Laura,
You can't feel guilty about seeking out another neurologist, someone you would be more comfortable with, regardless of your own doctor status. Sometimes it takes several tries before you find someone you feel will listen to you and will work with you to construct a treatment plan, and prescribe the appropriate medications.
I have been working this problem under the health system without any insurance for a couple of years, and have found that the level of treatment from a lot of doctors is colored by my financial status. There is only one neurologist in town that sees patients without insurance, at the City Free Clinic, and takes referrals from my health center. I saw him once, and he was a total ass. He barely listened to anything I had to say, and acted like he was doing me such a favor. He paid no attention to the list of medications I was taking, and prescribed a triptan that would have had serious interaction problems had I taken it. Since I get most of my meds thru the health center, the pharmacy filling the prescription would never have had an interaction warning. The thing that really pissed me off is that I told him that none of the triptan family of medications work for me. Either they have no effect or they make me violently ill.
I got another referral, to the University of VA Neurology Clinic about an hour away from home, but this time I got to see Doogie Houser. I think he was a first or second year med student, and seemed to know less about migraines than I did. He disappeared for about a hour after my exam, I guess to confer with whoever was monitoring him, then showed back up with a bunch of prescriptions, which he really couldn't explain very well. He said I could wait an hour until his supervisor got back, but I was getting a real headbanger and just wanted to leave.
Without insurance, doctors are much quicker to assume I am simply a drug seeker, so I really have to fight to get satisfactory pain management on a fairly regular basis. Week before last, I ended up having to get three shots for pain. The worst part is that I am very hard to medicate for pain. I have had so many miscellaneous injuries, operations, etc...in addition to my migraines, that a lot of standard meds just don't work on me like they would on someone else. Right now, if I go to the Health Center, they give me Nubain and Phenergan, which knocks the pain down to a 3 or 4 level for maybe six hours, but definitely doesn't put me to sleep. If I go to the ER, hopefully I get a shot of Dilaudid and Phenergan, which gives me a little more relief than the Nubain. If the doctor decides to give me Morphine, I have to have a double dose, which will knock me out, but I'll wake up feeling like somebody kicked me in the back of the head, so I've got to have some Percocet on hand to deal with that. The Health Center I go to is very strict on prescribing narcotics, so I can't keep enough on hand to be very helpful. For instance, my doctor will only write me a script for 30 Lortab 5/500 (one every six hours) every thirty days. One of the other doctors writes the same thing for eight hours. I'm way beyond that being of much help. I need three or four times that every six hours for it to do any good. Back in the days when I had insurance, my system was use to Lortab at 7.5/500, taken as needed. I might also mention that I had a gastric bypass, so there may be an absorbsion issue involved here. Unfortunately, the doctors are also limited on dosage by center policy.
The good news is that I'm going to see another neurologist on the 9th of NOV. He is in the same office as the ass, but I'm not going to breathe a word about seeing his colleague. This guy is supposed to be very highly regarded and even gets migraines himself. Hopefully, he will be the right doctor for me. If not, I'm going to have to do some accupuncture, massage therapy, or something else(except go near a chiropractor!!!).
OK, so who's the long-winded one now?!!!
Leigh Ann