Migraine

Any suggestions on how to find a doctor in my area who might be willing to cooperate/coordinate with my migraine specialist clinic? I live in IL and the clinic is in MI. Sometimes I need to see a doc but a trip to Ann Arbor just isn't in the cards.

An example. My head pain neuro wants me to start DHE injections. He said someone here could prescribe but I would have to be taught how to use it, so they would have to be willing to do that as well.

My PCP wants nothing to do with my head, telling me to go to MI if there is a problem. He is far from cooperative. (Well we call him Dr Useless for a reason I guess- I haven't been able tofind a Dr Useful yet!)

I wonder if a drug store clinic would be willing to pitch in when there is a circumstance like this.....

Good Morning Dawn,

You might need to interview doctors to find someone to help you. Perhaps a local neurlogist would be a route to check. It's always hard to know who will end up being cooperative with this type of situation.

If your insurance allows you to change PCP's and go to specialists without a referral, I think I would start calling the in network doctors and aske the question. My PCP has continued to be helpful and sympathetic to my migraines, even though she does not have to treat them often.

BTW, don't overlook your OB/GYN. They deal with alot of patients with hormonal migraines and he/she might be very cooperative in working with your migraine specialist.

Take care and good luck,

Cindy

Hi Dawn,

I have an out-of-state Migraine Specialist and a local neurologist. My PCM was like yours and didn't want to see me for my Migraines but he referred me to a local neuro. I see my local neuro every two or three months and I stay in touch with my Specialist either by email or by phone. I found that as long as I keep both doctors in the loop as to what each doctor is doing, prescribing and recommending, things go smoothly.

Anytime a new medication is added by my Migraine Specialist, I let my local neuro know the med, the dose and the tapering schedule. My local neuro has been very cooperative and understanding about it.

Maybe your PCP can recommend a neuro s/he thinks would be willing to work with you and your specialist.

Good luck!

Well, as I said we call my doc Dr Useless. I have asked him to refer a neuro doc here and he just tells me there is no one who deals with migraine as a specialty or an interest at our teaching hospital. (I used to work outpatient neurology and they did have headache docs once. They must have decided it was not profitable). Then he says to go to MI.

I haven't asked my OB/GYN for as much as I love him I don't like the hospital he works from. I asked him for a PCP and the guy worked out of the same hospital and wasn't interested in getting into any of my problems.....just being there for a cold and the flu. So that didn't work.

The hospital in my area I DO like wants me to centralize my care there. It is not close by and in an emergency I would have to go to the hospital I currently go to. And I have tried 2 PCPs there and did not like them- (both said that they would take me off all my meds and that I probably didn't have any of the problems on my diagnosis sheet.

At first that was hopeful, I sure am tired of taking a bag full of drugs every day- until they said they want to redo all testing- for all my issues!- to disprove testing I have had. The final nail in the coffin? One said my GI doc didn't know his butt from a hole in the ground (he is one of only a handful of GI docs in this area respected for the things I see him for- and the other said that Mayo Clinic was full of quacks.)

However we did see a neuro doc in the hospital there I liked......but since I don't want to switch GI or endocrinologist (at the local teaching university hospital which so far as in patient and emergency care goes I am not thrilled) then I would not be centralizing my care would I?

I was seeing a neuro I liked but again, he is at yet another hospital and that one is in the city. It was rather difficult getting in to see him.........

Oh! Argh! You can see how frustrating this is! What about 1-800-doctors? I really want to get lazy and let someone else do the work!

Hey, will someone stop the world? I think I want to get off......

I think a lot of us here know how annoying it is to not find doctors who can cooperate with each other.

Oh, but when you do!!! It's like angels singing to you! LOL It really is quite wonderful!

As far as the example you posed, if that is the issue, finding someone to help show you injections for your DHE....have you checked with the pharmacy? They may be able to help you.....

I know when I did ovum donation, they showed me how to take the hormone injections, but that is what their whole deal is. I would think that your neuro should or could find someone to help you with this situation. I mean, you can't really script a drug and not tell your patient how to use it. I mean, it just sounds odd to me, but then again, I have never run into this situation, so it's 100% possible I'm wrong!

I get very annoyed at groups (doctors or hospitals) that want you to centralize your care. I saw a really horrid "Migraine Specialist" - I use quotes because he knew nothing - and it was far from my home. Well, when he wanted testing and things done, they expected me to come all the way back down there to get all these tests done, when this guy didn't even know about IIH! I almost walked out on that one. Needless to say I never went back, or went for the tests. I found someone else.

My feelings are yes, they can suggest you centralize your care all they want - but it's YOUR CARE! You need to go to who helps you and who you feel comfortable with. Not just to a different doctor because they are located in the same building.

If your neuro is working well for your head, maybe it's time to fire your PCP if s/he doesn't want to cooperate.

I liked Cindy's idea of conducting interviews! LOL Or ask people who use other doctors who they like.

Hey.
I noticed that you live in the Chicago area? Have you looked into the Diamond Headache Clinic at all? They are right in Chicago and wonderful!! I started out at MHNI myself, went 2 years, and although the Drs are great, they couldn't help me enough. So I moved on to Diamond. I absolutely love my doc at Diamond and the 2 clinics are very similar. When I first went and told my doc that I came from MHNI, he told me they were very similar, asked who I saw, and then just started chit chating like he knew them pretty well. Anyway, this is just a suggestion. They have a web page and 1-800 number you can call for info. Good luck in your search!

The only way to find out if doctors are willing to work with other doctors is to ask, plain and simple. I've always had cooperative doctors who were willing to communicate with each other. I can't think of a single one that wouldn't entertain the idea of even minimal contact, be it a letter or a phone call or something. Then again, most of my doctors have always been at the same clinic complex, so that makes it easier to say yes to talking amongst themselves if need be.

Akk that said, I can understand why some doctors balk at "working together", particularly when it's across state lines. Some states have different rules and regulations on health care that can make working together problematic. For lengthy consultations, billing may come into play, and we all know how complicated that can be with insurance and state lines and that jazz. Some doctors are hesitant to get too involved with overlapping care in case treatment styles and regimens conflict with each other, because they don't want to end up doing harm by giving you conflicting info. It can get sticky.

Bottom line, though? You'll never know if you don't ask.

Thanks everyone for your responses and ideas. I guess I just keep searching.

The neuro did not order the DHE, he said he wanted me started on it but would rather a doctor here start the script so I could be properly taught how to give the shots and get all the info. Else he would do so next trip which is the 1st of June.

Alaura- here is an odd one. When I started going to MHNI many years ago my headache specialist from Loyola told me to go there saying that Diamond would make me a drug addict! I don't know if Diamond changed with the times and no longer prescribes narcotics or if they never really did and he just didn't like Diamond for some personal reason.

I have remained loyal to MHNI because they actually helped a lot with my migraines. (It is just recently that they have really worsened again.) And my last doctor there of many years was FAB. Totally interested in me as a whole person, not just in my migraines and even got me in for a total workup at Mayo. First time I saw him he told he was going home that night to read my chart cover to cover and he apparently did- he was extremely familiar with my history and my case.

We have recently considered trying Diamond because my lovely FAB doctor has moved on. The new doc is so earnestly interested in helping though and we have only had 1 appointment with him, that DH and I have decided to go to him a few times to see what happens.

I suppose this would be the most logical time to make the switch to Diamond if we are going to. I guess one gets used to something and fear of the unknown holds one back...

quote:

Originally posted by myachinghead:
Alaura- here is an odd one. When I started going to MHNI many years ago my headache specialist from Loyola told me to go there saying that Diamond would make me a drug addict! I don't know if Diamond changed with the times and no longer prescribes narcotics or if they never really did and he just didn't like Diamond for some personal reason.

I have remained loyal to MHNI because they actually helped a lot with my migraines. (It is just recently that they have really worsened again.) And my last doctor there of many years was FAB. Totally interested in me as a whole person, not just in my migraines and even got me in for a total workup at Mayo. First time I saw him he told he was going home that night to read my chart cover to cover and he apparently did- he was extremely familiar with my history and my case.

We have recently considered trying Diamond because my lovely FAB doctor has moved on. The new doc is so earnestly interested in helping though and we have only had 1 appointment with him, that DH and I have decided to go to him a few times to see what happens.

I suppose this would be the most logical time to make the switch to Diamond if we are going to. I guess one gets used to something and fear of the unknown holds one back...

Hi,

I'm really happy to hear that MHNI has helped you so much with your Migraines! I also understand your fear of the unknown. It is very scary making changes in your care.

I don't know about the other drs. at Diamond, but I see Dr. Nissan, and I think he is fabulous. If you consider Diamond, choose because of a certain Dr., not the clinic. I have written about Dr. Nissan on other threads. Click here to read one. Just scroll down to my post (which is the 1st reply) and you can find some of why I like Dr. Nissan so much. But, I'd also be happy to answer specific questions if you have any. There are other good dr.s there, but I don't know much about them.

At Diamond, in my experience, narcotics are prescribed very rarely and only in very dire circumstances. If you get admitted to the inpatient unit, you are required to be off all narcotics. I was surprised to hear you say someone said that Diamond makes you a drug addict.

Dr. Nissan has prescribed me DHE injections in the past if you are wondering if they do that there. They have a nurse teach you how to give yourself an injection.

Another thing to remember is that if you try out a dr. at Diamond and you don't like it, you can always go back to MHNI. Sure, it is time you are taking to investigate, but it seems like it might be worth it.

Good luck in your decision making! We're here for you.

Kelly

I have to second Kelly here. I also see dr. nissan, and I love him! I won't change dr.s again that is for sure. If you still want to try the DHE, with my first visit I was sent to the hospital and was given DHE for 5 days and then some other meds the last two, so I know that he can do that for you. i nkow that they also try to stay way from narcotics. They know so many way to treat headache that they really don't even need them. Any way, I just hope you can go/stay somewhere that helps you. No matter where you go, I hope you start feeling better . Good luck!

Add me to the list recommending dr nissan and dhc staff. I have been a patient of his a little over a year and from the first phone call I have had a very positive experience. Although the frequency of my migraines varies, I do have an occasional two week migraine free spree, the severity has really gone down with treatment.

But they are human, I have had one appt with a fairly long wait but was profusely apologized to. Phone calls are returned promptly, teaching/informing is thorough and Dr N listens!!

good luck,
lisa