Q: What should I do if I have a headache that is not like my usual migraine headaches?
A: Any headache that starts very rapidly and is very severe needs immediate medical attention to make sure you have not had a brain hemorrhage (bleeding into the brain) from an aneurysm (abnormal ballooning of an artery wall) or stroke. A headache associated with fever and stiff neck also needs immediate attention as it can be caused by meningitis. When in doubt about a change in your usual headache patterns, it is important that you see a doctor.
Q: How does having a chronic illness such as high blood pressure, asthma, or diabetes affect my migraine treatment?
A: If you have any other chronic illnesses apart from migraine, make sure that all your doctors are aware of your migraine. Your migraine medications must be safe to use with your chronic illnesses. In addition, review the medications for your chronic illness with the doctor treating your migraine to make sure that none could trigger an attack. Your exercise and relaxation program will benefit all your chronic illnesses. Your migraine diet may be a challenge if it has to be combined with the dietary restrictions of another illness, but you can get help from a nutritionist in working out different dietary requirements.
Q: How do I prevent a migraine when I have a cold, flu, or other acute illness?
A: The most important thing you can do to avoid a migraine attack when you have an acute illness is to have plenty of fluids. When you are ill, dehydration and hypoglycemia are especially likely to trigger an attack. If your illness causes nausea, you must stop the vomiting so that you can continue your migraine medications, eat, and drink. Before you take medication for an acute illness, you must make sure it will not complicate your migraine care.
Q: What will I need to do for my migraine if I have a surgical or dental procedure?
A: When you undergo a surgical procedure in which a general anesthetic will be used, you will be asked to fast for 12 hours before the procedure. The combination of fasting before the procedure and the post-procedure pain, along with the use of painkillers, may cause a migraine attack. During dental or minor surgical procedures, if epinephrine is added to the local anesthetic, an attack is likely. Ask your dentist or doctor if it is possible to avoid epinephrine. It is important that you resume eating as soon as possible after the operation and drink plenty of fluids. Analgesics often trigger migraine attacks, so try to avoid them after 48 hours. Ask your treating physician if you can use NSAIDs for your post-procedure pain.
Q: I have suffered from depression and migraine for years. Are these conditions related?
A: Yes, there is a connection between depression and migraine, but they do not lead to one another. The connection is thought to be genetic. Both illnesses can be inherited, and both are caused by a disturbance in the levels of serotonin. There are several serotonin-related illnesses—you will probably recognize many of these conditions, either because you have them or because someone else in your family does. These illnesses include, but are not limited to, anxiety, depression, insomnia, attention deficit disorder, irritable bowel syndrome, fibromyalgia, and restless legs syndrome.
Q: Is it necessary for me to search out specific treatment for each of my serotonin-related illnesses?
A: Yes, you need to see the appropriate expert for treatment of your individual serotonin-related illnesses. Although the conditions are caused by a disturbance in serotonin, the medications used to treat each illness can be very different. Your migraine-friendly lifestyle can help because stress management and exercise increase serotonin levels.
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