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Telemedicine for Migraine Patients

More than 39 million Americans suffer from migraine. For me, my migraine attacks started in childhood and unfortunately continued into my adult life, causing not only pain and fatigue but also tremendous frustration about the options for medical treatment and care. In fact, it took years for me to get a correct diagnosis. I felt tremendous relief when a doctor explained this condition to me. 

Migraine is both predictable and highly unpredictable. They sometimes occur at certain times of the month, during weather changes, or from lack of sleep, but often they appear for no apparent reason.  

Not getting clear answers along with the unpredictability of the condition is part of what led me to study neurology and specialize in headaches and pain management. And it’s absolutely what led me to develop my telemedicine practice. 

Where does telemedicine come in?

When people hear telemedicine, they don’t know what to think. What I offer in my practice is a one-on-one video chat with patients. 

Among the most important communication in medicine is the medical history, which is best obtained by a thorough and focused conversation between doctor and patient.   This includes an extended history about lifestyle, sleeping habits, diet, exercise, stress, mood, and anxiety surrounding the condition. This information can be obtained from the patient while they are in the comfort of their home with the help of an internet connection and audio/video.  

My goal in each session is to get as much information as possible to develop a plan– tailored to the patient personally– that includes both prevention and treatment of migraine and headache diseases. Medications can be prescribed, diagnoses are explained, and questions are answered.  

How does telemedicine compare to traditional treatment?

Much of the frustration in modern medicine comes from patients feeling like cattle– they can sit in a waiting room for 20 or 30 minutes, are put through tests with a nurse and sometimes only get 5 minutes face-to-face with a doctor. In a similar vein, doctors are inevitably pressed for time, have endless documentation and little time for listening. The listening, empathizing, diagnosing, explaining, reassuring, and educating gets lost in the traditional office and hospital environments of the 21th century. 

Patients often suffer in germ-filled, noisy waiting rooms for hours in severe pain with light sensitivity and nausea, often seeing a doctor only for a short time and then are referred on to see a neurologist. The wait time to see a specialist can be weeks to months, and often these neurologists do not specialize in headache care.  As many people with migraine, including myself, know, the symptoms are debilitating and life interrupting, typically it is hard to leave the couch, let alone the house. I started Modern Migraine MD as a way to fill in the holes I see in the traditional system. 

With telemedicine, you can expect: 

  •  Appointments available at off hours for busy professionals 
  • Quick turnaround times between making the appointment and getting seen – typically within 72 hours
  • Concierge medical services
  • Emailing and texting, and using technology to bring doctors and patients together who would be normally be separated geographically. 

And for those that might question whether telemedicine is safe for headache care, just take a look at this 2017 study that took place in Norway and was presented to the American Academy of Neurology.

In this study, 402 patients with headaches that came on gradually were divided into two groups. One group was seen in a traditional office setting and the other group was seen via telemedicine chat sessions. There was no difference in the outcomes of the groups. 

Telemedicine can be used in conjunction with in-person care.  I have patients who see me in the office and then want the convenience of a follow-up with a virtual visit.   Patients may also be a good candidate for treatment such as Botox and that needs to be done in an office. Overall, telemedicine can replace the office visit model completely and in the majority of cases, patients can get a diagnosis and most treatments via telemedicine.    Most of my patients do well with 3-6 visits over 6 months to a year, but each case is individualized. 

As a doctor who specializes and treats migraines and as a person who also has been a lifelong sufferer of this condition, I understand the complexities and the bureaucracy in the medical system. I am honored to have studied medicine and feel lucky to help patients heal, and consider it my duty to try to expand the way I can treat people.

 

MEET THE AUTHOR


Dr. Risa Ravitz had migraine headaches for as a long as she can remember. She went on to study medicine at Jefferson Medical College, then pursued a career in Neurology at Harbor UCLA, and headache medicine at Columbia University. From surfing to yoga, to studying and working, to spending time with family and friends, Dr. Ravitz strives to live an active lifestyle and understands firsthand how migraines interfere with life. She has a traditional office practice in New York City. She started Modernmigrainemd.com, a start-up telemedicine practice, to try to provide care to people in remote areas and in a way where doctors can give patients the time and attention they need.

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