For 29 years, the City of London Migraine Clinic has offered hope for Britain’s six million migraine sufferers. Now, the only specialist clinic of its kind in the world, which is run as a charity, is threatened with closure because of a short-term funding crisis.
The cost of a 40-minute consultation with one of its nine doctors – some are migraine sufferers themselves – is £208, but patients pay what they can afford. In these cash strapped times, this is falling short of the figure required to support the clinic, which is also a leading research and teaching centre.
The World Heath Organisation ranks migraine as the 19th most disabling disease worldwide (12th in the women-only disease rankings). It is the most common neurological condition, affecting 7.6 per cent of men and 18.3 per cent of women in the UK. Each year sufferers lose about six working days to migraine; on any one day, it keeps up to 90,000 people from work, at a cost to the British economy of £2.25 billion.
“We’re finding more and more that people taking annual leave for migraine attacks because there is a lack of understanding about the condition,” says Dr Anne MacGregor, research director at the clinic.
Despite this, migraine is still not seen as a public health problem and it is hugely underfunded.
Daryl Williams, 45, one of more than 40,000 patients treated by the clinic, says: “My first attack was when I was 13. I would get about two a year but they became more frequent, occurring daily at one stage.
“I would become disorientated and my vision would be affected. If I was driving, I would have to pull over – there have been several occasions when my husband has picked me up from the side of a motorway. I found the only way to cope was to take a painkiller, which often didn’t work, and go to bed.”
Daryl tried conventional and alternative treatments, none of which helped, before she discovered the clinic via the internet. Before her first appointment, she was asked to fill in a record card for a month to establish if there was a pattern to the attacks, or any common triggers. “I was told it could be low blood sugar, or hormones,” she says. “Bright light can induce an attack, and I’ve found I’m susceptible when I fly. I had been taking painkillers every day to treat my symptoms, but I was told that this can make things worse.”
Dr Giles Elrington, a consultant neurologist at Barts and The London, and an expert in management of headaches, says that dependency on painkillers is a major factor. “The single most common problem, which affects about 40 per cent of patients, is over-use of medication,” he says.
“It’s very hard to break that cycle. Patients tell me that they’re taking only eight tablets a day and not exceeding the recommended dose. But with regular use, within two to three weeks, they could end up with daily pain when they try to withdraw. To break this cycle you have to stop completely. I often sign patients off work for two weeks to allow them to stop taking painkillers, and then examine the root cause of their headaches.”
This will work for some patients who find themselves pain-free once they’ve quit the painkillers. Those who are still plagued by migraines will be prescribed the correct medication by the clinic’s team.
Daryl was advised to take 300mg aspirin every day, and this has reduced her attacks to one or two a month. “I now recognise the warning signs, and so I take 900mg of Disprin and one domperidone, an anti-nausea drug. My attacks are less frequent and less severe and I don’t suffer the anxiety that I did when I felt that I was always anticipating an attack.”
Helping patients gain control of their migraines is the overall aim of the clinic. Daryl says her quality of life has improved dramatically. “I wouldn’t have been able to continue working. The clinic has really changed things for me.”
•To make a donation to the City of London Migraine Clinic or make an appointment, visit www.colmc.org.uk or call 020 7251 3322
