Reflections of a medical encounter

After suffering from migraines for the last 17 or so years I went and saw a neurologist this week. I average at least one migraine per month. I get the severe and incapacitating kind of migraines that leave me nauseas and vomiting and basically horizontal for a minimum of 24 hours. I don’t get aura that many people get, which means often the prodromal symptoms are quite vague (hunger, yawning) and I’ve eliminated obvious things like red wine from my life (alas). Generally I’d describe the pain as 8/10 – so, pretty horrible experience that I don’t think I’d wish upon anyone.

I’m not sure why it took me so long to seek specialist medical advice. I’ve seen a lot of GPs and they didn’t seem very concerned about it – although perhaps I was too blasé or resigned to it myself.

The thing that prompted it was recently getting a migraine for 3 weeks straight – sufficient to make me thing: “Enough!”

So all I knew about my specialist was that she had an interest in migraines (‘good!’). Overall, it was a very helpful and interesting – she deepened my knowledge and, as importantly, gave me a road-map of how I can better manage and prevent them.

That said, I’m a little a little embarrassed to admit that I was a bit intimidated; despite the fact I am an intelligent and grown woman! Unlike when I see my GP, I was seated in front (not beside) the specialist’s very large and impressive-looking desk – and it’s amazing how that immediately set the dynamic of the relationship. Also unlike my GP, she was quite brisk, rather dismissive (even exasperated) of my questions and not very sympathetic (the sole online review described her as ‘rude’ and I would certainly agree!). Admittedly I’m sure she sees many more serious cases – brain tumours etc – but surely this is irrelevant in the service she provides me?

I also found it perplexing and disappointing that she was completely disinterested in the data I’d brought along (I use an app to track my migraines along with my periods).  How far we still have to go to integrate technology into consultations (if this is any indication)! Given the massive growth of use, sophistication and potential of health apps, healthcare professionals need to adapt and incorporate these tools into their practice.

The experience also made me reflect on young people seeing their doctor. There is good evidence to say that staff attitudes – including respect and friendliness – are critical in engaging young people in health care settings. Given that young people have the lowest rate of seeing their GP, ensuring they have a positive experience when they do attend is hugely important.

Thankfully, my understanding is that GPs are generally better trained and experienced these days in communicating and working with young people.

Ultimately I actually felt empowered by the experience which is a really what most of us – including young people – want from any medical encounter.