What should I expect at my Initial Visit?
Making the decision to see a clinician may not be easy.
“Why my headaches are so bad as to need medical help?” If you are asking questions like those, chances are that your headaches are a medial problem. If headaches are interfering with your life — if you are missing work, school family, or recreational activities because of them — you probably need to seek medical consultation.
When you are afraid of making plans because you may have to cancel them due to headaches, yo need to develop tools for managing your headaches so that you can control headaches rather than having them control you.
First Visit:
Your first visit will consist of a thorough diagnostic interview and examination, and your initial diagnosis will be discussed at its conclusion. Together we will design an individualized treatment program for you, to include prevention of further pain,or attacks, and tools to manage an acute pain or headache. Please bring to your appointment your insurance card, physician referral forms (if required), any recent X-rays and appropriate records, and the completed Wexley Headache Clinic paperwork.
What Your Clinician Wants to Know
It is important to use your time with your doctor effectively and efficiently. Your clinician wants to make an accurate diagnosis This diagnosis focuses on four key aspects:
- The pattern of your headaches over time.
- The symptoms you experience when you have a headache.
- How headaches affect your life.
- Findings from your physical examination.
The pattern guides the doctor in deciding if the headaches are primary of secondary (see headaches section) and what type of tests and treatment may be needed. If the pattern of headaches is stable over time and your examination is normal, your headaches are likely a primary headache.
If the headache is new or changing, or if red flags are present (as described in headaches section), further investigation may be required. Even in this setting, your headaches may well be primary.
Symptoms that occur during a specific attack are used to determine a headache diagnosis. For example, during a headache migraineurs typically experience nausea and sensitivity to light and/or sound. Tension-type headache is characterized by the lack of these migraineurs’ symptoms. Another primary headache, cluster headache, is characterized by red eye and stuffiness of one nostril, with excruciating headache on only one side of the head. Finally, the way your headaches affect you helps the clinician determine the type of medicine needed for treatment.
Preparing for the Initial Visit
Take some time to observe your headaches. How often do they happen? What is the “quality” of your pain (throbbing, squeezing, etc.)? Do you have other symptoms before, during, or after your headaches? Do the headaches wake you from sleep? Do you have visual disturbances, or tingling in any part of your body?
As a second step, make a list of all medications you are taking, including vitamins, minerals, herbs, and over-the -counter products, and the number of times a day of week that you are using the medications.
Third, focus on how the headaches impact you. Can you work? do you need bed rest? Can you do household chores?
Finally, examine how you feel between the headaches. Do you have problems with sleep or changes in your mood? Do you live in fear of your next headache?
Think about any specific concerns, questions, or expectations, you may have. I you fear that your headache is from a brain tumor, then make sure you communicate that fear. If you believe you know what causes your headaches, tell your doctor. If you are reluctant to take the medication that your clinician prescribes, make your concerns known. The initial visit is the first step toward forming a partnership with your health care professional and communication is essential.
Documenting the Pattern, Symptoms, and Disability of Your Headaches
Keeping a record of your headaches using a headache diary can help you and your doctor see the pattern of your headache. As mentioned in the prior section, paying attention to the characteristics of you headache is very important.
In the diary, record situations that happened before your headaches, such a sleep deprivation, certain foods, menstrual cycle, or weather changes. Documentation will help the doctor work with you to develop a treatment strategy.
Treatment Options
Depending on the medical factors involved, the doctor will select from the following strategies to relieve the patient’s suffering:
- Pharmacotherapy (medications)
- Splint/oral appliance therapy
- Home posture and stretching program
- Trigger point injections
- Nerve blocks
- Biofeedback
- Cognitive/behavioral strategies
