Finally got to see neuro within my HMO.  First words out of her mouth: "Clusters are just a kind of migraine."  Knew I was in trouble immediately -- shoulda walked then.  Put me on triptyline, trying to help me sleep through the night.  Triggered the worst headache I have had this entire cluster -- more than an hour of severe pain, 100 mg. Imitrex (which normally works in minutes) did nothing for 45 minutes.  Keeping appointment with expensive, but knowledgeable, neuro and headache center here in area.  What the hell is wrong with these morons that we know more than they do about CH?

Medical education in headache
Posted 9/26/07, MEDSCAPE   

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Abstract statements from a study of headache education in medical programs. Second para. specific to neurological residency training. Gives good idea of why it's difficult to find a sharp doc.
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"Objective. To explore the extent of headache education received by medical students and residents.
Background. Headache is a common, often severe, and sometimes disabling problem. However, 49% of sufferers do not seek professional treatment -- of those who do, only 28% are very satisfied. One possible reason is limited education of physicians about headache.
Methods. Surveys were sent to all allopathic and osteopathic medical schools, 200 family medicine residencies, and all 126 neurology residencies. Information requested included the amount and perceived adequacy of headache education and any plans to increase headache education.
Results. Response rates were 35% to 40%. MEDICAL SCHOOL LECTURE HOURS RANGED FROM 0 (4%) TO >5 (24%) WITH 92% HAVING NO PLANS FOR AN INCREASE IN HEADACHE EDUCATION. FAMILY MEDICINE RESIDENCY LECTURE HOURS RANGED FROM 1-3 (30%) TO >5 (34%) AND CASE PRESENTATIONS FROM 1-5 (23%) TO >5 (41%), WITH 88% OF PROGRAM DIRECTORS HAVING NO PLANS FOR INCREASE. NEUROLOGY RESIDENCY LECTURE HOURS RANGED FROM 1-3 (11%) TO >5 (64%) AND CASE PRESENTATIONS FROM 1-5 (23%) TO >10 (57%), WITH 80% HAVING NO PLANS FOR INCREASE.
Conclusion. Undergraduate medical education in headache is limited. Despite medical schools perceiving their training as adequate, both neurology and family practice residency program directors believe entering residents are inadequately prepared in headache upon entering the program."

"Neurology Residency Programs
Neurology residency program lecture hours varied from 1 to 3 hours (11%) to >5 hours (64%) (Figure 2). The number of case presentations ranged from 1-5 (23%) to >10 (57%) (Figure 6). Forty-two (95%) of program directors believed that their headache education was adequate (Figure 4). Interestingly, 20% of neurology programs indicated plans to increase training in headache management. Similar to the family practice programs, 68% of the program directors believed that new residents had inadequate knowledge about headaches upon entering the program while only 11% of the program directors believed that their residents were well informed about headache."

Yeah...many are "uneducated" as apposed to morons.

Your mission is to find one of the few who are well versed as well as accessible. One you feel comfortable with.

Once you do, it will be like finding a long lost friend!

Iddy

that is a f*&^%d up medicine.
I ve been on it years ago.
get rid of it and him.
taper it off slowly if you have to
and find another one.

;)

It's all too common for lazy, ignorant, arrogant, bordering on crimminally negligent neurologits to act as if they know the first thing about CH, even though clearly they don't.

Then they proceed to prescribe all kind s of wrong, harmful drugs, refuse to diagnose female patients, etc.

"Moron" is much too polite a term for this breed, and "uneducated" is just laughably WAY way too polite.

I just might start a topic where we call them out by name. Might as well warn others about them, and why should we protect the identities of these wrong doers?

Thanks, all.   Just glad to know others out there are supportive...read two articles this morning that said that the med she gave me is specifically for migraine and contraindicated for cluster.  Thanks, stupid woman.  You gave me a medicine that triggered the worst headache, maybe of my life.  And I didn't add the kicker -- her parting words were, "If you don't feel better, call me."  When I emailed her at 4 this morning, I received a return note that she is on vacation until May 3.  This is criminal behavior in my book -- she should have linked me to another doc immediately.

That's a disgrace!

Dorothy

Hmmm, amytriptyline is not contraindicated for clusters.  In fact, it's one of the drugs listed as an prevent on the OUCH website.

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Cynde wrote on Apr 22^nd, 2010 at 6:49am:

What the hell is wrong with these morons that we know more than they do about CH?

We are more motivated than they are, we have to live with the pain.  Plenty of "Self help" is available here.  Read it, live it, love it!

;) (a wink for the heck of it).  8-) (and a sunglass guy too, because it is late).

--Shaggy

My family doctor also said clusters are just a form of a migraine.  (i've never seen a neuro)
This same family doctor prescribed me topomax.  I don't give a hoot what he calls him, he currently has me PF.  If I wasn't a lazy, single, beer drinking male; i would have sent him a christmas card last year.

Really, I just consider myself lucky. He may not realize the difference, and at some point, I may have to edjumacate him.  Right now, I don't care.  I hurt, he helped.

Quote:

I just might start a topic where we call them out by name. Might as well warn others about them, and why should we protect the identities of these wrong doers?

May be more constructive to start a thread naming the educated ones rather than slandering the ones you know nothing about.

You said you e-mailed her at 4 in the morning. You got an auto-response. But she told you to call her. If you had, perhaps you would have gotten an answering service who would have had a covering doc call you back.

I don't think we should slander doctors we know nothing about, and by the same token, I don't know that we should shy away from naming the neurologists we've personally had bad experiences with regarding CH - the willfully ignorant ones who really have things wrong and are doing harm. For instance the ones who refuse to prescribe O2.

IMO our fellow CH'ers should know who to avoid, and if neuros start seeing their ignorant harm doer brethren being called out by name, maybe they'll think twice about their own level of knowledge about CH, and will consider getting a little educated?

It's not an open and shut case/black and white issue, I realize, since the potential for slander is there.

Not quite sure of the legalities, but one could say, "I had this *experience* with this *doctor*".   One would still need to be extremely careful not to let personal feelings overshadow reality (as in "he's a d*ck because he didn't do *so and so*" or he "misdiagnosed me with whatever") and then become libelous statements (once it's written down, it becomes libel as opposed to slander when spoken).

FWIW, I've seen online "doctor rating" sites where patients are free to speak their minds about their experiences with a specific, named, doctor, and heap as much criticism or praise as they wish.

For us CH'ers it might be handy to have a topic or sticky where we rate doctors regarding our experience with them pertaining to CH, good bad or indifferent.

Maybe the kind of angry "a-hole" this and "d**khead" that vitriol that I and others are known to level in diatribes against anonymous doctors could be disallowed onn that sort of topic.

Might be a better idea to use the "doctor rating" sites you say you have found than to put this site in a litigious situation.

You're not going to find much in the way of CH specific coverage of doctors on those sites - I think it would be much better for the forum members to have a specific go to place for that.

As far as a site being liable for something a member says in a forum, I'm not a legal expert, but I've never heard of such a thing and I have to wonder whether that is a real or imagined issue.

So far I'm still for naming those doctors who lead CH patients in harmful directions, telling them the sorts of things we've been hearing about here, for instance "oxygen doesn't work".

I'm sure DJ didn't intend ch.com to become a witch hunt. You should ask him?

As an environmental regulatory expert, I am expected to be current on everything related to my job.  I don't stop reading and learning just because I've already got my degrees and have been in the workplace forever -- my clients would never hire me if I showed the same level of ignorance about the evolution of a current piece of legislation that this doc showed about the evolution of headache treatment.  Any doc who still calls clusters "migraines" needs to be sent to this link, told to read what it says, and pay attention. 

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This is not new stuff - it's all over the peer-reviewed neurology and headache journals. 

To me, a moron is someone who can't be bothered to learn something new.  This neuro fits that definition.  And since none of you has a clue about whom I'm speaking, the whole discussion of litigiousness is just silliness.