Should I see a Migraine Specialist? And if so, how do I prepare for the appointment?

If you have been suffering from chronic headaches and migraine without getting much relief, seeing a headache and migraine specialist can help you get a correct diagnosis and make sure you are receiving the proper treatment. 

A specialist will check your symptoms, look for the cause, and set up a detailed plan to treat your pain and improve your everyday life.

Of course, your regular doctor can help you a lot. But a specialist often has a deeper understanding of headaches and migraines and may have access to different treatments, such as Botox

It can take people with migraine many years before they see a migraine specialist, but you shouldn’t wait that long if you feel that your current treatment is not providing the relief that you or your doctor expected.  

A migraine specialist may perform additional tests such as brain scans and blood tests to ensure that your migraines and headaches are not caused by any life-threatening condition such as a tumor.

Typically a migraine specialist is a neurologist, but increasingly there are other types of doctors that may have a particular interest in treating migraines, and it may be the case that you need to have different people on your team to help you with your migraines.  

Seeing a migraine specialist can be exciting and overwhelming at the same time. Many patients are optimistic that they will find the answer to their problem, but at the same time, they are scared that their symptoms might be caused by something sinister. 

So it's essential to prepare for the visit to ensure that you can give the specialist all the information they need to make an accurate diagnosis and have all your questions answered. This article will help to prepare you.

Before you make the appointment - Here is a list of what to expect and things to consider when making an appointment with a migraine specialist.

 

How do I find a good headache and migraine specialist?

Get recommendations from friends, family, or your GP. Your GP is the one who would make the referral to the specialist, so they are best placed to make the recommendation. However, don't discount doing your research for a migraine specialist. 

They come from numerous backgrounds, and there may be some types of experts that suit your presentation and preferences. For example, a neurologist will help rule out sinister pathology, diagnose your migraine and primarily recommend medication/procedures to help deal with a migraine episode.  Some people find this enough to control their migraines without significant side effects from the medication.  However, other people struggle to find relief from their migraines or the side effects is too severe from the medication to continue with them.   

Other migraine experts would focus on understanding the root cause of the migraines - why they are occurring in the first place and help you prevent migraine attacks. Many people with migraine would benefit from both approaches.  

 

Take some time to prepare for the specialist appointment.

Most people with migraine have had years of symptoms and a tumultuous journey with their health. It's important to know what is happening now and when your migraine first started and how they have changed over time. This can give critical information as to the underlying cause of your symptoms. 

Write down everything you know so you don't have to rely on your memory during the consultation, as this can be difficult, especially if you are not feeling well. 

 

Questions that you may want to reflect on before your specialist appointment.

  • How old were you when your headaches started?
  • How long do they last?
  • How often do they occur?
  • What is the severity of the pain?
  • Is there nausea or vomiting?
  • Do you have any aura symptoms (photophobia, phonophobia) before the usual headache symptoms occur when you have a migraine attack?

 

Identify your goals before going into the Migraine specialist appointment.

Think about whether you're there primarily there to receive a diagnosis and informally discuss treatment options or to form a design for managing your migraines as soon as possible so that you're able to communicate with the doctor and set realistic expectations openly.

Many patients' goals are to prevent the occurrence of headaches, to reduce their monthly migraine days, to be pain-free during an attack, to be free of bothersome symptoms during an attack, and to eliminate any associated disability.

Also are you happy with a medication-based approach to treat symptoms?  If so make sure you ask about the side effects and the average success rate for the medications.  That way you can make an informed decision with your migraine specialist.  If you would like to not rely on medication and try to get to the root cause of your migraines, then you can have a discussion with your migraine specialists about this.  Increasingly, true experts in the field of migraine are understanding that you need an integrative and complementary approach for migraine.   If they do not suggest or recommend any of these treatments ( they work as well as many medications without the side effects), then you need to seek another expert in migraine to assist in your treatment.  They can work together with your migraine specialist.  

Many migraine medications or a combination of medications often don’t offer enough relief from the complex symptoms caused by migraines, many migraine sufferers turn to complementary and integrative treatments including devices like supplements diet changes, yoga and mindfulness meditation, osteopathy and physiotherapy.  The problem is many just guess what they have to do, but when you have your specialist involved or another migraine expert, it cuts out the guesswork and you are more likely to do the right things for your particular migraine disorder.  

 

What should I expect at the appointment with the migraine specialist?

Expect the specialist to ask lots of questions about your history, medications, treatments, triggers, diet, etc.

So if you write down a brief description of each symptom and how it impacts you each day, you'll have a written record that you can look back on. It will also help your doctor know more about your migraines, which will help them figure out what's going on.

Keeping a daily headache journal is an easy way to track your migraine attacks.

There are many resources online that can provide tips on tracking headaches, such as Migraine Buddy (migrainebuddy.com) or the American Headache Society's "Headache Diary" PDF (ahainfo.org). Many smartphone apps also include headache tracking features which could help you keep track of your symptoms. It may be helpful to keep a written log of other factors that seem to trigger your migraines, such as missed meals, sleep disturbances or stressors at work.  Be prepared to give lots of information about these things. 

You will probably do some physical exams. This might include checking your reflexes, looking in your eyes with lenses or an instrument called an ophthalmoscope, checking the surface of your skin with what feels like little rubber-tipped toothpicks under different pressures or temperatures. The examinations aimed to look for any medical /pathological cause of your migraines so that they may order other special tests such as a brain scan or blood tests.

The specialist will want to know what medications you've tried in the past, whether they've worked for you. Keep in mind that most medications for migraines are not specifically designed to treat migraine pain but instead are used for general headaches or other purposes.

The doctor will also want to know what non-medication treatments have been effective for you in the past. If relaxation techniques have helped you cope with migraines before, let the doctor know! If dietary changes have been effective, tell them which foods seem to trigger your migraines and which seem to help prevent them.

The more information you can provide about your history, the better equipped your doctor will be to help.

You may want to ask questions that are important to you, so again, coming prepared with these questions makes sure that you get answers to your questions.

 

Some questions that you may want to ask

  • What is causing the symptoms
  • Is there anything that I can do to help prevent the migraine attacks
  • what are the side effects of the medication
  • Are there alternative treatments that I should consider
  • What is the long term prospect looking like
  • Is it possible to stop the episodes
  • Do my other health issues  affect my migraine (such as IBS, stress, anxiety, PMS, hormones etc.)
  • What is the role of diet, food sensitivities and supplements in managing migraine
  • Is it possible to prevent future episodes without relying on medication

 

Even though a migraine specialist is primarily concerned about the nervous system, we know that many body regions may affect it.

Diet, gut health, stress, hormones, sleep, exercise, etc., can be the underlying influences of migraines, so the migraine specialist you see must have experience in these areas. 

Most people that manage to put their migraine into remission do it through a combination of these environmental and lifestyle factors - not through medication.

Medication will help lessen the severity of the episodes, which is always a plus, but long term prevention is done through other means. So it's essential to discuss these preventative strategies, not just medication.

During the consultation, feel free to take notes and even your partner or friend to help you. The process can be overwhelming, and it may be challenging to remember all the provided information.

The migraine specialist may give you some information to take home in written form, which is always helpful.

Hopefully, this formation has assisted in preparing for your migraine specialist appointment.

Seeing a headache and migraine specialist can be a powerful tool in your arsenal to get rid of or at least minimize the frequency of migraines. If you are suffering from chronic headaches or migraines, see your doctor today and find the best migraine specialist for you. Also, consider doing your research to find the right migraine specialists for you and your health.  

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