from people  who are from greater and greater distances.  Headache specialty services are rare and seems to become more rare (with two major headache practices in Seattle closing).  I’ve worked in other … Continue reading

Our Specialty? Complex and Hard to Treat Headache Disorders

Posted on October 7, 2012

Recently I noticed that several patients were referred for appointments, then they canceled or simply didn’t show up. I was curious so I tried to find out why.  I saw a pattern.  These people were either people with very hard to treat … Continue reading

The Headache Forum is Ready!

Posted on August 30, 2012

For a long time I have wanted to created a way for patients, or sufferers in general for that matter, to connect and share their experiences.  We have launched the “Headache Forum” to meet that goal. To go there, simply … Continue reading

Migraine Care as Example of What’s Wrong in American Healthcare

Posted on August 7, 2012

Writer and surgeon Dr. Atul Gawande had an interview on NPR Morning Edition this morning (based on his New Yorker article) about what we can learn from the Cheesecake Factory in delivering better health care in America.  He starts the interview by … Continue reading

More from the American Headache Society Scientific Meeting

Posted on July 25, 2012

Three weeks ago I attended the scientific meeting of the American Headache Society, as I have for each of the past twenty years. It is the most important headache research meeting in the world.  There were several bits of research … Continue reading

News from Headache Research

Posted on July 24, 2012

I will get back to my previous two questions, with the remaining one being “What do we have to offer?” But first, I want to do a quick update in some of the thinking and research in headache. Last year … Continue reading

Two Questions: Are We Neurologists? What do We Offer? Part I

Posted on July 19, 2012

These two questions are the ones most commonly asked by inquirers who call. I wanted to give a brief answer to those here. I will deal with this first question and come back and address the second. No, neither Dr. … Continue reading

Research in Migraine and Headache

Posted on June 29, 2012

A quick source for reviewing the world’s research in headache disorders is at this government site.  You can change the key word to “headache,” “menstrual migraine,” “cluster headache” and etc. to see the great efforts to find a cure in … Continue reading

News from the Scientific Meeting Part II

Posted on June 27, 2012

Another important study was discussed by Sylvia Lucas, MD from the University of Washington.  Her team has been looking at headaches that develop after head trauma.  Not only are such headaches more common than what we previously thought but, those … Continue reading

News from the Scientific Meeting Part I

Posted on June 26, 2012

I have just a moment to give a summary of this year’s scientific meeting of the American Headache Society.  I know that most of my patients wish that I would come home with radically and curative treatments for headache. But, … Continue reading

54th Scientific Meeting of the American Headache Society

Posted on June 18, 2012

This week I will be attending this meeting for four days and will be out of the office. I think this is about the 15th annual scientific meeting I’ve attended. It is the premier meeting for headache research in the … Continue reading

Inhaled DHE (dihydroergotamine) Levedex hits a delay

Posted on May 16, 2012

Dihydroergotamine has been a mainstay of migraine treatment for years. It is a natural (plant bearing) substance and is highly effective in stopping migraines, however, it is not absorbed through the stomach.  We use it by injection and it does come in … Continue reading

St. George, the Maiden, the Dragon and the Ballet of Blame . . . A Migraine Metaphor

Posted on May 13, 2012

It may be a shot of melodrama, a bit of sexism, a hint of narcissism (suggesting that we headache specialists are represented by a saint) yet the allegory is the proper framework for the point I want to make. Imagine … Continue reading

Why We Must Charge for Completing Forms

Posted on April 30, 2012

It recently came to my attention that there was confusion as to why we must charge for completing paper work for patients. I want to try to candidly put this into perspective. In another post, a long time ago, I … Continue reading

American Academy of Neurology Report on Migraine Prevention

Posted on April 27, 2012

This week a group of headache specialists, some of whom I’ve worked with in the past, published the follow landmark article in the Journal of Neurology (also known as the “green journal”): Evidence-based Guideline Update: Pharmacologic Treatment for Episodic Migraine … Continue reading

PRHC to Offer Enhanced Acute Care for Headache Sufferers

Posted on April 18, 2012

If you read the news item below (two posts below) about discrimination against headache sufferers, you will understand why I felt it was imperative that we offer better acute care for our patients. Presently, I offer DHE-45, sumatriptan (Imitrex) and Toradol injections … Continue reading

No Place . . . or Almost No Place for Surgery for Headaches

Posted on April 16, 2012

One treatment for headaches, namely types of plastic surgery, have made a lot of news in the past couple of years. It was being promoted by a few plastic surgeons and not headache specialists.  After careful investigation, the American Headaches … Continue reading

Discrimination Towards Refractory Migraine Sufferers

Posted on April 7, 2012

This “news” item is not related to a recent study but to two recent conversations I’ve had with medical providers. One was an ER physician and the other was a Primary Care Provider. The term “refractory migraine(RM) ” in simple … Continue reading

What You Can Do, To Get Better

Posted on April 5, 2012

I’ve had several conversations recently with patients who are putting great efforts into making their headaches go away, but the things they are doing have no supporting research. We see our role as the coach for the patient and the … Continue reading

Latest Research from the World of Headache Medicine

Posted on April 2, 2012

Triptans and Serotonin Syndrome On July 19th, 2006 the FDA published a report that Triptans should be used with caution with SSRI (newer anti-depressants) because a risk of having too much brain serotonin. Since then pharmacies have been giving warning … Continue reading

Why Follow Up Appointments are Important

Posted on March 25, 2012

In the past week there were at least three situations where patients were upset with us and all three were versions of the same issue, wanting treatment over the phone in lieu of an appointment.  These misunderstandings make me realized … Continue reading

Latest News from the World of Headache

Posted on March 18, 2012

First with the news: Toradol® now in a Nasal Spray (SPRIX®);  If your are one of those patients who find great relief from an injection of Toradol, then it should interest you that the ingredient in Toradol (ketorolac) is now available in … Continue reading

Cure for Headaches

Posted on March 7, 2012

There is not a day that goes by that I don’t hear from a patient about an obscure new treatment . . .  or even cure for headaches.  These treatments or cures are nowhere on the worldwide headache research radar … Continue reading

Science Article on Headache.

Posted on March 2, 2012

This article was shared with me by one of our patients and is a good, reliable, description (in laymen’s terms) of migraine.

Whitney – A Teachable Moment

Posted on February 20, 2012

I will make no judgement on the recent passing of Whitney Houston, except that she had and incredible talent. But I will take this opportunity to talk about something dear to me . . . my patients. I had a call last … Continue reading

News from the World of Headache

Posted on February 16, 2012

It has been a very busy time here since we got back, so I haven’t had time to write here. I do read the research articles (quickly I may add, at least this week).  I don’t have time right now … Continue reading

Our Specialty is Treating the Difficult-to-Treat Headache Sufferers

Posted on February 16, 2012

We had a couple of conversations with potential patients this week. Their providers had made referrals to be seen by us, but then they hesitated to make the appointment because they assumed it was a waste of time. Both of … Continue reading

Next Available Appointments and Waiting List

Posted on February 7, 2012

Issue # 1 I have heard for years from headache patients that one of their most frustrating things about seeing a headache specialist is the long wait to get in, and then a brief visit. While we will keep our … Continue reading

Wanting A Second Opinion

Posted on January 26, 2012

The other day I had a request from a patient for notes, as he wanted to seek a second opinion. The thing I noticed was that he was very apologetic and seemed a bit embarrassed about the whole matter. I reassured him … Continue reading

Narcotic Addiction . . . The Bottom Side of Chronic Headaches

Posted on January 24, 2012

Is there a place for narcotics, (Vicodin, Fioricet, Oxycontin, Hydrocodone, Codeine) or Fioricet (butalbital) in headache treatment? A myth, which often permeates the halls of emergency rooms and other clinics, is that headache sufferers are nothing more than”drug seekers.”  This of course implies … Continue reading

Physician Payment Sunshine Act – Why That’s a Good Thing for Headache Sufferers

Posted on January 19, 2012

An item in the news this week, which may have gone unnoticed by many, was the discussion about passing of the Physician Payment Sunshine Act.  In summary, this act requires the full disclosure of money paid to physicians (and other … Continue reading

Evidence-Base Medical Treatment

Posted on January 15, 2012

If you haven’t heard the term mentioned in the title, you may have heard of “Western Medicine” Vs “Eastern Medicine” or “Alternative Medicine.”  You have probably heard many, somewhat derogatory descriptions, of these philosophies from their opposing viewpoints. Some people criticize “Western Medicine” for … Continue reading

Why Some Headache Sufferers Don’t Get Better

Posted on January 8, 2012

I wrote a paper about this years ago, and I’ve done several talks on the topic. However, the topic came up again this week with a patient. Virtually all major headaches have the same statistics of significantly helping about 75-80% of patients … Continue reading

Midrin Back on the Market

Posted on January 4, 2012

We have many patients who swear by Midrin as the only thing that has ever helped them. It was discontinued several months ago. I am happy to announce that it is being sold back on the market by Macoven Pharmaceuticals.  If … Continue reading

Why We Can’t Give You Refills Over The Phone/Fax

Posted on January 2, 2012

The Problem I’ve noticed an increasing amount of request for refills over the phone or coming directly from the pharmacy via fax or Electronic Health Record notice (about 20 request per day).  I realize that I needed to explain why … Continue reading

Potentially New (Natural) Treatment for Indomethacin-Responsive Headache Disorders

Posted on December 31, 2011

I was at the American Headache Society’s Fall meeting in Scottsdale, Az a few weeks ago. An old colleagues from Mayo Clinic approached me.  He told me how excited he was to be involved with a research project with a … Continue reading

Tis the Season for Open Enrollment . . . Which is the Best Insurance for the Headache Sufferer

Posted on December 31, 2011

Over the years I’ve noticed a big difference among the insurance companies when it comes to respecting and caring for the headache sufferer.  This is best defined by the insurance companies willingness to listen the us, the providers and the … Continue reading

The Economics of Medical Practice (in other words, why your visit cost so much) A Candid Review

Posted on December 25, 2011

If you know me, I sometimes speak very candidly about things, even to a fault.  However, I really thought it would be informative for patients to know how we created our price structure and to help them know why we … Continue reading

Botox® and Migraine

Posted on December 22, 2011

I thought I needed to add a news item because Botox® (Botulinum Toxin Type A) in the treatment for migraine is getting a lot of hype in the news and that will only increase in the coming year. Background: I … Continue reading