Seven Signs it’s Time and What to Know Before You Go
Often, living with migraine, cluster, or any other headache disorder, can feel overwhelming, challenging and isolating. That’s why one of the most important things you can add to your migraine treatment toolbox is a doctor educated in headache medicine – someone who can help you navigate treatment options and develop a personalized treatment plan. A certified headache specialist can help you understand your specific type of migraine and work with you to improve your overall quality of life. They can also work with you to create a treatment plan that may help reduce the chance of your migraine attacks becoming more frequent or severe.
The bottom line? If you’re living with migraine, you don’t have to go at it alone!
Here are 7 signs it may be time to see a headache doctor or specialist:
- Your attacks are happening more frequently.
- Your symptoms are worsening, changing, or are becoming difficult to manage.
- Your work, education, family, and/or social life is affected.
- Other health conditions are impacted.
- You are taking too many over-the-counter medications.
- Your current medications are no longer working.
- Your primary doctor or general neurologist doesn’t seem to be up-to-date on the latest migraine treatment options.
Seeing a headache specialist can reduce the risk of episodic migraine becoming chronic, and help you discover better ways to manage your attacks so they have less impact on your life.
Tips to Know Before You Go:
1. Finding a qualified doctor may require some patience and searching.
Ideally, you want a doctor with ongoing headache education as well as a certification in headache disorders (or working towards one). Both the UCNS (United Council for Neurologic Subspecialties) and the NHF (National Headache Foundation) offer certifications with ongoing education required. It’s important to be aware that headache disorder education is not mandatory in medical school, and, more shockingly, neither is it mandatory even in neurology residencies! Unfortunately any doctor can write “headache specialist” on their profile or website, but that doesn’t mean they have gone through specialized education or attend ongoing educational programs to stay updated with this fast-developing field of study. As a result, you may need to do some research to find a local doctor qualified to help you.
You can check out our headache specialist directory here for doctors who are certified, as well as others who are PATIENT RECOMMENDED. You can also ask around locally, do an in-depth internet search, and ask the online migraine community for recommendations. Look for the term “certified headache specialist” rather than the generic “headache specialist,” and remember to check your insurance to see which providers are covered. If you can’t find any bona fide headache specialists covered by your insurance, it is possible to request to see an out-of-network doctor, however be aware that the appeal process for this can be time-consuming, success is not guaranteed, and in some cases you will need to file an appeal for each and every visit needed.
Unfortunately, many people don’t have headache specialists practicing near where they live, or they may want a second opinion. In these situations, it may be worth seeing if your insurance covers a visit to one of the larger headache centers in the US. You can also check out online telehealth programs such as NeuraHealth, a virtual headache clinic that connects you with qualified doctors from the convenience of your home (use code: MIGRAINEM15 to receive a discount at NeuraHealth). Click HERE to watch a video presentation by Dr. Thomas Berk, medical director of Neura Health, about the importance of telemedicine and how his organization is seeking to make a difference in the lives of those who live with migraine.
2. Getting an appointment may take time.
Especially if you are a new patient, expect there to be a significant wait time to get an appointment. Wait times for neurologists are often up to three months, and for headache centers the wait can be six months or more—another reason not to wait if you are experiencing any of the signs listed above!
3. Check with your insurance.
Calling your insurance company or checking your online portal ahead of time to find out which doctors/treatments are covered may help you save time and allow you to go in with better expectations. You may need certain approvals and referrals based on your specific insurance plan, and having that information on hand can be helpful, as well as knowing which medications in a specific class are “preferred brands” or on formulary. This may help speed things along and get you the care you need faster. Remember, there are often barriers to receiving the medications or treatments prescribed by doctors, but often there are also ways around those barriers. Learn more about that in our Guide to Navigating Insurance, and look out for our upcoming blog on access barriers.
4. Be prepared.
Keep a headache diary prior to your appointment. This may help your doctor understand your specific type of migraine and make recommendations for the best treatment options. You can use free apps like MigraineBuddy or N1-Headache, which allow for easy data sharing with your doctor. You will also need to share a list with your doctor of all the medications and dosage amounts you have taken in the past as well as those you are currently taking. Preparing a one page “cheat sheet” of your medications, doses, side effects and efficacy is often helpful rather than going to your doctor with a folder full of paperwork which is unlikely to be read. For a new doctor’s appointment it may be helpful to complete the Bontriage Assessment by Dr Robert Cowan and Dr Alan Rapoport—this allows you to enter your entire history online ahead of time, and it then creates a concise report which can be printed out and taken to your doctor.
5. Don’t be afraid to speak up and advocate for yourself!
Do your research beforehand so that you can go into your appointment feeling knowledgeable and ready to get the most out of the visit. Be sure to show up at your appointment with a written list of questions so you’re not relying on your memory. And, don’t be afraid to ask your doctor about specific medications or migraine devices that you think might be helpful. You can print out our Migraine Treatment Toolbox guide and bring it with you to your next appointment to help with the conversation.
Most of all, make sure you leave the doctor’s office with a wholistic plan for migraine management, including a preventive medication (if necessary), at least one abortive medication, information on medical devices that are appropriate for you, and a written plan for what to do when/if your abortive treatments don’t work.
Add a Headache Specialist to Your Migraine Toolbox Today!
Finding a doctor you are able to partner with can be a life-changing step on your migraine journey. If you’re struggling to manage life with migraine, or even if you’re earlier in your migraine journey and the struggle is de minimis right now… don’t wait! Be proactive, customize your migraine treatment toolbox to help prevent migraine from becoming more frequent and severe, and get the help you need and deserve!
Let Us Know
What type of doctor do you see you see for migraine? Do you know the difference between a general neurologist, a “headache specialist”, and a “certified headache specialist”? Does your insurance covers the cost of seeing a certified headache specialist or do you have to pay out of pocket?