Migraine

Can someone post the links for tips for finding a new doctor? I've been clicking around here and found a few things but my computer or this web site seem to be messing up. I get a lot of "can't find page" and/or the thingy (so technical I know) just spins and spins.

I have an appt Thurs w/ my PCP. Several months ago he asked if I wanted to see a neurologist. I don't necessarily want to see one, but I think I'd like to try something different, maybe a TENS unit? for my neck/ back of the head headaches. They seem to be getting worse. I actually went back to a chiropractor that my massage therapist recommended (though I haven't been back to her in over a month - now no time or money - ). Maybe physical therapy is where I need to start? Any thoughts on that? My PCP recommended a PT group this summer for my hip during softball season. I never went so I didn't meet anyone. Can you use just any PT or should I ask if they specialize in neck/headache stuff? I don't think I need a referral so I could just go I suppose. The chiro actually does electrical stim, but right now he just uses moist heat before each treatment.

I think the PCP would work with me - something has to give. Just like on some of the old posts I printed out - Imitrex doesn't work well and these things last all day. My soma/advil/fioricet "cocktail" helps for a couple hours but then it seems to wear off too. And I can't get that thermacare up high enough. LOL - I think I should call them up and request thermacare headbands! Though ice is what I needed for the first time last week. No puking but nausea is there. A problem I have already so I don't need to compound it. Sometimes I wonder if THAT is the chicken/egg cycle? Sigh....

I know that there is one clinic in VA a couple hours away in northern VA. Boy, honestly, I avoid that area like the flu if possible. You gotta live there to understand that traffic. And I lived in Atlanta for 4 years so I full well know big city driving. I live in the "capital area" and it's Hillsville comparitively speaking. But with enough doctors to staff 7+ major hospitals (including a teaching hospital) we gotta have at least 1 headache friendly neuro if I choose to go that route locally.... Just need to figure out how to tactfully ask the screening questions and what those questions are.

Thanks,
Diane

Hi Diane...

Most of us have found our neurologists through trial and error. Lots of error! We do have a page here for information on Working with doctors. I hope you can access it. It has good information on what to look for in a physician and how to have successful appointments. I'm not sure if there is really a screening, but you can always ask when you make the appt if the neurologist treats a lot of migraine and headache patients. But that is no guarantee of the right doc either.

In my experience, the best thing in a neurologist is the willingness to think outside the box. I do think it's better to see a neuro than a PCP, and better to see an HA specialist than a regular neuro. I've been through 3 neuros, and most just want to stick to the 4 FDA approved preventives (Topamax, Elavil, Depakote, and Neurontin), when there are in reality over 100 meds we can use. I'm actually headed off to Jefferson HA in Philly (a three hour train trip) because after 2 years, I've made zero progress and I'm done messing around. I think how far a patient is willing to drive depends a lot on how many docs they've seen, how much progress they've made, and how fed up they are... (3, 0, and very for me!)

As for PT/Chiro/Massage, I think it really depends on what triggers your migraines. I know a lot of our members have had success with these treatments and some have not. I know when I slip a disc in my neck and pinch a nerve it will almost always cause a migraine.

If Imitrex doesn't work, there are 7 other triptans (Relpax, Frova, Maxlat, Amerge to name the ones I remember) and a few other non-triptan abortives you can try. Imitrex does nothing for me, but I find Maxalt to be quite effective. Don't give up on triptans if you have only tried one....

Good luck and keep us posted!
Kelly

Hi Diane,

Finding the right doctor can be so difficult! When I first moved to VA three years ago, I was referred by my insurance company to an awful neuro and I ended up firing her. After much debate with my insurance company, they allowed me to find my own neuro and I just stumbled upon a great one, pure luck for sure. He works with my Migraine Specialist and consults with me every other month.

I'm going to throw a bunch of articles at you, and hopefully they will help, along with the one Kelly gave you:

• Coping With Busy Doctors

• Migraines and Headaches - Tips for Living Well All Year

• Migraineur's Guide To a Successful Doctor's Appointment

I hope these help

Thanks guys!

I've printed this info off. I actually emailed Dr. Stark, who is in VA and is recommended on this website and he recommended someone in my area. VERY nice of him. He is about 2 hours or so away (as the crow flies - not counting northern VA/DC traffic-yuk). I worked at the hospital that the doc he recommended works at so I know the name, but I don't know much about him. Interestingly, his research specialty (it's a teaching hospital) is seizures, but I guess he likes headaches also.

And I got the name of another neuro from a coworker that she really, really liked. I had no idea that she had similar problems (headache wise) to me. So I have an appt with my PCP next week and I'll see what he thinks. I don't need a referral but it's always nice to get a "professional" opinion and to just let him know what's going on.

So I'll let you guys know how it goes. And thanks again for the info. I knew I'd seen it referenced here. I'm not sure what was going on that night. OK, got 4 loaves of banana bread with the timer going off and a chocolate zuchinni cake to make. "kitchen cleaning" tonight!

Diane

You're very welcome! Definately come back and let us know how everything goes, you know we love to hear from you

Good luck!!

Good luck with your appointment! I hope you are able to find the "right" person for you to work with and who will help you find some relief!!

Let us know how things go!

Cyn

Well, I saw my PCP today and dummy me was in such a hurry that I left my pile of stuff on the kitchen table, so I forgot my week ago prepared list of questions. Now looking at this question I forgot one of the most important - asking about the PT and tens. But at least I did print out my diary and calendar so I wasn't all out of it. It is a sinus headache rainy kind of day (I do have drainage and I raked tons of leaves and cleaned gutters this weekend so possible allergies). Sigh...

But I did mention that I had learned of 2 neuros if he did decide he'd had enough of me - all in a joking manner. He's always been kind of a serious, thoughtful guy, whereas I'm a happy-go-lucky sort of person unless you catch me on a bad day. But I go in armed and knowledgeable so don't get me wrong there. And I also had nicely tried to color code my B/W calendar with crayons (one day we'll get a color printer) so he could see my Imitrex days, my "4+" days and the start of my period days. The details are in my diary but when it's all there on the "calendar", I really saw the August/September pattern that many folks here have with hot, humid weather too. It was the first time I colored coded the 4+'s. I had way more relief in October - could be from the chiropractor (just 4 visits), better weather, aligning of the planets - who cares - but the 4+'s were down to just plain old "H"s. Still many headache days, but more annoying than day altering.

At any rate, he caught right on to the fact that I now seem open to seeing a neuro. I was rather disappointed by that since he really is trying. He even made another med change today and he knows his meds and how they work. He even keeps up with the side effects I'm concerned about and knows which ones to not use b/c of potential side effects that might lay me out (eg beta blockers - LOL - even though my BP was up today since the nurse and I were talking about kids!) He's one smart guy - I think he's just out of ideas even though I've given him the 100 meds list twice.

So he picked the neuro at the teaching college - looked him up and saw that he does specialize in headaches/migraines also. And found 2 backup docs there also if he has too long of a wait time. I don't need a referral but he said things work faster if they do the paperwork. I did find it odd that I got a call from the nurse and she said they'd be calling me back with a CT scan appt. When I asked why, she said the neuro would want that. In the 10 years I've been dealing with these headaches, I'd think that if something was really wrong, I'd be pretty bad off by now or have other symptoms - at least that's what I tell all the worry warts in my family.

So now I just have to see how Dr. Specialist is. The irony of all ironies is that this afternoon I got a phone call from the temp agency to work at that very hospital again. They want someone FT though and I have a permanent PT job so I don't know if they can use me. She never called back. But then I could maybe get some personality scoop on him...

Hope all our friends down south are weathering out IDA. I guess we should be happy to have had very few hurricanes this year. We've gotten tons of rain the last month after months of drought so I know it's needed - just in little inches, not big.

Diane

Diane,

Overall, it sounds like you had a productive visit with your doctor. He seems very concerned about your well being and that's an endearing quality for a doctor to have.

I've had Migraines for over 25 years and they still have me go in for an MRI every 5 years or so, just to help keep an eye on things. Plus, having the CAT scan will give your neuro a starting point on you.

Good luck with your meds and your specialist appointment