Migraine Tip of the Month: Providing a Clear History: How to Avoid Babbling
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Constructing a management strategy for effective treatment of migraine inevitably requires an accurate diagnosis, an accurate assessment of the individual migraineur’s headache burden and a concise but complete headache history that includes whatever therapies have been tried in the past.
Communicating with a healthcare provider can have a lot in common with a bad first date. Most readers will recognize this unfortunate phenomenon. You know, those better forgotten times when you wanted to make a good impression but found yourself blathering on about nothing as the smile on your companion’s face across the table became ever more forced. A part of you wonders, Why don’t you just shut up? And yet on you go.
Have you ever had the experience of showing up for a medical appointment confident that you could provide a clear history and then, in the moment, instead producing an incoherent stream of unlinked informational fragments? And then sat there wondering why in the world you said the things you did, nodding reflexively as you completely miss what the provider is saying and forget to ask the questions you’d prepared?
I certainly have, and I can assure you from personal experience that being a decent communicator as a physician does not necessarily extrapolate to communicating well when placed in the unfamiliar role of being a patient. Given my own experience as clinician and patient and acknowledging the critical importance of the patient’s history in managing migraine, I routinely make use of a headache questionnaire which ensures I will learn at least the essentials of what I need to know. Further, to insure that the patient understands what has resulted from the clinic evaluation, I send each new migraine patient an email message which summarizes my clinical impression and the management strategy we developed together, along with relevant educational materials.
A headache questionnaire similar to what we use at the George Washington University Headache Center is available at this magazine’s website. If you plan to seek medical attention for your headache disorder, download the questionnaire, answer the questions as accurately as you can and take a print version of the form with you to your appointment or, if the healthcare provider prefers, scan and email the questionnaire to him/her in advance of your appointment to be scanned into your electronic medical record. Be assured it will increase the likelihood of that appointment resulting in an eventual reduction in your headache burden.
Also on the website is a sample of the clinical summary that I send to my migraine patients after their initial evaluation. While your healthcare provider may or may not do something similar, this represents the information you want to have solidly in your hand and head following your appointment.
Finally, take a look at the article entitled “Your First Visit to the Doctor” in the issue of this magazine. It will help prepare you for that visit and maximize the benefit you receive from making the effort.
