Patients living and working in the UK should ask for a letter of referral from their general practitioner. Our patients mostly come from London and the Home Counties, but we do see patients from all over Britain and indeed from all over the world. As a charity there is no charge for anyone who is entitled to NHS treatment, although we do hope that all our patients will be kind enough to make a generous donation to support the Clinic’s research and keep the service going. Patients not eligible for NHS treatment, including those from abroad, can be seen as private patients - a referral letter is still required. Anyone can be seen as a private patient if they wish. Indeed if you have medical insurance this would be preferred because the doctors donate all fees to the clinic.
Fundholding general practitioners are not charged for referring patients.
Before you arrive
It is a great help if you have made a few notes. Keep a record of headaches in a diary for several weeks noting the time the headaches start, how long they last, other symptoms and the dates of your periods, if you think they are related. Click on migraine diary for further information.
When you arrive
Your details: name, address, phone number etc. will be checked. You will then be ready to see the doctor.
Medical history
The
doctor will first need to decide what type of headache you have. To help answer
this she/he will need to know roughly how old you were when the headaches
first started, how often you get them, how long they last and what your symptoms
are.
Such information helps the doctor build up a picture of your headaches. This is important because there are no specific tests for migraine, or the majority of other headaches, so the diagnosis is based mainly on your own description.
If the doctor decides that you probably do have migraine she/he will be looking for ways to help you cope. You will be asked about remedies that you have already tried and it is helpful if you have written these down, otherwise there is bound to be something you will forget! Make notes about changes you have made to your lifestyle and whether or not these have worked, about stress and sleep and other trigger factors, about the tablets or suppositories or the inhalers or the injections, about the doctors, the physiotherapist, the chiropractors, the osteopaths, the herbalists, homeopaths, and hypnotists...and so the list goes on!
The doctor will ask about your general well-being and past illnesses.
If you have migraine, and only migraine, then this will be obvious by now; but if you have a mixture of headaches, or if the description of your headaches does not suggest and immediate diagnosis, then you may need to keep a detailed record of your symptoms for several weeks. This should help the doctor to make a diagnosis.
There is no cure for migraine - that is a hard but undeniable fact of life. Fortunately though there is a lot that can be done to improve matters in terms of reducing the number of attacks and finding more effective treatment for those which do still occur.
How is this done? Well, the details of management will depend on your particular needs but generally the first step towards reducing the number of migraines is to identify trigger factors. There is more to this that avoiding chocolate and cheese. It is rare for people to have one single factor which will trigger their migraine one hundred per cent of the time. Trigger factors are more subtle than this. They tend to add up.
For
example some women find that a glass of red wine can trigger migraine in the
few days before a period, but not at other times of the month.
The doctor may give you a headache diary to help you search for your triggers.
Many patients are pleasantly surprised to find that by paying close attention
to their lifestyle they can significantly reduce the number of their attacks.
If these simple measures do not bring about an improvement then the doctor will consider preventative drugs. In practice more than ninety per cent of our patients manage very well without the aid of regular medication.
Of course medication is always needed to treat the actual attacks. The choice of drug is important but so is the time you take it (as early as possible). Eating a little food and resting for an hour can sometimes be a great help. The combination of a simple painkiller and an anti-sickness tablet can be used even if nausea is not an early symptom. Suppositories are sometimes an acceptable alternative for those who cannot keep tablets down, but there are many other options. The clinic’s doctor writes to general practitioners with suggestions about the therapy they can provide.
You will usually be invited to return within three months but this depends on the frequency of attacks and the individual case.
Follow
up visits
It is not always possible to make a diagnosis at your first visit. Over a series of visits, and with the help of a diary card, the doctor can give you further advice and if necessary adjust your treatment. Alternatively if you do not have migraine you may be referred to a centre that deals with your type of headache.
After a few visits, all being well, many patients find they do not need to return to the clinic because they are much improved. They are pleased to know they can be referred back should the need arise - they and we hope that it does not.
Your ideas
The doctors are always interested to hear any worries you might have about your headaches. Do not be embarrassed about this because a few words of explanation now can save a lot of worry later.
Any ideas you have can help our research and further our understanding of headaches.
Doctors undertake research projects; their results and findings are published in the medical press. Several paperbacks for the general public have also been written.
Clinical
trials are undertaken allowing new treatments to be offered to those patients
who choose to take part.