Treating Migraine: Be Proactive

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Nearly 30 million people in the United States have migraine headaches. The recent American Migraine Prevalence and Prevention Study, the largest-ever study of migraine sufferers, found that 18 percent of women and 6 percent of men have this disease. While these numbers are staggering, the sad truth is that most people who suffer from migraines are undiagnosed and undertreated

The good news is that migraines are treatable, but you must take the first step and get diagnosed.

Migraine is usually characterized as a throbbing, one sided headache that is accompanied by either sensitivity to light or nausea, or both. This type of headache often causes significant disability. The pain can be severe, causing the sufferer to require bed rest. Migraines, too, tend to run in families. In fact, if both parents have migraines, their child has a 75 percent chance of developing them.

If migraine is affecting your life, causing you to miss time from work, family, or social occasions, make an appointment with your health care provider to specifically talk about your headache problem. Before going for your visit, keep a headache diary. Record how frequently you get your headaches, how long the pain lasts and its severity, where the pain is located, which medications you took, and how they affected your headache. Also record other factors such as your emotional state and, if you are a woman, whether the headache was immediately before, during, or after your menstrual cycle. You should also keep a log of the foods you eat. Both of these tools can be helpful to your health care provider.

Most migraine diagnoses are made by taking a complete medical history. Since there is no test to determine migraine, your health care provider will use the information gathered during your visit to make the diagnosis. If tests such as a CT scan are ordered, they are usually used to rule out other diseases.

Be a partner in your health care. Make a list of questions before going to see your health care provider. Write down the answers during your visit so you can review them later. You may not have all of your questions answered on your first visit, so ask them in order of importance. It may be helpful to have a family member accompany you to the visit, as well.

Be sure you understand what medications have been prescribed and how to take them. Some medications are meant to be taken at the beginning of a migraine attack. These are called acute medications. Others should be taken daily, whether or not you have a headache, and these are known as preventive medications. In some instances, you will take a medication daily to prevent attacks as well as an acute medication periodically to treat a migraine that does occur.

Many different medications are used to treat migraine; some of these are migraine-specific such as the class of drugs called triptans. It is interesting to note that many of the medications that successfully treat migraine are actually medications for other conditions. Several anti-epileptic medications are indicated to treat migraine. Other medications such as beta blockers, calcium channel blockers, and tricyclic antidepressants are often prescribed for migraine.

Tell your health care provider if you are taking supplements or over-the-counter products or both to treat your migraine, as these may interact with medications that may be prescribed.

Finding the right medication for you may require some trial and error. Some medications may take several weeks or months before they become fully effective. Different doses of the same medication may need to be tried. Tell your health care provider about any side effects you may experience, and take your medication as directed.

Lifestyle modifications, too, can be helpful in lessening the frequency and duration of migraine attacks. It is important to maintain a regular sleep-wake cycle, getting up at the same time on weekends as on weekdays. Don't delay or skip meals. Watch your caffeine intake as caffeine can be a trigger in susceptible people. Get plenty of physical exercise, even if it is simply walking. Biofeedback, stress reduction exercises, guided imagery, and visualization are other nonmedicated ways to deal with migraine.

Life with migraine can, at times, be challenging, but by becoming educated about the disease and being proactive, you can empower yourself to live life fully.

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By Suzanne E. Simons

Suzanne E. Simons is executive director of the National Headache Foundation in Chicago.

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