If you don't want to read the whole thing, the short version is:  If you live anywhere near Philadelphia, go to the Jefferson Headache Clinic. 

I already posted this in the forums, but I know there are a lot of people who may read share posts, but not our forums, and I want to share my experience with everyone.

After two years of know-nothing neuros, I finally had my first appt at Jefferson on Tues 1/12.  The difference between a neurologist and migraine specialist is the difference between a puddle and the Pacific Ocean. 

First off, the reception staff is really nice. They were so impressed at how "together" my paperwork was. I said "One, I work for an insurance comany, so I know the drill. Two, I am a professional patient." I can't imagine how someone could be in bad enough shape to get to Jefferson and not have seen enough docs to be good at insurance and forms and such.

I saw the psychiatrist, Dr Tramuta. He was nice and thought my depression was well controlled on my Lexapro and we should leave it where it is.   Oh, and the psychiatrist is just because they know depression is co-morbid with migraines, and chronic pain conditions cause depression so they want to make sure that any emotional issues you have due to your migraines are being addressed as well.

I only saw the nurse for about 15 minutes, just do do vitals and go over my history. She was really sweet too.  Normally, time with the nurse would be longer, but Dr Young wanted to get me into his office. 

Then Dr Young. Wow. It is so nice to be with a doc who isn't just "winging it". He read through my last doc's notes, my pound o' paperwork migraine history, looked at my MRI, did the standard neuro testing. He asked me a whole bunch of questions, looked at my migraine diary and all my graphs.

Usually (and thanks entirely to this site) I know way more about my migraines than the neurologist sitting across from me.  Not now.  He knows what to do and how to do it.  He literally wrote the book on migraine treatment (okay, co-wrote the book)

So, new preventive is Zonegran. I'm tapering up to 300 mg over the next 6-8 weeks (I forget. The directions are long). I'm hoping I get the "reduced appetite" side effect. Oh, and if it prevents my migraines that'd be cool too  

He gave me a Rx for Imitrex injections as my new abortive b/c my migraines go on for too long for his liking (mine too). He asked me if I had a problem with needles, to which I laughed out loud and pointed to my three visible facial peircings. Though, now that I think about I'm really not thrilled with jabbing myself with a needle. But I'm sure I'll get over it after the first dose. I can't imagine it hurts all that much, especially compared to a migraine!  I just worry a bit because my fine motor skills tend to get shaky during my prodrome and the first part of my migraine. 

I go back in one month for a nerve block (which he said he would have done on the spot but my stupid insurance requires pre-cert). He thinks it will help with or possible get rid of my daily head pain. That would be nice. I mean, my head doesn't hurt all day, but it does hurt pretty much every day.