Deciding on a Doctor

I know ultimately this is my decision, but perhaps some of you can bring up points that I might not otherwise consider.

In 2009, after going thru every dept at my HMO I was diagnosed with a “miscommunication between my eyes and my brain” and Anxiety disorder. Not satisfied with these answers, in 2010 I went outside my HMO and paid out of pocket to see Dr Ishiyama at UCLA. Within minutes of describing my symptoms, he was confident it was MAV. I have seen him a few times

This week I went back to my HMO neurology dept (saw a different neurologist ) and shared Ishiyama’s dx. HMO neuro has heard of a Migraine variant. The things she told me matched what I have learned from Ishiyama and this forum.

So my choice is:

A_Stay with UCLA
Maybe MORE expertise and experience with MAV
$205/visit out of my pocket
Prescription expense out of my pocket
Poor to average communication ( took 2 weeks for him to call back after I was panicking with increased dizziness on AMI)
Stiffer bedside manner, I feel like he has more important things to do (probably just my own confidence issues)
20 mile drive to office, $11 parking

B_Follow my HMO
Maybe LESS expertise and experience with MAV (seems like she wasn’t too familiar with the balance aspects and would be treating this as a migraine, which is fine, right?)
$25 copay/visit
Prescription copay
Communication should be much better
Much better bedside manner, I feel like she cares
10 mile drive to office,free parking

They both seem to be in the same ballpark with medications. UCLA started me on Diamox and has added AMI, HMO would prefer I start with Topamax(which I see Mr Gonzaga is starting with positive results on).

Any thoughts would be greatly appreciated?


Hey John,

I’d stay with option B. You did the smart thing with option A initially to get an accurate dx and get yourself on the right track after being run around with the previous dx of “eye brain miscommunication mismatch” (kind of funny really … a bit like dxing hayfever as an excessively runny nose and prescribing 4 boxes of Kleenex). The rest of this now is all about finding the right recipe for you to manage this with lifestyle modification and drugs. You know the lifestyle part already (see MAV Survival Guide and books by Buchholz and Benstein) and all you need now is someone with drug expertise to guide you along as you trial the various drug attack strategies. Sounds to me that the latter Dr will serve you better as you feel more comfortable and that alone will help you through this. Option B will obviously save you a lot of cash as well.

Let us know how you go.

Best … Scott :slight_smile: