How to Talk With Your Doctor About Migraine

How to Talk With Your Doctor About Migraine

Have you ever visited your doctor and left feeling like you didn’t get the answers you were hoping for or didn’t get to mention the critical topics you were there to discuss? With the fast pace of medical care and seeing a doctor just a few times a year, time spent with medical experts is minimal. Rather than underutilizing these precious minutes, it’s important to be prepared when entering your doctor’s office. Stay with me as I review tips to help you get the most out of each visit. 

Know Your Plan

Empower yourself by treating your appointments almost like a business meeting rather than a casual friendly visit. This starts by writing down the list of topics to discuss including what you’d like to cover in each topic. The week before your visit, really give it some thought. Be prepared to share your migraine history. It may help to keep track with a digital or written diary. 

• How old were you when your attacks began? 
• Does anyone else in your family have migraine? 
• What treatments have you tried? For medications, include dosages.
• Do you have any comorbid diagnoses? 

In addition to knowing your history, be prepared to share your upcoming goals. Are you currently trying or planning to get pregnant? This can significantly change your treatment plan strategies so be honest and communicate it. 

Other important appointment topics include symptoms, triggers, past treatment strategies, new strategies you’re interested in trying and your overall concerns. Prioritize your concerns and write them down. There likely will not be enough time to discuss every concern so consider the ones that are most troublesome or important to you and plan to discuss those first. Bring a list of your symptoms, triggers, current and failed medications, and supplements with you. Are you curious about your doctor’s opinion on migraine diets? Want more information on botox, nerve blocks or certain supplements? Don’t be afraid to bring up these types of questions. 

Plan To Be Brief

Tracking your migraine attacks and discussing their frequency is important, but unless it’s requested avoid bringing lengthy journals that outline your attacks. Instead make the best use of your time together by bringing an attack tracker that can be easily and quickly reviewed. Remember you’re working with limited time. Quickly getting through the frequency and severity of your attacks will leave you more time to discuss treatment strategies for feeling better. I like color coding a calendar so the number of attacks each month can be easily tallied with a quick scan of the eye rather than lots of reading. Be sure to add how long your attacks last. Were you able to participate in your life during each attack or did you call in sick or seclude yourself in a dark room? Try using red for the most severe days and yellow for bad days you were still able to function through. If you have a menstrual cycle add the start and end days as well so hormonal trends can be easily seen. 

Determine Your Treatment Plans

Knowing how to prevent attacks along with what to do when they happen is vital to managing your disease. For quality migraine care that brings the most relief it’s important that you have a clear plan of action in three areas. 

1. Your preventative strategy. These are the tools you will implement to help prevent migraine attacks from occurring or at least lessen the frequency/severity of attacks. This might include medications, diet modifications, supplements and other natural treatments or lifestyle changes. Be sure to ask how long you should expect to wait for a particular treatment to improve your symptoms and what you should do if it doesn’t work. 
2. Your abortive strategy. These are any treatments used to end or lessen the severity of an attack once it starts. These can include medications to treat pain and nausea, supplements or devices. With any new treatment, it might be helpful to ask what you should do if the treatment makes symptoms worse or if there are any side effects to watch for. Make sure you know if there are limitations to how often you can take your abortive strategy, along with what you can do on days you’re in pain and can’t use it.
3. Your comfort strategy. These are any treatments that help you feel more comfortable during an attack, but do not prevent or abort one. Ask about the strategies where your doctor sees the best results. Options here are endless but can include heat or ice, essential oils or topical rubs. It’s helpful to know where your doctor stands on these treatments. If you have a migraine variant like vestibular migraine, medications to ease dizziness or vestibular rehab therapy may need to be prescribed.  

Make Sure You understand Your Plan Before Leaving

Understanding your diagnosis and the reasons behind each of your treatment strategies are important components of helping you get better. If your doctor explains things in a way that doesn’t make sense to you, ask for further clarification. Taking notes during your appointment can be crucial, especially if there is a lot of information discussed. Bring a trusted family member with you, if permitted, to help with remembering what is discussed. They can also talk through your doctor’s recommendations with you after your appointment. Know that there may not be time to get every question answered in just one visit. Don’t be afraid to ask for a follow-up appointment to go over questions that come up after you have had time to process your plan or use the patient portal to ask follow-up questions.  

Work Together

Building a reciprocal trusting relationship with your doctor is crucial to receiving the best care. It’s vital to remember that your doctor is your partner and wants to help you. If you are uncomfortable with a treatment, tell your doctor before you leave. Our job as responsible patients is to follow through with implementing suggested treatments and therapies. If you know right away that you are medication sensitive or have read too many frightening comments about a certain treatment in support groups, tell your doctor right away. It is perfectly acceptable to share your worries and ask for another option. 

Migraine is mostly a diagnosis of exclusion because of the lack of diagnostic testing specific to migraine. That means your diagnosis is based almost entirely on the information you provide during your appointment and ruling out other conditions. Being prepared to communicate effectively will build an honest, mutual collaboration that is vital to getting the most out of each visit with your doctor.

MEET THE AUTHOR