MIGRAINE

During my early years in medical school, I suffered a lot from migraines. Every day, towards the end of the day, I suddenly would have really bad headaches on one side of my head, that just wouldn’t go away no matter how much rest I tried to get later. My academics were affected negatively because I would sometimes lose focus completely during the afternoon/evening classes because of the headaches. Studying at night became an uphill task too. Apart from the way it affected my academics, it also affected my relationships because I would often get irritable and just want to sleep with the lights off while my roommates obviously wanted to use the light in the evening, I imagine they thought I was always acting up, when in fact I was always in a lot of pain, but I never wanted to burden them with my personal challenges. It was frustrating, and impacted me negatively. 

I had thought it was just stress because medical school is indeed stressful, but after almost 2 years of taking pain relievers, I sought medical help and was diagnosed with migraine. As I read more about migraines, I learnt it was really more common than I had thought and that it poses a real problem to not just myself, but a whole lot of people. In fact, I was stunned to find that migraine is the 3rd most common illness in the world.

WHAT IS MIGRAINE?

Migraine is a medical condition that involves severe, recurring headaches and other symptoms. Before the headache, there may be sensory changes that are known as an aura. A migraine episode is different from a headache unrelated to migraine. An episode usually occurs in stages and can last for several days. It can affect a person’s daily life, including their ability to work or study.

TYPES OF MIGRAINE

There are 2 main types of migraine headaches, depending on whether or not an aura occurs before the person gets the headache. Auras are things a person experiences before the onset of migraine headaches. 

The 2 main types of migraines are:

1. Classical migraine (migraine with an aura):
2. Common migraines (migraine without an aura).

WHAT CAUSES MIGRAINES?

The exact cause of migraines is unknown, but they’re thought to be the result of short lived, abnormal brain activity. It’s not clear what causes this change in brain activity, but it’s possible that your genes make you more likely to experience migraines as a result of a specific trigger  a factor that kickstarts an episode of migraine headache)

Many possible triggers have been identified and they include

1. Emotional triggers:

1. Stress
2. Anxiety
3. Tension
4. Shock
5. Depression
6. Excitement
   
   2. Physical triggers:

1. Tiredness
2. Poor-quality sleep
3. Shift work
4. Poor posture
5. Neck or shoulder tension
6. Jet lag
7. Low blood sugar (hypoglycaemia)
8. Strenuous exercise, if you’re not used to it.
   
   3. Dietary triggers:

1. Missed, delayed, or irregular meals
2. Dehydration
3. Alcohol
4. Caffeine products, such as tea and coffee
5. Specific foods, such as chocolate and citrus fruit
6. Foods containing the substance tyramine, e.g, yeast extracts, smoked fish (like smoked salmon), and certain cheeses. Also, foods that have been stored at room temperature, rather than being refrigerated or frozen, can have high levels of tyramine.
   
   4. Environmental triggers, like:

1. bright lights
2. Flickering screens, such as a television or computer screen
3. Smoking (or smoky rooms)
4. Loud noises
5. Changes in climate, such as changes in humidity or very cold temperatures
6. Strong smells
7. A stuffy atmosphere
   
   5. Medicines :

1. Some types of sleeping tablets
2. The combined contraceptive pill
3. Hormone replacement therapy (HRT), which is sometimes used to relieve symptoms associated with menopause.
   
    6. Hormonal triggers:

Some women experience migraines around the time of their period, possibly because of changes in the levels of hormones such as estrogen around this time. These types of migraines usually occur between 2 days before the start of the period to 3 days after. Some women only experience migraines around this time, which is known as pure menstrual migraine. But most women experience them at other times, too, and this is called menstrual-related migraine. Many women find these kinds of migraines improve after menopause, although the menopause can trigger migraines or make them worse in some women.

HOW COMMON ARE MIGRAINES?

According to the Migraine Research Foundation, migraine is a very prevalent neurological disease, affecting 39 million men, women and children in the U.S. and 1 billion worldwide.

Everyone either knows someone who suffers from migraine or struggles with migraine themselves.

Migraine is the 3rd most prevalent illness in the world and the 6th most disabling illness in the world. 12% of the population, including children, suffer from migraine. More than 90% of sufferers are unable to work or function normally during their migraine.

SIGNS AND SYMPTOMS:

The main symptom of a migraine is usually an intense headache on 1 side of the head. The pain is usually a moderate or severe throbbing sensation that gets worse when one moves and prevents one from carrying out normal activities. In some cases, the pain can occur on both sides of one’s head and may affect the face or neck.

Additional symptoms:

Other symptoms commonly associated with migraine include:

1. Feeling or being sick.
2. Increased sensitivity to light and sound, which is why many people with a migraine want to rest in a quiet, darkroom.
3. Some people also occasionally experience other symptoms, like sweating, poor concentration, feeling very hot or very cold, tummy (abdominal) pain, diarrhoea, etc.

Not everyone with a migraine, experience these additional symptoms and some people may experience them without having a headache.

4. Symptoms of aura
   About 1 in 3 people with migraines have temporary warning symptoms known as aura before a migraine. These include:

1. Visual problems – such as seeing flashing lights, zig-zag patterns or blind spots
2. Numbness or a tingling sensation like pins and needles – which usually starts in 1 hand and moves up the arm before affecting the face, lips and tongue
3. Feeling dizzy or off-balance
4. Difficulty speaking.
   Aura symptoms develop over the course of about 5 minutes and last for up to an hour.

Some people may experience aura followed by only a mild headache or no headache at all.

TREATMENT

There is no cure for migraine. However, medications can treat the symptoms when they arise, and people can take steps to reduce the frequency and severity of episodes.
Taking medication as soon as the symptoms start, may keep them from becoming severe.

Some over-the-counter pain relief medications may benefit people with migraine, such as acetaminophen, ibuprofen, naproxen, etc. A doctor will tell you what medications to take for migraines, and in what quantity to take them. You can speak with a doctor for free on the flexicare hmo plan by initiating a message via the AI health messenger here or via your dashboard on the website.

PREVENTION

While it is not always possible to prevent migraine episodes, there are ways to reduce their frequency and severity.

Identify and avoid triggers, many of which are listed above.

If making these changes does not ease the severity and frequency of migraine episodes, a doctor may suggest medication or other options.