Any recommendations for a Bay Area neurologist?
May 18, 2017 12:11 PM   Subscribe

I've had constant, severe headaches for nearly four weeks. Student health services will refer me to a neurologist of my choice, but I've seen bad neurologists here in the past and I'm not sure who to choose.

I've been treated for migraines in the past, and I've been really frustrated with some of the neurologists I've seen here in the east bay (for example, I offhandedly mentioned to one of them I might have had a migraine in a different spot than usual, and he said "oh that's good, otherwise I'd have to get you an MRI for a tumor" -- wait, then why didn't you ask me about that before telling me I didn't need an MRI?).

I've had constant headaches for the past several weeks. Some of them are migraines with auras (which I haven't had in years). The rest of the time I've just had a mild headache that instantly spikes if I think too hard or get the tiniest bit worried about something. I've also had a couple major dizzy spells, which I've never had before. I've been trying not to make a fuss out of it (I think it's residual stress and fatigue from the end of the semester), but my girlfriend is getting worried.

I saw a nurse practitioner last week, did fine in the basic neurological tests, and got tramadol for the pain, which does nothing. She referred me to a neurologist, but I got a message from the insurance office telling me to fax them a doctor's name and phone number. Who do I pick? I'm not going back to the shitty ones I've seen before. Yelp makes it sound like there is no such thing as a good neurologist. I'd go to UCSF's neurology clinic, but they have a 2-3 month wait.

I'm on my student health insurance plan, which is Anthem Blue Cross PPO. There's a bunch of in-network people in the area, but I want to be sure I can trust the doctor I see. I want to trust that if there is something serious, they're not going to miss it. Have you had experience with a neurologist that you liked? I live in Oakland, but I'm willing to go anywhere in the Bay Area if they're a good doctor (except maybe not, like, San Jose).

Also, as a minor related question, I'm supposed to be in the DC area for the first 2 1/2 weeks of June, for research - is this urgent enough that I should try to get in with a neurologist there, if I'm not able to get an appointment here? Does that even make sense?
posted by shapes that haunt the dusk to Health & Fitness (8 answers total)
Response by poster: (And to clarify, I have nothing against San Jose, I just mean I don't want to have to drive an hour and a half each way).
posted by shapes that haunt the dusk at 12:14 PM on May 18, 2017

I had my first migraine a little over a week ago (yuck). The PA that I saw for the migraine (I use One Medical) faxed a referral over to the UCSF Neurology's "Expedited Care Clinic" and I had an appointment for about a week later. 2-3 months seems extreme. My migraine had (finally) subsided by the appointment. The specific doctor that I saw was Neil Raskin, but I did not specifically ask for him; after they received the faxed referral from the PA, UCSF called me to schedule an appointment and it turned out to be with him.
posted by strangecargo at 1:00 PM on May 18, 2017

Mod note: Couple comments removed. No harm done, but if you're specifically noting that you aren't answering the question, please don't respond in thread.
posted by cortex (staff) at 1:54 PM on May 18, 2017 [1 favorite]

Response by poster: Hey, just to expand on the original question, I'm willing to hear more general advice on the headaches/dizziness/etc. while I'm trying to figure out which doctors to see -- especially if it's related to whether or not this is worth waiting 2-3 months for, or if I should be taking this more seriously and trying to get it taken care of more urgently. That might affect who I can see, who I call, and so on. But general advice is welcome, too, even if you can't name a specific provider.
posted by shapes that haunt the dusk at 2:37 PM on May 18, 2017

I'm a neurologist, not your neurologist (I don't hold a CA medical license, so this is definitely not medical advice). The only neurologists I know in the Bay area are UCSF-affiliated, but you probably don't need a tertiary academic medical center with a long wait time. You need a good general neurologist. Your insurance company should have a list of in-network people and may have patient reviews.

Nothing in your story sounds specifically urgent to me (again, not medical advice), but that said, I still would try to see someone in the next couple weeks, because headaches -- and migraines in particular -- are self-perpetuating and can quickly become refractory. As an example, once you have 15+ headache days per month for 3+ months, you meet criteria for "chronic migraine" for which the only FDA approved treatment is quarterly neurotoxin injections. Medication overuse, like tramadol (!!!!) or other short-acting painkillers like acetaminophen or ibuprofen, also plays a large role in the transformation from episodic to chronic migraine.

If you have vision loss (particularly peripheral vision loss, or anything different from your usual aura), focal weakness, or you start hearing your heartbeat or a ringing in your ears, get thee to an ED stat.
posted by basalganglia at 3:21 PM on May 18, 2017 [3 favorites]

It seems like any specialist in the Bay Area has a long wait for a referral. You might consider scheduling with the UCSF neurology dept and then call every day to see if there's a cancellation.
posted by otherwordlyglow at 3:29 PM on May 18, 2017

Yes! I LOVE LOVE LOVE my neurologist--Dr. Nelli Boykoff. She is at CPMC on Webster. She is amazing for so many reasons; HOWEVER! She is going on maternity leave in August so I don't know that she is taking new patients. But it is worth a shot to ask. I also saw Marina Kasavin who is really nice (older; Russian) and I think was pretty good too. Good good good luck.
posted by bookworm4125 at 1:18 PM on May 19, 2017

One thing that is not specific to your situation but in terms of general advice on of treatment of headaches: question anyone who prescribes you narcotics for migraines. Narcotics should not be near the top of anyone's list of meds for migraines. I'm sorry you haven't been able to access better healthcare yet and I think the vast majority of neurologists would be able to do a good job treating you for this, so I would prioritize speed of appointment time over finding the perfect person.

I'm sorry you haven't had good luck with neurologists before. Be sure to bring a record of any testing you've had done and any medications you've tried for headaches before to discuss when you go. I'm biased to cut doctors some slack, but the one you mentioned seeing the past may not have explained himself well, but was just trying to tell you that if you have a severe headache that's different than your typical migraines, that's one potential indication to get imaging tests.
posted by treehorn+bunny at 6:45 PM on May 20, 2017

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