Terrible doctor visit

I last saw my neurologist in November. My husband always went with me to translate, since we were under the impression that he did not speak English. Well, yesterday I had to see him by myself, since my husband is away on business. We tried to change the appointment, but he wouldn't have been able to see me until July, and I didn't want to wait that long.
Well, my doctor does speak English, though it is limited. I don't know if his limitations are the reason why this happened, but whatever is it, I need to VENT!
I wrote about everything major that I wanted to tell him, and my husband translated to Japanese, so I gave the doctor that paper to read. After he finished reading, he looked up and said "I have a few questions. Who diagnosed you with migraines." Well, that is a hard question to answer, as I have been separately diagnosed by 6-7 doctors, including 3 neurologists. So, I answered with the first doctor, back when I was a child. He responded "I don't think you have migraines." I was SO shocked! WHY?! He said that one of the medications I was taking that I stopped taking in January is not prescribed for migraines. I am WELL aware of that fact, it was prescribed for another disorder, but I was reporting the fact that I am decreasing and trying to stop all medications. Especially because there are some reports that the medication he was talking about can help prevent migraines when in combination with other drugs, and after I stopped taking it, I did have more migraines. Also, he said that if I had migraines, I should take triptans or ergotamine, but I got SO FURIOUS then - b/c on my chart it clearly states that I am ALLERGIC to triptans and ergotamine!!!!!!! I am sure that they WOULD help, if I could BREATHE after taking them!!!
Anyway, then he pulled out a powerpoint presentation to show me what migraines are: unilateral pain (check), pain so bad that you can't work (DOUBLE check), nausea and/or vomiting (Check!), sensitivity to light and sound (Yes, light and smell for me), and pain lasting hours to days (YES!). So, I said "This is exactly what I experience, so why do you say it isn't a migraine?!" Well, it seems that since getting a drip infusion of saline solution MIGHT have helped my migraines (I also stopped working at the same time, so I'm not sure which is the bigger help), he thinks I just have a type of intractable headache. Well, I asked why drip infusions help, and he said it is unscientific and he only has speculations, which he didn't want to share with me, except it had something to do with blood volume.
Finally got in touch with my husband and he was as outraged as I was. He said that the only explanation is a communication problem. We will go back to the doctor together in June and he is going to demand an explanation, but until then I will get a drip infusion twice a month to see if that helps.
I hate when a doctor makes you feel so confused!!
Carla

I don't understand! What on earth? Sounds like your doctor has a superiority complex. How frustrating and awful. Hope you're ok. You have enough to deal with without the doctor making you feel worse!

OMG!!!!!!!!!!!!!!! That is out of court on so many levels........

1) That he could speak English and never had the polite courtesy to say he did!

2) That he has not read or understood your notes - eg the other conditions and the allergy to Triptans!

3) That he did not understand your symptoms - I do not have massive knowledge on intractable headache - but understood it was a head pain which did not respond to treatment -that it was just head pain and not the other neurological problems / aura you have highlighted

This is a great paper on it

http://www.headachejournal.org/SpringboardWebApp/userfiles/headache/file/refractory.pdf

4) I also think the presentation was rude - you have had migraine for years - you know what migraine is... I suspect he could learn off you

Also, the presentation is wrong - you do not have to tick all those boxes to get a migraine prognosis - not everyone is sick, not everyone is sensitive to light and in fact you do not have to have a pain in your head to have a migraine...

I agree a superiority complex is going on.............. if it were me I would sack him and find another doctor..........?

Hugs xx


PS I am not sure how the infusions work - I have not heard of this as treatment - but I do think giving up work would have played a big part of the reduction - ie less stress, better sleep, less exposure to triggers in the environment, more time to relax and heal....

Yeah, it was very discouraging. The only reason I haven't already decided to never see him again is that when my husband goes with me, everything goes smoothly. He is the only neurologist I have seen in Japan who hasn't given up on me within 2 months, and he said he wanted to get to the bottom of why I have migraines, instead of just treating them. That was my husband's translation, at least! But my husband was really furious when I told him what had happened, and also very confused. He asked me if I was sure that the doctor remembered me, which I am not. But how many foreign patients can he have? Not many, is my guess. One reason I think he might not have remembered me is that he asked me if my husband is Japanese... when my husband has been there with me every other visit. Still, I find it discouraging that he could so completely forget me and be so... demeaning... after just a few months!!
No clue what I will do, but I do know I will go back to him in June, with my husband. At least then my husband can tell him off if he is rude and dismissive again!!

Hi Carla,

That was certainly not a helpful consultation. The only thing I wanted to add was that the saline infusion may help reduce dehydration, which can become an issue with chronic migraine. I've had several occasions where I've been hospitalised due to my chronic hemiplegic migraines and have sometimes needed intravenous fluids due to my inability to eat and drink - my body just shuts down. I'm now advised by one of my consultants to drink 3 litres of water a day to try and prevent further dehydration...it isn't an easy task to achieve but as I now know it may help alleviate the severity of my symptoms then it is something I try to maintain.

ATB,

Michala

Hi Carla, so sorry you had to go through that, it is frustrating and demeaning and leaves you feeling undermined. I have had a couple of consultations which have been just as upsetting-a locum consultant telling me to calm down, my fatigue was probably immagined and why wasn't I back at work fulltime? He then went onto say that I should feel grateful for the fact that I had a supportive husband and kids and to just get on with life and go back to work. I was so angry that my eyes filled with tears and he then said" See-you are just very emotional, if you calm down your symptoms will go" GRRRRRRR. I did not give up and ended seeing a different consultant , but the battle continues with my Migraines.
Carla I hope your next appointment with your husband attending is more successful,I would certainly agree with the 3 litres a day of water. Hopefully the infusions will provide some relief for you.

I can understand how you feel. The only suggestions I can offer is that perhaps he was having a bad day. If it proves to be a one-off event, that's what I would conclude. If it happens on several occasions, then he deserves a good reprimand.

I've only been able to find one neurologist who specialises in migraines. And he rubbished several of the symptoms I and family members described. The consultations felt more like interrogations than anything else.

He was adamant that auras lasted no more than 15 minutes and the only form of memory loss related to migraines was Transient Global Amnesia which typically lasts a few minutes and never more than an hour. He ridiculed about half of the symptoms we described and he gave the distinct impression that he thought we were making it all up.

To add insult to injury his consultation wasn't covered by our health system. Paying almost NZ$1500 only to be referred back to our local GP didn't do much for my self-confidence or faith in the health system. Each consultation required a 6-hour return trip and very exhausting for me at the time. I don't think I would go back to him even if I was paid to do so.

I wonder how such "professionals" can be highly regarded as was this particular neurologist, when they have such poor doctor/patient skills.