Annika Ehrlich: Member Spotlight

January’s Member Spotlight, Ehrlich highlights the importance of the Nurse Practitioner’s role in migraine care

This month, the American Headache Society is proud to spotlight Annika Ehrlich, MS, FNP-C, CN RN. Ehrlich’s work as a nurse practitioner focuses on adult headache care. She is involved with a number of the Society’s Special Interest Sections (SIS), including Advanced Practice Providers; Complementary & Integrative Medicine; Procedural Headache Medicine; Refractory, Inpatient and Emergency Care; Underserved Populations in Headache Medicine; Advocacy, and Women’s Health.

Ehrlich says that part of the NP’s role is not only caring for patients with headache disorders, but also to advocate and help patients be advocates for themselves.

“Caring for so many patients and seeing firsthand all of the individual lives affected makes quite an impact and has also taught me the importance of advocacy,” she says.

A History of Headache

Ehrlich’s entrance into the field of headache medicine comes from a personal place—she herself lives with migraine. Ehrlich thinks she may have gotten her first migraine headache in college, and notes that uncertainty of the diagnosis is common among people with migraine.

“I think, like a lot of my patients, you may not initially have the ability to recognize a migraine, or articulate the symptoms to differentiate migraine from other types of headaches,” she says. “My mom always had headaches, and I knew that she had migraine, but it didn’t occur to me that many of my headaches and associated symptoms were also migraine.”

Eventually, a particularly bad migraine sent her to the emergency room, where she was treated and referred to a neurologist. As Ehrlich got older, she learned to manage her migraine, although she also learned the hard way about the limits of treatment, especially for women who are trying to conceive, or who are pregnant or breastfeeding.

Valuable Experience

In her bedside nursing work at the University of California San Francisco (UCSF), Ehrlich started caring for patients with headache disorders in 2007, especially those admitted to the hospital for multi-day stays. This gave her extensive experience in “the nuances of inpatient management and care for patients with chronic migraine and other complex headache disorders” before becoming a Nurse Practitioner and joining the UCSF Headache Center in 2015 in this role.

Her background in caring for the inpatient headache population served her well as she helped manage the inpatient service and teach neurology residents about inpatient headache management alongside her neurology attending physicians while learning outpatient management of headache disorders at the Headache Center Clinic. This experience has increased her expertise and led to opportunities in research, teaching and leadership (such as recently joining the Board of Directors at the Headache Cooperative of the Pacific).

She enjoys and stresses the importance of Headache education. “Nursing and Nurse Practitioner programs tend to be very generalized, and just as in Medical education, there is not a lot of time spent on Headache management,” she says. She enjoys precepting Family Nurse Practitioner students in clinic, and has recently joined the faculty for “The Bridge” – a comprehensive Migraine education program created with AHS for new nurse practitioners and physician assistants caring for patients with migraine.

Patients Seeking Long-term Support

Ehrlich says that one of the biggest accomplishments a provider can achieve with a patient who has a headache disorder is building trust. She says there is still a lot of mystery and stigma around migraine and headache disorders, and many patients experience feelings of isolation or abandonment.

The more Ehrlich cares for patients with headache disorders, she says, the more she realizes the impact these disorders have on individuals, families and societies.

“I believe the most valuable part of the portfolio of any clinician is empathy,” she says. “And even if we can’t walk in our patients’ shoes, we can try to understand how their condition impacts their lives. But we can tell them we’re not going to abandon them or give up hope.”

She adds, “the future looks brighter for patients with headache disorders. There are so many new treatments available and in the pipeline, along with an increasing recognition of Migraine as a prevalent chronic neurologic disorder and one of the leading causes of disability worldwide.”

A Resource for Advanced Practice Providers

Ehrlich sees some of her most critical work within AHS coming from the Advanced Practice Providers SIS. In this section, NPs like Ehrlich can connect with Physician Assistants (PAs) and NPs who are working in Neurology specialties and providing comprehensive Headache care in a variety of practice settings across America.

“Nurse Practitioners, in particular, specialize in managing chronic conditions, and most practice in Primary Care. Bringing together Advanced Practice Providers who are focused on caring for Headache patients to both share knowledge and practices with each other, and then collaborate on improving education for our Primary Care and Neurology specialty colleagues, is so inspiring and rewarding.”

The American Headache Society is always seeking new members to join its ranks as it looks to gain a better understanding of headache and face pain. Become a member today to see what all AHS has to offer for those involved in headache treatment and research.

About Annika Ehrlich

Name: Annika Ehrlich, MS, FNP-C, CNRN

AHS Membership: Member since 2015

Primary: Nurse practitioner, UCSF Headache Center, San Francisco, California

Quote: Migraine and headache disorders affect so many individuals in our society that it is stunning how little both general health care professionals and laypeople know about them. Specializing in these disorders has given me an opportunity both to care for patients and share expertise.

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