How to Keep a Headache Diary
Anyone who sufferers from headaches regularly rather than only sometimes should keep a headache diary. Not all headaches are the same. Noting down details of each headache can help you spot patterns and/or ‘triggers’ so you can take action to avoid headaches.
First, get a small notebook to write down information about each headache you have, or print out one of the blank headache diaries online to carry around with you. http://www.headaches.org/wp-content/uploads/2015/02/248072334-Headache-Diary-from-the-National-Headache-Foundation.pdf?x92687
Use an online tracker such as http://www.iheadache.com/, or try Smartphone tracker app such as iHeadache or Migraine Buddy.
Collect your data for at least a week or two to help you spot patterns. Then make an appointment with your regular doctor to discuss your findings. They should be able to determine if you have been experiencing migraines and if so, what might be triggering them.
What should you include in your headache diary?
There are lots of different ways to keep one, but here is a useful detailed format to use if you are trying to get to the bottom of your headaches to see if you can improve your overall health.
Date and time the headache started: (approximately)
Location I was at when the symptoms first started_______
What I was doing when the symptoms first started_______
List foods, drinks and/or medicines you consumed before the headache started.
Was it an ordinary headache, or a migraine?
Location of the headache/migraine pain-check off all that apply:
Forehead (the area directly above my eyes, to my hairline)
Eyes/around the eyes
The crown or top of my head
The back of my head
The base of the skull
Other areas that hurt-specify (example, shoulder, stomach):
The nature of the pain experienced
The best words to describe the pain in each area I had it was:
other – describe
Write down your chosen word next to each of the areas you listed above.
The level of pain I experienced, on a scale from 1 to 10, with 1 the least pain and 10 the most severe pain
The level of disability I experience, on a scale from 1 to 10, with 1 being minimum impact on my activities of daily living, to 10, impact so severe I could not function
I had trouble with my vision/sensed an aura or glow:
I felt sensitive to light:
I had trouble with sound/noises
I had trouble with strange smells
I had trouble with strange tastes
I felt nauseous
I was so nauseous I vomited
I vomited ____ times in total, about
_ minutes apart (example)
I vomited 2 times, about 4 hours apart
I vomited all day for 8 hours
What I did to try to relieve the pain (list them):
These actions worked best to relieve the pain:
This migraine lasted around ________ hours in total
What I suspect might have triggered this migraine
monthly cycle (period)
pressure at work
Loud noise, such as a concert or club
Try to be as detailed as possible. Once you have a record of all your data, make a few copies to give to your doctor and any practitioner he might refer you to, such as a headache specialist or neurologist. You should soon be able to get to the bottom of your headaches, for effective treatment.
The 3 Classes of Drugs Used For Dealing with Migraines
There are 3 different classes of prescription medications being used to deal with migraines. They are:
There are 4 or 5 stages to migraines:
Not everyone who has migraine gets aura, but of those who do, they report it and prodrome as early warning signs that a migraine is on the way. That being the case, they can try to take preventive medicines to stop the migraine in its tracks.
Preventive medications try to stop the migraine before it ever happens. The classes of medications used for preventive purposes include:
Valproic acid and Topiramate (Topamax) alter the brain’s chemistry and have proven effective in preventing migraines.
Beta blockers are usually used to treat heart conditions and high blood pressure. They can smooth out and shrink blood vessels in the head to reduce pain. The best beta blockers for migraine relief are Propranolol (Inderal) and Timolol.
Calcium channel blockers
Calcium channel blockers are also used to lower high blood pressure. Research has shown that Verapamil (Calan, Isoptin SR) is most effective for migraine relief.
This is an older class of antidepressants used to alter brain chemistry. Amitriptyline, Nortriptyline and Doxepin relieve depression and treat migraine as well. Amitriptyline appears to be the most effective of the three.
Selective serotonin reuptake inhibitors (SSRIs)
SSRIs are the latest generation of antidepressants and includes Paroxetine, Fluoxetine (Prozac) and Sertraline. Prozac has been proven most effective for people with chronic migraines, that is, migraines which occur 15 or more days per month.
If the person takes preventive drugs at Phases 1 and 2 of their migraine but they still advance to a full headache, then it would be time to try abortive drugs.
B. Abortive Drugs
Abortive drugs try to treat the migraine by stopping it as quickly as possible. This group of medications includes certain classes of drugs, including:
Selective serotonin receptor (5-HT1) agonists (Triptans)
These relieve inflammation of the blood vessels and nerves of the brain. The most commonly used is Sumatriptan (Imitrex). It is available via injection, pills, nasal spray and transdermal patches (Zecuity). It offers a high rate of rapid migraine relief. Side effects vary but are generally mild.
Naratriptan offers slower relief for migraines than Imitrex, but it lasts longer. In addition, it is less likely to interact with other medicines that might be used to treat migraine, such as MAOIs.
MAOIs (monoamine oxidase inhibitors)
MAOIs are another type of antidepressant used to treat depression and migraine. They also alter the chemistry of the brain. Examples include rasagiline, selegiline and phenelzine. It is important to note that these medications can cause dangerously high blood pressure and can cause a range of side effects.
Ergot is a form of fungus that can affect rye and other grains, and was the first form of successful anti-migraine drugs. It is still used in 2 forms. Dihydroergotamine mesylate can give rapid relief in the case of severe migraines. Triptans are also ergot derivatives.
If the headache continues despite abortive medications, then it is time to turn to pain relieving drugs.
C. Pain Relieving
These medications offer pain relief once the migraine has progressed to Phase 3, headache. There are a number of options, including:
These include pain relievers such as aspirin.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
These include acetaminophen (Tylenol)
The preventive and abortive medications will require a prescription. Keep a migraine diary to track your symptoms and take it with you to your doctor so the two of you can discuss your best treatment options based on your potential triggers and the symptoms and severity of your migraines.
12 Lifestyle Changes to Help Relieve Your Migraines
There are a number of effective lifestyle changes you can make in reference to you migraines that can prevent them, or lessen their pain or duration. Migraines have a number of known triggers. Eliminating them from your lifestyle could make migraines a thing of the past.
The most common triggers are:
A few simple changes can add up to a lifetime of better health.
Those who smoke are more likely to suffer from migraines. People who live with smokers can also find that second-hand smoke triggers a migraine. Note that you will probably have some headaches afterwards due to nicotine withdrawal.
Try clean eating
Clean eating refers to cooking yourself and eating all-natural foods which are minimally prepared. This means no salt, sugar, artificial sweeteners and so on. It might also mean avoiding chocolate for some people. Fast food and convenience food should be off the menu.
Eat healthy meals regularly
Migraine can be triggered by getting too hungry. People who fast for religious reasons or because they are trying to lose weight or detox will often experience migraines. Eat small homemade meals often.
Alcohol such as red wine is a known trigger for migraine, in part due to fermentation and in part due to chemicals used to preserve the alcohol when it is bottled, such as sulfites.
Steer clear of caffeine
Coffee, tea, chocolate, and so-called energy drinks like Monster and Red Bull have been linked to migraines. Some energy drinks can be the equivalent of 5 cups of coffee. Skip the cappuccino, espresso and so on. If you really can’t live without the taste, try to cut down and go decaf. Note that you will probably have some headaches afterwards due to caffeine withdrawal.
Learn how to manage your stress
Too much stress at work or home can lead to tension headaches and migraines. There are a number of effective ways to relieve stress, including taking breaks, meditation, visualization of a calming scene and taking the time to do things you find relaxing for at least 30 minutes each day.
Exercise relieves stress and releases ‘feel-good’ chemicals known as endorphins, the body’s natural pain relievers.
Lower your blood pressure
High blood pressure can cause headaches and migraines. Lower it through meditation, exercise, the DASH (Dietary Approaches to Stopping Hypertension [High Blood Pressure]) diet, and the highly-effective Resperate device, which uses controlled, meditative breathing to lower blood pressure naturally without any medications.
Avoid bright light
Don’t use the computer too much or spend too many hours in front of TV or DVDs. Steer clear of clubs and don’t play too many video games. Stay out of direct sunlight and use high-quality sunglasses with UV protection. Beware in winter as well as summer-sunlight reflected off snow can trigger migraines.
Avoid loud music and noises
Don’t blast your stereo or MP3 player. If you live in the city, consider soundproofing and a white noise machine to block out noise.
Use natural cleaners and personal care products
Many migraines are triggered by strong smells, especially the cheap fragrances in household cleaners, colognes, fabric softeners and toiletries. Research simple but effective homemade recipes online using all natural ingredients like pure Castile soap, lemon juice and so on.
Steer clear of nail polish, nail polish remover, paint, paint thinner, turpentine, and other solvents, and of course cigarette, cigar or pipe smoke.
Make sleep a priority in your life
Every adult should have 8 hours of high-quality sleep per night. Set a regular bed time and wake up time and do not have a TV, DVD or work in your room. Make it comfortable and inviting, with nice bed linens.
Try these simple solutions and see what a difference they can make to your migraines.
The Role Hormones Play In Migraines
Migraine affects more than 37 million people in the US, mostly young women who are of childbearing age, that is, 15 to 55, from puberty to menopause. As a result of these patterns, researchers have speculated that migraines might be linked to hormonal activity in women.
Most migraine sufferers are women, and many female migraine sufferers report getting migraines at certain times of the month, that is, around the time they have their period. Scientists have linked this to a decrease in the hormone estrogen during menstruation.
Some women who use birth control pills report more migraines, and more severe migraines, than those who don’t. Other women begin to take the pill to try to reduce the symptoms of their migraines. The birth control pill uses various hormones, including estrogen, to regulate a woman’s ability to conceive a child.
Some women report that the migraines change when they are pregnant, which is another point in time when women’s hormones such as estrogen can fluctuate.
Some women report more migraines during perimenopause and menopause. The prefix peri- means ‘around’. Women can be perimenopausal that is, nearing the time of menopause, as early as their 30s. Most women will experience full menopause in their early 50s.
Perimenopause is a time of decreasing hormonal activity, especially estrogen. Menopause is defined as not having any periods for 1 calendar year.
Perimenopause can cause a range of hormonal changes. Periods might become less frequent and less regular. They might become more frequent, with fewer or greater than 28 days per cycle. Women might notice a smaller amount of bleeding, or a great deal more than usual on 1 or all 5 days. These are all signs of changing hormone levels, which might increase the frequency and severity of migraines.
When a woman reaches menopause, her hormonal activity, especially estrogen, radically decreases, which can lead to more migraines. Some women choose hormone replacement therapy (HRT) in order to deal with the more troublesome symptoms of menopause, including hot flashes, night sweats and loss of sexual desire.
HRT can also relieve migraine, but like the pill, can also lead to increased risk of blood clots and stroke.
HRT was recommended extensively in the 1990s to relieve menopausal symptoms and protect heart and bone health. However, extensive research has shown that HRT is not protective at all and can increase a woman’s risk of various hormonally related cancers, such as ovarian cancer.
Soy is a plant which is high in protein and substances known as phytoestrogens, which seem to mimic estrogen women produce naturally. Phytoestrogens have been linked to fewer menopausal symptoms and therefore might be helpful or migraine.
Hormones in the food supply
The food industry is the US is drive by profit-motives, not health-related ones. Many cattle are pumped full of hormones, steroids and antibiotics in order to get as much yield out of the animal as possible. Cow milk with hormone in it is of particular concern. Some studies show girls are starting to menstruate at even younger ages than the usual lower range of 11 and some boys have experienced ‘feminization’, such as the development of breast tissues, if they tend to drink a lot of dairy milk.
Whenever possible, aim for organic foods and consider using milk substitutes such as soy and nut milks for adults.
Hormonal fluctuations are often accompanied by food cravings. Some women will crave salty foods, which can trigger migraines. Others might crave sweets, and go for sugar-free products because they are weight conscious. The artificial sweetener aspartame (NutraSweet) has been linked with migraine.
The stress and a lack of sleep many women experience around the time of their periods can also lead to migraine. Master stress management techniques and see what a difference they can make to your migraines.
The 5 Main Phases of a Migraine
Migraine headaches affect more than 37 million people in the US alone, around 1 in 7 Americans. Migraines are one of the leading causes of visits to the doctor and emergency department. Migraines mainly affect women between the ages of 15 and 55, leading some doctors to suspect they have a hormonal component, but some men can get migraines too.
The National Headache Foundation also estimates that more than 50% of those who have migraines have not actually been diagnosed, meaning they are putting up with the pain when they could be preventing or treating their migraines. That being the case, it’s important to not take your headaches for granted. Could you have a migraine?
Migraines come in phases
Knowing the phases of a migraine are important because it is possible to actually stop them from happening if you:
* Understand what triggers your migraine
* Can spot signals that a migraine is on its way so you can prevent it in its early phases
The 5 phases are:
* Aura (not everyone has this)
* Headache Termination
Let’s look at each of these in more detail.
Many migraine sufferers report a range of subtle changes in mood, taste, smell, vision and energy level before the onset of a migraine. They will often feel tired, achy and tense. Their stress levels might go higher and their sleep lessen. Those feeling run down are at particular risk for migraine.
Auras affect around 15 to 20% of those with migraine.
They usually look like a halo or bright glow around an object. Other visual disturbances can occur as well, including blind spots, temporary loss of vision in one eye before the migraine starts, wav lines and more.
Those who have these ‘early warning signs’ that a migraine is coming can try to prevent it from advancing to Phase 3 by using preventive medications as prescribed by their doctor.
If the migraine arrives, it will usually occur on one side of the head only, though it is possible for it to occur on both sides. The pain has been described as throbbing and stabbing at the same time. The head pain is also often accompanied by nausea and/or vomiting.
Sensory disturbances include:
* extreme sensitivity to light (photophobia)
* extreme sensitivity to sound (phonophobia)
* strange smells
* food tasting strangely
The headache phase can last hours or days depending on what is done to treat it. There are ‘abortive’ medications that can shorten the duration of the headache so a person get back to living a normal life. Sleep can often help end a migraine.
Pain relief medication and anti-nausea drugs can also help ease the discomfort of migraine.
Migraines can usually be treated successfully with abortive and/or pain relieving medications and healthy lifestyle measures. If the medications don’t work, sleep can usually help. In most cases, the migraine will usually go away by itself. However, if it does not stop within 72 hours, it should be treated as a medical emergency. Various drugs can be injected or administered by other means to help terminate the migraine safely.
Even after the migraine is gone, there can be some lingering effects, a kind of migraine hangover. These include loss of appetite, problems with focus and concentration, tiredness and ‘fogginess’.
Doctors will prescribe various medications based on whether you have aura or not. Therefore, it is important to keep a headache diary to track potential causes, your symptoms if and when you get a migraine, and what you’ve done to try to deal with your migraine during each of the phases.
Note down what works best in terms of lifestyle and medication and you should soon have a migraine prevention and treatment routine you can live with.