• Women are three times more likely to suffer from migraines than men, and if a parent had migraines you are more likely to inherit the tendency as well.  I’m a fifty-four year-old woman and my mother tried to deal with her severe migraines when I was growing up, when migraine treatment wasn’t as sophisticated as it is now.  She became addicted to the painkiller Fioricet.

    My migraines became disabling when I started caring for my aging father with whom I had a conflicted relationship.  After I left his apartment and drove to my home an hour away, the glare of the oncoming headlights exacerbated the pain.  He passed away in April of 2013, when I was fifty-two, and in June of that year I woke up with a migraine that refused to go away. My neurologist tried multiple interventions such as steroids and IV Depakote.  I was admitted to the hospital for three days for intravenous DHE (Dihydroergotamine), but the migraine always came back. I became a regular at the emergency room when the pain became unbearable, where the doctors administered intravenous dilaudid, a powerful narcotic.  Again, the pain returned.

    Finally in September of 2013, my neurologist threw up his hands and sent me to IMATCH (Interdisciplinary Method for Assessment and Treatment of Chronic Headache) at The Cleveland Clinic.  It’s a three-week outpatient program from 8:00 AM to 5:00 PM each weekday. All the medication I had overused for the past four months was flushed from my system in the first week through IV’s and I was also given medication to prevent withdrawal.  The second and third week were filled with groups and individual sessions consisting of topics such as relaxation/meditation, biofeedback, nutrition, sleep hygiene, triggers and relapse prevention.  We also received physical therapy and were required to work out in the gym for an hour each day.

    IMATCH changed my life.  When I stepped off the plane after three weeks, my migraine was gone.  I was smiling again and I was ready to participate in life.  No longer hiding in the dark or frequenting the emergency room, I embraced all that was available to me.

    A year-and-a-half after IMATCH, I still use the lessons I learned there and benefit from the treatment I received.  I continue to get migraines, but they are far less severe and less frequent and I haven’t needed to go to the ER since I returned. Summarized below is what I’ve learned and the ways in which I manage my severe and chronic migraines:

    • If possible, find a neurologist who is a headache specialist and works out of a headache center. I switched neurologists soon after I returned and it has made a world of difference.
    • My new neurologist helps me manage my migraines with quarterly Botox injections and monthly nerve block injections.  This is what works for me; discuss with your physician what treatment plan works for you.
    • I take a preventive medication each day (Toprimate) and I use the generic of the triptan, Imitrex in its injectable form.  It’s an abortive medication and I give it to myself when I feel a migraine starting.
    • I get regular exercise; yoga and swimming are what I enjoy and the combination works well for me. How to Start an Exercise Program After 50.
    • I receive maintenance physical therapy with a physical therapist who is a headache specialist.  She is wonderful and the treatment relieves the tension in my head, neck, shoulders and upper back.
    • I am aware of my primary triggers and I do my best to manage them:
      1. Skipping meals is probably my number one trigger so I eat three meals and two snacks a day.
      2. Stress is also a big trigger for me.  I have a job as a psychiatric social worker and the amount of stress I encounter in the course of a day is not always under my control.
      3. When the barometric pressure drops, I usually get a migraine.  I can’t control the weather.  All I can do is be prepared.
      4. Not getting enough sleep can be deadly when it comes to my migraines. It’s a trade-off, but I make sure to get at least seven hours a night.
    • I take supplements: magnesium, vitamin B2 (riboflavin), CO Q-10 and butterbur. These supplements were recommended by the neurologists at IMATCH. Check with your doctor before starting any supplement regimen.
    • I try to lead a balanced life; work, time with friends and family, writing (which is a passion of mine) and time alone (which is a necessity).
    • I am aware of possible food triggers; caffeine, MSG, red wine, aged foods, although I don’t consider these my primary triggers.
    • I’m in psychotherapy which is helping me to gain insight into unhealthy patterns and behaviors which may be contributing to negative outcomes in my life.

    This may seem like a great deal of work, almost as though I am living my life in order to control my migraines.  I can assure you that I’m not.  Living according to the above guidelines is just a way of living healthier overall and one of the outcomes is better control over the migraines.

    If you are suffering from severe, chronic migraines I encourage you to seek out a qualified neurologist who is a headache specialist in order to make a thorough assessment of your situation and develop a treatment plan.  There are many options available and you no longer have to suffer needlessly.  Migraines are often seen as an “invisible illness” because there are no definitive tests for them and no visible symptoms.  Only those of us who have them can empathize with the disabling pain and the toll they take on our lives.

    A good place to start is the website for migraine sufferers, www.migraine.com. There you will find interesting articles and a discussion forum on many relevant topics. I hope you feel better soon. Andrea Rosenhaft

    Photo credit: Dreamstime

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    Article by: Andrea Rosenhaft

    Andrea Rosenhaft is a licensed clinical social worker who writes about topics In health. She writes about mental health and recovery as well as other aspects of wellness. She lives in Westchester, N.Y. with her cat, Zoe.

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    1. Linda rains says:

      I noticed that this lady never addresses Hormone replacement therapy. She is still obviously taking a lot of different medications and may really benefit by seeing a specialist that deals with horomones. I have been greatly helped by adjusting my hormone levels and reducing chronic headaches. You do your readers a dis-service by not addressing this as a viable alternative or at least an included option for assisting with chronic headaches.

    2. Genie says:

      Very helpful article. Just a correction: The ingredient in the preventive medicine is not Toprimate but Topiramate.