Use a Symptom Diary to Get to the Root of Your Headaches, Without The Headache
As any migraine sufferer knows, the best medicine for migraines (or any headache, really) really is the proverbial prevention. But how can you prevent something so debillitating, that strikes randomly and without warning? How do you prevent blinding pain that dulls your senses and robs you of your ability to focus or think?
Many migraines are precipitated by a trigger of some sort. Any doctor will tell you that if you can find your trigger you've won half the battle. There are some medical practices that even charge quite a bit to lecture for 45 minutes about the importance of finding your personal migraine trigger.
Most attendees walk out of that lecture agreeing wholeheartedly in the theory. Some make a halfhearted attempt at actually tracking down a trigger. But many simply file it away and mention it when friends or colleagues ask about that last migraine that put them out of commission. "Yeah, I've really got to track down what triggers those..."
Put it off no more. You don't have to be a rocket scientist, a nutritionist or even a medical practitioner to track down the triggers for your migraines. You just need a plain, lined notebook that's small enough to carry with you in a purse or pocket and a normal everyday pen or pencil.
That's right...those are the only tools you need. Notebook. Pencil. Now. Sit down and pay attention.
What Do I Do First?
Use a ruler or simply fold the first page into 3 columns, and head them "Time of Day", "Possibly Triggers" and "Symptoms".
If you aren't currently symptomatic, stick that diary in your pocket and go about your day. When you get your next headache, record it. Write down what time you noticed symptoms, describe them briefly (pounding, one sided, dull, etc) and then try to fill in any recent triggers you can think of. Remember to include the last thing you ate, and the approximate time it was consumed. Don't let denial get in the way, don't try to analyze your diary just yet. Simply record your symptoms and your triggers. The rest can wait.
Migraine and Symptom Diary
Time of Day
This is where you'll write what time an incident occurred.
Record foods you ate
Record your headache, describing in a few words any relevant details.
Approximations for triggers are fine.
The full list of ingredients is most helpful
Include whether nausea was present.
Leave plenty of space between symptoms to record more triggers as they occur to you.
Any loud noises or bright lights that seem trigger-worthy
Use a scale of 1-5 to rate the headache and nausea. 1 is "Ouch" 5 is "OMG, Call an ambulance my head is exploding"
Common Food Triggers
Anything can trigger a migraine; but here are a few of the more common food triggers:
- Aged cheese
- Citrus products
- Chocolate (especially dark)
- Caffeine (or not enough caffeine)
- Sulfites (which could explain the wine issue)
- Sugar substitutes like aspartame
What Should I Record?
Record anything that seems noteworthy to you. If your headache began soon after inhaling a bunch of exhaust from a bus, write it down. If it began after that morning meeting with the boss, write it down. If you'd just been sitting watching TV for half an hour when it hit out of the blue, write that down, too.
And always record your last snack or meal. No one wants to admit that food can be connected to headaches (or any general aches or pains that can't be cured with an antacid), but often food intolerances can cause difficult to manage symptoms. Identifying food as the cause of discomfort doesn't mean you have to avoid it completely, necessarily, it just helps you to take control of your own symptoms.
Some people don't know what to record when it comes to the headaches. Most people who experience headaches, experience multiple types of headaches. In your symptom diary, you can differentiate by recording severity of the headache, how long it lasted and any unique symptoms. You should also include a headache aura if you experience them; even if you manage to head off the headache by taking a pain killer at the first sign. (Record that information as well!)
The purpose of a symptom diary is to help you, personally, get control of your symptoms. Identify whether there are any habits that frequently are followed by a migraine and then try to figure out whether or not those habits are always followed by a migraine. Once you know what causes a migraine, you get to decide how much of a risk you want to take in the future.
Track the Trigger
After about a month, look back over your diary. Look at the headaches, and then see if there are any common triggers recorded. You might notice that you get a headache at 11am every single Tuesday. You can't avoid 11am. But you might be able to figure out what's special about Tuesdays, and then find a way to minimize your migraine risk. (If it's donut day, eat an egg sandwich first to avoid plummeting blood sugar. Or skip the donut altogether. If it's meet with your boss day, quit. No...wait. I'm kidding. If stress is a trigger, you might benefit from taking some yoga or deep breathing and mindful meditation courses.)
You might notice that headaches always follow certain meals, or snack foods. If so, you'll want to keep a more detailed food diary to find out if food is always a trigger or just sometimes a trigger. If it's always a trigger, you'll need to rethink your snacking habits. If it's only sometimes a trigger, save those foods for special occasions. Or better yet, the end of special occasions...when you won't be missing anything special by going to bed for 12 hours.
Scents and air fresheners can trigger migraines as well. My daughter was getting headaches in the same classroom every day. Eventually we realized there was a plug in air freshener by her desk. She removed it for the duration of her class period and functioned much better for the rest of the year.
Some people respond poorly to fluorescent lights, or certain repeated sounds on the radio. They may not be able to avoid all exposures to these things, but can generally accommodate their day to day surroundings by changing out the lightbulbs in the office, or wearing lightly tinted sunglasses. Electronics are another possible trigger. Frequent rest for the eyes, and avoiding 3d animation and certain screens can help.
If you notice your headaches follow any sort of long term reading, whether it's on screen or in books, it's a good idea to get your eyes checked. It's a good idea to get them checked regularly anyways, but a headache makes a great excuse to actually make the appointment. A proper prescription for eyeglasses may be all it takes to get your headaches under control.
What if You Can't Control the Trigger?
Tracking down the trigger may be half the battle, but it's only half. Knowing what triggers your individual headaches may help give you some control over the attacks, but it doesn't always help you conquer them. For instance, one of my daughter's worst migraine triggers is a change in the weather.
Obviously, we can't change the weather. But we can identify when the barometer is most likely to be changing and make arrangements to lay low on those days or to avoid making plans that can't be changed. We can also try to keep her indoors, in temperate conditions, to minimize the effects. And, when the weather is changing, we can be more vigilant about any other potential triggers. A careful sleep schedule and staying hydrated can be just enough to keep the next winter storm from putting her to bed with a bucket and cold cloth for the duration.
There are some triggers we can control. Food is one of them. We can also control sleep schedules, and stay hydrated. Medication can help with migraines, but it isn't the only step to take. As a migraine sufferer, you need to know what makes you more vulnerable to an attack. By taking charge of your life to avoid triggers, rather than just popping pills, you can feel in control of your migraines. It's much better than being a victim to them.