As you may gather from the above, I do not own an iPhone so have have no personal experience of this application. Keeping a migraine diary can be a bit of a chore. If you love your iPhone and it is your constant companion, this could offer a neat solution to keeping track of your attacks. I haven’t seen the app in action, but I did visit the website to check it out though and it seems like it could be pretty useful.

The aim of the site is to provide physicians with web based tools to better monitor the outcomes of their patients and improve their practice. They provide some good information and resources on using the app. iheadache allows you to record details of your headache in real time. You can record the time it begins, the change in symptoms and severity over time, what medication you use, if any and your level of disability due to the headache.

You enter symptoms by giving yes/no answers to questions and give a numeric score to your headache pain. There is a medication page to record your usage. If you update this at the time you take the medication, the time is recorded automatically, but this can be edited. Standard medications are pre-programmed but others can be added.

If you have a tech savvy doctor, you can send him reports directly and even discuss with him what should be included in them. This information could be helpful in making an accurate diagnosis of your condition. It could even flag up the possibility of rebound headaches due to overuse of medication.

Based purely on reading the quick start guide on the website, this looks like something really useful you can do with your iPhone. I didn’t know that such things existed! It works on iPhone, iPod Touch and a Blackberry version is on the way.

You can find out more at : http://betterqol.com/iheadache/index.html

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Migraine meds are in two broad classes.

Migraine abortive medications

These are designed to stop a migraine that is already in progress. These are best taken as soon as a headache starts.

 Prophylactic or preventative medications

These are intended to reduce the number of attacks for those who suffer frequently.  They  are taken on a daily basis.

Migraine Abortive Medications

I know from my own experience that when a migraine is severe, normal analgesics just don’t offer any relief from the pain. Prescription drugs are usually required to achieve the desired effect. The two commonly used types of  abortive medication are Triptans and Ergots. They do not act on the pain, the symptom, but on the cause of the pain. Triptans (Sumatriptan, Naratriptan and Zolmitriptan are some of them), attach themselves to the  serotonin receptors on the blood vessels in the brain.

This blocks the receptors and so reduces inflammation and allows the blood vessels to constrict. If administered in a timely fashion, triptans can stop up to 80% of treatable migraines within two hours. They come in the form of tablets, nasal sprays and injections. They are not appropriate for all types of migraine so good advice and a proper diagnosis are required before taking them. They also produce side effects in some users, including warm, cold or prickling sensations, heaviness or tightness of the chest and tiredness and vertigo.

They may also not be suitable for people who are using other medications or have certain risk factors. Ergots (Ergotamine or Dihydroergotamine), act in a less targeted and longer lasting way than triptans, causing constriction of blood vessels throughout the body. They can particularly cause prolonged constriction around the heart are considered to be a less safe alternative to triptans.  They are more likely to cause nausea and vomiting.

Prophylactic Migraine Medications

Once the management of acute migraine has been appropriately dealt with, a preventative regime can be considered. This would be in cases where:-

• There are two or more migraines a month, that cause at least 3 days of disability a month
• Migraine abortive drugs are being used more than twice a week
• Acute treatments have not been effective or had unacceptable side effects
• For certain, more uncommon migraine types.

There are several types of medications that have been used for this purpose. These include beta blockers, antidepressants, anticonvulsants  and anti inflammatory drugs. They have been found to have varying levels of effectiveness. There is no point listing individual drugs here, as they are under constant review. Make sure that your doctor is up to date with the latest research. There needs to be a carefully monitored program which may take up to six months.

It would begin with the drug that has proven most effective with the fewest side effects, starting at a low dose. The dosage can be increase or different drugs tried, to find what works best for the individual patient. The program is considered successful if the frequency of migraines can be reduced by 50% or more. Once this has been maintained for between 6 and 12 months, treatment can be reduced or discontinued. Despite the success of this type of treatment, less than 50% of migraineurs follow such a program.

Many people, myself included, would not believe that the severity of their condition warrants such prolonged use of medication. Cost and personal preference are also factors to be considered. Despite my own reservations about the use of drugs, there is no doubt that these migraine preventative drugs produce very good results for a lot of people. If your quality of life is severely impacted by migraine, such a course is definitely worth considering.

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In fact, for a condition that affects so many people, it is still relatively poorly understood. There are theories about the underlying causes of it, what triggers individual attacks, and what courses of action we can take to alleviate it. But there is not very much agreement about most of it.

Faced with this, we need to get advice from the experts, but I believe that in the end, we have to make choices for ourselves. We each have different experiences of the condition, as well as different beliefs and preferences. One solution will never fit all.

In my own case, most of my attacks have been relatively mild compared to what a lot of people experience. They have also not been too frequent, especially as I get older. I also have a strong preference to avoid pharmaceutical solutions to any health problem, if at all possible.

With that background, I have tended to rely mainly on lifestyle changes to help to control and alleviate the condition. I have been laid low by an occasional, very severe attack, when I have resorted to normal painkillers, which have done very little for me.

I have never tried specific, migraine abortive drugs, and the prophylactic types wouldn’t be appropriate for me, given my infrequent attacks. I can well understand that these would be more attractive options for those whose lives are impacted more severely than mine is. But for me, it is not the way to go.

I don’t like to think of myself as a victim. I believe in taking responsibility for where I am in life, including in matters of health. I would rather be doing something myself than sit around and wait for the doctors to come up with migraine cures. I would rather get the best information available and act on it now.

I think it is agreed that lifestyle can have a massive impact on our experience of migraine, even though, for example, exercise is regarded as both a trigger for attacks and as preventative measure! It comes down to finding out what works for ourselves.

Keeping a migraine diary might not be the most fun you can have, but it could potentially lead to some small changes that transform your life. I personally believe that the way you habitually think, can have the biggest impact of all. Just decide that your migraine’cure’ is in your own hands.

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Basilar migraine or basilar artery migraine is one rare form of the condition. It has been grouped, along with a couple of other varieties, under the heading of complicated migraines. When it it was first described in the early nineteen sixties, it was thought that only girls and young women were affected.

While it is strongly associated with the menstrual cycle in this group, it has now been shown to occur in both sexes and all age groups. There is a female predominance, as with classic migraine. Some people experience prodromes, or precursors to an attack, as much as a day or two before the event. Then, thirty minutes to an hour before, comes the aura stage.

The International Headache Society has described basilar migraine as, “a migraine with aura symptoms clearly originating from the brainstem or from both occipital lobes.” Disturbances here can cause symptoms such as, visual hallucinations like bright lights or jagged patterns or a partial loss of vision.

There can also be numbness on one or both sides of the body, face and tongue, as well as weakness, dizziness or confusion and a lack of coordination. These symptoms can be confused with a Transient Ischemic Attack(TIA), a sort of mini stroke. Much less commonly, hearing may be affected. The headache phase of the attack can appear to be a normal tension headache.

It usually lacks the unilateral aspect of the classic migraine, with the severe, throbbing pain being felt around both eyes or temples. There may well be nausea and vomiting associated with the headache, which often reduces the severity of the headache.

The IHS provides a specific set of diagnostic criteria for basilar migraine which would be difficult for the layman to apply. As always, the first step in dealing with any condition of this kind, is a proper diagnosis from a qualified and experienced headache doctor.

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Keeping a migraine diary and trying to deduce what your particular migraine triggers are, can be a long drawn out and frustrating process. The real causes of migraine are still unknown and there is little scientific evidence of the links between these so called ‘triggers’ and the condition.

The problem is that we are all different and what we discover is necessarily anecdotal. I could find that, consistently, if I eat chocolate, a migraine follows the next day. So, I stop eating chocolate and reduce the frequency of my migraine. But that doesn’t constitute scientific evidence.

Someone else could stop eating chocolate and find it has no effect on their migraine. The same thing applies to our experience with exercise. My own migraine began as a child, at around the age of ten. I thought that my headaches were partly associated with swimming, but what was really going on? At that age, I was still unable to swim because I had never been very enthusiastic about it.

For me, it was as attractive as a visit to the dentist. Back then, pools were heavily chlorinated and I came to associate that smell with an unpleasant experience. I began to link the smell of the chlorine with the headache. But was that true? I have recently read that some people think the exertion of swimming, the aerobic aspect, is the cause. Also, stress is commonly thought to be a factor.

Was it because I found the whole experience stressful. Whatever the reality, in my mind, there was a link. That was many years ago and I am still not a fan of swimming. On the other hand, I was a regular runner for about fifteen years. I had many aches, pains and niggles, but never headaches. I also SCUBA dived for a similar period with no problems, apart from sinus pain in extremely cold water!

Is it a coincidence that I found both of these activities very mentally relaxing? I have just read about a study carried out at the University of Gothenburg, in Sweden. They had twenty migraine sufferers follow a program of exercise using an exercise bike, over a three month period. Whilst all the participants became noticeably fitter, only one of them suffered a migraine that was associated with the exercise.

They concluded from this that there is little risk of increased migraine due to exercise. That seems to me, unconvincing and not very scientific. Surely more participants doing a variety of exercises are required to come to any conclusions. They now plan to go on and do a trial to find out if exercise is beneficial to migraine sufferers.

I won’t be awaiting the results with bated breath. Based on my own experience, I am left wondering if there is such a thing as exercise induced migraine or whether it is more to do with the way we think, because of a previous bad experience with exercise. How many of us have let one  bad experience put us off exercise in general.

Given the lack of real evidence, we have to draw our own conclusions. I am firmly of the belief that exercise is good for all of us. It may not have a direct connection with alleviating migraine symptoms, but if you feel fitter, you feel better and more positive. It certainly can’t hurt. There are lots of different forms of exercise out there. I think it’s worth finding one that works for you.

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There has been an increasing trend for people to seek natural alternatives to medication to treat their ailments. For some, this due to concern about the effects that drug manufacture and disposal have on the planet. For many more it is the potential side effects and long term effects of taking medication, as well as the prohibitive cost.

Herbal and other alternative treatments have a long history of success in treating various conditions. In the case of migraine, medical science does not yet offer a cure. This means that a sufferer is faced with the prospect of long term use of medication or looking at the alternatives. And there are many ways to manage the condition without resorting to drugs. So, what is feverfew and how can it help?

Feverfew or Tanacetum Pathenium, is a common flower that is found all over North America, Europe and Australia. It looks quite like a daisy. It has a yellow centre surrounded by narrow white petals, with a furry stem and small, greeny yellow leaves. Ancient Roman medical texts refer to it as remedy for headache.

Medications for migraine are either abortive, that is, used to stop an attack that has already begun, or prophylactic, designed to reduce the number and severity of attacks. Feverfew is best used as part of a preventative regime. Several trials in recent years have shown some very good results for some patients. Two or three daily doses of feverfew reduced the frequency of their migraine episodes by up to 50%.

Also, participants who experienced Chronic Daily Headaches as well as migraine, reported that their daily headaches stopped, four weeks into their feverfew treatment. Feverfew can be obtained ready prepared, as tablets, capsules or in liquid form. It is also available fresh or dried, or you could grow it yourself. In addition to migraine, it is used to treat arthritis and menstrual pain, and also as an anti-inflammatory.

Feverfew is so called because of its original use in fevers, to reduce the temperature. While there are generally fewer side effects associated with the use of herbal remedies, they are not entirely free of them. Feverfew is no exception. In some people, it may cause nausea, indigestion, diarrhea,(it is also used as a laxative), and vomiting.

Mouth ulcers are another possibility, but this is most often associated with chewing the leaves. This list doesn’t look too good, but compare it to the possible side effects of one of your normal prescription medications. Few of us bother to read the information that comes with them, but if we did, we would think twice about taking them. Few people are likely to experience any significant side effects, but as always, it is worth consulting your doctor and/or a qualified herbalist before taking feverfew. This is particularly important if you are already taking other medication. And it should NOT be taken by pregnant women or nursing mothers and is not recommended for children.

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The condition may even effect infants but this is not easy to verify. The International Headache Society has set down criteria for the diagnosis of migraine. This can be applied to child migraine but in children, it is more problematic. For adults, a migraine should last for between 4 and 72 hours. In children, they tend to be generally shorter, which needs to be taken into account. A characteristic of migraine headaches is that they commonly effect one so of the head, though they can be two sided.

In migraines  in children, it is very much more common for pain to be experienced in both sides of the head. This can lead to migraine being mistakenly ruled out as a diagnosis. The onset of child migraine tends to be between the ages of 5 and 11. Before puberty, the number of male and female migraineurs is roughly equal. After puberty, this changes drastically, with women being almost 3 times more likely to experience migraine than men are. It is not known why this is, but a very high proportion of female sufferers experience migraine around the time of their periods.

For some child migraineurs, the condition may disappear, at or soon after puberty. But having migraine as a child, makes it far more likely that you will have it in adulthood than someone who didn’t have it as a child. I have a personal bias against using any kind of medication, particularly where migraine is concerned. I prefer natural treatment methods if at all possible. I think that this is also excellent advice where children are concerned. Obviously though, expert medical advice should be sought before making this decision.

My own experience of migraine was that my headaches began at around ten years old. I did experience one sided headaches, along with nausea and light sensitivity. We were not the type of close knit family where I could talk to my parents about it. It was during the summer break so school wasn’t an issue. Back then, parents weren’t so paranoid about letting their children out. It was not uncommon for me to be gone all day. It was just as easy for me to be unnoticed in my room. I suffered in silence, staying out of the sunlight and imaging all kinds of terrible things.

I had heard of a brain tumor and though I didn’t know what it was, I was sure that’s what I must have. The pain passed after a day or so, and I discounted it and carried on. When it came again, I was less fearful. The attacks became less frequent as I went into my teens and as an adult, they have been few and far between. They do tend to lessen as you get older. I have also developed strategies to cope with them. There is much more information available now than there was. I have collected some of it on this site, to help others like myself.

I would hope that most children nowadays, would be able to discuss this sort of problem with their parents, but it pays to keep an eye on them. It could explain them suddenly becoming less active than normal. Adult migraineurs should be particularly watchful. If both parents experience migraines, the child has a 70% probability of having them too.

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And I have been fortunate to mostly experience fairly mild attacks. Others have it much worse than I do, but at least the condition is not life threatening. By comparing your symptoms to a migraine definition, you can get a reasonable idea of which of these categories you fall into and what further action may be appropriate.

So how do you define migraine? I was surprised to learn that there is an International Headache Society, (IHS). This society publishes a book called  ‘The International Classification Of Headache Disorders’, and the book defines the criteria for diagnosing a migraine. According to the book, a common migraine headache is defined as follows.

Recurrence

You must have experienced at least 5 of these headaches.

Duration

The actual headache, excluding other symptoms, should last for between four and seventy-two hours. A headache lasting longer than this requires immediate investigation by a doctor to be sure that no, more dangerous condition exists.

The nature of the pain

Migraine headache exhibits particular characteristics. Does the quality of pain meet at least two of these criteria?

1) The pain is clearly experienced mainly on one side of the head.

2) It is not a constant pain; it could be described as throbbing, pound ing or pulsating.

3) The pain must be of a degree of severity that inhibits the sufferer from carrying out their daily activities, amounting to a temporary disability.

4) Normal physical activities such as sudden movements, bending or climbing stairs, can increase the pain.

Side Effects

At least one of these common side effects must be present:

1) Nausea

2) Vomiting

3) Photophobia – sensitivity to light

4) Phonophobia – sensitivity to sound

Secondary Exclusions

In severe cases, medical testing such as a MRI or CAT scan, as well as physical examinations may be appropriate, to rule out the possibility of other conditions causing the headaches.

For many people, this definition of migraine has simplified the diagnostic process. However, the perception of migraine is that it involves severe pain. There could be many people, such as myself, who experience milder symptoms and don’t even realize what their condition is.

I still believe that this migraine definition is a useful tool in deciding whether migraine is a possible explanation for headaches and if further investigation is required.

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Though little is yet known about the whys and hows of migraine there are plenty of statistics relating to who is effected. And it is disproportionately women. In fact, over 70% of sufferers are women. And many of them have noticed that they tend to experience headaches in the run up to their period. It seems that migraine and premenstrual syndrome very often come as a pair. Sixty percent of female migraineurs are prone to get these headaches before or during their period, as well as at other times of the month.

Could you be suffering from PMDD,(Premenstrual dysphoric disorder)? This is an extreme form of PMS that affects a small but growing number of women. Learn how to diagnose it and what to do about it HERE.

Another fourteen percent, only have a migraines associated with their periods. That is a massive seventy-four percent of female migraineurs who associate their symptoms with menstruation. Medical science does not dispute this connection, but as yet, they are no further forward in coming up with a reason for it. There appears to some connection with hormonal changes in the body, but that is neither an explanation nor a cure. Migraine is usually the cause of symptoms other than headache and menstrual migraine is no exception. And the bad news doesn’t end there.

Women who have begun to experience migraines later in life, report that their symptoms from premenstrual syndrome(PMS), have grown more acute since the headaches started. A study that was published in January of 2006, confirmed this anecdotal evidence. Those taking part in the study reported that during a migraine, weight gain, bloating, mood swings, breast tenderness, back pain, and abdominal cramps all became more acute. The participants in the study were given a drug to halt the action of the ovaries and produce a temporary artificial menopause.

Even though the hormonal fluctuations of regular periods were eliminated, they still experienced worsened PMS symptoms during a bout of migraine. Those fourteen percent of females who experience migraine only during their period, are said to suffer from Menstrual Migraine. So are they doomed to suffer until the menopause? Maybe not. For some women, anti-inflammatory medications such as Ibuprofen, have proven to be effective.

Taking a course of them for several days before a period, and the first few days into it, can alleviate or prevent the symptoms of menstrual migraine. Anyone thinking of trying this preventative measure should discuss their options with their doctor first. However, before resorting to medication, the natural migraine relief methods that work for others can still be beneficial to women with menstrual migraine.

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We are all different. As with prescription drugs, one person may achieve greater benefits than another from a natural medication. What works well for you may be less effective for someone else and vice verse. Word of mouth is good, but don’t assume that you will get the same results that someone else did. And if something didn’t work for them don’t dismiss it out of hand.

There are many alternatives to taking medication in the treatment of migraine headaches. One of, or maybe a combination of these alternative methods will turn out to be your ideal solution. A word of caution. If you choose to go down this route, you are likely to meet opposition from the medical profession. They will say that some of these treatments have not undergone rigorous scientific analysis. And there may be some truth in that.

But if real people are finding them effective… Also, clinical trials evaluate the performance of a new drug against a placebo. They are only required to outperform the placebo by a tiny fraction to be considered effective. Rigorous testing doesn’t necessarily equate to amazing results.

Another caution. The presence of a treatment here does not represent an endorsement of it. I merely present the possibilities. Also, some herbal remedies are not compatible with prescription medicines. I would get the advice of a doctor before mixing treatments or discontinuing prescribed medicines.

That being said, here we go:

Chiropractic adjustments or manipulations, have been a very popular natural  headache relief method for many years. Patients with migraine headaches are said to have achieved very good results. Over 80% of headache patients show improvement from chiropractic care. Also, chiropractic treatment has proven very safe. Correcting spinal problems may help to relieve headaches that are caused by them.

Exercise can be a trigger for migraine attacks in some people, but it also  enhances life and health. This is a case where what is good for us generally is also helpful in dealing with migraine. It is just a question of finding the right exercise. For me, swimming in a chlorinated pool has been a trigger for attacks, but I was always able to run. The impact from running could be a problem for many migraineurs.

The thing is, not to give up at the first attempt. Try out different things and record your reactions to them. Most people will find some form of exercise they can do. Being fitter, stronger and with a more positive outlook on life has to help. My main current activity is Tai Chi. It is a low impact, surprisingly good exercise that also helps to relieve stress. You might also consider things such as Yoga and Pilates.

Stress is thought to be a major trigger for migraine and we are all exposed to an increasing number of stress factors. Stress itself is not a thing, it is just our reaction to what goes on around us. We all have a threshold for what we can handle being thrown at us. If we are exposed to much more than we can take or are above our threshold for long periods, we start to exhibit typical stress responses, including migraine attacks.

Ways that we can increase our threshold include, relaxation techniques such as meditation. Technology now provides ways to do this easily, without retreating to a mountain top. It doesn’t have to be too time consuming either. There are also many self help courses available, aimed at helping us to release old thought and feelings that are holding us back from living naturally and freely. I have taken some very good ones.

I have come to believe that our attitude to migraine, as well as to life in general, is everything. They say that what you resist persists, so I think that talking about a war or a battle against migraine is not the way to go. Is being in a war going to help you to relax? It is much better to accept or even embrace it. Look at it with interest. I know this sounds like a mad idea if you are in the middle of a severe migraine, but has fighting it ever helped.

I resisted the temptation to use the phrase ‘migraine attack’ there. It just occurred to me that it sounds like something from outside is attacking you and causing you pain. That is not going to put you into a resourceful state to deal with it. It sounds like something that is out of your control, which it is not. There are many things you can do to improve the situation.

Diet is one area that can really make things better or worse. Here again, what would be a good healthy diet for anyone is beneficial for migraineurs. We should all eat a variety of foods, including protein, fresh fruit and vegetables, whole grains and pulses. Most of us could reduce the amount of fat, salt and processed foods we eat.

Just having a healthy, balanced diet could help to alleviate our symptoms. This is before we look at food elimination diets. There are the usual suspects when it comes to foods that may trigger migraine. Some of these are, strong cheese, wine, caffeine, chocolate and some food additives. But we are all different. You might be fine with all of these, but there is something else that sets you off.

The only way to know for sure is by keeping a food diary. This takes work, but it could pay off in the end. It involves recording what you eat, at what time of day, and what symptoms you experience and when. Over time, you may start to see patterns emerging, of eating a particular food and having a headache later. Then you try eliminating foods from your diet, one at a time, and see if there is any improvement.

Some people have had great results just from doing this. These are just a few natural migraine relief methods you can try, that could greatly improve your quality of life. And I didn’t even get to herbal remedy alternatives to drugs. That will have to be another article. As always, though there is much of this that you can do for yourself, it might be worth a discussion with your doctor.

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