Helping Veterans with migraines and headaches

Every day of the year, the VA Connecticut Headache Center of Excellence (HCoE) focuses on treating Veterans suffering from migraines and headaches.

The mission for the HCoE team is to provide quality headache care to Veterans. They do this by taking a holistic approach to treating Veterans. This can include physical therapy, exercise, diet and nutrition changes, Botox injections, medications and other advanced therapies.

Leading the charge in the fight against headaches at VA Connecticut is Dr. Emmanuelle Schindler, a neurologist who has been with VA since 2016. “I always found the brain really interesting,” he said. “When I did my rotations during medical school, I liked seeing headache patients. That’s because there are a lot of treatments out there and you can make peoples’ lives much better.”

VA Headache Centers of Excellence were approved by a Senate Appropriations Committee. The committee recognized that over 350,000 Veterans sustained traumatic brain injury (TBI) during the Global War on Terror. It also recognized that chronic migraine/post-traumatic headache is the signature symptom of TBI.

Members of the Headache Center of Excellence. From left: Pharmacist Alex Guirguis, Nurse Practitioner Maxine Coore, Dr. Ashish Adlakha, Dr. Emmanuelle Schindler

“Headaches now manageable so they can enjoy life.”

“I would tell Veterans if you are getting headaches regularly, tell your primary care physician, and from there you can be referred to the HCoE,” said Schindler. “It’s been very rewarding working at VA. I’ve had several patients who weren’t able to work and didn’t have much of a life due to their headaches. While we haven’t gotten these patients down to zero headaches, we have able to make their headaches manageable so they can enjoy life.”

Posttraumatic headaches occur in up to 92% of military personnel who have sustained mild TBI and is associated with chronic daily headaches. The prevalence of chronic daily headaches in returning soldiers after a deployment-related concussion is 20% higher than that seen in the general U.S. population.

At the HCoE’s satellite office at the VA CBOC in Newington, CT., Dr. Ashish Adlakha runs what he calls a headache bootcamp. “Officially, it is a multi-disciplinary clinic we run every week to treat patients. I work part-time in the private sector as well. I can confidently say that what we offer here with a multi-disciplinary approach to treating Veterans, with availability to different doctors, treatments and medical devices, is unique to VA. You will not find that level of care in the private sector.”

Four-pronged approach: clinical care, education, research, innovation

HCoE’s strategic plan to treat Veterans suffering from headaches and migraines includes a four-pronged approach in which they utilize clinical care, education, research and innovation to treat Veterans. At its helm is National HCoE Program Director Dr. Jason Sico.

“One of the reasons I love neurology is that our brain, our nervous system, makes us who we are in large part,” Sico said. “When people have headaches, it impairs their quality of life. It can be disabling and prevent them from doing the things they love most, like spending time with family, friends and loved ones. That’s one of the many reasons while I’m drawn to treating patients with headaches.”

Almost half of adults have had a headache at least once within the last year. Migraine is the most common type of headache that led patients to seek medical care. In 2017, approximately 380,000 Veterans sought care in the Veterans Affairs system for a headache disorder.

“When you look at the numbers, for patients under the age of 55, headaches are one of the most disabling neurological conditions in the world, not just the United States. When you look at that age group you could argue that’s when people are at their most productive,” Sico added.

Nineteen headache centers across America

“This is when people are having families and managing careers. When you look at such an important time of life, how could you not want to help those people?” said Sico. “What I really love most about VA’s Headache Center of Excellence program is [that] it really demonstrates VA’s commitment to caring for and serving Veterans living with headache disease.”

The HCoE program started with seven centers. The program has been so successful, there are now 19 centers across the country and at least one in every Veterans Integrated Services Network. Over the next year, Congress has asked VA to grow to at least 28 centers total.

If you suffer from headaches, contact your primary care provider for a consult. You may be referred to a VA HCoE.