Lifestyle treatment for Migraine

Lifestyle Issues.  I highly recommend that all of these ideas be followed by all migraine/cluster patients.

1.     Decaffeinate yourself either slowly by decreasing by one cup of coffee or two colas every three days or do it quickly-cold turkey.  The reason is that caffeine is a vasoconstrictor and can give medication overuse headache.  Caffeine is the number one drug in America causing an increase in the intensity and frequency of migraine.  Caffeine is addictive.  Caffeine is confusing to some patients because they know that it may be used to treat headache, but they need to learn that if taken frequently, more than 2 days a week, it can cause medication overuse headache, previously called--rebound headache.

2.     Eat Three Meals a day.  A small breakfast will suffice, for example a single sweet roll or a piece of toast with juice.  Remember breakfast means “break the fasting of sleep.”  If you don’t eat and without your knowing it, your pituitary gland will sense your low blood sugar and send out a hormonal signal that will cause vasodilatation of your cerebral arteries and start your “hungry headache” migraine.  Three meals a day is advised for all medically accepted weight loss programs (Jenny Craig/Weightwatchers).  Most mothers will feed their children three meals a day but not themselves.

3.     The American Heart Association recommends that all persons exercise Aerobically for 20-30 minutes, 3-4 times a week.  Aerobic exercise means that you do an activity that gets your heart rate at a certain desired target range and keeps it there for the entire workout.  Consult tables for your age heart range at bookstores, the YMCA, or your local fitness center.  The more aerobic the exercise, within heart rate limits for age, the better.  You can treat migraine, anxiety/panic disorder, depression, tension headache, and sleep problems with aerobic exercise.  There are hundreds of scientific articles over the past 20 years proving that exercise works for headache therapy.  Aerobic exercise is:  dance aerobics, jogging, cycling, swimming, rowing, cross-country skiing, and stair-stepping.  It is not walking, lifting weights, stretching, or playing most games, like tennis or racquetball.  If you are already exercising and still have bad headaches, consider increasing your exercise program.  Exercise is something you can do for yourself to take control of your headaches.  It takes determination, time, and effort.  Some migraine patients get a “work out headache” if they get hot.  If this happens to you then try to work out so you don’t get so hot.  Exercise in front of a fan or in air conditioning.  Take ibuprofen, Excedrin, or a half of a Triptan drug before you work out.  If you still get a work out headache, then try swimming.

4.     Set your sleep/wake cycle to rise and go to sleep at the same time every day-even through the weekend.  Adults should sleep between 7 to 8 hours every night.  Migraine may be treated by sleep RESTRICTION.  Avoid oversleeping Saturday morning or falling asleep for that seductive two-hour nap on Sunday afternoon.  Set an alarm for 15-20 minutes for a short, energy restoring nap. If you never learned how to take a short nap, then learn.  It can be done. 

5.     Try to destress your life.  Talk over your daily life problems with your friends, family, preacher, priest, or rabbi.  Develop a support system to sustain you in life, built up of key people that are there for you when you need them.  Plan time to relax and spend on hobbies or interests.  Normal people have hobbies which is something you do for fun and relaxation, that is creative and not goal or money-making oriented.  Children and family are not hobbies.  Please look up the word “hobby” in the dictionary if you think this.  Turn off that cell phone, computer, or IPad and get a life.   Plan three day weekends four or five times a year rather than one two-week holiday in August.  Leave that depressing, stressful job, or get counseling and try to change a personal relationship that is causing problems.

6.     Don’t take too much caffeine, over the counter drugs, triptans, or painkillers for headache.  In general, all migraine patients should limit all such drugs to no more than 2 days per week.  The migraine process generates neurochemicals which are released in the brain and that inflame the thalamus, trigeminal nerve, and cerebral arteries.  These neurochemicals stay in the body 3 days and once they inflame the brain they are repeatedly released every time other pain killers, caffeine, Advil, Tylenol are consumed, starting a process of continuous headache.  I once saw a man taking 10 Excedrin migraine pills for over fifty years (10 X 65= 650 mg) and he had a headache all that time until I convinced him to stop Excedrin.  There is no data that opioid narcotics help migraine headache, they just cause problems and shouldn’t be used for “rescue treatment.”  The U.S. is now going through a change in the use of opioid narcotics and barbiturate drugs since they cause people to die in their sleep, are addictive, and cause medication overuse headache.  Narcotics should be used only for persons who are in pain and near the end of life, for acute trauma, or surgery, only for a month and then stopped.  Death from opioid narcotics is a top problem now in America.  Butalbital has been banned in every country in the world except Canada and the U.S. because it causes medication overuse headache.  The word “narcotic” comes from the Greek word that means “sleep.”  In Texas the number one reason for the State Medical Board to restrict physicians concerns their use of opioid medications and more licenses are restricted or revoked regarding this issue than any other.