When you give specifics, your doctor can make more informed treatment decisions.
Your doctor wants to help you find relief from your migraines. Thanks to advancements in migraine treatment options over the last several decades, your doctor has the tools to help you live a better life.
However, your doctor needs your help: The more details you can give them about your migraine experience, the more informed decisions the two of you can make as a team about the best course of action.
What to Know About Your Options
If you suffer from migraines, it’s important to know that there’s not one single treatment option. If one isn’t working for you, you’re not “doomed” to a life of migraines.
Migraine treatment options fall on a spectrum. If you have mild or occasional migraines, your doctor may start you on the lower end of the ladder—such as over-the-counter pain relievers. If these options aren’t working, your doctor can progress up the ladder to more aggressive treatment options.
How to Prepare for Your Appointment
If you’re not seeing the results you want from your migraine treatment, the best thing to do is to talk to your doctor. Preparing for your appointment and getting organized can help you have a more effective conversation with your doctor. In fact, it might even help you find the best treatment option sooner, since you’ll be equipping your doctor with the best information.
Here’s what doctors recommend to prepare for an appointment about your migraine treatment:
1. Keep a headache diary
A headache calendar or diary can help you keep track of how many days you’re experiencing migraines. “When you go to see your doctor regarding your migraines, you should definitely try to have some idea of how often they’re occurring and how bad they really are. I think that’s really the most important thing is to … assess the degree of migraine disability,” says Sylvia Mohen, MD, neurologist in New York City.
These notes serve two key functions. First of all, it can help prepare you to discuss the specifics of your migraines. Second of all, it can give your doctor a better picture of your experience, which may hint at a better treatment option.
“Doctors recommend keeping a headache diary because it’s often very hard for people to recall how bad their migraines actually are,” says Dr. Mohen. “There’s actually a number of even apps you can get for your phone that can help you track your migraines as well.”
2. Assess your migraine disability
Migraine disability refers to how your migraines affect or disrupt your life. For example, if your migraines are causing you to miss school or work, to struggle to care for children, or to miss social events, these are all markers of disability.
To help you talk about your migraine disability in your appointment, consider filling out a questionnaire. You can find these online, such as the Migraine Disability Assessment Test.
If your migraines are severely holding you back, your doctor will likely want to try a more aggressive treatment option.
3. Know your migraine treatment history
This is especially important if you are seeing a new doctor or getting a second opinion. Your medical chart may list your history of treatments, but it’s helpful for you to be able to discuss:
- What treatments you have tried
- How often you took them
- What side effects they caused
- Why they weren’t successful for you
4. Bring a notepad to the appointment
For an effective appointment, you need to be able to remember what was discussed. Unfortunately, appointments can fly by, and it’s easy to feel overwhelmed and forget the specifics. That’s why it’s beneficial to come prepared with a notepad and writing utensil, so you can take notes during the appointment.
Take notes about your new treatment plan, including what to expect, possible side effects, and how long it may take to see results.
If your migraine treatment isn’t working, it’s important to be patient. Each patient is unique, so it may take a couple tries before you find the best treatment option for you. However, being an active member of your treatment team may help you find relief from migraines a little faster.
“It’s important to work very closely with your neurologist … and to really give [them] the information about why things aren’t working,” says Dr. Mohen. “Are you able to take it? Are you taking it at the right dose? Is it just failing? In which case, then you can work with your doctor to find the right fit for yourself.” Learn more about finding the right migraine treatment option here.
Sylvia Mohen, MD, is a neurologist at New York Neurology Associates, P.C.
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There are a number of patients who end up
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failing a number of migraine medications
for various reasons,
00:00:06.767 --> 00:00:10.532
and sometimes it's just you haven't found the right fit
for the right person.
00:00:10.533 --> 00:00:12.999
Sometimes you have to use a combination of treatments.
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There are definitely patients who end up using
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maybe two or even three preventative treatments
00:00:18.833 --> 00:00:22.832
to actually attain some kind of control over their migraines.
00:00:22.833 --> 00:00:25.332
Sometimes it's just that you haven't found the right fit.
00:00:25.333 --> 00:00:30.032
Sometimes it's just that the patient actually needs
a little bit more.
00:00:30.033 --> 00:00:34.366
00:00:34.367 --> 00:00:37.732
There's definitely a treatment ladder
in terms of treating migraine.
00:00:37.733 --> 00:00:40.799
If you have just a few very mild migraines a month
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and they respond to something over-the-counter
like an NSAID,
00:00:43.333 --> 00:00:45.999
you can definitely stay with that,
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but if they progress to become a little bit more intractable,
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it may be an option at that point to introduce
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either a migraine-specific acute treatment,
00:00:55.800 --> 00:00:57.766
or even add a preventative medication.
00:00:57.767 --> 00:00:59.166
And if that doesn't work,
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then you explore the injectable options,
either the monoclonal antibodies
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or the botulism derivatives.
00:01:06.500 --> 00:01:08.532
When you go to see your doctor
regarding your migraines,
00:01:08.533 --> 00:01:11.066
you should definitely try to have some idea
00:01:11.067 --> 00:01:13.832
of how often they're occurring
and how bad they really are.
00:01:13.833 --> 00:01:16.332
I think that's really the most important thing is to really
00:01:16.333 --> 00:01:19.666
kind of assess the degree of migraine disability.
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Other factors you may want to bring up to your doctor
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Things that tend to set off your migraines.
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You may also want to speak to your doctor about
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things like difficulty sleeping
because some migraine medications
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may be able to target that as well,
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and other medical issues that you may have as well
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that may respond to the migraine treatments.
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In general, doctors recommend keeping a headache diary
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because it's often very hard for people to recall
00:01:45.533 --> 00:01:47.532
how bad their migraines actually are,
00:01:47.533 --> 00:01:50.366
and there's actually a number of even apps
you can get for your phone
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that can help you track your migraines as well.
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A lot of times when people come to see a neurologist,
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particularly for headache,
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headaches have just reached a point where they're,
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they're really causing a lot of disability
and disabling symptoms,
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and people will come in and take in a lot of information,
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and sometimes it's hard to remember everything
that was said,
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so I think taking notes is a very important thing to do
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during your migraine visit just so that you yourself
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can remember what you guys spoke about.
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This is why it's important to work very closely
with your neurologist
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to find something that's the best fit, and to really
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give your neurologist the information about
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why things aren't working.
Are you able to take it?
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Are you taking it at the right dose?
Is it just failing?
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In which case, then you can work with your doctor
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to find the right fit for yourself.
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- Acute treatment of migraine in adults. Waltham, MA: UpToDate, 2020. (Accessed on July 28, 2020)
- How to talk to your practitioner about your headaches. American Migraine Foundation, 2015. (Accessed on July 28, 2020)
- Preventative treatment of migraine in adults. Waltham, MA: UpToDate, 2020. (Accessed on July 28, 2020)