James. A. Haley Veterans’ Hospital (JAHVH) in Tampa, Florida, has been designated a Headache Center of Excellence (CoE) by VA. JAHVH is one of two facilities throughout the Veterans Health Administration to receive the designation.
“We’re very lucky because we probably wouldn’t have it if we didn’t have this awesome Polytrauma Center,” Dr. Georgia Kane said. “It means we can offer so much more to our patients. Everybody’s highly excited.”
Kane, a neurologist and head of the Chronic Headache Management Program (CHAMP), said the designation was due in large part because of the hospital’s Polytrauma program.
Veterans with a history of polytrauma or traumatic brain injury commonly experience headaches. Headache management for Veterans with TBI and multiple co-morbid conditions is challenging and is best managed by an interdisciplinary team. That’s precisely what CHAMP has been doing for several years.
“We started an interdisciplinary team about four years ago,” Kane said of the five-week outpatient program. “We noticed that with people with headaches, it’s difficult to treat just the headache, so occupational therapy, psychology and me, we all work together and we meet weekly on patients to maximize their care.”
Program participants are required to keep a diary, noting the time a headache starts, what they were doing, what they were eating and other aspects of their lives that can be critical to understanding what might be triggering the headaches.
Options other than medications
“The number one thing is education. Once you know more about what is affecting your situation, we can then teach options that are other than medications,” Kane said. “Medication will do a certain percentage, but if you only relied on medications to help your situation, then you would be discounting the fact that you’re not sleeping well, or to distract yourself with relaxation techniques or biofeedback that we do to try and get your mind to think of something else.”
CHAMP participants meet once a week for lectures and other forms of treatment that includes recreation therapy, Botox injections and precise injections in the neck if needed. Botox is used to relax muscles that, when tensed, can cause headaches. The treatment is very effective, Kane said.
About 60 people are in CHAMP at any given time, including those patients who are followed after discharge.
While many of the TBI patients with headaches tend to be younger, chronic headaches are non-discriminatory, affecting men and women, young and old, and the additional funding that comes with the Center of Excellence designation will allow the CHAMP staff to add additional treatments for them.
They hope to work with the lighting in the treatment areas since lighting can affect headache sufferers. Equipment for neck injections, electrical stimulators, and virtual reality equipment are a few of the items Kane said she hopes to procure for the program. Headache treatment is offered to all Veteran patients at all VA medical centers. Patients can get referred to any Center of Excellence but because not all centers offer the same thing Veterans should confirm with their VA health care team and the Center of Excellence that they will receive the specific treatment they need.
Patients should keep in mind that this is an outpatient program. Patients come once a week for five consecutive weeks – plus the follow-up after they complete the treatment – which is not always easy if referred from a distance.
“Becoming a Headache Center of Excellence means that we can expand and do more, to be able to offer more things, more physical therapies, recreational therapies, art therapies,” Kane said. “When we were presented with this, it was one of those truly amazing moments.”