If headaches are stealing your days and the painkillers barely dent them any more, you’re standing exactly where most migraine sufferers stand for years — one short conversation away from treatment that actually works. A registered Irish doctor can tell migraine from tension headache over the phone, prescribe triptans and daily preventives to your pharmacy, and unwind the painkiller-rebound loop nobody warned you about — €34.99, seven days a week.
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Consulting with Dr Abdul Rehman
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Run the 60-second check below — it applies these rules to your pattern and carries your answers into the booking.
Seven quick questions using the same sorting rules doctors use. It cannot diagnose — but it will tell you which pattern your headaches fit, and whether the painkiller-rebound trap might be part of the story.
When a bad headache hits, can you carry on with your day?
Does ordinary movement make it worse?
Climbing stairs, bending over, walking about — does the pounding step up?
During attacks: nausea, or does light / sound hurt?
Do you ever get warning signs before the headache?
Shimmering zig-zag lights, blind spots, or tingling that builds over minutes then fades — doctors call this "aura".
How many days a month do headaches show up?
How many days a month do you take painkillers for them?
Any kind — paracetamol, ibuprofen, aspirin, or anything containing codeine.
Any of these — now or recently?
A "thunderclap" headache (worst-ever, maximal within a minute) · weakness, slurred speech or confusion · fever with a stiff neck · a first-ever new headache pattern over 50 · headache worse lying flat or on coughing · new severe headache in pregnancy.
Before any talk of treatment, the warning that matters most: painkillers on more than 10–15 days a month will eventually manufacture a headache of their own. Paracetamol, ibuprofen and — worst of all — anything with codeine, taken often enough for long enough, lower your brain’s headache threshold until every morning starts with one. It’s called medication-overuse headache, it drives a huge share of “constant” headaches, and it cannot be fixed by finding a better painkiller. It’s fixed by a planned, doctor-supported stop — with real preventive treatment covering your back while the threshold resets. If this paragraph feels personally addressed to you, that’s the consultation to book.
Different beast, different plan: the occasional band-of-pressure day is fine with simple analgesia used sparingly — but the real treatment lives in sleep, screens, hydration, eyesight and, above all, regular exercise. When tension headache turns up on more days than not, a low nightly dose of amitriptyline — prescribed and reviewed properly — prevents it at doses far below its old antidepressant use. What frequent tension headache should never get is frequent painkillers; see the trap above.
Migraine tracks hormones — puberty, cycles, pregnancy and perimenopause all move it. The single rule that changes management: if you get aura (the zig-zag lights), the combined pill is off the table — the stroke-risk maths is unambiguous, and switching to a progestogen-only method takes one conversation. Mention aura when you book; it’s one of the most useful facts you can hand a doctor.
How can a doctor diagnose a headache over the phone?
Because headache diagnosis IS the conversation — there’s no rash to see and no blood test for migraine anywhere in medicine. The pattern (one side or both, throbbing or pressing, nausea or none, better or worse with movement, how long, how often) hands a doctor the diagnosis more reliably than any scan. Ten focused minutes usually settles what years of guessing didn’t.
Painkillers have stopped working on my headaches. Why?
Read this one twice: painkillers taken on more than 10–15 days a month eventually CAUSE a daily headache — medication-overuse headache, the least-known common condition in Ireland. The tell is headache on most mornings that tablets only dent. The way out is a doctor-supported stop (rough for a week or two) with a proper preventive started so the migraine underneath doesn’t run riot. More tablets is the one answer that can’t work.
What’s a triptan and why hasn’t anyone offered me one?
The question half of Ireland’s migraine sufferers should be asking. Triptans are migraine-specific prescription medicines that switch the attack off rather than muffle it — taken early in the headache, most attacks are gone within two hours. They’ve existed for thirty years; people just never make it past the pharmacy shelf to the prescription. That’s precisely the gap an online consultation closes.
I see zig-zag lights before the headache — should I be worried?
That’s aura — common, frightening the first time, and almost always benign. It matters for one practical reason: aura plus the combined (oestrogen) pill is an unsafe mix for stroke risk, and any doctor should move you to a progestogen-only or non-hormonal method. Aura that occurs WITHOUT a headache, or with weakness or speech trouble, steps outside migraine and needs proper in-person review.
When do frequent headaches justify daily preventive medication?
A useful rule of thumb: when headaches cost you more days than a daily tablet would. In practice that’s migraine eating several days a month, or tension headache on more days than not. Propranolol, amitriptyline and candesartan all roughly halve attack frequency; they need 8–12 weeks of patience and a doctor adjusting the dose — which follow-up consultations handle without you leaving the house.
Do you treat cluster headache?
We recognise it — which for cluster headache is half the battle, since sufferers average years before diagnosis. Strictly one-sided agony around the eye in bouts, same hour nightly, watering eye, restlessness. Treatment (high-flow oxygen, injectable triptans, verapamil) is specialist territory, so what we do is confirm the story, start what’s safe, and write an urgent neurology referral naming the condition — full details on our cluster headache page.
This page is general health information, not a diagnosis. A registered Irish doctor will assess your individual situation during your consultation. In an emergency call 999 or 112.
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