I myself am in Washington state, I don't have access to pain management specialists, but I am now doing well with general practioners at Seamar Clinic, there are several Seamar clinics in western Washington, maybe east too. They are designed for low income folks etc., they take my medicaid, and I've been actually impressed with the quality of help.

The last two health care folks I saw there took me seriously, knew how damaging migraines can be, were up to speed with latest research, and clued me on things I did not know yet. Also, fortunately, one med is actually helping, propananol. I also take Amerge as needed, it is quite an expensive drug, so I only get 9 per month.

I guess the trick is to keep trying til you find a doctor who will listen and actually help.

I also do really well with reading up on migraines both on web and through library.

Good luck,
Sarah

(Migraine thread also down in Health Support, might have other ideas for folks too.)