Is an Inpatient Migraine Clinic Right for You?

Those of us living with migraine often reach a point where we feel stuck or out of options. If we find ourselves at this crossroads, it may be time to consider a more in-depth approach to addressing our migraine condition. An inpatient clinic can provide a unique opportunity to evaluate our condition in a comprehensive manner with a fresh perspective, resulting in an updated more effective treatment plan.

Why might you consider an inpatient clinic?

There are many reasons to consider an inpatient clinic. We may feel:

• Our treatment plan is no longer working
• Medications we’ve taken for years have lost their efficacy
• Our migraine patterns (frequency, severity, and length of attacks) are changing
• Intractable attacks are increasing
• Our migraine condition has become unmanageable
• We are juggling multiple health conditions, which complicates the development of an effective treatment plan
• We have never been properly evaluated, head to toe, to ensure that migraine is the right diagnosis
• Our patient/doctor relationship is lacking – leaving us feeling unheard
• Overwhelmed and at a loss as to next steps and/or how to better manage the condition

What do inpatient migraine clinics offer?

Inpatient clinics offer a multidisciplinary approach to the evaluation and treatment of migraine. An inpatient headache clinic stay can span from a few days to multiple weeks, with evaluation often including CT and MRI scans. The team generally includes migraine specialists, nurses, physical therapists, psychologists, and nutritionists who work together to create an updated tailor-made comprehensive treatment plan.

What treatments are given?

Patients are often connected to IVs around the clock to ensure hydration and administer medication. Frequently, patients are carefully weaned off of medications that are no longer serving them while new medications may be on-boarded with care. Regular meetings with the team are held to monitor progress. Support groups or group meetings on topics relevant to migraine are available as well.

During the course of the stay, a natural camaraderie between patients often takes place and helps ensure a sense of support and lessen the feelings of isolation that so often accompany migraine.

What can the clinic help with?

An inpatient clinic dedicated to migraine can help clarify our diagnosis. Some people learn that there is an underlying addressable condition that is causing our migraine attacks. Others emerge knowing what type of migraine is at play (chronic, hemiplegic, vestibular, etc) with tailored treatment strategies to manage the condition. The emotional toll of migraine is addressed as well as lessons as to how to navigate its demands. Self-care techniques are taught that can help improve response to attacks. An inpatient program often results in the sense of a restart to the treatment plan and overall journey.

What are the downsides?

• Many clinics require patients to share rooms (and they are sometimes housed in a wing of a larger hospital). For better or worse, this means living with someone who is in the midst of their own migraine journey.
• Wearing an IV around the clock for weeks on end can become uncomfortable.
• Special diets may be tested by hospital-type food.
• The cost related to these clinics is frequently exorbitant and not always covered by insurance.

Are inpatient clinics worth it?

Everyone is different. Some people find these stays to be transformative and emerge with new more effective treatment plans and a better understanding of their diagnosis and its impact on their lives. It can be helpful to have new tools to manage the condition.

That said, after dedicating three weeks to studying and addressing this condition, some patients may emerge with a very similar set of circumstances as to when they entered (frequent, intractable migraine, and cyclical challenges with treatment/medication/management of the condition).

The decision to enter an inpatient clinic is a personal one and the expense and time it takes must be weighed carefully. For those of us who feel as if we’ve tried everything else under the sun and are still overrun by migraine - it may feel like the only option.

What are our outpatient options?

There are a number of multidisciplinary teams dedicated to migraine which offer outpatient services around the country. This experience can offer a more in-depth treatment and evaluative experience than might be found in working with an individual doctor, but less of the intensive and group approach that an inpatient clinic provides (far less costly, too). For those interested in this approach rather than an inpatient experience, please see a list of outpatient headache clinics below.

What was my personal experience?

I went to one of these inpatient clinics over a decade ago. While the expense was difficult to shoulder, the experience was unforgettable. I learned new strategies to think about and manage migraine that remain applicable and useful. Although I emerged with the diagnosis of chronic migraine (which has no cure) I felt relief on some level that there wasn’t something worse happening. Migraine can be scary to experience and can leave us worrying there may be another more serious condition at play. That said, my roommate learned an operable nose tumor was causing her migraine attacks. I was admittedly jealous that she had a relatively easy fix to her condition. Taking three weeks out of my life to be admitted to a clinic hundreds of miles away was logistically trying, but I emerged knowing I had done all I could to evaluate and treat my migraine condition.

Have you been to an inpatient migraine clinic? Or, is this something you’d be interested in pursuing? We’d love to hear your thoughts and experiences on this topic in the comment section below.

Inpatient headache clinics in the United States

This list is alphabetical and not comprehensive. If you are interested in attending an inpatient program, do careful research to find the right one for you:

• Baylor Scott and White Headache Center, Dallas, TX
• Dartmouth Hitchcock Headache Center, Lebanon, NH
• Diamond Headache Clinic, Chicago, IL
• Jefferson Headache Center, Philadelphia, PA
• MedStar Georgetown University Hospital Headache Center, Washington, D.C.
• Michigan Headache & Neurological Clinic, Ann Arbor, MI
• Montefiore Headache Center, New York, NY
• UCSF Headache Center, San Francisco, CA
• University of Miami Miller School of Medicine Headache Division, Miami, FL

Outpatient options in the United States

The aforementioned list of clinics provides outpatient options as well:

• Cleveland Clinic Neurological Institute, Cleveland
• Johns Hopkins Headache Center, Baltimore, MD
• Mayo Clinic Headache Center, Scottsdale, AZ
• Stanford Headache Clinic Palo Alto, CA
• UCLA Goldberg Migraine Program, Los Angeles, CA
• UCSF Headache Center, San Francisco, CA
• University of South Florida Headache Center, Tampa, FL
• University of Utah Headache Clinic, Salt Lake City
• Yale Headache and Facial Pain Center, New Haven, CT