I Already Have a Headache, Why Do You Ask So Many Questions?

By: Jacqueline M. Hagelberg, RN, MS

When you see your headache specialist he or she may ask many questions that at first seem unrelated to your headaches.

Some of the questions and the reasons for them include:

How much sleep do you get at night?

As well as, what time do you go to bed, do you fall asleep right away, do you wake up during the night? These are all important questions because if you don’t get enough sleep, you are more likely to have migraines.

If your schedule varies from day-to-day so that sometimes you go to bed at 10 p.m. and other times stay up until 2 a.m., this can cause problems with your total amount of restorative sleep and can trigger migraines.

Do you eat meals on a regular schedule?

It’s important to eat throughout the day—either breakfast, lunch and dinner or a larger number of smaller meals spaced during the day. If you have too much time between meals this can be a trigger for migraines.

How much liquid do you drink each day?

It is important to keep your body hydrated. If you become dehydrated this can trigger a migraine. We can become dehydrated before we feel thirsty, so you must plan on drinking at least 6- 8 eight ounce glasses of water per day.

How much caffeine do you drink?

Although you may have been drinking 6 cups of coffee or diet coke or mountain dew daily for many years, this can be a problem as any change in the amount you drink can trigger your migraines. The general recommendation is no more than two 8-oz. caffeine containing beverages per day.

Even better, consider gradual withdrawal and becoming caffeine-free! This is a good goal for many people. If you don’t use caffeine at all, or use it infrequently it may actually have a medicinal effect of helping in the “acute treatment” of a migraine headache.

Do you exercise regularly?

Regular exercise increases the body’s production of endorphins, which are natural pain relievers. Having a higher level of endorphins in your body can increase your sense of well being, helps you sleep better at night, and helps with weight control.

And of course, the question that you always expect…

How frequent and how severe are your migraines?

It is important to keep track of your migraines on a calendar, either the paper kind or one of the phone apps that helps you keep a record. When you rely on your memory to recall the frequency of headaches over the last several months, you may only be able to really remember the last few weeks. A headache calendar is a valuable tool for your doctor, nurse practitioner or physician’s assistant to use to assess how frequent your migraines are and what type of treatment would work best for you.

Once a treatment plan has been set up, it is also important for your provider to know how the plan is working for you.

If you are taking a daily preventive medication, is it well tolerated?  Are you having side effects? Have you seen a change in your headache pattern since you’ve been on this medication?

Consider your acute medications; the ones you take when you have a migraine – do they work well? Is the headache resolved within a few hours? Can you resume your usual activities? Does the medication keep the headache from returning later in the day?

There are many questions to ask in order to treat your headaches appropriately. Be prepared to answer these questions on your next office visit with your headache specialist. And of course, don’t forget to bring your headache calendar to your appointment!

Jacqueline M. Hagelberg, RN, MS, Family Nurse Practioner, Greater Rochester Neurological Associates, Rochester NY.

This article is a legacy contribution from the American Headache Society Committee for Headache Education (ACHE) and the Fred Sheftell, MD Education Center.

Last Updated: 7/24/2012