When I checked in at the reception desk, they gave me a brief information form to complete got a copy of my insurance card, and gave me a multi-page personality test to complete. A few minutes later, Nurse Lois came out to greet me. We went to an examination room where she checked my vital signs, took a detailed medical history, and asked many questions about my Migraine history. As she worked, she entered all the information into her computer, which is on a network so that the doctors can easily access the information later in the appointment. Lois was professional, kind, and caring. When we finished she showed me to a small waiting area outside the exam room where I could complete the personality test.
A few minutes later, Dr. Tramuta, the psychiatrist, escorted me to his office. I was admittedly apprehensive about this part of the visit because, as many other Migraineurs, I've had too many doctors take the attitude that Migraine is "all in our heads." My apprehension was short lived. Dr. Tramuta understood my feelings, and we talked about them. His job is to assess patients for depression, which is much more prevalent among people with headache disorders than it is in the general population, and assess the patient's ability to cope with a chronic pain illness. We spent about an hour discussing Migraine, my general health, and how I deal with health issues. He told me that although I would not be automatically scheduled to see him on my subsequent visits, I may call at any time and request that a visit with him be scheduled.
After a short lunch break, it was time to see Dr. Young, my new neurologist. Since I had taken films from a recent MRI with me, he was able to view those films and discuss them with me as he performed a standard neurological exam. He confirmed my previous diagnosis of Migraine, with and without aura. He pointed out the blood vessels on the MRI films, telling me that they were in perfect condition, making me a good candidate for using triptans (Imitrex, Maxalt, Zomig, Amerge, and Axert) as Migraine abortives. After the examination, we sat in his office and discussed treatment options. He gave me his opinion of changes to make in medications for Migraine prevention and the use of Imitrex tablets and injections as Migraine abortives. We discussed rebound headaches, and the proper use of my medications to ensure that I didn't bring on rebound. He provided me with a preprinted sheet with a phone number to call of medication refills and a number to call if Migraine pain persisted more than 48 hours. Since the clinic is an eight-hour drive form my home, should I experience an attack with pain in excess of 48 hours, he will work with my primary care physician or local emergency room to see that I receive proper care. Since he had prescribed Imitrex injections for me, and I had never used them before, Nurse Lois brought in the Imitrex Stat Dose (self injector), showed me how to use it, and watched while I injected myself. She then sat with me for about 20 minutes and checked my blood pressure to be sure that it wasn't elevated by the Imitrex. The in-office Imitrex trial was so that I would not be frightened by the mild side effects that are expected immediately following an injection and to be sure that there would be no adverse reactions to indicate that I shouldn't use Imitrex. After Dr. Young and I spoke for another few minutes, I was on my way, armed with instructions, prescriptions, and a follow-up appointment set for nine weeks later.
