Managing Migraine Misery: Merle Diamond, MD

By Merle Diamond
WebMD Live Events Transcript

Migraine sufferers -- the doctor is in! In recognition of National Headache Awareness Week, join us for migraine prevention and treatment tips from Merle Diamond, MD, associate director of the Diamond Headache Clinic.

The opinions expressed in this transcript are those of the health professional and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician.

Moderator: Hello, Dr. Diamond and welcome to WebMD Live. We have so many questions from our members, let's get right to them.

Member: I have been having headaches for a few months now. How can I learn if they are migraines?

Diamond: The question is how can you diagnose migraines or self diagnose. Migraine is typically a sick headache. It's associated with:

  • Nausea
  • Occasional vomiting
  • Light and noise sensitivity
  • The pain is usually throbbing
  • Sometimes it's one-sided
  • It typically lasts four to 24 hours
  • The patient is usually pain-free between episodes

Member: Is it possible for another type of headache, such as a sinus headache, to "turn into" a migraine?

Diamond: That's a great question. Many people believe that their sinus headaches are migraines. And many people with migraines believe they have sinus headaches because they get the pain when the barometric pressure changes and these symptoms are often seen with a runny nose or pressure in the face. This can be confusing for patients as well as doctors. So what many people call sinus headache may actually be migraine. The nerve that's involved in migraine also has branches that go to the sinuses. So it is likely that migraine in the face is often called sinus headache.

Member: Even though I stay away from chocolate, cheese, and alcohol I still have such pain. Just days ago I had to go the emergency room because it hurt so bad! How do I recognize the oncoming symptoms before the migraine begins? Once I took Imitrex too soon -- I didn't know it would turn out to be just a regular headache, and I was nauseous all day.

Diamond: Some patients, almost 60% who have migraine, have something called prodrome. These premonitions of migraine can be yawning, carbohydrate craving, light sensitivity, neck pain, irritability, and lethargy (tiredness). Recognizing this occurs with your migraine may help you to get your treatment as early as possible.

Member: This may seem like an odd question, but can rain or change in weather cause migraines? It seems that whenever my allergies act up I get crippling headaches. Some mornings I will wake up with my eyes swollen shut. I am currently taking Zyrtec to act as a preemptive measure but it does not always work. At times the headaches are so bad I am unable to get out of bed, let alone go to work. Any suggestions?

Diamond: It sounds like migraine, and barometric pressure changes are common triggers for migraine patients. Forty percent of migraine patients get their headaches between 4 a.m. and 9 a.m. And once the migraine is in place, it is very hard to treat. For these kinds of headache, having a medication to treat your migraine in an injectable (shot) form or suppository can be helpful. When migraine is severe when you catch it, the patient's stomach sometimes does not absorb medicine well, and that's why having another avenue to get medication in like with the suppository or shot can be useful in those situations.

Member: I never go a day without headaches or migraines. I have been to doctors and neurologists and all they do is give me pain medicine like Darvocet, which I do not want to take. I do yoga to help with stress and circulation but this does not always help me headaches. Any suggestions? I just want my life to be pain free.

Diamond: Chronic migraine or chronic daily headaches is a very common problem seen in a neurologist's or headache specialist's office. There are many treatments available, some of which include drugs and some of which are behavioral. Some simple things to address include caffeine consumption, over-the-counter medications, decongestants, and prescription pain medicine. These can all lead to rebounds. Having a healthcare provider who is interested in managing your treatment over a long period of time is important. The National Headache Foundation may be able to give you appropriate resources in your area.

Member: I recently had a migraine that lasted over 10 days (no medication helped. I took Excedrin on top of Amerge and Tylenol with codeine) and ended up going to the ER for relief and a CT scan (normal results). I don't get migraines often, but when I do, they have lasted up to two weeks. Why?