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-This is Joe.
Joe suffered a mild traumatic brain injury, or TBI,
due to a blast injury during his deployment in Afghanistan.
He felt dazed and confused with no loss of consciousness.
Immediately following the injury,
he started experiencing post concussive symptoms
such as headaches, dizziness, sleep disturbances,
poor concentration, difficulty with memory,
feeling anxious or irritable, and being sensitive to light.
He went to his local VA hospital to receive care
for the symptoms that had bothered him since his TBI.
He was treated by a team of specialists
to address the various physical, cognitive,
and emotional symptoms
that were interfering with his quality of life.
Joe was mostly concerned about his headaches,
since his headaches seemed to be getting worse.
They were occurring most days out of the week
and didn't seem to be getting better with time.
He was taking over-the-counter pain medications frequently,
but it didn't seem to be helping.
He was missing work,
and his mood was bad when he had his headaches.
This was starting to affect his relationships.
He was referred to a headache specialist,
who diagnosed him with post-traumatic headache,
or PTH.
-Joe, what you have is post-traumatic headache,
one of the most common, persistent symptoms
in someone who has had one or more TBI.
These are headaches that start shortly after trauma
to the head or neck.
They vary in frequency and severity
and are often worsened by symptoms of insomnia,
low mood, and frequent use of as-needed pain medications.
Generally, brain imaging
and other diagnostic tests are normal.
-Thank you for helping me understand.
I'm glad I know what I have and that I'm not alone.
What can we do about my post-traumatic headache?
-There are a lot of different types of treatments
for your headache.
It will be important to review the options with you
and see what we should try together.
-Joe and his doctor discussed a treatment plan
that included three parts.
Lifestyle changes that included decreasing the amount
of over-the-counter medications he was taking,
diet modifications, and identifying and addressing
Joe's most frequent headache triggers,
which were lack of sleep and increased stress.
A preventive treatment, which is an intervention or medication
designed to decrease frequency and intensity of headaches.
A rescue treatment to use at the onset of a bad headache.
Joe worked with his doctors to find a treatment strategy
that worked for him.
In addition to lifestyle changes,
Joe decided that he wanted to try pain procedures
to prevent his headache.
He found that decreased the frequency and intensity
of his headache.
His doctor also prescribed him a medication
that worked well to stop a headache
before it ruined his whole day.
But most helpful for Joe was working with a therapist
to learn how to better manage stress and get better sleep.
This not only helped reduce his headache
but made him feel better in general.
By working with a headache specialist
and taking an active role in managing his headache, pain,
and other symptoms,
Joe was able to successfully return to work,
spend more time with family and friends,
and enjoy a healthier life.
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