I frequent a few migraine communities on Livejournal and Mothering.com, and one question comes up over and over. How do I find a doctor that will listen to me? It can take many forms, but the bare bones of it is that many people want to know how to find a doctor that will not only listen, but treat them as if they have a problem every bit as severe as it is.

I am so lucky. I have Dr. W. She is my primary care physician, and has been through so much with me. She has seen me through several neurologists, one of whom told me to go cold turkey on methadone. She recognized the fallacy of that, and convinced me that weaning off of it was better. She has also been with me through pain clinics that insisted that my job as a mother was not as important as getting off all narcotics and learning to live with my pain. She stated "Oh, so you aren't allowed to have a life?" and talked to me about medical alternatives. I love my doctor. She not only knows migraines, but is willing to listen, to let me express my frustrations. She knows what works for me.

So- how do you go about finding a Dr. W. of your own? The best way is through word of mouth. If you have a friend who gets migraines, or has another chronic pain condition, ask who they like, who they dislike. Then interview. Make an appointment to talk. Go over your symptoms, the medications you have tried, what has worked, what hasn't, allergies, lifestyle, and what you expect and would tolerate as good control of your migraines.

If you feel at all that you do not click with this person, don't go back. Don't feel that you have to see that doctor. If they insist that triptans are the only form of abortive relief they will give you, and they don't work for you, know that this is not the right doctor for you. If they do not believe in narcotic treatment for hard cases and that is the only thing that has worked for you, tell them and see how they react.

If they have ideas for prevention that are not medicine related and they fit with your personal beliefs, it might be the person for you. Dr. W. has come up with some pretty amazing things for me, from red-lensed glasses that make going into places with florescent lighting a breeze, to properly diagnosing Polycystic Ovarian Syndrome when my OB-GYN thought I was over-reacting.

Really, though, when it comes to finding a doctor that will work with you and for, asking questions is key. Ask how they will handle ER visits. Ask if they will send in an action plan to your local ER. Ask how they handle emergency med refills. Ask how emergency visits are handled and who a back-up doctor is for when they are on vacation, and if that back-up doctor is one who will follow their plan or come up with one of their own.

These may seem like too many questions, but it is better to have things like this out in the open rather than be surprised by something coming up. The other big question to ask is what they do if a medication stops working. Having that happen can be heart breaking and frustrating, and if not dealt with quickly can lead to a migraine cycle that can be hard to break.