If You Get Migraines Your Doctor Will Want to Know This
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 American
Migraine Foundation, 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 FDA 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. Read
more about why migraines happen here.