Aimovig Approved for Migraine Prevention

Aimovig is the first CGRP (Calcitonin gene-related peptide) monoclonal antibody to be FDA approved for preventive treatment of migraine in adults. This announcement took place on 5/17/18. The recommended dosage is 70 mg once monthly given as a subcutaneous injection in the abdomen, thigh, or upper arm.

Details of the best way to prescribe this for all of you interested are being worked out this week by Amgen/Novartis as well as our office. It appears there will be a service request form that needs to be completed and signed by both the patient and the prescribing provider. Two months of free treatment is offered as one of the options. For more information go to

Please don’t call the office to ask the staff questions as our office is working out details of how best to get you started on this break-through preventive treatment for migraine. There is no need to rush in for a visit or samples as the free samples will most likely be shipped directly to you for the first 2 months. Many of you are comfortable with self-administered subcutaneous injection and won’t need to come into the office for your first treatment. However, a follow-up visit during the 2 month trial  will be important to pursue insurance coverage for continued use beyond the 2 month free trial.

Please stay tuned. I am very pleased that 2 months of free samples can be an option for almost everyone interested. We will make available the service request form for completion as soon as possible. Hopefully, it can be provided as a link on our website. You would complete your part and return to us electronically or by fax or hard copy in person or mail.  The prescriber would complete her part and the request faxed in. A separate visit to get started may not be necessary if you are up-to-date with your visits and have already discussed CGRP Monoclonal Antibody treatment with one of our providers. There will be a processing fee to cover our time to enroll you in this free 2 month trial. Details on this to follow.

To learn more about this exciting break-through for migraine prevention, please visit


Continued good health,


Dr. Susan Hutchinson
Dr. Molly Rossknecht
Orange County Migraine & Headache Center
May 21, 2018

OC Migraine & Headache Center Angels 5K & 1 Mile Fun Run Was A Blast!

We had a great time at the Angels 5K run which benefited the Angels Charities which help children throughout Orange County! Dr. Hutchinson took 3rd place in her age group! We appreciate everyone who came out and joined us! We look forward to next year’s event!

Improved Office Environment

In late 2017, Orange County Migraine & Headache Center committed to renovating its office to support a more tranquil and modern environment. This transformation optimizes the patient experience and empowers our physicians with more advanced technology to explain and reinforce communication of critical information. Additionally, employee working conditions are more ergonomic and productive.

Improvements include:

  • Waiting room with a video screen providing latest health care information
  • Patient rooms that allow our physicians to demonstrate, via touch screen video monitor, detailing and visualizing the patient’s condition on both a general and specific level.
  • All patient rooms now have computers and exam tables, allowing for both face-to-face interaction with the patient and performing procedures in the same room.
  • A tranquil design environment with pleasing color combinations and decor
  • New hypo-allergenic flooring
  • The practice have added a certified medical assistant to assist the doctors in basic medical care of their patients – including injections to relieve pain.

Please view photos below.

We look forward to seeing you for your next appointment.

Introducing Aurora Bernal-Renteria

Orange County Migraine & Headache Center is pleased to introduce Aurora Bernal-Renteria to our staff. Aurora is a certified medical assistant that adds a new dimension to our services. She is able to assist the physicians in many aspects of back-office care. Aurora also handles all facets of our Botox process from getting approval by prior authorization to ordering and securing Botox for the patients. Her infectious laughter and positive attitude are a perfect complement to the care and working environment we hold dear.

Why shouldn’t I use a narcotic to rescue a severe migraine attack?

Increasing evidence from research shows that narcotics can worsen a headache condition by causing narcotic/opioid hypersensitivity. This means that over a period of time no acute medication will work as well. Narcotics are not migraine specific and are not FDA approved for the treatment of migraine. There are migraine-specific medications, oral and non-oral, that are much more appropriate for the treatment of an acute migraine attack such as the triptan category.


To make an appointment, please call 949-861-8717.

Why are my headaches worse in the winter?

There can be many reasons for worsening of a headache pattern during winter months. Weather changes can be a factor, especially drops in barometric pressure that can occur before a storm. Turning heaters on can be a trigger if dust or mold has accumulated in the air ducts. For some, Holiday stress can be a trigger either from travel or entertaining. Also, there is a tendency to fall off your exercise program, not eat as healthy, and not have a consistent sleep schedule during the Holidays. Now that the Holidays are over, resuming a healthy life style should help.

To make an appointment, please call 949-861-8717.

New Year’s Newsletter 2018

(Download PDF)

Dear Patient,

The beginning of the year allows a “fresh start” including setting goals and for some, a new direction to take in life. For our practice, the new direction for 2018 is to move towards being a narcotic/opioid free practice by the end of 2018. Heightened scrutiny and increasing regulation for prescribing narcotics like hydrocodone has occurred in this county. Some pharmacies now set limits on how many days a narcotic may be dispensed. As prescribers, we are required to regularly monitor controlled medication use on a statewide system called CURES.

Our medical practice is devoted to helping those with headaches and mood disorders. We are not a pain practice and are not set up to do urine drug testing as pain practices commonly do as part of monitoring their patient’s narcotic use. In addition, narcotics can work against good headache control by promoting medication overuse headache. Narcotics can create a condition called opioid hypersensitivity in which medications do not work as well. This is possible even with non-narcotic treatments such as triptans.

We realize this change in our practice will cause some of you to have to begin seeing a pain specialist if you are unable or unwilling to give up your narcotic. Our office will help in this process by referring you to a pain group that will work with you to take over the prescribing of the narcotic. We are actively meeting with pain groups to create a network of providers willing to see our patients.

During this process, we will continue to refill your narcotic as we don’t want our patients to suffer withdrawal symptoms. However, any narcotic/opioid medication will only be filled as part of an office visit and cannot be requested to be mailed or picked up in our office. For most, that will mean a monthly visit and the amount prescribed must last 1 full month. Early refills will not be honored. Activity will be monitored monthly on the CURES data base.

Fortunately, there are many effective non-narcotic treatment options for migraine and other headache disorders. Getting off your narcotic may be one of your goals for 2018 – We can help.

In closing, this change in our practice is not meant to be a punishment for those of you taking narcotics. We are moving our practice in a healthier direction and hope you come with us in this journey.

Susan Hutchinson                                                                                        MD Molly Rossknecht, DO

Orange County Migraine & Headache Center

Newsletter: Update on Office Policies

(Download PDF)

Same day appointments:  Our office will make every effort to accommodate same day appointments upon request. However, you need to call first to allow us to see where we can fit you in. Please do not show up without an appointment. Also, keep in mind, that what we can provide for a severe headache is limited to non-narcotic injections such as Toradol or Imitrex, trigger point injections, occipital nerve blocks, and SPG blocks. We are not equipped to administer IV fluids, IV meds, or narcotics.

Prescription Refills: Please allow up to 3 business days for refills to be handled. Do not call our office to request a refill. Have your pharmacy fax us the request. In the case of an ADHD medication like Adderall, then email your request to Keep in mind that in most cases, if you need a refill you probably are due for an appointment.

Appointments: All patients must be seen a minimum of every 6 months even if you are doing well: NO EXCEPTIONS.  This is Good Medicine! If you are doing well and do not feel you need to be seen this often, then consider having your primary care provider take over future prescription refills.

Completion of Forms/Letters: Keep in mind that there will be a fee to complete forms or to compose letters you request. The fee varies depending on the request and how long it will take the provider to complete. Please allow up to 2 weeks for completion. There could be an additional fee if a faster turn-around is requested. The cost will be determined and payment collected prior to the doctor fulfilling the request.

Email: We provide limited access to email. Emails take up to 5 business days to respond to so DO NOT email us with any urgent requests. Also, keep your emails short and to the point. Long emails will not be answered in full and are best handled by scheduling an office visit. For those living out of the area, phone visits are an option. Our office email is If your email response requires specific personal medical information, our office will initiate a secure email protocol using Neo-Certified.  Your email will be responded to with a request to sign up with a password for Neo-certified to keep email correspondence HIPPA compliant and confidential.

After Hours Urgent Needs: Dr. Molly and Dr. Hutchinson rotate after hours coverage. If you have an urgent issue, you may call (not text) the after-hours line (949-514-4429) and the doctor covering will do their best to return your call within 1 hour. If you are experiencing a severe problem it will be better to call “911” or go to the Emergency Room.  Do NOT call the after hours line during regular business hours as it will go unanswered.  During business hours it is better to call our regular office number (949-861-8717) for urgent issues.

Office Hours: Current office hours are as follows:

Mondays: 8:30 am-5 pm

Tuesdays: 8:30 am-5 pm

Wednesdays: 8:30 am-5 pm

Thursdays: 9:30 am-5 pm

Fridays: CLOSED

Saturdays: 9 am-12: 30 pm Two Saturdays per Month (on average)



Holiday Schedule:

Closed Wednesday Afternoon 11/22 to Monday 11/27 Morning

Closed Friday 12/22 to Tuesday 1/02/18


Feel free to call us if you have questions about our office policies. We look forward to continuing to provide quality care for our patients.  Suggestions, comments, and criticisms will be taken seriously.


Susan Hutchinson, MD                                Molly Rossknecht, DO, MPH


Orange County Migraine & Headache Center