My Personal Exercise Plan
Type of Exercise
How many times/week
When will I do it? (before work, lunch hour, after work)
Prep needed? (equipment, etc.)
6. Nutrition
I will put nutritious food in my body every four to six hours. I will eat at least three healthy meals a day, and eat healthy snacks in between. I will keep healthy foods stocked in my kitchen.
Do I eat healthfully now? (See Chapter 12.)
Yes
No
If not, how will I develop healthy eating?
Visit a nutritionist
Use another resource ____________________
Do I need to lose weight to be healthy?
Yes
No
If so, how will I lose weight without getting more migraines?
Visit a nutritionist
Join Weight Watchers or Overeaters Anonymous
Use another resource ____________________
Do I have an eating disorder?
Yes
No
If so, I will get help by seeing a therapist or ____________________
Do I have any particular food triggers?
Yes
No
If yes, what are they? (Use food diary and/or migraine diary in appendix to figure them out; also, see Chapter 4.)
7. Sleep
I need to keep a regular sleep routine and get _____ (at least 7 or 8) hours of sleep each night.
Changes I can make to my bedroom to improve sleep:
Changes I can make to my routine to improve sleep (e.g. go to bed at the same time each night):
8. Staying Migraine-Free When I Travel
I will prepare ahead to avoid migraines when I travel by. (See Chapter 14.) Steps I will take:
9. Staying Migraine-Free at Work
I’ll make my workplace as migraine-free as possible (see Chapter 14) by taking these steps:
10. Staying Migraine-Free at Home:
I will help my family understand that migraine is an illness, and though it isn’t curable, they can help me have fewer migraines by doing these things:
I’ll make my home as migraine-free as possible by:
11. Relaxation
Relaxation is important for reducing stress, a major migraine trigger. I’ll find time to relax or be alone at least three times a week by:
12. Mental and Emotional Health
Am I in good spirits and feeling energetic?
Yes
No
If not, have I taken an online depression test or other depression self-test? What was my score? ____________________
If it appears that I am depressed, I will talk to my doctor about treatment.
Do I have other mental health or emotional issues I might want to get help with? ________________________________________
Would therapy be helpful to me? If so, I will talk to my doctor about a referral to a good therapist.
13. Relationships:
Am I safe in my home?
Yes
No
If not, I will talk to a therapist or my doctor about my options
Am I happy in my relationships? If not, is this something I want to discuss with a therapist, counselor, or minister or other religious guide?
14. Other things to consider in taking care of My Migraine Brain.
My Daily Migraine QuikList
Each day, to avoid migraines today, I’ll ask myself:
Sleep: Did I get enough sleep last night?
If not, I will have abortive plan ready.
Nutrition: What will I eat today and when?
Do I keep water and healthy snacks readily available?
Hydration. I need to drink 8 glasses of water throughout the day.
Medication: If I take a daily preventive med, did I take it today?
Do I have my abortive meds with me?
Do I have rescue meds with me, too?
Exercise: When will I exercise today?
Relaxation: When will I build in at least 10 minutes of relaxation today?
Stress: Am I facing any particularly stressful events today?
If so, can I avoid them?
If I can’t avoid them, how will I keep my stress to a minimum?
Triggers: Am I facing other particular triggers today? What are they?
Can I avoid them? How?
If I can’t avoid them, I need to try to avoid “a perfect storm” and keep other triggers to minimum. How will I do this?
9. Other daily reminder: ___________________________________
APPENDIX
In The Migraine Brain, we’ve mentioned a number of forms, diaries, charts and other tools that can help you get to migraine wellness. We have included these below, for you to use as you need them.
You don’t need to use all of this charts! Use them only if you find them helpful. Maybe you’ll use some and not others. And if you want to keep it simple, you can keep track of each of these things on one calendar (a paper calendar or e-calendar, whichever is easier for you). On the other hand, if you’re trying to focus on one thing—sleep, for example—keeping a separate sleep chart may help you keep more accurate records to help you figure out your migraine
Migraine Diary
The Migraine Diary is one of the most important tools for understanding and treating your migraine. On the diary, you should write down the date and time of day of every migraine attack you get; the severity of the pain on a scale of 1 to 10; the symptoms you experience; whether you had any warning signs including aura and prodrome; the medication you took, if you took any, and what time you took it; the food or drink you had in the two hours before the attack started; and any other comments you want to add. Note any triggers you think might be connected to the attack, including whether you have your period, and any unusual symptoms about your period such as heavy bleeding.
If you’re trying to do a more focused understanding of your migraines connected to your monthly cycle, you may instead want to simply use a monthly calendar and mark on it, each month, when your period arrives and when you get migraines. To get a clear idea of the hormone-migraine connection, keep this diary for three months (see example in Chapter 5).
My Migraine Diary
My Migraine Profile
You can use these questions for your own understanding and/or for discussion in a migraine support group.
My Migraine History
The first migraine I remember getting was when I was ______ old (I may not have realized it was a migraine at the time; now, looking back, I now believe it was).
As I recall, the symptoms of that migraine included ________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________
From that point on, I typically got migraines every _______ (how often) from the first time I got them until I was ________ years old.
At the age of ________, I began to get more/fewer migraines. At that point, I started having migraines every _________ (how often). The symptoms were ______________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________
I was formally diagnosed with migraine at age _________________.
The first treatment doctors tried was _____________________________ ____________________________________________________________
It did/did not work.
Other treatments I have tried include ____________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ _________
___________________________________________________
The ones that worked were ____________________________________
The ones that didn’t work were _________________________________
These treatments still work now/do not work now.
The people in my family who also get migraine are _________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________
Today, I get migraines every ___________________ (how often).
My worst migraine attack ever was when I _______________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________
My weirdest migraine symptom or other thing associated with my migraine is ___________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________
The thing I don’t totally understand about my migraine is __________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________
The Phases of My Migraine (See Chapter 3)
My Prodrome Symptoms
Do I get this during every attack?
How long before the pain phase?
My Aura Symptoms
Do I get this before every attack?
How long does it last?
My Pain Phase Symptoms
Do I get this with each attack?
Describe symptoms
Postdrome: My Migraine Hangover
Do I get this after every attack?
Describe symptoms
My Personal Top Ten Migraine Triggers
Trigger
How Serious a Trigger?
Avoidable?
How to Avoid It
My “Perfect Storm” of Triggers
_________________________ (trigger one) plus
_________________________ (trigger two) plus
_________________________ (trigger three)
= Whopping migraine!
Form to Bring to the ER, Signed by Your Doctor
Physician Provided Emergency Room Treatment Form
This form is being provided to assist you in treating my patient who is a diagnosed migraine sufferer. My patient sometimes experiences migraine so severe he/she requires emergency treatment. Migraine is a chronic, recurring neurological disease which is treatable. My patient is not a “drug seeker” or substance abuser. My patient uses the prescription(s) listed below to provide abortive and/or preventive treatment for migraine. Unfortunately, some migraine episodes may require treatment beyond the current prescribed regimen. My patient may need pain relief medications to treat this episode.
Patient Diagnosis and Treatment Information
Patient Name ____________________ Date of Birth_______________ Date of Diagnosis __________ Date of Last Visit __________ Current migraine abortive medication(s) _________________________ ____________________________________________________________ Current migraine prevention medication(s) _______________________ ____________________________________________________________ Other pain medication(s) ______________________________________ ____________________________________________________________ Prescription(s) proven ineffective for my patient’s migraine treatment ____________________________________________________________ ____________________________________________________________ Medication allergies ___________________________________________ For my patient’s emergency treatment, I suggest the following medication(s):______________________________________________________ ____________________________________________________________ ____________________________________________________________ Thank you for reviewing this important information and treating my patient. My patient has a legitimate migraine condition and is not visiting the emergency room to obtain narcotics or other medications under false pretenses. ____________________________________________________________ Signature / Date ____________________________________________________________ Office Phone / Office Address ____________________________________________________________
This form was created by National Headache Foundation. Copyright 2003. Used with permission of the National Headache Foundation. For more information on headache causes and treatment, visit www.headaches.org
My Migraine Exercise Plan
For peak migraine wellness, your goal should be to exercise at least half an hour a day. Five days a week is fine. Use the form below to mark how long you exercised each day, and what kind of exercise you did. This can help you see whether you’re as disciplined about exercise as you should be, and also whether it’s helping your migraines.
Mon
Tue
Wed
Thu
Fri
Sat
Sun
My Migraine Sleep Journal
If you’re focusing on your sleep patterns to try and find a migraine connection or try to improve your sleep hygiene, keeping a separate calendar like the one below can help. Note how much sleep you got each night, whether you slept uninterrupted, what if anything interrupted your sleep, and whether you awoke refreshed. See Ch. 12.
Mon
Tue
Wed
Thu
Fri
Sat
Sun
My Food Trigger Chart
If you’re trying to figure out whether any foods trigger your migraines, using a separate chart like this, where you focus on what you ate, may help. List every single thing you eat or drink (including candy, gum, and alcohol), and when you ate it. Also mark every migraine you get and when you got it. See if you can find patterns between things you ingest and your migraine pattern.
Mon
Tue
Wed
Thu
Fri
Sat
Sun
For My Partner: My Triggers and How We Can Try to Avoid Them
My Partner’s Migraine Triggers
How We Can Try to Avoid Them
1.
2.
3.
4.
5.
6.
Creating a Women’s Headache Center
Years ago, I began envisioning a center for women with headaches, a place dedicated to their special needs, where all their health concerns related to migraine and other headache would be addressed. I felt that women deserved a special place to get treatment for migraines and disabling headaches, that they needed a peaceful, quiet clinic where they would be treated respectfully and be able to receive multidisciplinary, topnotch care. The Cambridge Health Alliance, the hospital where I have worked since 1992, recognized that a women’s headache center would be a positive addition to the many other services it offers, and gave me the green light to start planning.
One of the first things we did was to convene a panel of women headache sufferers. Invitations went out to the women headache patients I was seeing in the neurology clinic, as well as to other women interested in joining our advisory board. We had our first meeting in the winter of 2005, a little over a year before the center opened. The women in our advisory group had wonderful, creative ideas on every facet of the proposed clinic. They described the ideal décor, ambience, and layout. Board members had extremely similar ideas, which supports the theory that those of us with migraines have similar “tuning”! Since so many migraineurs have problems with harsh sounds or lights du
ring an attack, they suggested blue or green for the wall colors, soothing music, and most, important, dimmer switches on all the lights. Indeed, the center is so dark from the outside hallway that people often assume it’s closed, and we had to put an “open” sign on the front door! Board members also suggested that we have fragrance-free magazines in the waiting room. They wanted green tea and ice water to sip while waiting for their appointments. They asked for multiple services under one roof: neurology, psychiatry, nutritional advice, biofeedback, headache support groups, and emergency availability for bad headaches that won’t quit. And they asked for a sympathetic staff that would understand what they’re going through.
The Migraine Brain Page 36