As I walked in,
- the reception area (waiting room) was dimly lit with incandescent lighting. No fluorescent lighting here.
- the room was peaceful and quiet - no noise from television or radio.
- the colors were soft and muted.
- there were signs requesting that nobody wear cologne or perfume here.
- I was greeted by a very professional receptionist who spoke softly, was gentle and friendly, and treated me with respect.
Had I died and gone to "Headachers' Heaven?" No, I'd gone to the Jefferson Headache Center at Thomas Jefferson University Hospital in Philadelphia, Pennsylvania, to see Dr. William B. Young.
If you've read many of the posts in our forums, you've seen that many people who have Cluster Headaches, Migraine, or other headache disorders have problems finding doctors who:
- take them seriously,
- treat them with respect,
- and are knowledgeable in current treatment methods and medications.
The last point, being knowledgeable in current treatment methods, is somewhat understandable, especially for general/family practice physicians. Most of them have too-busy practices, and are trying to keep up with treatment advances in every area of health care. General practice neurologists encounter a similar situation. Although their scope is narrowed to neurological disorders/diseases and injuries, there are still a vast number of conditions about which they must be continually learning to remain current. Though it sometimes seems to us that no progress is being made, there is a vast amount of ongoing research in the field of headache disorders, new uses determined for current medications, and new medications reaching the market at a good pace. Only the most brilliant and dedicated of these general practice doctors and neurologists have a chance of knowing about the most recent research into the cause of these disorders, the most recent and most effective medications, and other methods of treatment.
On the other hand, headache/Migraine specialists and the doctors at headache/Migraine clinics treat only patients with headache disorders. Their focus, therefore, is not divided among various types of disorders. They are more able to maintain a high level of current knowledge. The fact that they chose headache disorders as their specialty indicates that they take headache disorders seriously, and are more likely to understand not only the pain of the disorders, but the other effects on our overall physical and emotional health.
As with any medical specialty, not all clinics and doctors work in the same fashion, but to give you a more complete picture, I'll detail the rest of my visit.
The
first appointment:
I was told in advance that the appointment would last five to six
hours and would include a psychological evaluation and a visit with a
psychiatrist. An information packet was sent to me with directions to the
clinic, some basic information about Migraine, and a short, standardized
personality test to complete and bring back with me.
When I checked in at the reception desk, they gave me a brief information form to complete got a copy of my insurance card, and gave me a multi-page personality test to complete. A few minutes later, Nurse Lois came out to greet me. We went to an examination room where she checked my vital signs, took a detailed medical history, and asked many questions about my Migraine history. As she worked, she entered all the information into her computer, which is on a network so that the doctors can easily access the information later in the appointment. Lois was professional, kind, and caring. When we finished she showed me to a small waiting area outside the exam room where I could complete the personality test.
A few minutes later, Dr. Tramuta, the psychiatrist, escorted me to his office. I was admittedly apprehensive about this part of the visit because, as many other Migraineurs, I've had too many doctors take the attitude that Migraine is "all in our heads." My apprehension was short lived. Dr. Tramuta understood my feelings, and we talked about them. His job is to assess patients for depression, which is much more prevalent among people with headache disorders than it is in the general population, and assess the patient's ability to cope with a chronic pain illness. We spent about an hour discussing Migraine, my general health, and how I deal with health issues. He told me that although I would not be automatically scheduled to see him on my subsequent visits, I may call at any time and request that a visit with him be scheduled.
