The Ten Steps

A panel of leading headache specialists recently convened to identify specific steps migraine patients can take to better communicate with their health-care providers and obtain a successful treatment program. Effective physician/patient communication is increasingly important given today's time constraints for office visits and the variety of new treatment options available. 

1. Seek help. Be a self-advocate. You owe it to yourself. Let go of the biases and guilt--there is no need for you to endure headache pain. Understand that migraine is a disease, and deserves the same attention and care as any health condition.
2. Educate yourself about migraine so you will know what to communicate to a physician. Attend support groups and join resource organizations such as the National Headache Foundation (NHF); 1-888-NHF-5552. Pay attention to newspaper, magazine, television and radio coverage of migraine and ask your physician about what you've seen or heard.
3. Visit a doctor specifically about your headaches. Search for a physician who is interested in treating headaches and make an appointment about your migraine. Find out if your primary care physician (family physician, internists or OB/GYN) treats migraine. Consider seeing a headache specialist or neurologist. Call the NHF for a state-by-state list of member physicians.
4. Prepare for a dialogue with your physician. Keep a headache diary. Be organized, specific, direct and ready to talk details. Be prepared to provide information on your headache history and general medical history. Track your attacks and how you treat them. Note the date, length of each migraine, severity, symptoms, triggers and impact on your life (i.e., how many days lost from work, how many family/social activities missed). Track medication taken, when, for how long and effectiveness in relieving pain and symptoms. Get to know your migraine patterns and triggers so you feel more "in control."
5. Have reasonable expectations about treatment. Understand there is no cure for migraine; however, the disease can be managed with an effective treatment program. Be patient and give treatment time to work. Realize that treatment success will ebb and flow. Be willing to listen to your physician and to yourself. Be flexible, open-minded, and prepared to modify your treatment as necessary.
6. Be honest about all current medications and other medical conditions. Tell your doctor about all your current therapies, including prescription, over-the-counter and natural remedies (because certain medications interfere with each other). Share any psychological history or "emotional disturbances" and medications taken for those now or in the past.
7. Focus on solutions. Be positive. Don't blame yourself; headaches are not your fault. Focus on finding the best treatment options by working with your physician to find solutions.
8. Ask for detailed instructions for taking medication--and follow them. Ask for specific instructions on taking prescribed medication; i.e., how often, with meals or on an empty stomach, what to do if a dose is missed, side effects, and what to do if pain and symptoms persist.
9. Partner with your physician for treatment success. Enter into a partnership with your physician and bridge the communication gap. See your physician on a regular basis and develop a relationship -- treatment is a process that works better with in-person visits.
10. Follow-up regularly with your physician. Your treatment program will only be as good as the time you invest. Schedule a follow-up appointment as you conclude each physician visit. Physicians say three months is usually a reasonable time period to evaluate the effectiveness of a treatment program.