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The first thing many people do is to lay down in a dark room. Keeping still, in the dark, in a comfortable room - will help to avoid any increases in pain. If you can try and sleep off the migraine, it may be in your best interest. If you are unable to sleep, relax in the dark and remain hydrated. If you are vomiting, slowly ingest water or Gatorade, a tablespoon every 2-5 minutes. Besides this, here's what else you can do... Natural prevention. From food triggers, to anything else under the sun (including the sun), there are many, many things you can try to manage in your daily life to avoid migraine headaches. Getting consistent hours of sleep, drinking enough water, eating consistent meals are all simple things you can do. Medical prevention: Once you cross the threshold of having two or more migraines a month, you qualify for preventive medications. Medications such as SSRIs, tricyclic anti-depressants, anti-epileptic medications, beta-blockers, and calcium channel blockers all can play a part in reducing the frequency and severity of migraines. If you haven't reach that magic number yet, you can try prevention with the following things: * ** Oral magnesium ** B-complex supplement, in particular B2 ** Petadolex It happens to everyone, even those who manage their migraine triggers superbly, and have found their magic preventative method: sometimes we still get them. What do we do then?

It is extremely important to recognize the prodrome or aura phase of the migraine. If you don't, begin your abortive therapy as SOON as you begin to experience pain. This includes pain medication, as pain medication works much better if it can get its foot in the door before the attack is in full swing.

Abortive Therapies (Medical): * ** Over the counter medications like Excedrin, two doses of Aleve (Naproxen) ** Other strong prescription NSAIDs, like Toradol, Ketoprofen, Diclofenac, Indomethacin ** The triptans are the major abortive medication prescribed. (You have not tried all the triptans, until you have tried ALL seven. Each one works slightly differently with serotonin receptors) ** DHE nasal spray (Migranal) ** Steroid tapers ** Midrin ** Certain anti-nausea medications, namely Reglan and Compazine, can abort migraines because they affect the re-uptake of dopamine. Dopamine excess is thought to be a component of migraine in some people. ** Caffeine - for some caffeine is a trigger, for others it is a blessing. ** Lidocaine nasal spray or drops ** Benadryl, Periactin or other histamine reducing allergy medicines.

Nausea/Vomiting: Nausea and vomiting is often one of the more miserable migraine symptoms aside from the pain. You can try at home methods, like ginger, REAL Coke (not diet), and simple carbohydrates - like crackers. You can take an OTC nausea medicine, like Dramamine/Gravol. Or you can be prescribed a medication, such as Reglan, Phenergan, or Compazine. If you are vomiting too much to take an oral form, you can ask for all three in suppository form.

Pain Management: * Once again, OTC medications like Excedrin and Aleve, sometimes even just plain aspirin, can dull the pain of migraines. Stronger NSAIDs can help as well. * Narcotic medications

* Ice pack on the back of the neck or direct ice rubbed over the painful side of the head for no more than 10 minutes (limited to once every 2 hours)

* Biofeedback * TENS Unit or Interferential Stimulator

Other methods of management:

* Botox injections (an injection to paralyze the nerve from sending pain signals) * Greater Occipital Nerve Block (an injection of local anesthetic and a steroid to temporarily freeze the nerve and reduce inflammation) * NTI Oral Appliance (a dental mouthpiece worn overnight to prevent jaw clenching and teeth grinding) * Surgery for Patent Foramen Ovale * Myofascial Therapy * Craniosacral Therapy * Acupuncture * Chiropractic Care

* Massage

* Microvascular Decompression Surgery * Medtronic Occipital Nerve Stimulation (implanting electrodes)

If you end up in the ER, there are many things they can do for you besides just narcotic relief. * ** IV Saline (because dehydration is a trigger) ** IV Benadryl ** IV Decadron ** IV Lidocaine ** IV Magnesium ** IV Depakote ** IV Compazine ** IV Keppra ** IV Propofol ** IV Ketamine ** IV Robaxin

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