What to expect from your first appointment with a headache specialist and how to prepare.
By the time most people get to a headache specialist’s office, they’ve been on a long and difficult journey. It makes the first visit feel significant, even momentous — and swamped with emotion and expectations.
We get it. You likely have been rubbed raw after suffering with your headache for years, being misunderstood, disbelieved, and isolated. You’ve been to many doctors, some of whom may have been unkind. In order to see the headache specialist, you may have waited on a months-long list for your appointment, perhaps traveled a long way. The visit is the culmination of so much effort, frustration, and hope; you want it to go well. The pressure cooker of pent-up feelings is so stressful for first-time patients that they inevitably leave their first visit and have a migraine attack.
Let’s talk about how to get the most out of your visit, while also reducing the stress of the occasion. The key is to be prepared, so the doctor has the information they need, while also mentally reframing this day to lower the stakes: Rather than viewing this as your one shot at wellness, see it the beginning of your journey with this doctor. Your health does not rest on the outcome of this single day.
Before Your Visit
Your doctor will require a lot of detail about your headache symptoms and health background, including details you’ve maybe never even thought about before. It’s all part of the diagnostic criteria they use to guide your individual care. Many offices send you a packet to fill out beforehand. If not, you’ll need to prepare yourself with the answers for your first visit, including:
Timing and duration: At what age did your headaches begin? How frequent are your attacks? How long do they last? Do they occur at a particular time of day, week, month? Can you sense a migraine coming?
Pain characteristics: Does it usually start in one location? Does it move? How would you describe your pain sensations: stabbing, throbbing, tingling, something else? How does that quality change over the course of an attack?
Other symptoms: Do you have nausea or vomiting; sensitivity to light, dizziness, trouble speaking or thinking, numbness or weakness?
Triggers and aggravating factors: What brings on your migraines? What makes them worse?
Family history: Who else in your family has headaches?
Treatments: What medications and therapies have you tried so far, including alternative treatments?
- Helpful tip: Set shame aside. Some people feel embarrassed revealing the alternative remedies they’ve sought. No one is judging you but yourself, so show self-compassion: Whatever methods you’ve tried, list them and remember you were doing your very best to make yourself well.
Be sure to fill out any forms carefully. If the information is complete, the doctor will have more time to get to know you during your visit and get to a deeper understanding of your headache disease, matching the available treatments to your needs and values.
On The Day Of Your Visit
It will be a long day. Try to prevent a migraine by taking your regular medications, eating breakfast, and bringing a snack to stave off hunger. Prepare to be as comfortable as you can in the waiting room by wearing non-restrictive clothing and bringing a book or activity to keep you quietly occupied. During the day, feel free to get up and stretch, take a stroll, use the bathroom, and get water refills from the cooler — whatever makes you more relaxed and comfortable.
Bring someone with you, if it makes you feel more calm and secure. If you are traveling, it may help to let that person do the driving. Having someone to help you find the office or just keep you company can ease stress. Remember, though, that close companions bring their own emotions, which can sometimes be disruptive to the visit. Whether you decide to bring anyone is entirely up to you.
Come ready to sum up the overall picture of your migraine. Think of it as an overview of your headache frequency and severity over the past year, and how it has impacted you. This snapshot will be used as a benchmark to compare against for the future, to see how treatment is affecting your headaches.
- Helpful tip: Don’t bring every medical record you’ve ever collected. By the time patients see a specialist, they’ve usually seen multiple doctors and have stacks of documentation. Some come into the office with a rolling suitcase bursting with paperwork! Leave it home — that level of detail will bog down the process.
During Your Visit
You may meet with several people over the course of your visit, each gathering information to help create a full picture of your condition. That might include an intake nurse and a psychologist, as well as the headache specialist. Be patient and don’t worry; all of the information will be reviewed by the doctor.
Don’t feel pressure to be the “perfect patient.” Very often, people with migraine feel that they need to answer each question correctly and remember every date, symptom and medication ever taken, or else the visit will have been a failure. There are no such expectations of you, and no need. This first visit is not a test you need to ace, and it’s not a make-or-break moment. It’s a way to begin getting to know you better so the doctor can figure out what treatment approach to take. Rest assured, if they need more information about anything, they will ask.
Don’t worry about taking notes. The process will be much more productive with your full attention. Most offices give you a printed summary of your visit to take home.
Ask questions to make sure you understand the treatment approach. Your doctor should be happy to explain it to you. Generally, the better people understand their plan, the more likely they are to stick with it. For example, if you didn’t know that a certain medication needed time to build up to therapeutic levels in your bloodstream, you might be tempted to bail early upon seeing no change. And if you didn’t know that headache doctors often prescribe drugs used for diseases other than migraine, when you got to the pharmacy you might think you’d been given the wrong medication!
By the end of your first visit, you will have a treatment plan. One plan for managing a migraine attack and, if necessary, another for prevention. Make sure you know your personalized plan for each:
- Acute therapy: How will you treat a mild attack (0-3 on the pain scale), a moderate attack (4-6) and a severe migraine attack (7-10)? When you’ve exhausted those remedies, at what point you call the doctor?
- Prevention: What is your plan for migraine reduction if you have frequent attacks? This is likely a multi-modal approach that could include medication, lifestyle changes and mindfulness practices to reduce stress.
Remember that your treatment plan is a work-in-progress that will be tailored to your body’s unique response. At each of your future follow-up visits, you’ll be asked whether your migraine condition has improved since your last visit, gotten worse, or remained the same. Based on your answers, your doctor will continue to modify your treatment plan over time. Like we said, this is just the beginning.
For now, at the end of your visit, take a moment to celebrate your courage. You’ve come so far, and with your new tools for migraine management, you’re about to take another step on the journey.