New Patient Exam

Up to one and one-half hours are allotted for a new patient visit. Patients are asked to complete a past medical history form and are asked to bring old records of medications used in the past and any testing that has been performed. The doctor will take a comprehensive history and do a physical examination. Laboratory studies may be ordered to exclude certain causes of headaches and make sure medications can safely be used. An electrocardiogram may be performed to rule out any underlying problems before starting medications, many of which can affect the heart.

Next, the doctors educate patients on their headache diagnosis and causes of their condition. An attempt is made to identify and modify individualized headache triggers. A comprehensive treatment plan is instituted based on patient characteristics, lifestyle and preferences, and based on experiences with past medications. Patients learn about treatment rationale, and a follow-up appointment is made. Headaches are a dynamic condition and often change with time, making it necessary for the doctors to provide adjustments to the patients' medication. Once the headaches begin to improve, there is a reduction in the patients' medication. Alternatives to medication treatment are also offered as part of a comprehensive treatment approach.