29 Dec The Headache Clinics: The Michigan Headache Clinic in East Lansing, Michigan
Doctor Edmund Messina attended medical school at the University of Illinois in Chicago. He remained in Chicago to complete an Internal Medicine internship at the former Michael Reese Hospital, and then traveled to Saint Louis, MO for a neurology residency at Washington University. Dr. Messina reflects on his years in medical school and internship in the book, The Spattered White Coat. He advised that his introduction to headache medicine occurred when he attended a lecture on headache in medical school which was presented by Seymour Diamond, MD, the Executive Chairman of the National Headache Foundation.
He is certified in Neurology by the American Board of Psychiatry and Neurology, and received subspecialty certification in Headache Medicine from the United Council for Neurologic Subspecialties in 2008. He became a Fellow of the American Headache Society on November 15, 2012. Dr. Messina is Clinical Associate Professor of Medicine at Michigan State University’s College of Human Medicine. He is the founder and Medical Director of Arbor Medicus™, a patient and physician advocacy and educational website.
The typical patient at the Michigan Headache Clinic presents with painful disorders of the head or face, and usually with a complex medical history. Adults, as well as children, 12 years and older, may be seen at the clinic. Self-referrals are accepted if the Clinic participates with the patient’s insurance.
The first appointment consists of an in-depth interview by the nurse, a thorough history, and neurological examination conducted by Dr. Messina, and followed by personalized patient education by the nurse. A typical day at the Clinic consists of new patient visits, return visits which start with the nurse or medical assistant taking an interval history, and a detailed encounter with Dr. Messina or the nurse practitioner. The nurse will conclude the visit with additional patient teaching. Some return visits are conducted through remote telemedicine for patients living at greater distances. Because of the pain being experienced by new patients, all efforts are made to evaluate them within a couple of weeks. Initial visits are expedited even if it means modifying the schedule. If a colleague has an urgent request for a referral, the staff will make every effort to accommodate the patient’s evaluation.
The main philosophy of the Clinic is to consider the “entire patient” in order to not only establish the diagnosis (or diagnoses) but also to identify and treat those factors which will interfere with a successful outcome. Factors that may impact the patient’s treatment include other neurological problems, neck pain, sleep disorders, anxiety, depression, and other issues. All painful disorders of the head and face are treated at the Michigan Headache Clinic. The treatment plan is individualized according to the patient’s needs.
Treatment may include medications, counseling, physical therapy, and intervention therapies, such as Botox. At the Clinic, patients are taught auto-relaxation techniques and cervical muscle exercises, and are encouraged to utilize online and personal counseling services, including mindfulness. If inpatient therapy is indicated, Dr. Messina has a long-standing relationship with the Diamond Headache Clinic in Chicago for possible referral of recidivist patients.
The biggest immediate change that Dr. Messina described for the Clinic is the ability to offer virtual visits for established patients, via telemedicine. Patients living at great distances are now able to complete a visit through a secure video connection. The Clinic is also expanding its artificial intelligence expert system to more efficiently gather medical histories. A pioneer in the use of electronic medical records, Dr. Messina has been utilizing computer-assisted history taking since the 1980s. He believes that the future medical climate will be driven by cost effectiveness and that its advanced technology will continue to make the Michigan Headache Clinic affordable to the average patient, despite the rise in insurance deductibles.
When asked what he enjoyed most about working in headache medicine, Dr. Messina revealed that it is gratifying to see patients improving. From visit to visit, patients change for the better, making the practice very worthwhile. Dr. Messina became interested in headache medicine because he had experienced migraine since the age of 8 years, and he recalled watching his mother suffer from headaches all of his life. There is a long history of migraine in his family, and several of his staff are also migraine sufferers.
In addition to his clinical practice, Dr. Messina has been active in headache education through the media. With his son, Dan Messina, he wrote, produced, and directed a documentary on headaches, Life and Migraine, which was broadcast on public television and was released on DVD in 2006. The documentary was featured in an international film festival, and in 2006, Dr. Messina received the National Headache Foundation Award for Media Excellence. Another film, The Headache Which Would Not Go Away, was completed in 2008, and aired on The Learning Channel and the Discovery Health Channel. The feature-length film, Lily’s Mom, was released in 2011. Dr. Messina wrote, produced, and directed the film (and had a supporting role) which focuses on self-advocacy in a woman suffering from severe migraine and depression. It was a recipient of an independent film festival Drama Award and a nominee for the Voice Award in Hollywood in 2012.
Dr. Messina was asked what general advice he would give to the patient experiencing headache. He noted that headache patients need to take the initiative to modify their lifestyle and to seek help from those who are willing to spend the time to help them. Patients must realize that most headache disorders, no matter how daunting they seem, are probably quite treatable when the best individualized treatment plan is established.
For more information on the Clinic, you can visit,
Michigan Headache Clinic
1675 Watertower Place, Suite 600
East Lansing, MI 48823