Migraine Headaches Support Group

Katie,
Often a specialist knows nothing about what brings you to their office beyond what the insurance referral says, so you're going to need present your history and tell your story concisely, especially since it covers 20+ years. At a minimum, bring a list of all your medications (current and past, regardless of type) and your headache diary (which hopefully you've been keeping; if not, try to make one based on the last few months of headaches and how you've been feeling, eating, sleeping and treating them), as well as your medical history.

In your history, include all the medications you've taken to treat the headaches in the past, what worked, what didn't, as well as any other treatments you've tried. If you have copies of any scans (CT, MRI, etc.) or the reports, bring them as well as any other medical records you may have (DO NOT leave your only copy; if they want a copy of prior scan they can make one). Take some time tonight and think about your medical history, from birth till now (I know, mine is really long), as well as any times you've had a head injury, hit your head, dizziness, vertigo, back injuries, etc. Also write down all your surgeries and hospitalizations, allergies, etc. (all of this is part of your medical history and even something you think is minor may be signficant to the neurologist). Include that first bad headache you had when you failed a midterm in college (okay, that was me, but it turned out to have been my first migraine; no one recognized it at the time, they suspected meningitis...thankfully it abated before the spinal tap was ordered). Write down everything healthwise you can think of, ideally in chronological order, even some of those aches and pains we just assume are age-related.

Don't rely on your memory to explain how your headaches feel; write it down and be very specific. Stabbing versus throbbing versus aching, etc. Same with location, level of pain, frequency, etc.

You should expect the doctor to take a full history and review all the paperwork you fill out before the appointment (show up early; there will probably be a number of questionairres specially about your headaches and other neurological issues). The doctor should also perform a full neurological exam, top to toe, checking reflexes, eyes, strength in your arms and legs and how they compare from side to side, how you walk on your toes and heels, etc. (all are neurological indicators). Be prepared to take off your socks and shoes and to walk either barefoot or in your socks on the floor (part of the neurological testing).

As for the discussion, it all depends on you and the doctor. What do you want out of this appointment? Write it down. Be specific. This is a first appointment. You can tell the doctor you ideal expectation is complete and permanent relief from migraines (insert laughter here), but realistically, you understand that's probably not a reasonable first step (smile). So have him/her recommend a course or courses of action and explain why that course and what other options are. If you have some particular treatment options in mind, bring them up, but also be open to other options as well.

Remember too, you are interviewing this doctor to be a member of your health care team. Look at the office, ask about qualifications, talk to the staff, get a feel for how the doctor and the staff interact with patients. You want a doctor who will respect you, make eye contact with you, listen to you, engage you in conversation, and work WITH you to determine what the best course of action is for YOU right now. You also want someone who wil work with your primary care provider, especially if you have other medical issues, and will take your overall health.

There are no silver bullets or magic wands, but a good doctor is a great start towards finding an effect treatment that works for YOU.

Good luck and please let us know how your appointment goes!

Thank you so much ihavepkd. You've given me a terrific check list for my appointment. I think if it weren't for your message I would have gone empty handed and that would have been a waste of an appointment it took me 5 months to get! :) Thanks for your help and concern, I'll let you know what happens!

Katie