lovemyboz, my mom and brother have suffered for years with migraines - neither had ever seen a neurologist for them - only their regular docs. When I first started with migraines (last June), I went to my regular doc (whom I can't stand) one time, he basically blew me off as a whining woman and I swore I would never go back. There are only two neurologists in the area where I live and I asked around the hospital where I work which one to use. All fingers pointed at one of the docs so I made an appointment. I am so thankful that I did (without delay). He spent over an hour with me at my first appointment. He explained to me how most docs do not understand migraines and truly don't want to get involved with treating patients who have them. Why? Because it takes so much time. My doc told me at our first appointment that treating migraines is ongoing (probably forever). He said it would take awhile (probably) to get my meds adjusted where they were working. He also told me, up front, that even if, and when, we found meds that worked, they might work for awhile and then stop working and then we would have to change and go through the process all over again. He said that the goal is not to get rid of migraines completely (although, he laughed and said if he could do that, he would be very rich) but to reduce the frequency and severity. He also said that his goal was to keep me out of the ER and the hospital. That appointment was like music to my ears! He actually spent time talking to me and explaining and was so very compassionate. I think he is extra sensitive because his wife sufferes from migraines. He told me I wasn't crazy! My brother and mom have both used him since I started and my brother has had so much success, also. My mom is a whole other story.
He also explained to me that migraines are not "just headaches" where you can take a couple of Motrin and keep going. He explained that migraines make every blood vessel in your body (not just your head) dilate. This is what makes the headache so painful and also why you feel so lousy after you get rid of a migraine.
My advice - find yourself a good, caring neurologist. Make an appointment and then, if you don't think that doctor is compassionate and knowledgable about treating patients with migraines, find another. I know it is frustrating, exhausting, expensive and depressing to keep looking, but it will be worth it when you find a doctor who cares.
Good luck and let us know how you make out. Having to take that much Maxalt a month is not "controlling" your migraines. You need something that is more effective as an abortive but also need something to take as a preventative!