Navigating Med School with New Daily Persistent Headache

How a second-year medical student lives with new daily persistent headache and what it teaches her about chronic disease

When medical student Vaishali Ravikumar started getting headaches early in 2020, she thought she just had too much coffee. But then on April 21, she got another headache, and it never went away.

At the time, she was a first-year medical student. As COVID-19 spread across the globe, she had to take courses online. She gave it a week to see if her symptoms resolved, but her pain continued. So she talked to two neurologists. They gave her an initial diagnosis of hemicrania continua, a chronic and constant form of headache. She tried multiple medications with very little relief. After three months of trying different medications, Vaishali was diagnosed with new daily persistent headache (NDPH).

Diving into Research

As a medical student, Vaishali threw herself into researching headache and migraine treatments. In July 2020, she tried Onabotulinum A (Botox) treatment and a couple of weeks later, added acupuncture. By August, her headache episodes decreased from every day to about three times a week.

Despite her new diagnosis, Vaishali wants to learn more about NDPH through the American Migraine Foundation and American Headache Society. She keeps up-to-date with current medical literature, even though there isn’t much for NDPH. She even reached out to a doctor to help him conduct a clinical trial for NDPH. “Because it’s such a new diagnosis, I feel like so much can be learned, so that’s exciting.”

Living with NDPH during COVID

Vaishali’s headaches and diagnoses all happened during the COVID-19 pandemic. Because it was difficult to get an in-person doctor’s appointment, she relied on telemedicine. “I think that my doctors did a pretty good job of trying their best to get it done through virtual platforms,” she says. While she was unable to get a complete physical exam over telemedicine, she is grateful that diagnosing headache disorders over telemedicine are easier than other medical conditions that could require an in-person visit.

When she found out she had new daily persistent headache, Vaishali was at the end of her first year of medical school. The constant pain made studying difficult, frustrating her to tears at times. Thankfully, the dean of student affairs at her medical school was understanding. They allowed her to move exams so she had more time to study.

She had a hard time focusing on much else other than the pain. She was unable to study or do anything else, not only because of the headaches but also COVID. “Being home the whole day with not a lot of things happening just gave me more time to sit and think about my headache,” she said, “When I would go see a friend or go on a walk with a friend, it was pretty helpful, but I’d have to take a painkiller before I went so I could be able to have a conversation.” For Vaishali, who was trying to limit how much medication she took, it felt like a lose-lose situation.

Her parents worried about her, and her headaches began to take a toll on her relationship with her boyfriend. “My mom is a big worrier, so we had a little bit of an issue in the beginning where she would continuously ask me how my headache was, and I just didn’t want to be constantly reminded of it,” Vaishali says.

She now keeps a daily headache log in her Notes app. That way, she can share it with her parents and boyfriend. “Sharing it with them was a game changer because they didn’t really understand that it was literally 24 hours a day, seven days a week,” she says. “I think reading that helped them a lot rather than me trying to constantly explain it.”

Understanding for Chronic Diseases

Vaishali’s diagnosis helped her understand chronic diseases in a way she never had before. One of her closest friends had type 1 diabetes, and Vaishali thought she understood. “She would always tell me how she would go to therapy and talk about her diabetes,” she says. As a medical student, Vaishali thought because her friend could manage diabetes with insulin, it wasn’t such a big deal.

“As soon as I had this issue for months where every day I woke up with something that was just not right with my body, my outlook on that completely changed,” she says. She called her friend in tears to say she finally understood the impact a chronic disease has on your life. “That’s just a crazy thing to not know how you’re going to feel that day when you wake up,” Vaishali says, “whether it’s diabetes and your blood sugar is all over the place and your pancreas isn’t working, or you have a headache all the time.”

While she’s still early in her medical school journey, Vaishali is considering specializing in pain management. “I think that working with patients with chronic conditions would be very, very satisfying for me,” she says. She wants to use her experience to help others and show compassion for their pain. She also encourages them to try different medications and treatments until they find what works. “You have to tell yourself that this isn’t going to be forever,” she says. That positive outlook keeps Vaishali moving forward.

The American Migraine Foundation is committed to improving the lives of those living with this debilitating disease. To help us with our mission, share your story today to show the world what migraine looks like and how it affects people every day. Together, we are as relentless as migraine.