How do you take care of yourself when you have a migraine?
April 25, 2013 7:52 AM   Subscribe

I live alone and suffer from migraines. What can I do to take care of myself?

I've been to doctors, and they won't prescribe me anything because I have other health conditions and they don't know how I'll react to migraine meds.

I know my triggers - red wine, eating improperly, not getting enough water, super-vigorous exercise - and avoid them. But I still get migraines; usually, I have them once a month. They are not accompanied by aura. I am not sensitive to noise or light, but I am extremely sensitive to motion. I also have nausea. Nothing (pain meds, sleeping, quiet) helps; I just have to ride it out. I've tried tylonel to vicodine to morphine for the pain, and while the morphine helped me get a few hours of sleep in it actually - shockingly - didn't make it hurt much less. Plus, I can't go to the ER and ask for a shot of morphine every month.

So, when I get them, what should I do? What kinds of foods should I be eating? What things should I be doing to help ease the pain - or distract me from it? What can I do to make this as painless and easy as possible?
posted by k8lin to Health & Fitness (46 answers total) 16 users marked this as a favorite
Best answer: I realize this is going to sound oversimplistic, but have you tried Excedrin? Acetaminophen and ibuprofen do nothing for my migraines; stronger stuff like vicodin doesn't really get at them. I hate to shill for a particular brand, but Excedrin is the one thing I carry with me all the time.
posted by theredpen at 7:56 AM on April 25, 2013 [9 favorites]

I used to get migranes all the time, now, only occasionally. I used all kinds of meds, but weirdly enough the one that works for me is Excedrin. It's Aceteminophone/Asprin/Caffeine and it works really well. I gave one to a friend who swallowed it and said, "Wow! That seems to work instantly."

I try to get up and have my morning cup of coffee at around the same time every day.

You may also try birth control pills, that helped me A LOT, but it's really individual, some folks report an increase of YMMV.

A cool compress over my eyes used to help, and for nausea, Bonine is pretty great.

The Excedrin works so well for me that all I have to do is take it and within the hour I'm fine.
posted by Ruthless Bunny at 7:57 AM on April 25, 2013 [3 favorites]

Do you have health insurance (I'm assuming yes, as you've been to an emergency room recently)? If yes, see a pain specialist. Get referrals - more than one if the first one doesn't work. You need to be an advocate for yourself but being completely out of commission once a month is unacceptable.

FWIW - I know how to catch mine fairly early and knock it out before it takes hold. If it takes hold, I knock myself out with medication and sleep through most of mine.
posted by Sophie1 at 7:59 AM on April 25, 2013

Best answer: I get migraines and anything from the poppy derived family of drugs makes me extremely nauseas and dizzy, so they might be worsening your problem. You kind of have to ride it out, but some things thath help me are doing little pressure massages or holds around my head such as gentle pressure on my sinus area by laying on my back and having my arm over my face so my elbow-pit is on the bridge of my nose, laying on my side and having the weight of my arm on my temple, and other such things. Sometimes breathing steam like you do when you have a cold helps. BRead, plain crackers, matzo are pretty easy to keep down. sometimes something cold to suck on helps, like a popsicle (maybe those prego pops would be more healthy?).

But really, and unfortunately, the best advice I can give is to apply for FMLA so that if you work you dont get disciplined for absences due to the migraines.
posted by WeekendJen at 8:01 AM on April 25, 2013

for the nausea, ginger chews, candied ginger or ginger tea. also Dramamine.
if I catch a migraine monster early enough, I try Excedrin; a little later, I try Imitrex, which I see you don't have access to, unfortunately. (not that it always works.) other coping mechanisms, when I realize I just have to ride it out: wearing sunglasses indoors, resting on the ground instead of the bed, massaging my head, sometimes taking a lukewarm bath, using cold/warm compresses on my forehead. if it's murder and it's late enough, I give up and try to sleep through it by taking a couple Benadryl and going to bed.
posted by changeling at 8:01 AM on April 25, 2013 [2 favorites]

Absolutely a vote of confidence in the Exedrine Migraine blend! In the nearly 50 years I've had migraines, this, finally, is the only thing that has EVER worked for me. Years of vomiting in dark rooms and weeping with such insane pain - done!
posted by henry scobie at 8:02 AM on April 25, 2013 [2 favorites]

Best answer: Even if you don't have aura, and don't THINK you have light sensitivity, turning the lights down and using a sleep mask to block light out while you rest may help (here's why). I've heard lots of other sufferers say it helps, and I know it makes a big difference for me (but I do have light sensitivity and aura, so YMMV) . Also, I have noticed that staying hydrated (with actual water) and sticking to a healthy sleep schedule as much as possible makes a difference for me. And since I tend to get more migraines when I'm stressed, I've been trying lately to be kinder to myself (taking time to relax, etc.) when I've got a lot going on.
posted by BlueJae at 8:03 AM on April 25, 2013 [1 favorite]

nthing Excedrine, for me and my mom. I just wanted to say something because I assumed for years that it would be weaksauce and do nothing for me, but it works.
posted by stoneandstar at 8:04 AM on April 25, 2013 [1 favorite]

(Oh, and on reading what Ruthless Bunny said -- birth control pills make my migraines WORSE. Much worse. Three-a-week worse. So keep in mind that changing your hormone balance could go either way.)
posted by BlueJae at 8:05 AM on April 25, 2013 [1 favorite]

Daily magnesium supplements are usually recommended as migraine prophylaxis. YMMV due to sensitivities (it can upset your stomach).
posted by elizardbits at 8:10 AM on April 25, 2013 [1 favorite]

Sleep, crying, cold packs in the dark. My migraines and daily headaches stopped near dead after I had a minor surgical procedure that was serendipitously related. Now I only get them occasionally, and can enjoy things that used to trigger them. Most often they are now triggered by cycling of the female sort (I am on a non-monthly schedule) and stress and sleep deprivation and I go into "hibernation" and do Excedrine Migraine (or generic equiv) like mad. Ingredients: 250mg Acetaminophen, 250mg Aspirin, 65mg Caffeine. I'll take one if it's coming on, I'll take two if I've been blindsided.

Other than that, I take Aleve for general/female cycle pain (which only manifests in my leg).

I too have various health conditions for which I must what what I consume medically.
posted by tilde at 8:11 AM on April 25, 2013 [1 favorite]

Best answer: I have life-long migraines, they have gotten much less severe in the last few years, here are a few things that I have changed:

--switched to decaf coffee
--take coenzyme Q10 (I also take DIM and vitex, which I was taking for hormonal acne and night sweats, and they also had a positive impact on my migraines).
--try to reduce stress (stress makes them much worse)
--a series of accupuncture visits helped
--walking helps

When I get a migraine I do the following:

--drink a cup of real coffee and/or
--drink coke with lots of ice and eat ruffles potato chips (with ridges)

The latter sounds crazy, I know, but 2 out of 3 migraines will go away with this weird combination, I figure it is the sugar, caffeine, carbs, salt and oils combo. I also may take ibuprofen. But I have found over the years that pain meds may or may not work. I found opiates worked for awhile, then they stopped working and just made me feel worse and contributed to more.
posted by nanook at 8:11 AM on April 25, 2013 [1 favorite]

What you really need is to be taking a migraine preventative. There are dozens of choices, and most are fine for people who can't take migraine drugs such as tryptans. Find a doctor who will work with you on this, preferably a headache specialist. If one preventative treatment doesn't work, try another.
posted by artistic verisimilitude at 8:22 AM on April 25, 2013

This will sound weird, but Alka Seltzer controls my migraine nausea very well. Back in the mid-80s I got a tip from an older relative--take two Alka-Seltzer tablets, a pain reliever (I use whatever is on sale at the store), and put an ice pack on the back of your neck. If I have these items on hand, my migraines don't get past tension headache severity, and there's little to no nausea.
posted by xyzzy at 8:25 AM on April 25, 2013 [2 favorites]

Best answer: We have very similar triggers, though I get an aura. Like you I have to basically ride it out, often, like others, just trying to sleep through the worst of it. But when I'm left with that still-painful tail end of the headache, I lie down, cover my eyes with something, and listen to podcasts or books on tape. Anything to provide a distraction. It helps.

Also, making sure I have some salt in my system (potato chips you say nanook?) usually via broth also makes me feel better, but that again is after the worst is past.
posted by eralclare at 8:28 AM on April 25, 2013

Best answer: This is all super-individual. So you're going to get a long laundry list of things that work for some of us, and you'll kind of just have to go down the list and try them until you find what works.

That said: Here's another vote for ginger, and for a cold pack on the back of the neck. And another suggestion I haven't seen in the thread so far is cayenne pepper — either in capsules, or brewed with hot water like it's tea.
posted by Now there are two. There are two _______. at 8:30 AM on April 25, 2013 [1 favorite]

Seconding Coke (and in my case I've found the faster you can get it down, the better -- punch your brain with that caffeine and sugar! punch it in the FACE!), and also once you've already got one, the combo of sitting in a hot tub with a cool/cold compress on your face has helped me, too. (With the lights off, or way down).

Pain meds rarely work on me so I've had to get creative.
posted by at 8:35 AM on April 25, 2013 [2 favorites]

Tylenol does nothing for me, but aspirin or Aleve really help if I catch it early enough. (Which means pretty much at the first twinge. The times I've thought, "oh this is just a tension/lack of food headache and will probably go away soon" I've inevitably been wrong.)

I also have some luck with nasal sprays or other decongestants. Whether that means my headaches aren't really migraines and are just caused by swollen sinuses, I don't know. But Aleve and a couple of squirts of Afrin are my go-tos now.
posted by MsMolly at 8:39 AM on April 25, 2013 [1 favorite]

The tryptans work a charm, but if you can not take them:
Here is my recipe (I have treated people according to this protocol with success):
Take a combination of magnesium, vitamin E, D pills and camomille tea with ginger.
Have a massage which creates freedom in the neck, especially addressing the splenius capitis and scalene muscles. Vigorous bilateral compression and massage of the frontal branches of the superficial temporal artery. Craniosacral manipulation might help. Relaxe while having a tight, warm towel around the head (a turban might work).
posted by Eltulipan at 8:39 AM on April 25, 2013

Lavender aromatherapy helps me. I dab a little essential oil on my wrists and neck and try to go to sleep; often when I wake up it's better.
posted by mchorn at 8:45 AM on April 25, 2013

The only thing that helps me with my migraines is Excedrin Migraine (and it has to be the migraine formula, not the regular Excedrin). Seconding Ruthless Bunny - it works within the hour. It's a godsend for me!
posted by Nutritionista at 8:53 AM on April 25, 2013

Hormonal birth control and artificial sweeteners both made my migraines more frequent and worse.

I take promethazine (Phenergan in the non-generic), which is an anti-nausea medication that has a side effect of often stopping or lessening migraines. If it doesn't stop the pain, at least I can eat (as hunger makes them worse for me). Often in combination with hydrocodone, as my doc says that the combo has been known to knock migraines out (but quitting the BC and diet sodas have lessened my migraines to such an extent that I don't get them frequently enough or bad enough to take both meds at one time often, so I can't tell you if it really works or not).

Cold makes me feel better; eating ice cream, Popsicles, ice, and so on. Also a cold cloth on my forehead or head, and thoroughly wetting my hair and allowing it to air-dry to take advantage of the cooling effect that evaporation has (put a towel on the pillow to keep from soaking it). I have not yet gotten a Chillow (warning: auto-play video on page) to see if it would help me, but I think it probably would.
posted by telophase at 8:54 AM on April 25, 2013 [1 favorite]

The bonus to the promethazine is that it puts me to sleep, so I can at least wait out part of the migraine in blissful unconsciousness.
posted by telophase at 8:55 AM on April 25, 2013

Avoid MSG. MSG pops up in the most unusual places, so read carefully -- my migraine-suffering friend used to have noodles (the sauce had MSG) for lunch every day until she made the connection. She managed to remove one trigger that had been confounding her, which helped in a small way.
posted by mochapickle at 9:07 AM on April 25, 2013

Best answer: Wow. I'm a migraineur and until this thread I never knew that my love for Excedrin was echoed by so many others. Please give it a try. (I literally don't go anywhere without it.)
posted by BlahLaLa at 9:30 AM on April 25, 2013 [1 favorite]


For as long as I can remember, I've gotten kneel-by-the-toilet-and-lose-my-lunch migraines because I don't get enough water. You've mentioned that quiet and sleep don't do anything for you -- when I've got a migraine, quiet and sleep don't help me because I'm still pain/nauseous/aura-y if I just lie down in a dark room.

So this is what I do:

1. Force myself to drink a large amount of water (drink till I'm not thirsty, then another five big gulps, then another three big gulps, so that I feel kinda awash in water, but not to the point of wanting to throw up again).
2. Take acetaminophen, not because it helps with the migraine, but because it takes care of the pain I have in my shoulders from hunching because the migraine hurts so much.
3. Slather my tongue with toothpaste, because the burny feeling on my tongue is better than the migraine/nausea.
4. If I have Ben Gay, I put some on the parts of my head where it feels like the migraine is -- again, not because of the acetaminophen in Ben Gay helps, but because the burny feeling sort of displaces the migraine pain.
5. Lie down in a dark room with a good sleep mask and (since I'm usually not sound-sensitive during migraines) comfortable headphones and a fairly boring audiobook.
posted by joyceanmachine at 9:36 AM on April 25, 2013

Response by poster: I am not supposed to take NSAIDs, but called my doctor and begged. They said a low dose of aspirin (500 mg) once a month wouldn't kill me.

So I took Excedrin and I am not 100% but it really helped.

This changes my life, and I'm not even exaggerating. Thank you.
posted by k8lin at 9:40 AM on April 25, 2013 [8 favorites]

I do a version of excedrin migraine - drink a can of coke and take two ibuprofen. I've also found that putting myself to bed sitting up is better than laying down. Cold compresses occasionally help. This sounds silly, but visualizing myself into the center of the pain makes it more bearable.
posted by sciencegeek at 9:51 AM on April 25, 2013 [1 favorite]

I have to stay away from screens. No TVs, phone, computers, etc as well as other light sources (sun, bulbs, etc.)
And good dark chocolate.
posted by missriss89 at 10:03 AM on April 25, 2013

Nthing Excedrin swallowed down with real Coke. Coke is about the oldest migraine hack out there! The caffeine stops the blood vessels in your head from expanding and there's something about the Coke format (sugar to speed caffeine absorption?) that speeds this. I used to take a migraine drug called Cafergot, which combined ergotimine and caffeine, and it was still more effective with Coke.
posted by DarlingBri at 10:08 AM on April 25, 2013 [4 favorites]

There are a lot of good suggestions here but I had one other -if you have only seen a primary care physician about the migraines, you could try asking for a referral to a neurologist who specializes in headaches. There are several prescription options out there aside from triptans (which are very tricky for people with other medical problems) and if Excedrin isn't enough, you might have other choices worth a try.
posted by treehorn+bunny at 10:15 AM on April 25, 2013 [2 favorites]

I double-dose on Excedrin (regular kind, not Migraine kind) and drink a cup of black, highly caffeinated tea the moment I start seeing a aura. (My migraines are always accompanied by aura). That usually kills the visual effects within 20 minutes and while I still have a headache for about an hour or two and what I refer to as a "migraine hangover" for the rest of the day, it is about 90% better than an untreated migraine.

Put Excedrin in your car, purse, manbag, desk drawer, and anywhere else so you can always catch it immediately. Life will be so much better.
posted by olinerd at 10:15 AM on April 25, 2013

I don't get migraines so take this fwiw, but I have been doing a lot of research lately on MTHFR, and somewhere in there I remember that it said migraines might be another symptom of the mutation, and following some of the vitamin protocols could help. I am still in research phase so I can't speak with any authority on what vitamins might be best to help, but it is one avenue to investigate.

I also have heard from a couple of people just recently that essential oils can help with migraines. You should get a food-grade product, such as Young Living (sorry, I don't mean to shill, but I've been advised not to use products you couldn't ingest).

Good luck!
posted by vignettist at 10:17 AM on April 25, 2013 [1 favorite]

Going on Topamax changed my life. I went from 8-15 migraines a month to maybe 2. I take Imitrex, the nasal spray, when I get them. For nausea, I take Zofran. It doesn't always work, but I'm so grateful. If you've obtained a second opinion and prescription drugs aren't an option for you, here are some random things I use instead of the big guns sometimes or that I used with some success before I had access to those:

1. Goody's headache powders. Same stuff as in Excedrin, but it works faster. They're little envelopes of powder that you either dissolve in water or basically pour into your mouth. They taste awful! That makes my psychologically feel that THIS WILL WORK.

2. Benadryl. I had a really bad, weird reaction in the ER (twice) to two different nausea medications. The antidote was one of the benzodiazepines + Benadryl. The physician remarked that Benadryl is sometimes used in combination with other things to treat migraines. A couple of times when Imitrex didn't cut it and I didn't feel enough like dying to go to the ER, I thought that maybe I could just try to sleep, so I took Benadryl. Both times, the migraine was gone by the time I woke up. Of course, this only works if you're not throwing up everything you swallow.

3. Ice on the back of my neck.

4. A bit of low-grade white noise.

5. Breathe, breathe, breathe.
posted by houseofdanie at 10:21 AM on April 25, 2013 [2 favorites]

Daily complex B vitamins and hot, dark showers (I generally sit in the bottom of the tub/shower and let it cascade on my head and neck). The article contains links to reference papers for the B-complex supplementation preventing migraines. I can always tell when I've fallen off the train by when I start getting migraines again.
posted by bookdragoness at 10:21 AM on April 25, 2013

Best answer: Look at your diet. Do you have food intolerances? You might try Gwyneth Paltrow's new book on the elimination diet. I know dairy can be a trigger. Also, look into biofeedback and acupuncture. All this might sound weird and out there, but what you have got to lose but pain? Wishing you well
posted by TRUELOTUS at 10:49 AM on April 25, 2013

I am not your doctor and this is not medical advice. But I get Terrible Migraines (we share some triggers). Phenergan helps for me and so does a recent thing I tried on the advice of a PA I saw for a migraine-Aleve gel caps and children's Benadryl taken together. BAM. It has cut short a few migraines for me now. Things that also help: dark rooms, cool air, heating pad behind the neck, sleep,and SOMETIMES accupressure. Again, alll these things that work for me or someone else might not be best for you or apply to your situation...I really recommend talking to a medical professional before trying new medications or diets if you can, particularly if you have complicating health conditions. Feel better!
posted by anonnymoose at 11:14 AM on April 25, 2013

My teenage daughter's life has been impacted by her frequent severe migraines. These are the things that have worked--

Excedrin [aspirin/acetominephen/caffeine combination]
the cocktail [aspirin/acetominephen/ diphenhydramine (Benadryl)]
dark quiet room
clean, pleasant fragrance [which also means the absence of foul odors]

To reduce the frequency and severity of headaches, these have been effective

400 mg riboflavan
low-estrogen birth control pills
physical therapy with biofeedback-- neck and shoulder relaxing as a preventative
posted by ohshenandoah at 12:15 PM on April 25, 2013

Seconding the diet suggestion. I had all-day migraines EVERY SINGLE DAY for 15 years. Turns out I'm allergic to wheat. As soon as I stopped wheat, they went away. If you do elimination diets, though, please PLEASE be sure to do them long enough. Even one gram of gluten can cause immuno-responses for up to two weeks. I know lots of people who do eliminations, cheat and then declare the elimination void. Give it time to work. Losing out on bread has been a tiny sacrifice to not have pain every day (or even some days).

During the Dark Times of Migraines for me, cold packs worked, dark rooms, Excedrin (the best thing out there) and caffeine. Finally, visualization helped a LOT. I visualize the pain on a in-breath. I gather it all up into a ball in my mind and then on the out-breath I push the ball away from me. I think this is an old Lamaze trick.

My neuro has prescribed a B-12 vitamin.

Also, since your question specified that you live alone, I would take time to talk to my employer and let them know of your condition and that some days you might be late or not be able to come in. Maybe let a friend at work know that if you call in or if you text them a certain word/phrase, that you are having a migraine. It might help to have someone know that you are feeling bad (understatement) and that if they don't hear from you that they might check in. It's probably very unlikely, but if you pass out from the pain or are incapacitated in some way, it would be useful for someone else to be aware of what's up. That person might also need a house key from you and maybe instructions on doctors/health issues/etc.
posted by mrfuga0 at 1:06 PM on April 25, 2013

Oh, and when I get a really bad pukey migraine, I can't stand feeling like anything is touching me, so I take off all my clothes and get between cool untucked sheets. So maybe get naked. Getting naked works for so many things. Why not migraines?

And wow, I'm not the only Benadryl person!
posted by houseofdanie at 1:59 PM on April 25, 2013

Avoid annatto. I get super duper severe migraines (the stroke + other symptoms ones) and regular migraines. I notices annatto causes most of my regular migraines. I get small headaches if I even just touch the stuff.
Its what they use to make yellow cheese yellow. Its used in processed corn meal to make it yellow. Its also used in cheap margarine to make it yellow also . I bet if you looked specifically for it in ingredients you will get less migraines.

This is advice for all people who commented here. Try it I bet it works. Its in a lot of stuff because its considered natural. more and more processed foods are using it so they can claim all natural.

Most European products do not use it . they use beta carotene instead.

In some people it effects them right away some people it can take 1 day or more to cause the migraine. it depends on how slow or fast it gets digested.

Foods that usually have it. Jiffy corn muffin mix, Most yellow cheeses like cheddar, and American , All friendlies ice cream, Most box macaroni and cheese, Non smoked gouda cheese, Some types of vanilla ice cream , Some boxed pizza uses it, About half the pastries at Panera bread use it .

That's a short list off the top of my head of things that have annatto. ITs in more things than you realize
posted by majortom1981 at 4:13 PM on April 25, 2013

I have a long history (45 yrs) of brutal migraines and problems with meds. Way back in 1976 I went to the ER with a migraine and was treated with oxygen. Yes, plain old oxygen, the doc said it was once a popular remedy but the pharmaceutical companies didn't make money from it so pills had become popular. He also stated that it was used diagnostically, if oxygen did not cure the headache it was not a migraine. I've never met another doc who'd even heard of it, but never met one who refused me treatment with it. Doesn't interfer with other meds and does not leave with a hangover.
posted by misspat at 4:52 PM on April 25, 2013

I just remembered--I listened to a course on nutrition by Dr Roberta Anding, who works as Texas Children's Hospital, and in the section on riboflavin, she said that riboflavin deficiency can cause migraines, enough so that when a kid comes into the hospital with chronic migraine, they automatically supplement with riboflavin. (Provided I remembered that correctly.)
posted by telophase at 8:54 AM on April 26, 2013

Take Excedrine at the first sign of a migraine, it doesn't always prevent it entirely, but it really helps with the pain. I used to make the mistake of waiting until I was in a significant amount of pain before taking it.

Regular Coke (not diet!) seems to help, as well as dark room. My grandpa swears by ginger chews for migraine-induced nausea. I actually like that stupid Head-On stuff, just because it makes my forehead feel cool, and I can't stand anything touching my head or face when I have a migraine. Other people find that wrapping a bandanna around their head helps.

This is probably an obvious question, but since you say you get migraines once a month, do you get them at the same time every month? It took me a really long time to realize I was getting a migraine at the same time every month before my period, and changing my birth control pill took care of that (at least it got rid of that one, I still get migraines).
posted by inertia at 1:34 PM on April 26, 2013 [1 favorite]

Have you tried biofeedback? I've read that it can help with migraines. I get migraines and was going to sign up for biofeedback training, but then found Imitrex instead. Biofeedback might be worth trying since you're restricted in the medications you can use.

If your doctors allows it, I have found that Doxepin is great for preventing my migraines. I was shocked that it actually worked. I thought there was no way it could possibly work, but it really worked. I also take hormonal birth control pills without stopping. Stopping the hormonal birth control each month always ended in horrific migraines. Now, I just take it every day and I get fewer migraines.
posted by parakeetdog at 2:06 PM on April 26, 2013

I have a prescription for 300 mg Neurontin (gabapentin) three times a day as a prophylactic, and it works wonderfully well. Three or four times a month, I get a breakthrough migraine. I've discovered recently that two Excedrin and a zinc lozenge abort the migraine if I take them at the first sign of trouble. Couldn't be happier about that.

FWIW: Excedrin Extra Strength and Excedrin Migraine have precisely the same active ingredients; it's the same stuff. Don't let labels throw you off. I use the inexpensive Walmart version.
posted by bryon at 11:04 PM on April 26, 2013

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