DO headache medicine specialist uses her unique experiences to raise awareness of headache disorders

This month we bring to you the “Headache Doc” Abigail L. Chua, DO. Dr. Chua is a Filipina American from Wayne, New Jersey, and a graduate of the Philadelphia College of Osteopathic Medicine (PCOM). She followed her passion and completed a residency in neurology at Temple University, as well as a fellowship in headache medicine at the Jefferson Headache Center at the Thomas Jefferson University Hospital in Philadelphia.

She is currently the director of neurology at Geisinger Wyoming Valley Medical Center. In her prior life, she was a nurse. She also has a master’s in human nutrition from Columbia University. She’s an advocate for patients who have chronic headaches and can be found spreading medical awareness on her various social media platforms.

Let us give an osteopathic welcome to our column’s first nurse-to-DO, Dr. Chua.

What brought you to osteopathic medicine?

I stumbled across osteopathic medicine when a friend who had been suffering from chronic neck pain saw an osteopathic physician after several failed procedures left him more impaired than he already was. After just a few sessions, my friend felt so much relief that he cried.

I was amazed and found that learning more about the field was so exciting. I liked the “wholistic” approach that seemed different from what I had seen in allopathic medicine. I also liked that osteopathic medical schools seemed to encourage non-traditional applicants with diverse backgrounds. Having classmates who had interesting backgrounds and life experiences was important to me. When I walked into PCOM for my interview, everything just seemed to fall into place. I felt like I was exactly where I was meant to be.

You were a nurse before starting medical school. How did your nursing background help shape your journey to becoming a physician?

I learned a lot about myself and what I was capable of during my time as a nurse. There were a lot of tears at first. Nursing is not for everyone. It is a very practical, hands-on and humbling vocation. You need to be quick-thinking, efficient and not afraid to get your hands dirty, while at the same time remaining compassionate and kind. From day one of nursing school, these skills and traits were part of every lesson we had. Over time, I became less afraid of getting dirty and more confident in my ability to convey empathy.  

Working as a nurse in a nursing home opened my eyes to the reality of health care and made me better prepared to enter the field of medicine. I felt less afraid to start clinicals in medical school because I already had experience caring for patients. I credit my procedural skills to the training I had in nursing school (what nurse doesn’t pride themself on getting that “hard stick”?). And as a nurse, I occasionally experienced the wrath of impatient physicians. While I was angry at the time, I’m grateful for those challenges because they have helped keep me humble.

You are a board-certified neurologist who completed a headache medicine fellowship. Can you tell us more about this unique fellowship?

Headache and facial pain disorders are complex, and not much time was spent on these conditions during medical school lectures. During my residency, an audible groan could be heard from the residents whenever a “headache patient” was put on the schedule. I didn’t mind seeing those cases, so over time my co-residents would trade with me so that they could have more “interesting” cases. I saw so many patients with headaches that I joked to my program director that I was really enjoying my headache fellowship. He encouraged me to follow through with that, and I was lucky enough to get a fellowship at the Jefferson Headache Center in Philadelphia.  

Headache medicine is a small but growing field. One of the great things about this field is that we have clinicians and scientists with diverse training and backgrounds. While most headache specialists are neurologists, there are also specialists with backgrounds in family medicine, PM&R, psychiatry, dentistry and many others. 

A fellowship is essential to receiving advanced training in headache and facial pain disorders. Most residents don’t get enough exposure to these conditions or the wide variety of treatment options for patients. As a headache fellow, I saw cases I had only read about in textbooks. I also became comfortable with using more complex treatment plans, including medication management, neuromodulation devices, procedures, intravenous infusions of lidocaine or ketamine and so much more. 

My headache fellowship attendings also made sure to get us involved in advocacy work very early on in our training. This is really important because there are a lot of stigmas associated with these conditions and being an advocate is part of being a good physician. 

You are open about your personal history of migraines. Can you share what it is like being on the patient’s side of this diagnosis?

Being a person who gets migraines allows me to better relate to my patients. I can appreciate their struggles with getting an appropriate diagnosis and finding treatments that work. I also understand how even small changes can make a difference for people with headaches and facial pain disorders. For example, slowing down and taking a few steps back when checking extraocular eye movements can make a huge difference for someone with headaches. Standing too close or moving your hands too quickly can make us dizzy.

Also, I am more aware of scents. People with migraines can be very sensitive to strong scents such as perfume or strongly scented lotions. I ask all my patients to adhere to a scent-free policy when coming into the office, which I think helps everyone.

You are active on Instagram [login required]. How can doctors use their different platforms to improve patient care and health literacy?

Social media platforms are a great way to share information to people who may live in medical deserts, or who may not be quite ready to seek care for their symptoms. With so many people relying on the Internet for medical advice, it’s important for well-trained medical professionals to help dispel false information in a way that is easy for lay people to understand. 

Having a social media presence is also a great way to network and market yourself. Just make sure to review your employer’s policy on social media to avoid potential problems in the future. If you are interested in having an online presence, I would also recommend that you get media training early in the process. 

What are some important tidbits that you would like other medical specialists reading this Q&A to know about migraines, headaches, chronic pain, etc.?

Treating patients with headache disorders is fun and rewarding! Gone are the days when we only had NSAIDs and other nonspecific treatments. There are now so many different treatment options that we’re able to help people who have suffered with headaches for years; some since childhood. Nothing makes me happier than a patient telling me they were able to go back to work, school or something they love because they were no longer in constant pain. 

I think osteopathic physicians have an advantage in fields that treat pain. Our philosophy on health and wellness, our patient-centered approach to care and our skills in osteopathic manipulative medicine make us well-suited to care for patients with chronic pain conditions. I encourage all students to shadow a physician who enjoys caring for patients with headache disorders. Perhaps they’ll find their calling and join me in this exciting specialty.

Related reading:

How sports-related concussions affect mental health

How I Matched into neurology