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Great New Articles on About.com

About.com’s headache page has long been a resource for headache patients. Teri Robert, the headache “guide,” has been hard at work lately writing some great new articles. Here are some of my recent favorites, but be sure to poke around on the site — it’s chock full of information.

Top 7 Steps To a Head Pain Sufferer Friendly Home
Reducing environmental triggers, simplifying chores and setting up your own headache place (much like finding “home”) are all ways to minimize the impact that headaches have on your life. By reducing odors, chemicals and stressors, you may also reduce your headache frequency.

Doctors – Helpful or Hopeless? How’s Yours? Need Help?
Tips on finding the right doctor for you and how you can help your doctor help you.

Headache and Migraine Medications and Wal-Mart’s $4 List
While no triptans are available for $4 (because there are no generic triptans), many headache preventives are. Teri provides a short list of meds and links to more information, including a comprehensive list of Walmart’s $4 prescription drugs.

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Prescriptions More Common Than Explanations

I always tell you to talk to your doctor before taking any medications or supplements or latching on to a diagnosis. As well-intentioned as these pronouncements are, I sometimes feel like I’m doing the same CYA that drug companies do in ads. Really it’s that I want you to be safe and hope that a doctor’s input may help.

I know even that may be a long shot, a belief backed up by a recent study. The findings indicate that many doctors prescribe medication without explanation of the drug’s purpose and side effects or even it’s name. According to the New York Times article on the study:

“Although there were variations, depending on the type of medicine
prescribed, 74 percent of the doctors mentioned the trade or generic
name of the medicine, and 87 percent stated its purpose. Sixty-six
percent said nothing about how long to take the medicine, 45 percent
did not say what dosage to take and 42 percent failed to mention the
timing or frequency of doses. Physicians mentioned adverse side effects
only 35 percent of the time.”

So you can’t always rely on your doctors for information on drugs, is there anyone who can help?

Check with your pharmacist. They are trained to know drugs inside and out. Many enter the field with a goal of helping people, but the reality of the job doesn’t involve much of that. Most pharmacists I’ve met are more than happy to explain medications — even if they are over-the-counter — and answer questions. If the pharmacist at your local Walgreens is a dud, try the Walgreens that’s two blocks down the street!

Talk to a friendly person in your doctor’s office. Maybe you get along great with the nurse who takes your blood pressure; it can’t hurt to ask for clarification that you don’t get from the doctor. In some offices, a physician’s assistant or nurse practitioner returns phone calls for the doctor. You may find that they have more satisfactory answers to your questions. If you get along well with the PA or NP, why not consider making your next appointment with him or her? Or if you’ve always seen the head honcho of the practice, you might consider seeing some other doctors in the practice. They may be less harried and, thus, have a more patient-friendly demeanor.

A naturopathic doctor is another option. By focusing on the person instead of the patient, much of the appointment is about addressing the person’s questions and concerns. Licensed NDs are trained to integrate their treatments with those of western medicine — understanding pharmalogical treatments is a vital component of this practice.

Last but not least, ask your doctor! Yes, it seems like the job should require such explanations, but it’s also a high pressure job. Haven’t you ever forgotten to explain things to your co-workers, employees or clients? Being a recipient of information is as big of a job as being the giver of that information. You aren’t a passive recipient. You’ve got to ask your questions to have them answered. Of course, if your doctor consistently comes up short, it’s probably time to look for a new doc.

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Choosing & Getting the Most From a Doc

Choosing a new doctor is always tough. Recommendations from family and friends can only go so far. We’ve all got different ideas about what makes a good doc and our expectations aren’t the same. And it’s likely that friends can’t give you the name of a specialist that you need, like a neurologist.

Case in point, I love my new headache specialist and tell that to everyone who’s looking for one in the Seattle area. Most people I’ve talked to agree, but some disagree — vehemently.

In My Humble Opinion has a a doc’s suggestions for finding the right general practitioner for you and getting the most out of that relationship. Having a good GP has proven invaluable for me. I’ve gotten the first level of headache care — which I recommend everyone new to headache tries — and referrals to specialists.

(A caveat: I’ve heard horror stories about seeing a specialist of another doc’s recommendation. I tend to think that if you have a doctor that you really like — be it a GP or specialist — you’re much more likely to get a good referral. But I could be naive.)

Although the post is specifically about finding a GP, the suggestions can also apply to choosing any specialist. Check out my earlier post too if you’re looking for tips on finding a headache doctor.

[via this week’s Grand Rounds]

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Finding a Headache Doctor in Your Area

Finding a doctor you like is hard enough. The additional requirement that the provider be is well-educated and up-to-date on headache seems unattainable.

Instead of immediately narrowing the pool to well-known headache specialists or clinics, consider looking for a doctor who is dedicated to treating headache, no matter what his or her medical specialty is. With a wider selection, you’re much more likely to find a doctor that you connect with. And will be saved the hassle of having to travel far from home or wait six months for your first appointment or both.

A good resource for finding such providers is the National Headache Foundation’s list of headache management-certified docs. According to the NHF, these are the requirements to get the certificate:

“…[T]he physician must have a practice which involves a substantial case load related to headache research or patient management, must have published an article in a peer reviewed journal, have completed 50 Continuing Medical Education credit hours in the area of headache in the past five years, presented at scientific meetings or published articles and been involved in teaching, lecturing, publication or research in the past seven years.”

If you don’t have luck with the list, ask around. Don’t know anyone to ask? Keep your ears open. People mention headache and migraine a lot more than it seems like they would — a coworker, neighbor or barista may give you a terrific lead. If there’s an active support group in your area, go! The folks in the group are an amazing resource. Asking on an online forum might help, but there’s a good chance that members who live close to you won’t see your post.

Other resources include member lists from the NHF (call (888) 643-5552) and ACHE, as well as About’s headache section. The list is comprehensive and well-managed. To be included in the directory, doctors have to be recommended either by other doctors or by patients. The source of the recommendation — doctor or patient — is noted.

I found one doctor by looking in the Yellow Pages for neurologists with ads that listed headache as one of their interests. She was a great doctor and I loved working with her, but her knowledge of headache was basic. She was still willing to treat my headaches aggressively.

With any of these sources, you should do your own research. When you call to schedule your first appointment, it’s a good idea to ask if that doctor sees a lot of headache patients. If the answer is no, you may want to follow another lead. Some other questions to ask at your appointment will help narrow down the field even more.

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The Other Side of the Fence

Many doctors chose to study medicine to compassionately help and cure people, but moving through school and residency they can become jaded, rushed and exhausted. On the Lingual Nerve, Spacefan illustrates how overwhelming the transformation can be.

Spacefan’s post made me think of last week’s New York Times article on medical organizations trying to shape up docs whose patients are dissatisfied (see Dealing with Difficult Docs). Of course there’s no excuse for being rude, condescending or dismissive of patients, but society needs to recognize that the actual practice of medicine isn’t as glamorous, lucrative or exciting as it seems.

Becoming a doctor takes so many years that people have traditionally decided on that career path by the time they were 23. Are any of you currently doing what you thought you’d be doing when you were that young? I’m certainly not, but I have explored many different career options where the glitz fades after a couple years. I’ve been able to switch from one field to another with relative ease. If I had spent college, four years of graduate school and four years of specialized training for something as specific as medicine, I wouldn’t have the guts — or the financial wherewithal to pay off my loans — to stop.

Lots of people are in careers that they don’t like. With lives at stake, doctors have more responsibility to engage in their jobs even if they are unhappy than a mid-level manager at a corporation would. But shouldn’t teachers, lawyers and police officers be held to the same standards that we hold doctors to?

Again, I’m not excusing doctors who are disrespectful of their patients — I’ve had several that I don’t think should be practicing medicine — but that maybe we should give them a little slack. Even if some think of themselves as God, they are in fact human.