The Importance of Keeping a Migraine Diary
Keeping a Migraine Diary is one of the first pieces of advice doctors will give a migraineur when they visit them. It’s one of the first things we here at MAI tell people. But why? We’ve been asked questions like this in the past so I will attempt to answer them.
Question 1: What’s the reason for keeping a Migraine Diary?
Keeping a migraine diary is a small practical step towards figuring out and learning about your own migraine. Migraine is individual to the person who lives with it. This is probably due to the fact that no two brains are the same.
Triggers that affect me may not affect you, treatments that help me may not help you, and vice versa on both counts.
When you track your attacks if your episodic, or the worsening of symptoms if you’re chronic, you can discover certain things about your individual migraine that may help you, and your doctors to understand and treat it better.
Question 2: What good does it do? How can it help me?
One of the frustrating things about starting to find out about your migraine is it takes time, a lot of time even if you’re quickly and accurately diagnosed and treated. Some people wait for what feels like an eternity before this happens to them.
Having a diary of your symptoms, and other factors in the hours before and during your attack can, over time identify patterns to your attacks. You may spot triggers, times when you may be more susceptible to attacks or worsening of symptoms, and whether or not your medication and other treatments are working for you.
Not every migraineur has a trigger, and many migraineurs will not find their trigger, if one exists, e.g., food triggers are implicated only in 20% of attacks. Your trigger may not be food related at all, you may be triggered by weather such as storms, bright sunshine, changes in heat and cold.
Your trigger may be light, sound or smell, which as a migraineur you’re already sensitive to. There are hundreds of potential triggers, in fact as a migraineur absolutely anything could be a trigger which is why it can be a long and somewhat confusing search.
Over time, you may discover patterns to your attacks or chronic migraine. You may find that they coincide with your menstrual cycle, or with those storms coming in off the Atlantic. You may find that attacks are more frequent at the weekend, and rarely at work.
Migraine triggers or trigger factors are not causes of migraine but they can help to bring about an attack or worsen symptoms.
Some people can get away with one trigger but most migraineurs have a “migraine threshold” when there is a build-up of possible triggers throughout the day. This can lead a person over their threshold and trigger an attack. E.g., a stressful day at work could mean you are not drinking enough water, not eating irregularly and the glass of red wine you drink to unwind when you get home could send you over your “migraine threshold”.
Watching your patterns and triggers can help you to avoid or remain below this threshold.
Noting the success or lack thereof of your medication and other treatments can show the doctor show well or how badly your current meds are working. They may then be able to adjust the dosage or change the medications completely. It may also prompt them to recommend alternative or complementary treatments such as CBT or Supplements. Recording the acute medication you take can also show the doctor whether or not you’re in danger of developing Medication Overuse Headache
Question 3: How do I fill it out?
Migraine diaries come in many different guises, be they in paper or via an app. The basic information you should aim to record is the following information.
- time and date of your symptoms,
- the pain score if headache is present (1-10)
- the symptoms you experience,
- the medication you take for it,
- the results of the medication, whether positive or negative; – if positive record the time your symptoms stopped or lessened.
- note the possible triggers but don’t be concerned if you can’t find any
- note anything you think may have been a factor that day or in the days or hours leading to onset of your symptoms,g., did you happen to walk through a shopping centre at lunchtime where they were demonstrating a new perfume?
Pay close attention to lifestyle, environmental and dietary factors in the 48 hours preceding the attack. Keep the diary for at least three months so that patterns can be established, and triggers appear. You can of course keep the diary for as long as you want to.
Question 4: Does it have to be the MAI diary?
Of course not, it can be any diary or piece of paper, however, our one is very snazzy indeed. It has tips and hints, suggestions of triggers, an area for notes and abbreviations, plus it’s set out for 6 months, and we will post it to you free of charge!!
Seriously though you can use whatever diary you like once you record the important information as listed above. It doesn’t even have to be an actual diary, just as long as the headings are there and legible so that the Doctor can use it to help you.
Question 5: Should I keep a paper diary or download an app?
This is personal choice at the moment, many doctors prefer the traditional paper diary, but more and more people are turning to the apps, such as Migraine Buddy. Arguably the apps have the potential to record vast amounts of information and identify many more factors to a person’s migraine. Some even map the attacks over time and can alert you to thing that may be helpful to you as opposed to triggering you.
Some people use both. Really, it’s up to you. If you do decide to use Migraine Buddy, don’t forget to check out their blog, it’s very informative.
Question 6: Can children use diaries?
Yes, children can certainly use migraine diaries. We have a children’s diary, again we’re happy to post it out. It would suit children up to the age of 8 years, 10 years maximum, after that, our general diary would be more suitable.
Although some of the apps are child-friendly and really excellent, such as Happyr Health, young children may prefer to use a paper diary, with Mam or Dad writing one along with them. Keeping a diary together can help a vulnerable child feel better about having to do something different from their friends. It can also be better for capturing details the child can’t tell you about. Some parents may notice early symptoms the child would not be aware of, such as irritability or excessive yawning in advance of an attack.
Remember, headache is rarely a prominent symptom in young children. Migraine most likely will manifest as a sick stomach in a child, possibly followed by a headache, but also by nausea and vomiting.
There are many migraine diary templates online, and it looks as though each of us patient organisations, even internationally has our own version, so use whichever type of diary that suits you best.
So hopefully that has answered some of your questions. Please let us know of you have any other questions about keeping a migraine diary or indeed if you would like us to send you one. Email firstname.lastname@example.org
The information contained in this email is for information purposes only and is not intended to replace medical advice or diagnosis