Where Discovery Creates Hope

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We specialize in complicated. Every patient is different, so we look at the whole patient, not just her head(ache).
Dr. Jakub Tolar
Dean of the University of Minnesota Medical School
a monthly series

where discovery creates hope

Team takes aim at a long misunderstood disease

Kelly Aanestad’s first migraine attack came out of nowhere in her early 30s.

Others followed—sometimes one bout right on top of another. The Rockford woman experiences piercing eye pain, vertigo, nausea and a head that feels like it’s going to explode.

There is something else, too. Something all too common for a disease that others can’t see or feel.

People, co-workers in particular, simply didn’t believe her.

Two years or so into this nightmare, Kelly found help and hope from University of Minnesota expertise through the M Health Fairview Headache Care program.

Its collaborative, innovative approach brings a wealth of resources to this long misunderstood disease.

Even better, it hopes to advance a science that, because the patient has all too often been blamed, hasn’t garnered the attention it deserves.

Says Dr. Abby Metzler, the assistant professor at the University of Minnesota Medical School and M Health Fairview neurologist who leads Kelly’s care team: “I hope that someday we can come closer to a cure for migraine.”

“We specialize in difficult.”

Just about all of us have, at one time or another, experienced a headache. But, of course, not all headaches are created equal.

Even migraine attacks, which affect some 15 percent of us, differ in severity. Most, in fact, can be managed with the help of a primary care doctor.

It’s the severe cases, some of which can last for days, not just with migraine but other types of headaches, where the program hopes to make a difference.

Says Dr. Metzler: “We get people from all over—not just Minnesota but surrounding states. Some have been seeking help for decades.”

“It’s not one thing. It’s like 200 things.”

There’s a good reason the program brings a team approach to its work. Headaches, and migraine in particular, can’t be traced to just one culprit.

Even so-called triggers vary wildly, everything from stress to light, heat, menstrual cycles and certain foods.

Other medical conditions come into play, as well—aggravating or being aggravated by a headache disorder.

Each patient, as a result, is assigned his or her own group of specialists, depending on the expertise needed.

Says Dr. Metzler: “We pull in those members of the team that are most helpful to the patient. So it’s really individualized care.”

The power of academic medicine

Another strength of the program is the treatment advances that can come from research at the University of Minnesota Medical School.

This research means that team doctors may be able to offer access to promising clinical trials.

Says Dr. Metzler: “A lot of people are interested in that. Even if they’re not personally benefiting from it, they want to advance the field to help others.”

“It’s like your head is in a vise and Thor is cranking it closed.”

Kelly still suffers migraine attacks. But thanks to her team, she now has tools to reduce their intensity and even frequency.

She’s working again, this time in a job she can do from home on her own time. It’s too difficult, even with a part-time job, to find a replacement when a migraine attack strikes.

Kelly looks forward, not just to her team’s continuing efforts to find more effective medicine, but to something just as important: Bringing much-needed awareness to this bewildering disease.

She says: “My hope is that people understand it’s not just a bad headache and to try to have compassion for others.”

The Four Stages of a Migraine Attack

More than just a headache: Dr. Abby Metzler shares her insight on migraines.

1. Prodrome

2. Aura

3. Headache

4. Post-Drome

PUTTING DISCOVERY INTO PRACTICE

M Physicians are an extension of the University of Minnesota Medical School. As Medical School faculty, they are always looking for new and better ways to treat patients, whether in the laboratory or the clinic. And through clinical trials, cutting-edge therapies are sometimes available to patients when the standard of care is no longer enough.

What is Academic Medicine?

Most medicine is practiced within what is called “the standard of care.” Simply put, “standard of care” is the treatment that is commonly accepted for treating illness. This is a good thing! It means that patients receive treatments that are known to be generally effective and reliable.

The goal of academic medicine is to treat patients while looking for better therapies. It takes the toughest problems from the clinic and looks for solutions in our research. Many of our physicians — leaders in their fields — are also scientists.

When a patient faces an illness that requires treatment that exceeds the standard of care, academic medicine can provide access to newer therapies.

Dr. jakub tolar
Dr. jakub tolar
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