Here's how my medical care currently breaks down:

Primary care physician. His name may currently be on some of my older migraine meds, like the triptans. He referred me to my neurologist (see below). A couple months ago he rescued me from a crisis with a prescription for Percoset and some trigger point injections. But I don't normally consider him part of the migraine regimen.

Neurologist. Poor woman. I have flummoxed her. She tries, but she can't keep up. She referred me both to a pain specialist (see below) and a migraine guru (see everywhere). She tries to be helpful. Which includes a prescription for very few of a very low dose of Percoset, and an exhortation not to go the ER. So, not the most actual help.

Pain Management Guy. He's given me trigger point injections and done the occipital bilateral nerve blocks. He's also the prescriber of my Lidoderm, lidocaine patches that I apply on my neck or shoulder.

Migraine Guru. Now, he doesn't see patients, per se. He consults with a doctor that sees you more often. He's seen me once, made the protocol for the hospital visit, and the soonest I could get back in to see him is September--and I made that appointment over a month ago. He has half a day of clinic time a week.

Migraine "specialist." Hrrmph. I was sent to her during one of the long waits for Guru. She saw me for about a year and just kept piling on the drugs and the hugs and really wanted me to take more Botox. We've come to a parting of the ways.

I emailed my neuro today with the summation of the post-DHE so far (short form: Ouch, what next?) and asked for next steps.

Contact the guru, she says. Now, I have neither an email address nor a direct phone number. He's House-like, I guess. So I have to leave messages and enter into phone tag at work about the pain.

Ah, well. That's for next week.

Also planned for next week is quite a treat. I've made an appointment with my PCP and I will plead for more trigger point injections. And...a referral to Cedars Sinai. Way less in my neighbourhood, but not prohibitively so. And a little bird emailed me to tell me that they have the area's best specialists.

Maybe they can get me in before September. We'll see.