Pacific Rim Headache Center – Summer Newsletter

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 received an invitation from Group Health Cooperative to join their network as a headache/face pain specialty clinic. Pacific Rim Headache Center will be the first headache clinic in the state that is contracted with Group Health.  We are presently in the credentialing process and hope to be able to schedule our first in-network Group Health patients on Jan 1st 2014. Until then we can see those who have out-of-network benefits. If you are a Group Health subscriber consider letting them know how much you appreciate their decision.

International Headache Congress: Pacific Rim Headache Center Presents the Highest Patient Satisfaction Level Ever Recorded for a Headache Clinic!

The International Headache Congress is the most prestigious scientific meeting for headache research in the world. It is held every other year and combines the scientific meeting of the American and International Headache Societies. Over four hundred studies were presented this year, representing the cutting edge of headache research.  This year, Michael Jones, MPAS-C was invited to present a study of our patient attitudes and satisfaction. We are unique because we offer world-class headache care in a rural setting.

Based on a random, nonbiased survey, 97% percent of patients seen at Pacific Rim Headache Center report a higher satisfaction than any prior treatments for headache, including other headache clinics. This is significantly higher than other such studies done in the US, Europe and Asia.

Other news from the meeting included many fascinating studies into the basic biology of migraine and other headache disorders. As far as practical treatments, the future looks very bright. The emphasis right now is to create a natural blocker for one of the main chemicals the body uses to create headaches, CGRP (Calcitonin Gene Related Peptide). In the past pills were created to block this chemical and were effective but ran into rare liver irritation with daily use, so they were abandoned. The new approach is using humanized antibodies to block this chemical. In the end it could be somewhat like a migraine vaccine. You could do an injection if you had a bad headache or you could also do a monthly vaccination that would block headaches from coming. Being a natural human antibody, it is unlikely to have any serious side effects or risks. However, studies with thousands of patients need to be completed to make sure it is effective and safe.

Coming this year, hopefully, will be a new treatment for the acute treatment of migraine called Levadex®.  It is actually a very old medication, dihydroergotamine (extract from the ergot fungus) but in a totally new and more effective delivery system, a bronchial inhaler.  Last year all the studies had been done and presented to the FDA, proving its effectiveness and safety. The FDA rejected it due to quality controls at the factory that filled the canisters. The company (MAP) went back to the drawing board and tried to improve the manufacturing of the device. Then, this spring, Allergan (the makers of Botox®) purchased Levadex® from MAP. Once again, the FDA rejected it due to the quality assurance issues at the factory.  Allergan has promised to bring their manufacturing expertise to solve this problem once and for all and get it on the market later this year.  Dihydroergotamine is a great choice in headache treatment because it is natural, plant-based, it is effective, it is long-lasting and doesn’t cause rebound. Our only concern with Levadex® is that Allergan paid almost one billion dollars for it and somehow they will need to recoup their money, which will probably come in prescription cost.

Also coming this year will be a totally new way to stop migraines, a migraine magnetic gun. This device uses a powerful magnetic wave to block the start of migraine. It involves no medications. The only down side is that it is large, heavy (few pounds) and will probably be expensive. Its use is also limited to those patients who have an aura (usually visual disturbance) or some other warning that a migraine is about to start. Once the headache starts, it is too late to use the gun.

Lastly, Cindy McCain (wife of Senator John McCain) was at our meeting and is launching a huge public awareness about headache and migraine.  The campaign is called “Thirty Six Million Migraine.”  The point is that there are 36 million migraine sufferers in the U.S. and they are trying to raise 36 million dollars in research, one dollar for each patient. Migraine disorders have long been discriminated against and these efforts are trying to change that.

James Moren, MD is Board Eligible for the Headache Medicine Board Exam in 2014

Most neurologists are not headache specialists, however, most headache specialists are neurologists . . . but not all of them.  About 20% of the headache specialists in the US are not neurologists. The current president of the American Headache Society, Elizabeth Loder, is highly esteemed by her colleagues and is chief of the Headache and Face Pain Division/Neurology at the prestigious John R. Graham Headache Center in Boston and is not a neurologist. The first and largest headache center in the world (Diamond Headache Clinic) was started by an Internist and is now directed by an Emergency Medicine physician, Dr. Merle Diamond.  The fact that we are not neurologists confuses some patients, referring providers, and most notably, insurance companies.

Dr. Moren has been granted a onetime special exemption by the United Council for Neurologic Subspecialties to take the national headache medicine boards next year. His passage would make us only the second board-certified headache specialists in the state of Washington. We want to make it clear that we treat even the most complex headache and face pain disorders and even our best work is among those patients who have failed many other treatments.

There is Never a Place for Giving Up!

A study a few years ago showed that almost 50% of patients seen at the typical headache clinic, never kept their follow up appointment. The most common reason cited for their not returning is that they have lost hope. They were expecting a simple answer and a quick fix (which had been promised to them by previous providers).  We have a much higher return rate, but there are still patients who give up prematurely.  We never do. There are an endless supply of things to try, plus new things (as mentioned above), which, are on the horizon.  Most of our patients do well and those who improved the most are those who stuck in there and experienced a couple of failures before a great success.

Phone: 360 588 1460