Dell Children's starts pediatric headache clinic
Dell Children's Medical Center of Central Texas has opened a headache clinic as part of its pediatric neurosciences department, which began last year as a joint project between Dell Medical School and Dell Children's.
Dr. William Qubty will lead the clinic and said he is one of only about 20 doctors in the country who has this pediatric subspecialty training. Qubty, who grew up in Corsicana, trained at Mayo Clinic in Rochester, Minn., and University of California San Francisco.
The clinic will focus on migraines as well as headaches caused by brain tumors, auto immune disorders and concussions. Qubty will focus on getting a thorough heath history and detailed neurological exam to see what might be causing the headaches and which treatments will work best.
He estimates that about 15 percent of children have migraines. While many will go to their primary care doctor first and then to a neurologist, Qubty said, "the pediatric headache clinic is hopeful to work with the community of providers to tackle the toughest cases."
"We expect we have plenty of needs not addressed," he said.
This is a field of emerging science with many advances in the treatments available. Previously, doctors would use medications that were for other conditions, but starting last year, migraine medicines became available that target the root cause, Qubty said. He also works with families to help figure out what can lessen the migraines, such as vitamins.
• Teens need 8½ to 9½ hours of sleep a night, and the first change they can make is to stop using electronic screens at night.
• He recommends drinking four 16-ounce glasses of water throughout the day.
• He doesn't put kids on restrictive diets, but he talks about not skipping meals, especially breakfast, and avoiding MSG, which can be a known migraine trigger.
• To reduce stress, he recommends cognitive behavioral therapy to help kids understand stress and pain.
• He recommends cardio exercise three days a week to reduce stress and produce endorphins, which help with migraines.
"No treatment is 100 percent effective," he said. "It's a complex pain disorder." New treatments reduce symptoms in 70 percent of cases, he said. "There's still room for improvement, but it's a big step up from prior treatments."
Qubty will be working with kids and their schools to help them understand that a migraine isn't just a headache kids can shake off. It causes sensitivity to light, sounds or movement; nausea; and dizziness. "They need to rest," he said.
Some are in pain for hours, some for days. Sometimes migraines happen once a month; sometimes kids have pain that never goes away. And sometimes migraines become more frequent. "They are missing school and falling behind in work," he said. "There's a lot of things we can do to work with them and their school districts to make sure certain steps are in place."
In addition to Dell Children's offices at 'Specially for Children clinics near the hospital and in Westlake, Qubty's said he plans to develop a telemedicine practice to allow him to see patients all over the state. He'll be able to do follow-up visits by video to avoid parents missing work and kids missing school to drive to see him.
He also plans to develop a curriculum at Dell Medical School to educate students there in pediatric headache management and offer residents a pediatric headache rotation.
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