Managing Migraines

“I have learned to appreciate all the days without pain.”

(This post was sponsored by Kaiser Permanente #THRIVEambassador)

It is said that 38 million people suffer from migraine headaches, and sadly to say I am one of those people. I remember my first migraine, I was about 8 years old. I was sleeping at my grandparents house and woke up to my head pounding and feeling sick to my stomach. I tried to alert my mom but couldn’t even make it to the bathroom in time before getting sick.

Growing up with migraines was difficult. I would have to miss school, dance class and other extra curricular activities to stay at home in the dark huddled in the fetal position. A few times I ended up in the emergency room because the pain was just too much to bear.

Today I have partnered with Dr. Alamshaw from Kaiser Permanente who has been practicing family medicine for almost 20 years. I wrote down all my questions about managing migraines and he was able to help me get a better understanding of how to deal with this debilitating pain. So let’s get started…

What is the difference between a headache and a migraine? All mammals suffer from headaches, but only humans suffer from migraines. Migraines are more debilitating, more common in women, usually there is more pain on one side of the head than the other. People that get migraines also can get an aura about them, which for me could include blurry vision, extreme sensitivity to light and sound and nausea. Migraines are also resistant to the typical headache medications like Tylenol or Advil. Migraines also tend to last longer, up to 72 hours if untreated.

What is happening in the brain when a migraine is occurring? There are various theories, one used to be a constriction of blood vessels in the brain. Another theory is that it is a primary neuronal dysfunction which leads to a sequence of changes intercranially and extra cranially that account for a migraine. Dr. Alamshaw explained that something is obviously going on, but the cause is not quite clear.

What can cause a migraine? What are some triggers? It is different for different people, but some triggers could be caused by your atmosphere; perfumes/cologne, any strong smells, extremely loud noises. It could be caused by diet; aged cheese, wine/alcohol, chocolate, even processed food could be triggers. Migraines can also be caused by hormones; some women tend to get them the week before or the week of their menstrual cycle. And last, but certainly not least, migraines can also be caused by lack of sleep, or even too much sleep as well as being over weight.

Personally, I think it is a good idea to keep a journal of what you eat, how regularly you exercise, keep track of your cycle, etc…then when you get a migraine you can see if any of the same components were the cause. Mine tend to be caused by lack of sleep, stress and hormones.

What type of medications are recommended? Dr. Alamshaw emphasized that typically a migraine is resistant to most over the counter medications. Even something like Excedrin Migraine, which has caffeine in it, can cause a rebound headache. He suggested trying a triptan type of medicine like Imitrex or Sumatriptan. Some of these triptan medicines can come in nasal sprays, oral pills, shots and even dissolvable tablets. If you are like me and get nauseated I don’t suggest the dissolvable tablets, they don’t taste the best and made me feel more sick to my stomach.

He suggested, and I have found this to be very true, that as soon as you feel a migraine coming on it is best to take a medicine right away. You can even mix a triptan medicine with an over the counter medicine like Tylenol or Ibuprofin to help kick the migraine at the first sight.

Are there any natural ways to reduce the pain or frequency of a migraine? Exercise was the first suggestion from Dr. Alamshaw, he said being active and staying fit helps with so many medical issues. Eating right and staying away from foods that may be triggers is also a good idea. Some small success has been shown by taking a daily dose of magnesium and B2 together. I do this and I can’t say I don’t get migraines anymore, because I do, but I have found them to be slightly less painful and less frequent.

How do you know if it’s going to turn into a full-blown migraine or if it is just going to be a headache? Usually people with migraines get a few early signs that it is not just a typical headache; from the aura, to the nausea, sensitivity to light and sound, pain on one side of the head. And if it is a migraine, Dr. Alamshaw suggests taking the medication as early as possible. If you wait past 4 hours the medicine is less likely to help.

Does Botox help? Botox can help, once a month on the scalp, temples and over the head. It is not an acute help and it is only suggested for people that get about 9 migraines a month.

Are migraines hereditary? Unfortunately, there has been signs that migraines are hereditary. This one makes me so sad because I really hope our kids never have to experience what I have the past 25 years.

Does caffeine help or hurt? Some patients drink coffee every day and it doesn’t cause a problem, the issue would probably be when they tried to go without the coffee, then they might get a migraine. Others who don’t drink coffee, or caffeine, everyday might have the opposite problem, they may get a migraine when they have some sort of caffeine.

What about other types of care? Chiropractor? Acupuncture? Massage? Although there hasn’t been any evidence for chiropractic care, if your body alignment is off then it may definitely help. Acupuncture and massage could both help as well, but all of these options are not acute help, more preventative type care.

If it is a hormonal imbalance what can a woman do to help? Dr. Alamshaw suggested that a woman could try different forms of birth control to balance out her hormones. There are many options today like the ring, the patch and of course oral birth control.

When should you see a doctor? You should talk to your doctor anytime! Obviously if you only have a migraine once a year it might not be very concerning, but it you are getting them once a month or more then it is definitely time to talk to your doctor.

Is there any other information you would like my readers to know? There are always new emerging medications, for instance, there is a newer, once a month injection, which is why it is so important to see your doctor annually to discuss any new options.

Are there any Kaiser Permanente resources that I can share? Kaiser Permanente does have a migraine class with Lynette Zorbas, a nurse practitioner, who is an expert at managing migraines. You can go to their website to sign up for her class.

Migraines can be days spent in pain or in a haze. Seeking proper help is vital to managing and living a better life. Have you ever suffered from a migraine? What do you do to manage your episodes?