After a short lunch break, it was time to see Dr. Young, my new neurologist. Since I had taken films from a recent MRI with me, he was able to view those films and discuss them with me as he performed a standard neurological exam. He confirmed my previous diagnosis of Migraine, with and without aura. He pointed out the blood vessels on the MRI films, telling me that they were in perfect condition, making me a good candidate for using triptans (Imitrex, Maxalt, Zomig, Amerge, and Axert) as Migraine abortives. After the examination, we sat in his office and discussed treatment options. He gave me his opinion of changes to make in medications for Migraine prevention and the use of Imitrex tablets and injections as Migraine abortives. We discussed rebound headaches, and the proper use of my medications to ensure that I didn't bring on rebound. He provided me with a preprinted sheet with a phone number to call of medication refills and a number to call if Migraine pain persisted more than 48 hours. Since the clinic is an eight-hour drive form my home, should I experience an attack with pain in excess of 48 hours, he will work with my primary care physician or local emergency room to see that I receive proper care. Since he had prescribed Imitrex injections for me, and I had never used them before, Nurse Lois brought in the Imitrex Stat Dose (self injector), showed me how to use it, and watched while I injected myself. She then sat with me for about 20 minutes and checked my blood pressure to be sure that it wasn't elevated by the Imitrex. The in-office Imitrex trial was so that I would not be frightened by the mild side effects that are expected immediately following an injection and to be sure that there would be no adverse reactions to indicate that I shouldn't use Imitrex. After Dr. Young and I spoke for another few minutes, I was on my way, armed with instructions, prescriptions, and a follow-up appointment set for nine weeks later.
The
follow-up appointment:
Nurse Lois met me in the reception room promptly at the appointed
time. She checked my vital signs, recorded changes in my health and other
medications, and asked questions about my Migraine attacks since my first
appointment. There was a short wait for Dr. Young, as he needed to see a
patient in distress. Although Dr. Young was a bit behind schedule, there was
no sense that he was hurrying to catch up. We discussed and adjusted my
medications, talked about my progress and his treatment plan for me. We also
discussed other health issues that may be affected by some of the same things
that affect Migraine, and he recommended discussions with my other doctors.
Approximately 90 minutes after my appointment time, I had my next appointment
scheduled, and was on my way.
Summary:
Headache disorders and Migraine disease are complicated and need appropriate and
adequate treatment. This treatment may not be available from your primary care
physician or through a general practice neurologist. When this is the case,
headache and Migraine specialists and clinics offer specialized care that can be
literally life saving and greatly increase our quality of life. If you feel
you are not receiving the best care for your Migraine Disease, Cluster
Headaches, or other headache disorders, these specialists and clinics should
be considered. You may need to travel a bit to reach one, but it will be well
worth the effort. For a listing of specialists and headache clinics, click
HERE.
