Cove: My Experience With the Online Migraine Concierge
Have you heard of Cove? It’s an online service that provides at-home, migraine-specific care.
When I first came across Cove, it was in an advertisement on my Instagram feed, the same day I’d been Googling "migraine treatment options." I was in a season of desperation with my migraines and willing to get help anywhere I could find it.
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Seeing a neurologist, not a migraine specialist
Let me back up.
For the last few years, I had been seeing a neurologist. However, she was not a migraine specialist. For a while, the prescription she had matched me with worked to abort my migraines, and we both carried on our way.
However, this past fall, when we were six months into a global pandemic and adjusting to telehealth life in general, I experienced my worst migraine to date. I called my neurologist after two doses of Fioricet hadn’t made a dent in my pain. It was noon on a Friday, and I was terrified of going into the weekend without additional support. She returned the call after 8 pm and told me that the only advice she could give me was to go to the emergency room.
Looking for better advice
Living with Crohn’s disease and a compromised immune system, this did not feel like a safe, ideal, or necessary option. I truly felt that had she been able to offer me other prescription medication that day, the migraine may not have lasted until Tuesday evening’s eventual trip to the hospital.
A hormonally triggered attack
That migraine experience was terrible, and it was also directly correlated to my hormones.
In fact, I was in the middle of a miscarriage when it occurred.
During my next menstrual cycle, I found that again, when my hormones rose and fell, my migraines did as well. I found a new neurologist I wanted to meet with, but his first availability was two months out. What was I to do in the interim?
Finding new solutions
Enter Cove. An entirely virtual migraine concierge. Too good to be true, right?
In my opinion, using Cove has been incredibly beneficial. Let me start by saying I am not a Cove Ambassador, and I have no affiliation with Cove. I am simply a migraine patient who has used and benefited from their services.
How does Cove work?
To get started with Cove, you choose your treatment plan.
If you know what migraine medication you take and it works for you, you can indicate that. Otherwise, you choose to get a doctor's recommendation. Next, you fill out an online consultation, which in my experience, is similar to the forms you're given to fill out in any neurologist's office - detailing your medication, your health history, your migraine history, etc. I was truly impressed with the video upload section, which had me perform several tasks a neurologist would ask to see in person.
After submitting the documents, a doctor reviews everything you include to determine what treatment plan or options may be a good fit for you. You then correspond with your Cove doctor via website messenger to adjust your plan, ask questions, inquire about medications, or any additional information. I have continually been surprised that my Cove doctor always responds to me within 24 hours, even on weekends. This has been really valuable when I've been in a migraine crisis.
My personal experience
In looking at my treatment plan, my Cove doctor was hesitant to prescribe anything preventative as I was/am still trying to conceive, and many of the migraine medications don't have safety data on pregnancy at this time. What she did recommend was the Nerivio device - one I'll share more about in another article. I hadn't heard of the device before, but I had used a TENS unit, and this felt similar.
My Cove doctor was able to submit my prescription for Nerivio, and it was then mailed directly to my house, along with literature on the device, the company that created it and use case instructions.
I did not have to leave my house or get out of my pajamas.
I did not have to enter a doctor's office or a pharmacy to consult with a physician, get a prescription, or have that prescription filled. That felt like a huge win.
It also felt like a perfect gap filler while I was waiting to see a new local neurologist.
Adding to my care team
I now have two individuals involved in my migraine care. My local neurologist and my Cove physician. I look to my local neurologist for most things, but I occasionally reach out to my Cove physician for other questions, to ask about supplements as well as other migraine support options.
Transparency note: To utilize the Cove physician, there is a $4/month fee. Medications and supplements through Cove each have their own cost, and while they are often discounted, the prices do vary.
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