How To Talk To Your Migraine Doctor

Many times I will see a new patient (with my migraine doctor) who seems confused as to what they are supposed to bring with them to the doctor's office and what is important and what isn't.

I'd like to give you some tips, from the doctor's office point of view, as to what to expect and what the expectations are on YOU.

Most migraine doctors are neurologists who specialize in headache. Since this is the most common compliant in neurology, and the second most common in primary care (behind back pain), these doctor's are really busy!
Laszlo Mechtler, MD

My doctor, Dr. Laszlo Mechtler (picture right) will see 30-35 patients per day, and about 25 are new consultations! He has five mid-level providers (like me) who see 20-25 patients and if we have new ones, he has to see them too.

You can see how things get very very busy and a doctor like him might get backed up. My point here is to try and be patient. If you are new to an office like this you should expect to spend a few hours in an office like this for your visit.

  • What You Should Bring With You

There are some things you should bring with you on a first visit to a migraine doctor that will speed things along a bit..I will tell you quite frankly that when I enter an exam room and a patient hasn't filled out any paper work, but expects me to review everything for them..well it definitely slows things down.

So..tip #1: Fill out all paperwork before the practitioner enters the room. This person will then review it with you.

Tip #2: Remember to include ALL medications, herbs and vitamins you are taking OR have previously tried for your headaches. Bring a list, with doses included.

Tip #3: Have you had an MRI or CT of the brain in the last 6 mos? Even if the office didn't tell you to bring them bring them anyway. Most times the doctor does not know what the staff said on the phone to you and he/she will want to review the films.

If the films are several years old, you probably don't have to bring them.

  • What I Like To Hear From Patients

From a personal point of view, here is what I like to hear that makes it easier for me to help a patient with their headaches.

Tip #4: Tell me all about your headaches..when did they start..how frequent are they now.. how severe are they?

Tip #5: Tell me what works best for your headaches when you treat them..no matter how silly you think it might be, I might find a correlation with a medical procedure.

For instance, many migraineurs have trigger points along their shoulders from muscle spasms. Patients find if they have someone dig their fingers into them it relieves the pain..then less neck pain and less headaches. We then will do trigger point injections to relieve the spasms.

Tip #6: Discuss your feelings honestly. If you are feeling depressed or anxious, I need to know this in order to treat it properly. Mood, such as anxiety can really make migraine headache symptoms worse if not addressed.

Tip #7: Approach things with an open mind! A fresh look from a new source might just help you with the headaches. Don't try to control what I and my doctor are going to suggest for you.

Many patients will try to take the ABC approach (what?). "Well if A doesn't work then I'll try B, then C."

Well we recommend AB and C and maybe D all at once! This is the best approach when treating chronic pain.

Tip #8: Agree to be patient. If you have had headaches for years, I cannot control them in a few weeks..but I can in a few months, so please give it some time.

Tip #9: Don't start and stop therapies a migraine doctor recommends. Many people will stop things the first week, after one or two pills or just one try at acupuncture. The brain takes time to adjust (90 days) to new things. Of course if you are having severe side effects to anything, I need to know right away!

Tip #10: (last one!) Please don't suffer in silence! If you have a headache that goes beyond 72 hours and you can't break it with your meds, call your migraine doctor. When my patients call me, I can prescribe something to break the headache or bring them to our infusion center for further treatment.

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