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Don't let yourself get dehydrated, even a little...
This is important all year, but especially in the summer. You may hear or see news reports warning about dehydration and heat stroke. Heed them. Dehydration is a major headache and Migraine trigger for many people. WHAT you drink can make a difference, too. Large quantities of soda or regular iced tea, although summer favorites, have a great deal of caffeine. Lemonade is super unless citrus is a Migraine trigger for your or your stomach is sensitive to all the acid. Water is always a good choice!
Beware of the sun...
Summer sun can be one of our worst enemies, and I'm not talking about sunburn, even though that can be a problem. Too much time in the summer sun is another serious headache and Migraine trigger. That doesn't mean we have to stay indoors. Try hats with broad brims that keep sun off your neck and upper chest and back as well as your face. Beach umbrellas can be great at ball games and the like. You can also cool yourself down with a spray bottle of water or a cold, wet bandanna around your neck.
Beware of fragrance in summer products...
Are you sensitive to fragrances and/or other odors? Remember that when shopping for sunscreen, insect repellent, and other summer products. Look for fragrance-free products. If you're not sure about chemical names listed in the ingredients, your pharmacist may be able to help you.
Don't get caught without your sunglasses...
Summer can be tough on the eyes. Invest in some good sunglasses. Polarized lenses are great because, in addition to darkening, they cut glare. If you can go for optical grade lenses, do. They aren't as likely to produce distortion as inexpensive sunglasses. Still troubled by light from around your glasses? Try a baseball cap or another type of hat to block out the sun that comes in from above the sunglasses. See Good Sunglasses - Vital for Migraine and Eye Health.
Try not to stray too far from your routine...
It's easy to get off schedule in the summer. It gets dark later, things seem a bit lazier. Don't let that lull you into getting off your schedule for meals and sleep. Even on vacation, be careful not to skip meals, and try to resist the temptation to indulge in trigger foods. Try to keep your sleep schedule regular, too. Remember that too much sleep can be a trigger, too, so watch out for sleeping in!
Take care of your meds...
Be aware that medications have storage temperature ranges that can easily be exceeded by summer temperatures. Prolonged exposure to higher temperatures can make your meds less effective. When traveling, keep your meds in your carry-on rather than letting it go with the luggage on a plane and in the car with you rather than in the trunk in your luggage. At home, keep your meds in a cool, dark place. Your bathroom is not the best place because of the heat and steam from the shower.
Check your exercise routine...
If you exercise outdoors or don't have air conditioning, you may need to modify your exercise routine for the summer. Summer offers options for exercise that aren't available in the winter. You may be able to swim, walk, hike, or play sports such as tennis or volleyball more in the summer. If you have questions, check with your doctor.
Plan Ahead...
Plan ahead so stress doesn't bring on tension headaches or exacerbate your Migraine triggers. When cooking, cook big batches and freeze meals. Make lists. Delegate chores to family members. Make travel reservations well in advance. Be sure your car is serviced before traveling. Mark prescription refill times on your calendar so you don't run out of meds. MAPP your Migraines and put your Migraine bag together so your headache and Migraine needs are already put together for easy traveling. Too often, we're so busy taking care of our families or thinking about our jobs that we put off taking time for ourselves. Please take a few seconds to consider this -- If we're not at our best, how can we give our best? Take time to relax. Look around your home to see how it could be more "headache and Migraine friendly." Do your best to take at least 30 minutes of me time each day to meditate, pray, journal, or just be quiet -- whatever you need. This will help you stay healthier, and staying healthier will help your body resist headache and Migraine triggers.
Wrapping it up...
There's no sure way to avoid every headache or Migraine, but we can take steps to minimize them and their impact. Summer is a time with many opportunities for family and fun, vacations and get-aways. When we take care of ourselves, we can keep more of the fun in summer. Enjoy!
© Teri Robert, 2008

by Teri Robert, MyMigraineConnection's Lead Expert Patient
We're often told that we need to exercise for better health; told that our Migraines and headaches would improve if we exercise. We all understand that, BUT how are we to exercise when we feel as if our heads might explode? Good question!

Below, you'll find some ways to sneak in a bit of exercise... some simple exercises that we'll be able to manage even on some of the days we're in pain. They may not seem like much, but the effects of them will build up...

1. Just Stretch.
Careful, gentle stretching feels good and is good for us. Stand with your feet shoulders width apart. Slowly bring one arm up over your head and bend at the waist the opposite direction. Repeat the other direction. Gently bend forward at the waist. If your balance is good, put one foot on a chair and bend your knee to stretch in. These may be done holding a chair if balance is a problem. You can also do stretches sitting. If your balance is good, stretching in a hot shower is great!

2. Dance With Your Swiffer!
UGH! We all hate to dust the furniture and wipe down the walls, corners, and ceilings for cobwebs. Put on your favorite music, and dance away that dust! Don't be tempted to skip the top shelves or far corners. Again, stretching is good. If you're concerned about the neighbors wondering what you're doing, pull the draperies. Of course, it's more fun to leave them wondering!

3. Fold That Laundry!
We all have baskets of laundry to be folded. Put the laundry basked on the floor. Then bend to take the laundry out -- one piece at a time -- to fold it. You're doing something that needs done and getting in some bending at the same time.

4. Work the Stairs.
When you need to go up- or downstairs at home, turn around and make the trip a second time. Walking stairs is great exercise. If you live or work several floors up, and aren't able to walk up the stairs, but can walk down them, do. Even going down the stairs gives you a bit of exercise, and is better for you than the elevator.

5. Pick Up Some Veggies.
Canned soup or vegetables make wonderful light hand weights. You can use them to work on upper body strength and/or range of motion. These exercises can be done one arm at a time, standing or sitting. Start with your arms straight at your side and bring them straight out to the side, pause level with the shoulder, then on up, straight toward the ceiling. Bring slowly back to your side. Do the same moving your arm forward. As you get used to these movements, increase the number of repetitions.
6. Park Farther Away
When we run errands or go shopping, most of us try to
park as close to the door as possible. Don't. Instead, choose a parking space at the end of the aisle away from the door so you walk farther. When grocery shopping, don't leave your cart next to your car. Take the extra steps to return it to the containment area in the lot. Every step counts.

7. Lift Your Feet.
Did you hate leg lifts in gym class? Do they hurt your back now. There's still an easy way to work your legs. Sit in a steady chair and lift one leg slowly until it's parallel with the floor. Hold for a few seconds, then slowly lower it. You can do this with your toe pointed away from you and with your toe pointed toward you to work different muscles. Then repeat with the other leg. Again, as you get used to the activity, increase repetitions.

8. Remake Your Bed.
After you've been up a bit, and you aren't stiff, instead of just pulling up the covers on your bed, strip it. Stripping off all the sheets and blankets and remaking the bed is a good mini workout with a bit of light lifting and some good stretching.

9. Play!
Take some time to play with your children, grandchildren, or pets. It's fun, will lift your spirits, and gives you a bit of exercise to boot!

10. Watch for opportunities!
Once you review these easy ways to "sneak in" some exercise, you'll find it easy to spot other ways. These tiny bits of exercise can definitely add up to a healthy boost. BE SURE TO CHECK with your doctor first if your health in any way restricts your physical activity.

Migraine
More than 29.5 million Americans suffer from migraine, with women being affected three times more often than men. This vascular headache is most commonly experienced between the ages of 15 and 55, and 70% to 80% of sufferers have a family history of migraine. Less than half of all migraine sufferers have received a diagnosis of migraine from their healthcare provider. Migraine is often misdiagnosed as sinus headache or tension-type headache.

Many factors can trigger migraine attacks, such as alteration of sleep-wake cycle; missing or delaying a meal; medications that cause a swelling of the blood vessels; daily or near daily use of medications designed for relieving headache attacks; bright lights, sunlight, fluorescent lights, TV and movie viewing; certain foods; and excessive noise. Stress and/or underlying depression are important trigger factors that can be diagnosed and treated adequately.

Migraine characteristics can include:

Pain typically on one side of the head
Pain has a pulsating or throbbing quality
Moderate to intense pain affecting daily activities
Nausea or vomiting
Sensitivity to light or sound
Attacks last four to 72 hours, sometimes longer
Visual disturbances or aura
Exertion such as climbing stairs makes headache worse
Approximately one-fifth of migraine sufferers experience aura, the warning associated with migraine, prior to the headache pain. Visual disturbances such as wavy lines, dots or flashing lights and blind spots begin from twenty minutes to one hour before the actual onset of migraine. Some people will have tingling in their arm or face or difficulty speaking. Aura was once thought to be caused by constriction of small arteries supplying specific areas of the brain. Now we know that aura is due to transient changes in the activity of specific nerve cells.

The pain of migraine occurs when excited brain cells trigger the trigeminal nerve to release chemicals that irritate and cause swelling of blood vessels on the surface of the brain. These swollen blood vessels send pain signals to the brainstem, an area of the brain that processes pain information. The pain of migraine is a referred pain that is typically felt around the eye or temple area. Pain can also occur in the face, sinus, jaw or neck area. Once the attack is full-blown, many people will be sensitive to anything touching their head. Activities such as combing their hair or shaving may be painful or unpleasant.

Diagnosis of migraine headache is made by establishing the history of the migraine-related symptoms and other headache characteristics as well as a family history of similar headaches. By definition, the physical examination of a patient with migraine headache in between the attacks of migraine does not reveal any organic causes for the headaches. Tests such as the CT scan and MRI are useful to confirm the lack of organic causes for the headaches.

There is currently no test to confirm the diagnosis of migraine

Treatment
Many factors may contribute to the occurrence of migraine attacks. They are known as trigger factors and may include diet, sleep, activity, psychological issues as well as many other factors. The use of a diary to record events that may play a role in causing the headaches can be useful for you and your healthcare provider. Avoidance of identifiable trigger factors reduces the number of headaches a patient may experience. Healthful lifestyles including regular exercise and avoidance of nicotine may also enhance migraine management. Non-pharmacological techniques for control of migraine are helpful to some patients. These include biofeedback, physical medicine, and counseling. These, as with most elements of migraine, need to be individualized to the patient. Acute

The Food and Drug Administration (FDA) has approved three over-the-counter products to treat migraine. Excedrin® Migraine (a combination of aspirin, acetaminophen and caffeine) is indicated for migraine and its associated symptoms. Advil® Migraine and Motrin® Migraine Pain, both ibuprofen medications, are approved to treat migraine headache and its pain.

The use of other prescription anti-inflammatory agents may be effective for some migraines. These agents may have gastrointestinal side effects, which limit their use since larger than normal doses may be required to treat the migraine attack.

Migraine-specific therapies are designed specifically to treat migraine attacks. Ergotamine preparations are no longer readily available. Dihydroergotamine (DHE) may be used for self-injection. DHE is also available as the nasal spray Migranal. A combination product containing isometheptene (Midrin®) is not usually effective for migraine. Sumatriptan (Imitrex®), a 5-HT agonist, is available in self-injectable, nasal spray and rapidly-dissolving tablet forms. Other 5-HT agonists are almotriptan (Axert®), naratriptan (Amergeý®, rizatriptan (Maxalt®), zolmitriptan (Zomig®), frovatriptan (Frova®) and eletriptan (Relpax®). All are available in tablet form. Both rizatriptan and zolmitriptan are available in an orally disintegrating tablet (Maxalt-MLT and Zomig-ZMT), which can be taken without water. Zomig also comes in a nasal spray.

Abortive medications are most effective when taken early in an attack, while the pain is still mild and before skin sensitivity increases. The goal is complete relief of pain and associated symptoms, allowing the sufferer to quickly return to normal functioning.

Some attacks may not be eliminated by abortive therapy, yet the patient requires pain-relieving measures. Due to the severity of the headaches, some patients may require a narcotic analgesic, but if the patient is experiencing frequent migraine attacks habituating analgesics should be avoided. Butorphanol (Stadol®) is available for intranasal administration and is not typically associated with dependency problems, but may result in dependency if used regularly for pain relief. Alternative medical treatments with medications belonging to the group known as the Phenothiazines have proven useful as non-analgesic options for treating severe migraine headaches. Patients with prolonged migraine attacks lasting more than 24 hours are experiencing status migraine and corticosteroids may be used in these cases due to their anti-inflammatory effects.

Preventive
If patients have frequent migraine attacks, if the attacks do not respond consistently to migraine specific acute treatments, or if the migraine specific medications are ineffective or contraindicated because of other medical problems, then preventive medications should be given to reduce the migraine frequency and improve the response to the acute migraine medicines. Cost considerations also may lead to increased use of preventive medications. The FDA has approved four drugs for migraine prevention. These include propranolol (Inderal®), timolol (Blocadren®), topiramate (Topamax®) and divalproex sodium (Depakote®). These have had many years of use and make up the majority of the items considered 'first line' therapy for migraine prevention. Amitriptyline, which is an antidepressant, may also be very effective as a migraine preventive. All migraine preventive medications require that adequate doses of the medicine be given for a sufficient length of time to determine the effectiveness. Titration of the doses may be needed to reduce adverse effects to medicines.

There are a host of alternative choices for patients whose headaches do not respond to the first line medications. These include calcium channel blockers, NSAIDs, a variety of antidepressants and several miscellaneous medications.

Biofeedback
As an alternative to drug therapy, this training uses special equipment that monitors physical tension to teach the patient how to control the physical processes that are related to stress. Once familiar with this technique, people can use it, without the monitoring equipment, to stop an attack or reduce its effects. Self-hypnosis exercises are also taught to control both muscle contraction and the swelling of blood vessels. This patient-directed therapy, with the clinician serving as a guide or teacher, should be practiced daily. Children have an excellent response to biofeedback training, since they are open to new methods, learn quickly and have not become firmly entrenched in a chronic pain pattern.