Feel a Migraine Coming On? Take Action ASAP

Doctor poses for photo.

Feel a Migraine Coming On? Take Action ASAP

Say the word “migraine” and four letters come quickly to mind: P-A-I-N. Brendan Kelley, MD, a neurologist and memory disorders specialist with the UC Gardner Neuroscience Institute, wants us to think of four different letters: A-S-A-P.

No fancy acronym, it’s just what it sounds like: as soon as possible. With migraines, sinister headaches that can cause nausea, vomiting and extreme sensitivity to light and sound, the sooner we act the better.

“The first step in treating migraines is to interrupt the headache’s progression,” Dr. Kelley says. “Migraines usually begin gradually, and you want to intervene with medication as quickly as possible rather than allowing the headache to develop into a full-fledged, knock-down, drag-out headache. Medications are more effective if you take them early in the headache.”

Individuals who experience an “aura,” a physical symptom preceding a headache — manifested, perhaps, as a change in vision or tingling in the hands or arms — can reach for the Advil or Excedrin or other over-the-counter medication at that time, before the pain even begins.

The second rule in migraine treatment, Dr. Kelley says, is to reduce headache frequency. “Repeated headache episodes appear to predispose you to more,” Dr. Kelley says. “There may be a kindling effect, and a bad problem can evolve into an even worse problem. In some cases, headache specialists see people who have become hypersensitive to such a degree that light touch on the scalp is perceived as discomfort or pain. This condition known as allodynia.”

In the United States,  17.5 percent of women and 8.6 percent of men (13.2 percent overall) will experience a migraine at some point in their lives. For some, the condition is hereditary. Migraine headaches occur on a continuum, from the merely painful to the utterly debilitating headache that keeps the sufferer out of work for a week. Known triggers include stress, insufficient sleep, missed meals, allergies, excessive alcohol consumption, chocolate and red wine. Cured meats, such as salami or pepperoni, which contain high levels of nitrates, are another commonly overlooked trigger.

Because there is currently no cure for migraines, lifestyle changes are at the front line of defense. “Any changes that reduce the likelihood of a migraine are highly recommended,” Dr. Kelley says. “They represent an ideal first-line form of therapy, as they have no cost and no negative side-effects.

“If headaches persist, and if they’re so severe that they are impairing one’s quality of life, the patient and doctor should develop a regimen to both combat episodes of headache and to reduce the frequency of headaches,” Dr. Kelley continues. “We currently have eight medications at our disposal for this type of therapy, which is known as headache prophylaxis. If an individual typically has one migraine a month and we can reduce that frequency by half, we have improved the person’s quality of life.”

Whether one suffers from migraines often, occasionally, or not at all, adopting healthy behavior that minimizes the risk of a future migraine is something we all can consider. ASAP.

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