Brain and Spine Care
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Migraines have a way of ruining your day—or even your week. Instead of going for a run or playing with your kids, you’re stuck in a quiet room with the shades drawn. And you don’t know when you’ll be back on your feet.
Megan Mackenzie, DO, a neurologist, wants women to know that it doesn’t have to be that way. “Some people think they should just live with migraines, and they don’t even ask their doctor for help,” she says. “But in the neurology world, we can actually manage migraines or at least make them significantly better.”
A migraine typically includes head pain behind one eye, plus a sensitivity to light or sound, nausea, or vomiting. Some people experience an “aura” five to 60 minutes before other symptoms begin. Auras can include visual disturbances such as flashes of light, blind spots, or tingling in the hands or face. Doctors don’t know why, but women are three times more likely than men to get migraines.
Treatment options for painful migraines
Dr. Mackenzie says that migraine treatment falls into two categories: abortive and preventive. “Abortive medications are what we take when we want the migraine gone now,” she says. “They can include everything from over-the-counter oral medications to injections to what we call a migraine cocktail, which is delivered intravenously. Migraine cocktails contain a mixture of several drugs that target pain and other symptoms such as nausea or vomiting.”
Migraine cocktails are available at hospitals, outpatient centers, and even from home health care providers. They are especially useful when a migraine is intense, or when a person is stuck in a cycle of migraine pain lasting several days.
Preventive care for people with four or more “migraine days” per month
Preventive pain management is for people who experience migraine symptoms more than four days a month. Treatment can include:
- A medicine (delivered by injection) that blocks a protein called calcitonin gene-related peptide (CGRP), which is associated with migraine attacks
- An injection of Botox to help block pain signals from your brain
- Daily oral medication
Understanding when your migraines occur and what their triggers are is important. For example, some women only get migraines when they are ovulating or have their period. Knowing this could help the doctor develop a treatment plan that addresses this specific occurrence. Apps available from Android and iOS phones can help you track this information and keep it handy.
Targeted treatment for specific symptoms
During your first appointment, the doctor will talk to you about your health history and experience with migraines. “The more I understand about a patient’s migraines, the better I can target the specific symptoms,” Dr. Mackenzie says. “If migraines are affecting your sleep, I might prescribe a medication that would target both migraine as well as sleep. If your migraines cause neck pain, a muscle relaxer could help. I also can help you figure out what triggers your migraines, and whether some of the things you’ve tried at home could be making your migraines worse.”