What Is Your Migraine Profile?

We all experience migraines differently. Hence, caring for a person who suffers from migraines requires an individualized approach. So, if you visit a neurologist or headache specialist for your migraines, they will likely delve into a discussion of various factors in order to sort your unique migraine profile. Here are some key issues your doctor will likely address: 

 

1. Age: This is a big factor when it comes to diagnosing and treating migraines. Particularly when it comes to children versus adults. Migraines in children share some features with migraines in adults, but, they also have their own unique features. For example, children tend to experience migraine pain on both sides of the head, while adults - just on one side. Along with migraine headaches, children tend to experience unique symptoms you don't typically find in adult migraine sufferers. These include: 
1. Abdominal pain
2. Osmophobia (sensitivity to smell)
3. Vertigo
4. Autonomic symptoms—runny nose, tearing eyes, facial sweating, etc.
Treating a migraine is different between adults and children. Some children and adolescents will not respond to typical adult migraine medication, like ibuprofen or certain tripants. Pediatric headache specialists focus on more unique migraine therapies, like minimizing stress through relaxation techniques and meditation, formulating a migraine action plan at school and ensuring proper sleep and eating schedules. 

2. Family History of Migraines: Migraines are hereditary, which means that the disorder tends to run in families. According to the doctors, if one or both of your parents suffer from a migraine, you have a 50% to 75% chance of suffering from migraines too. So, talking to family members who have migraines and finding out more about their attacks can be helpful, considering that migraines within the same family tend to share similar symptoms and triggers. It is also interesting to note that migraine medication that works for one family member often tend to work for other family members. So, after speaking with family members, share this information with your doctor. 
3. Migraine Pattern: Before going to your doctor's appointment, take down notes about the pattern of your migraines. Here are some pattern factors to consider:
Time of day: Take note if your migraines begin in the morning after waking up, afternoon, evening or the middle of the night.
Number of migraines: Take note of how many migraines you are experiencing - is it more than fifteen days per month? This indicates chronic migraine.
Associated symptoms: Do you experience nausea and/or vomiting with your migraines? And are these symptoms more or less debilitating than an actual migraine headache?
 

Aura: Do you experience a visual "aura" with your migraines?

Triggers: There are certain foods, weather changes, sleep deprivation, skipping meals and strenuous exercise which can trigger a migraine.
Hormone connection: Among women, migraines can occur prior to their menstruation, or may worsen or improve during pregnancy, perimenopause (transition into menopause) and so on. This can be extremely important for women. If a young woman notes her migraines are getting worse before menstruating, a doctor may prescribe continuous birth control pills, or a medication like Frova, taken five or six days prior to menstruation. If migraines are worsening because of menopause, hormone replacement therapy may be an option, particularly if the doctor suspects estrogen depletion as a culprit.  

4. Medication History: Migraine medications consist of two types of drugs: treatment and preventative. Determining what medications you have tried and what has worked or not worked for you is an important part of your migraine profile. 
5. Treatment Drugs: Your doctor may ask you about your migraine treatment medications, and these include nonsteroidal anti-inflammatory (NSAID), triptan, a combination of NSAID/triptan, an herbal supplement, or do you wait for your migraine to pass on its own? Your doctor will also want to know how many times you take the medication per week, if it's at the onset of your migraine if it is tolerable and effective. By better understanding the nuances of your medication, your doctor will better be able to form a unique migraine profile. Perhaps, she will be able to decipher whether you may be suffering from medication overuse headache, in addition to your migraines, or if the side effects are limiting their use. 
6. Prevention Drugs: There are some migraine preventative medications, including blood pressure medication, called Inderal, an antidepressant called Elavil, and an anti-seizure medication called Topamax, among others, are full of side effects and require months before a benefit is seen. Botox is also a reasonable option for chronic migraine therapies, approved by the government for treating episodic and chronic migraines. Aimovig (erenumab); Ajovi (fremanezumab); Emgality (galcanezumab) are injectables, targeting a protein that plays a major role in migraine pathogenesis, called calcitonin gene-related peptide (CGRP). These drugs have many advantages, but they are only approved if a person has not tolerated prior preventive medications. 

7. Underlying Medical Conditions: Your medical history is a major factor when considering your migraine care. For instance, compare a healthy person suffering from migraines, versus a person with multiple medical problems like uncontrolled high blood pressure and kidney disease. Even if they do share similar migraine symptoms and disabilities, the treatment plan will differ based on these underlying medical problems. A thoughtful discussion with your doctor is required when sorting out a person's migraines from alternative or additional symptoms. It is also possible, that what people consider to be their usual migraines, are actually headaches occurring as a result of another condition, such as sleep apnea, high blood pressure, or thyroid disease. Certain health conditions, like obesity, may also worsen your migraines.  
8. Lifestyle: Your daily habits and general lifestyle can affect your migraine experience, be they triggers, contributors, or interacting with therapies. Your doctor may want to know if you consume caffeine or alcohol on a weekly basis, whether you exercise, and what your usual daily meal plan is like. They may ask if you engage in mind-body therapies, like yoga or meditation, and what medication you take, including supplements and vitamins. They'll also want to know if you see a primary care physician regularly. 

Whatever may be causing your migraines, know that it is important to see a headache specialist, just be sure to write down the factors that comprise your personal migraine profile and know that there is no right or wrong feeling or answer. The best thing to do is to be honest. 

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