Latest News from Cascade Neurologic Headache Clinic and the World of Headache

I want to do an update weekly, as time permits.

This week:

Cefaly Money Back Guarantee

I’ve had many patients want to try the Cefaly device but were afraid that they would pay $250 for the device and then it not work. We had one that we loaned out but our last “borrower” never brought it back. But I noticed from their website that the Cefaly company is now giving a 60 day “Money Back Guarantee.” The devil is in the details but it may be worth checking out. From my experience, roughly half of the patients that try the Cefaly daily (20 minutes each session) has significant headache improvement.  For more information go here:

Virtual Appointments now at Cascade Neurologic

Life is complicated and more of our decisions (in medicine) are now controlled by insurance companies than ourselves.  At the Pacific Rim Headache Center, virtual patient appointments were a vital part to our practice. The reason being, the Pacific Northwest is the most under-served region in our country for good headache management, and it is only getting worse.  Our typical patient came from 125 miles away. A virtual appointment made it much easier for those patients.

Cascade Neurologic has never had these types of appointments and I lobbied hard to get them here.  The malpractice insurance company was concerned but did lay out parameters to allow us to do this. First of all, the patient must be an established patient at this clinic and had their initial work up in person (which I agree with). Also, if they have a new symptoms (eg. now having numbness with their headaches) they must be seen in person (and I agree with this too). So, if you have met these conditions, you can schedule for an appointment.

The health insurance companies, even if they advertise that they now allow virtual appointments, usually don’t and it has to be cash only. Why? The ultimate goal for the health insurance company is to make a profit and the more things they don’t pay for the more profit they have. So, they will deny these services until, eventually, their subscribers demand it or the government forces it.

I really do want to reach out to the masses of under-served patients throughout our region. This is where my heart is. When I came here 13 years ago, there were five decent headache clinics in the metro Seattle area. Now there is a couple at best count. The wait for those is almost a year. They don’t have time to work with many patients, scheduling follow ups in months rather than weeks.

Our waiting time is a few weeks. I have the luxury to spend as much time with a patient as needed, 90 minutes for the first appointment and up to one hour for each follow up. That doesn’t make economic sense (insurance pay less for longer appointments) but it is essential to good headache care. I will also give the exact same level of care as I gave at Mayo Clinic, and our department there was voted the highest standard of care in the country by our peers.

As I mentioned in a previous post, I am focusing my care for those patients who want to get better and who accept the realities that migraine and other headache conditions are complex and difficult to treat. It does not matter if the patient has been seen by numerous other headache clinics. I can guarantee that there are more things to try. Having 34 years of experience in headache management, working with some of the brightest people in the field, has given me almost endless ideas.

Other News

I mentioned on our Facebook page about new cluster research. Rather than retype it I will link it here.