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Discovering If Your Physician Understands Migraines

So you go to see your doctor, and — oops! — you discover that she's just not "into" headache diagnosis. If you're not happy with her response to your concerns, shop around for another doctor. Find a doctor who'll agree to team up with you on a treatment plan. Some primary care doctors are old hands at treating headaches, while others may want to refer you to a headache specialist for diagnosis and treatment. You can also check out doctors on your own.

If your doctor smirks or rolls her eyes when you describe your headache problem, you know you're in trouble. The signals probably won't be that obvious though. So you have to look for subtle clues that let you know that diagnosing and treating headaches just isn't your doc's cup of tea. (You show up with a nice case of strep throat, and she's totally in the groove — but headaches aren't her bag.)

Truth is, some doctors aren't very knowledgeable about headache diagnosis and treatment, while others just think in terms of "too many headaches, too little time." Doctors often prefer that you get help from a specialist in the head-pain field — a neurologist, pain-management expert, or internist who has made treating headaches her special passion. However, physicians who don't treat headaches themselves can usually recommend a doctor who specializes in headache diagnosis and treatment. (This specialized doctor's home base may be a headache clinic.)

The first doctor you visit may recommend a treatment plan that actually works. But if it doesn't help — or you're worried that you may have a complex problem that requires a specialist — ask your primary care doctor for a referral to a specialist. Don't be shy. Just ask your doctor if she thinks that you should see a headache specialist.

Keeping the faith even if your doctor is a disbeliever

Okay, you weren't thrilled with what your doctor said. You got a pat on the arm and were instructed to "take some acetaminophen," even though you clearly explained that you tried that approach already. If your doctor is skeptical about your headaches, find a headache specialist to diagnose and treat you.

Don't let your doctor's lack of interest keep you from looking further for relief for your headaches. You're definitely doing the right thing by seeking additional opinions. You shouldn't feel any more reluctant to seek help for your headaches than you would if you had a gaping wound or chest pains.

If you feel like you need to see another doctor, or if your doctor refers you to a specialist, don't take it as a sign that you have an awful disease lurking inside you. Actually, the chances of you having a serious health problem are fairly unlikely. You may have high blood pressure, which definitely requires monitoring and medication, or you may just need the right migraine medication and some lifestyle changes.

Giving up on finding help is a bad idea. Help is out there, but it just may take a little effort to find it.

Spotting signs that you need to look elsewhere for a doctor

What do you do if your doctor seems marginal about treating headaches? She wants to help you, but she doesn't appear to be overflowing with headache knowledge. Or she is clearly leaning toward sending you to someone whom she considers better equipped to diagnose your problem.

You need to be able to identify the components of a deal-breaker, the indications that point you to the exit door so that you can do some more doctor shopping. If you notice even one of these signals, keep looking for a doctor to treat your headaches:

  • Your doctor makes a dismissive comment: "Well, after all, this is just a headache — not exactly anything earthshaking. . . ." or "Women have a lot of headaches due to hormone changes. . . ."
  • Your doctor looks bored when you describe your symptoms, as if she has heard all this a million times before.
  • Your doctor seems eager to refer you to a specialist.
  • Your doctor looks confused when you describe your headache symptoms.
  • Your doctor comes from the bite-the-bullet treatment school and wants you to go to bed and tough it out until the headache goes away (obviously, this healthcare provider has never had migraines herself).
  • Your doctor doesn't discuss your medical history or answer your questions. (This bit of advice refers to doctors who are treating migraines, but be advised that this is not a good sign of a helpful healthcare provider in any domain!)
  • Your physician seems eager to finish up and suggests a pain medication right away.
  • Your diagnosis is still up in the air after a visit or two.

You may want to shop around for a headache specialist if your primary care physician tells you that she doesn't feel comfortable trying to diagnose and treat your severe headaches, or if an existing medical problem leads you to believe that you may benefit from seeing a headache specialist. You may also need a headache specialist if you take over-the-counter medications almost every day, and you don't get any new solutions when you visit your doctor.

If you see disinterest or reluctance on the part of your doctor to work with you on migraine management, don't hesitate to ask for a referral to a headache specialist. The specialist will probably be a neurologist or internist who specializes in treating migraines.

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