Tracking migraines can help in plan to avoid them

I was 40 years old when my migraines started. Every month, like clockwork, the headache would descend on me around period time, and continue as an unwelcome guest for several days. I had that look around my eyes that said, “I’m barely hanging on here; what I really need is a dark room and SLEEP.”

Migraines are much more common than previously thought, and many headaches that were categorized as tension or stress headaches are actually migraines. Now, a study in the Archives of Internal Medicine reports that 88 percent of nearly 3,000 people diagnosed with “sinus headache” actually met the criteria for migraine headaches.

Doctors have no problem making the diagnosis when their patient tells them about recurrent headaches that follow wavy lines in their field of vision. In this study, the misdiagnosis resulted not only from physicians but from the patients themselves, because of additional symptoms not considered “typical” for migraines. Of the patients who met migraine criteria, more than 80 percent complained of sinus pain and pressure, 60 percent had nasal congestion, and 40 percent reported a runny nose and watery eyes.

What is a migraine, anyway? These headaches, as every migraine sufferer (migraineur) knows, are recurrent and are usually one-sided, though not necessarily the same side each time. The pain is moderate to severe, throbbing, and can be aggravated by even routine physical activity. The headaches are often accompanied by nausea and vomiting and an extreme sensitivity to light or sound. And they definitely interfere with work, and play, and just getting stuff done.

Among migraineurs, 20 percent have an “aura” that serves as a warning sign that the headache is on the way. This may be a visual change, like dancing lights or shimmering stars. Numbness or tingling in an arm or leg, or weakness on one side of the body can also signal the approach of a migraine.

Migraines are often brought on by a “trigger,” such as stress or fatigue, or foods like red wine, or the MSG that some Chinese restaurants still use. If you’re thinking sinus headache, then you might not think to look for those triggers, and to avoid them when possible.

Women may note a hormonal trigger. Some women get migraines while taking birth control pills, while others get relief with them. Some women get migraines with the onset of menopause. Mine virtually disappeared with that blessed event.

Migraineurs who have an aura preceding their headache have the advantage of intervening early. For some, biofeedback training or relaxation exercises may help. Others head for the drugs. For many migraineurs, ibuprofen or aspirin with caffeine may be all they need. But a class of drugs called triptans has been a real breakthrough in the treatment of migraine headaches. These drugs, available as self-administered shots, pills or even nasal spray, can squash the migraine out of existence and allow its victim to get on with life.

Neurologists, familiar with the syndrome of “rebound headaches,” advise against using any acute migraine treatment (even aspirin) more than twice a week. Using these medications too often can result in getting a headache when you don’t use them and in less effectiveness when you do. Migraineurs who have frequent headaches will often benefit from taking a pill daily to prevent the headaches in the first place. Drugs such as propranolol, verapamil, and even the antidepressant amitriptylline are helping prevent millions of migraines.

If you suffer from headaches, try keeping track of the time and length of each headache, the location and type of pain (dull, throbbing), any symptoms before the headache begins, food or drink you had before the headache, and if you’re a woman, track your menstrual cycle and any female hormones you’re taking.

Armed with this information, you and your doctor can make a plan. Saying no to a glass of red wine may be all it takes to avoid a migraine.