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Is It Time for a New Migraine Doctor?

Most of us begin treatment our Migraines with our family doctors, which is the logical thing to do. They know us, our medical history, and our needs best. Unfortunately, many of our family doctors quickly run out of ideas for treating us. Their training in treating Migraine and other headache disorders is limited, and with all the various illnesses they treat, it’s difficult for them to stay current in every specialized field. If their attempts at devising a successful treatment plan for you don’t meet with success in a reasonable period of time, a referral to a specialist is in order. Your doctor may suggest this before you do. If not, don’t hesitate to ask for a referral to a neurologist or a Migraine specialist. This brings me to an interesting point: Neurologists aren’t necessarily Migraine specialists, and Migraine specialists aren’t necessarily neurologists. Seeing a neurologist is a reasonable step, but many of us find that a time comes when we need to find a true Migraine specialist.

Changing doctors or adding a new doctor to our team can be a difficult decision. There can be some emotional attachments that make it difficult too. Here are some points to remember:

  • No doctor, regardless of how good they are, is the right doctor for everyone.
  • We can’t let the fact that we like a doctor tie us to him or her if he or she isn’t able to help us.
  • Good and caring doctors understand when patients want a second opinion.

When is it time to add a specialist or change doctors?

When our doctor doesn’t like to answer questions.

Some doctors don’t like to answer questions, and they don’t want their patients looking for information on the Internet. Too bad. Dr. William B. Young, of the Jefferson Headache Center in Philadelphia, once said to me, “An educated patient is a better patient. I’d far rather have a treatment partner than a dish rag.” He went on to comment that Migraineurs need to learn about their Migraines, partly because we have to make our own treatment decisions when we have a Migraine. We can’t call our doctor every time we have a Migraine, so we need to decide when to take our medications, and sometimes, which medication to take. We can’t do that if we aren’t educated about our Migraines. As for information on the Internet, yes, there are some sites with bad information. How to determine which sites are accurate is a topic for another time. For now, suffice it to say that there are excellent sites too.

When our doctors aren’t up-to-date or what they say is inaccurate.

Some doctors haven’t learned anything new about Migraines since medical school. Others have learned some, but aren’t keeping up with research and information in the field. If that applies to our doctor, it’s time for a change. Here are a few examples:

  • Doctors who say that Migraines are “vascular headaches.” This theory has been disproven repeatedly. Changes in the blood vessels of the brain may or may not occur, and when they do, they occur after other events.
  • Doctors who don’t know about the various medications used for Migraine prevention. There are now over 100 in use.
  • Doctors who are still prescribing pain medications for when we get a Migraine rather than looking at the Migraine abortive medications such as the triptans (Imitrex, Maxalt, Zomig, etc.) and the ergotamines (Migranal Nasal Spray and D.H.E. 45 subcutaneous injections.

When the doctor offers no plan for getting help after hours, on weekends, and during holidays and their vacations.

No, we can’t expect our doctors to be available to us every hour of every day. We can, however, reasonably expect them to have a plan in place for times when we need help outside of regular office hours.

When we don’t make progress in our Migraine management after a reasonable time.

Obviously, it’s not realistic to expect any doctor to hand us an effective Migraine management and treatment plan immediately. This takes time and patience. If, after a length of time, we’re not making progress, it may be that the doctor we’re seeing isn’t the right one for us, and it’s time to move on. How long we work with a doctor before changing varies from one case to another.

When the doctor’s staff is a problem.

Many people have told me of instances where office staff members have been rude or dismissive, didn’t relay messages to the doctors, or were problematic in other ways. If this happens, we need to find a way to let the doctor know there’s a problem. Until they investigate, doctors will usually hesitate to say much about their staff members, but if the problem continues, and it’s hindering our care, there’s often not much choice but to change doctors.

Wrapping It Up:

The selection of doctors is one of the most important aspects of our health care. We literally put our lives in doctors’ hands. If you’re having trouble bringing yourself to change doctors, remember that.

We need to do a bit of homework when choosing a new doctor for our Migraines. There are doctors who call themselves Migraine specialists when, in fact, they know no more about Migraine disease and its treatment than the “average doctor.” One of the best ways to choose a doctor is to choose one who comes recommended by his or her patients. There are several well known Migraine and headache clinics, but it’s better to choose a specific doctor rather than choosing a clinic or facility. It is, after all, the doctor who works with us to manage our Migraines. It’s the doctor who really makes the difference.

Always remember these points:

  • The person with the most at stake gets to be in charge. When it comes to our health, the person with the most at stake isn’t the doctor. It’s us.
  • Optimal health care can be achieved only when patients are educated about their health and patients and physicians work together as treatment partners in an atmosphere of mutual respect.

If you find the decision to find a new doctor difficult, remember the two points above. If you know it’s time for a change, but you need a bit of a “pep talk,” leave a reply below, please.

It can take time and patience, but we no longer have to just live with difficult Migraines that rob us of our health and quality of life.

If you need help finding a Migraine specialist, take a look at my listing of Patient Recommended Migraine and Headache Specialists.

Editor’s Note: You can also view specialist search directories from the The Migraine Research Foundation, National Headache Foundation, and American Headache Society here: Looking For A Migraine Specialist?

Last updated December 11, 2010

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • kimmersutphin
    2 years ago

    Don’t want to hurt my nurologist feelings but had several extremely bad months even for me. So went to try experimental treatment of katamine infusions which are helping so much. Now I need to call my nurologist and let him know. Not sure how

  • John McCracken
    6 years ago

    Any names for Migraine Specialists in Austin, Tx? Just moved to the area and need help choosing!!!

  • Carolyn Frazier
    7 years ago

    I think it can be frustrating because Doctors are not always sure what will work or what your exact causes are. It’s a lot of trial and error no matter who you see, but the key is that your Doctor LISTENS to you. I go to a headache clinic with 5 doctors. I saw 3 of them before I finally found the right match for me. The first Dr. I saw over medicated me and pushed me into participating in a biofeedback study he was doing. My current physician’s second question (after how are you headaches) is what’s going on in your life, how are things? She really cares about me and is very supportive of holistic or natural treatments that I try.

    Terri you make a great point. I know that my doctor is always learning new things about migraine, because she has new suggestions or samples for me to try each time I visit. She’s constantly adapting her thinking to the ways that my migraines tend to shift or change in nature over time. I have had better success with headache specialists over neurologists.

  • Shani Baldauf
    7 years ago

    Any specialists Migraine specialists in Florida? I’m in Tallahassee and have been through so many different things. I’m so frustrated. Any recommendations for trying new antidepressants (comorbid)?

  • Nicole Bockelmann Espland
    7 years ago

    There is only 1 in MN and NONE in South Dakota! I am working with a doctor who decided to farm me out to other doctors before he even met me. My primary relies on him for my pain management and he said it is up to her…..so I am getting very little pain treatment for my chronic daily headaches and all of the other pain conditions that I have. Nice.,

  • Lifetime_Migraine_Sufferer
    7 years ago

    I was referred to the pain clinic at UC Davis for trigger point injections/occipital nerve blocks AFTER the UC Davis Headache Clinic said they weren’t taking new patients! When I met with the medical director at the UC Davis Pain Clinic, he belittled me and said “if you’ve had this pain for so long, you should be used to it by now” and every time I referred to my pain – he corrected me by saying, “you mean, your headache” as if it was a minor issue. He was the worst, most non-compassionate doctor I’ve ever been to. PLEASE search for a good dr so you never have to experience what I went through. What a sad and pathetic excuse for a pain dr.

  • Pauline Lowman
    8 years ago

    I have the wonderful option of working for a company that allows us a choice in insurance. However I had to choose a different company after yet another rate hike (over $850 for an individual per month). This insurance does not allow care at two of the three Headache clinics in the state. They have stated they would allow care at the one clinic (over 100 miles away) on the basis of IF I COULD FIND no other provider within their network who could offer their care. ZERO (yes that is Z-e-r-o) of the center’s neurologists are HA specialists nor do they have expressed interest in HA’s. In the remaining 50 or 60 authorized neurologists, there is no printable or accessible information as to whether or not these professionals specialize in HA or even have an interest in HAs. The Customer Service people have the same information as I have looking online at the insurance website. So disappointing and frustrating. After 3 weeks of searching, I have narrowed down leads to just a handful of people. In the mean time, I get referred to a Neurologist 45 miles away as he is the soonest available Neuro. My hopes that he was to help – HA HA! 4 weeks wasted now. Then I find that one of the Neuros I consulted 2 years ago may be taking patients. I contacted the office. She is covered. She is a certain clinic’s HA person etc. I worked all through the day to line up care under her. It is set up for an appt 6 weeks out then she emails me and says she will defer my care to the current neuro. The one who has no interest or care in my migraine in the first place. GRR!
    So that was a slap in the face. This guy hasn’t responded to any request for care or further information. I am so tired of putting up and shutting up. I need help and I need it now. I am tired of waiting and trying to do this or that. This struggle started about 17 years ago with an increase and worsening of all things headache. Then the dx came in 2005. Its been the past 6 years that things have gone from yuck to nearly unbearable – at times it has been unbearable — where all I could do was is exist. This is not life. It is so frustrating to have so many road blocks to getting care. If this pain was as visible on the outside (other than the obvious slurring of speech, glazed eyes, puking, inability to think or even walk) maybe like a massive open gaping wound, complete with maggots and foul smelling flesh eating bacteria maybe we could get some one to do some quick action. Someone to realize there is a TRUE problem!

    three doctors have said I see you are no longer working – my talk to them is Yes I am working – I work an official 4.5 hour workday for a public school. I love my job and my kids. but there are many days my ability to work to the best of my ability is not there or I can just summon enough within me to do my job only to come home seek refuge on the floor of my bedroom for hte rest of the entire night – only to come out just in time to dress for the next shift. If this stuff does not get taken care of soon, I may not be able to keep my job or be able to be functioning to anyone. Its all falling apart.

    Honestly if it wasnt my faith in the Lord Jesus Christ, and my love for my mother and knowing how much it would devastate her – I can clearly see why people end their lives early..Yet there still remains hope inside of me. I do not understand how or why with all this day after day but there is For that I am thankful.

    I am also thankful that I have leads on two more people who may help. One is a clinic 45 miles north of here and another is 75 miles south. The latter is the approved clinic but I have been told that I can not go to it yet as I have not proven my need for their care. Well more of this circle hopping and crossing of the t’s and dotting of the I’s are in store. oh wellllll just maybe.

  • Susan Cleveland
    8 years ago

    There are a whopping 6! headache specialists in all of California, all in San Fran or L.A. Great going, medical profession, way to drop the ball.

  • Nicole Bockelmann Espland
    7 years ago

    Teri Robert I agree with you. No one around here wants to touch chronic pain. I mentioned treatments that the Mayo Clinic had suggested to me and the doctors where I live won’t do it. They are not used to dealing with a person my age with multiple chronic pain conditions and I end up no help, no job, no life.

  • Erin Fleming Block
    8 years ago

    I’m in San Diego and my primary was just finally able to get my insurance to approve me seeing a neurologist at UCSD who specializes in migraine. Half the time he conducts research and writes articles on the matter and the other half of the time he sees patients. He knows the latest and greatest in the field and is wonderful! So if there isn’t a specific migraine specialist, then you can look for a neurologist who specializes in migraine, especially if they are at the collegiate level, like my Dr, who is constantly researching and testing.

  • Teri Robert
    8 years ago

    Susan, Several states have no Migraine specialists at all. I fear it’s only going to get worse. When doctors are choosing their specialties, many are interested in research opportunities. Research funding for Migraine and headache is so scarce that many young doctors don’t see it as a good field to go into.

  • Susan Joyce Wood
    8 years ago

    No Nightshades in the diet will help, maybe: tomatoes, potatoes, eggplant, bell peppers of all kinds (paprika, capsicum, chiles, etc..) and tobacco, sorry.. I know that last one is the toughie.. Chronic pain from consuming these plants (arthritis) might cause migraines. Source: Dr. Norm Childers, please see his site. ONE fruit of the potato plant would kill a kid if eaten, but how do we warn the kids if the parents aren’t made aware of that (by the FDA)? OOO! CollUsion!

  • Susan Joyce Wood
    8 years ago

    No Nightshades in the diet: Toamatoes, potatoes, eggplant, bell peppers of all kinds (+ paprika, capsicum, chiles, etc..) and tobacco, sorry, will help. Try it a few weeks and see the aches go away! Source: Dr. Norm childers, please see site. I think this insidious plant infects more than the bones.. It has hallucinogenic effects.. just before you DIE! ONE fruit of a popato plant wil kill a id, but how do we arn the kids if the parents aren’

  • Joy Perez
    8 years ago

    I need a new doctor. Been seeing a headache specialist & I am very disappointed w/the care I’ve received up to this point. It’s going on 7 months or so w/chronic migraines of about 5 a week on average. Now, I’m pregnant, therefore my options are limited. And, frankly, I’m just pissed off at this point cuz he had me taking a med that generally isn’t recommended to take during pregnancy early on. Now, the baby is having some issues. Therefore, I am in need of finding a new dr to help with this. Also, I’m sick of being told that my migraines should start getting better during preg. For some, they may. Not so much for me. And, the OB dr says to take Tylenol. Are you kidding?

  • Nicole Bockelmann Espland
    7 years ago

    I was told after a full hysterectomy at age 33 I would get over the headaches. This as after I was told they would get better after pregnancy, after I got older, after I got other issues solved, after, after, after….Guess What?! It is after and I am still suffering!

  • Ellen Schnakenberg
    8 years ago

    Hi Taz,

    It sounds like you’re having a tough time. Hang in there though, okay? It can take quite a lot of looking before you find a doctor who is the best fit for you. That “good fit” will make all the difference though. Not all doctors are the same, nor are all patients. This can be a discouraging journey at first, but one that is well worth it 🙂

    Playing Devil’s Advocate: a good thing to remember too, is that doctors are people, just like you and I are people, and this means they have good days and bad days. We sure hope that the good days far outnumber the bad days, but sometimes it takes more than one visit to get a really accurate feel if this is the doctor that can help you. Listening though is key…

    My last headache specialist was much more interested in my other neurological issues, almost ignoring the intractable Migraine I was there to see him for that first visit. In the end it turned out that he was one of the most helpful doctors for my personal situation. If I’d had a choice that first day I saw him, I wouldn’t have returned – actually I didn’t at first because I was so discouraged. There were no other qualified doctors for hours around me so I had no choice but to go back. I was nearly in tears because I really felt that I was in the wrong place… but that second visit was a completely different story, and made all the difference to me. It doesn’t always work out this way, but it’s good to remember that sometimes it does.

    That said, I know how hard it is to spend so much time and money looking for the right doctor, and being disappointed by poorly run offices and appointments that don’t seem to get anywhere. It sounds like Teri might be a really good person to talk to about this as she is much closer. Like her, I send many wishes that you are able to find better treatment in the new year, and hope that you will keep in touch with us here to share your experiences as your journey progresses. You never know who else you may be helping along the way…

    Ellen

  • Teri-Robert author
    8 years ago

    Hi, Taz!

    I’m sorry you’re having such a rough time. The right doctor is so very important, as you already know. This is exactly why I think it’s better to choose a specific doctor rather than choosing a clinic. It’s the doctor, that person, who really makes the difference.

    I don’t know where you live in Pennsylvania. Depending on where you live, Long Island may be closer than some of the specialists I know in Pennsylvania. Still, there are quite a few in Philadelphia and a couple in Pittsburgh. If you want to check them out, you can find their contact information on http://www.helpforheadaches.com/doctors/migraine-headache-specialists-pennsylvania.htm.

    Will you please keep me posted on what’s going on and how you’re doing? I truly hope that 2011 brings you closer to better Migraine management.

    Happy New Year!
    Teri

  • taz
    8 years ago

    geez its almost as if that message was meant for me I switched from my doctor in ny I live in pa A very well noted dr opened a office 20 mins from here so it was easier for me than the trip to long island. I wasn’t too crazy about him form the start I get daily migraines since going to him my pain level hasnt changed and Im on no prevetatives and only on an abortive that doesnt hep for only 2 days a week. When I went in nov he said come back in jan when I went to check out they said they didnt have his january sched someone would call me. Almost 4 weeks later i call and was told he was booked couldnt be seen till march that would be 4 months later.. The girl in scheduling wouldnt even let me talk to the office. i sent them email they change appointment to jan 19th. but I just think I will go back to long island to my other doc this is not the first time they did this to me. I tried so hard to make this work this doctor seems more interested in my dr in ny then what he can do to help me. They say he is an excellent doctor and was at the mayo clinic. I just dont see it. I feel like a number and not a patient plus he doesnt remeber what i told him last visit where my prev doc remembered something from a few years ago.So you post really stood out to me.

  • kuksool76
    5 years ago

    I have gone through 3 doctors before I found one that actually listens. The funny thing is the first one I had was supposed to be the head of a headache clinic. His way of helping me was to prescribe narcotics. If I had a side effect from a medication he would prescribe another medication to treat the side effect. He did try preventatives and triptans but he mixed two meds together and I almost got fired from my job. That’s when I knew it was time for a new doctor. My new doctor goes with the theory the less drugs as possible.

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