MIGRAINE HEADACHES
PROBLEM
You have been diagnosed with migraine headaches. There are many ways that a migraine headache is described, including pulsating on one side of the head or behind one eye, seeing spots before your eyes, and a possible loss of vision for a short time.
Other symptoms of a migraine include nausea and vomiting; sensitivity to sound; sensitivity to light, especially to flickering lights; sensitivity to smells; and pain that gets worse with activity.
CAUSES
A.Migraines run in families; your mother or sister may also have migraines.
B.Head trauma may trigger headaches.
C.You may have a migraine headache when you start your period because of the change in your hormones.
D.Medicines such as birth control pills and hormones may cause migraines.
E.Many odors, such as perfumes, cigarette smoke, scented candles, and food, may trigger a headache.
F.Changes in weather and high altitude may also make you have a migraine.
G.Alcohol and some foods can trigger a headache.
H.Another cause of a migraine headache is a rebound from taking too many over-the-counter pain medications, such as ibuprofen, Aleve, aspirin, and Excedrin products. The headache gets better with the pain products but comes back the next day so that you take the medicine again, causing a vicious cycle.
PREVENTION
A.Keep a diary to identify food triggers to your headache:
1.Alcohol, especially red wine.
2.Foods such as hot dogs, ham, and bacon.
3.Aged cheese.
4.Citrus foods such as oranges, lemons, limes, and tomatoes.
5.Not eating.
B.Read labels for the following preservatives:
1.Aspartame—often found in yogurt.
2.Saccharin—often found in diet drinks and artificial sweeteners.
3.Tyramine—found in aged cheese such as feta, blue cheese, pickles, and olives.
4.Phenylethylamine—often found in sugarless gum and breath mints.
5.Monosodium glutamate (MSG)—often found in Chinese food.
6.Nitrates and nitrites—found in cured meats, such as ham and hot dogs.
C.Keep a diary to identify visual triggers:
1.Strobe lights.
2.Flickering light from going from sun into shade.
3.Fluorescent lights.
4.Sunlight glare off shiny objects and water.
D.Keep a diary to identify other triggers, including the following:
1.Too much sleep/too little sleep.
2.Strong odors.
3.Medicines.
4.Changes in weather.
TREATMENT PLAN
A.One of the first things to look at is your diary of triggers in order to avoid or modify them.
B.You may be sent to a neurologist to evaluate if you need any special testing.
C.You may be sent to have your eyes examined for glasses.
D.Many medications are used to treat migraines:
1.Over-the-counter pain medications, including Ibuprofen, Aleve, aspirin, and Excedrin in limited amounts.
2.Medications for depression are commonly used.
3.Medications for seizures are also commonly used.
4.Medications for blood pressure have been found to control migraines.
5.Medications for nausea and vomiting.
E.A special class of drugs called triptans is used to treat the migraine when it first starts. These medicines come in pill form and nasal spray, and are also given as a shot.
Activity: Relaxation training, such as yoga and biofeedback, helps headaches. Physical therapy and hypnosis have also helped migraine headaches.
Diet: There is no special diet for migraines:
A.Avoid the food triggers that you identified from your migraine diary.
B.Drink plenty of liquids.
You Have Been Prescribed the Following Medication for Acute Pain to Help Stop Migraines: ___________________________________________________________
You Need to Take: ___________________________________________________________
You Have Been Prescribed the Following Medication to Take Every Day to Manage Migraines: ___________________________________________________________
You Need to Take: ___________________________________________________________
You Have Been Prescribed the Following Medication for Nausea: ___________________________________________________________
You Need to Take: ___________________________________________________________
You Need to Notify the Office If:
A.You feel that this is the worst headache you have ever had.
B.You have difficulty with speech.
C.You have fever with a stiff neck.
D.Other: ___________________________________________________________
Phone: ____________________________
RESOURCES
Mayo Clinic: www.mayoclinic.com/health/migraine-headache/DS00120
Migraine diaries are available for iPhones, iPod touch, and the iPad on iTunes.
The Migraine Trust migraine diaries: https://www.migrainetrust.org/wp-content/uploads/2015/11/FS05aMigraineDiaries.pdf
PATIENT TEACHING GUIDE