“If a migraine is just a headache, then Godzilla is just a lizard”

One in seven of us will suffer from migraines, so there is a good chance that someone you know suffers with migraines – it might even be you.

It is estimated that there are nearly 200,000 migraines every day in the UK. More common in women than in men, it can affect us at any age – even as children.  On average, a migraine sufferer will have 13 attacks a year, lasting up to 72 hours at a time.

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Migraine is a complex problem and the truth is that medical science isn’t entirely certain on its cause. Whilst many people with migraines will experience headaches (usually a severe, throbbing, one-sided headache), there are many other symptoms and features of a migraine, such as: flashing lights or visual changes or sensitivity to the light, sensitivity to sound or smells, nausea or vomiting, numbness or pins and needles, slurred speech, irritability or abdominal pain. Sometimes, someone with a migraine will not even have a headache.

Migraines are thought to occur in five stages: prodrome, aura, main attack, resolution, recovery.

The prodrome can be tricky to pick out from normal day-to-day life, but those who can recognise it will talk about feelings of lethargy or irritability, or just feeling a bit off.

For some this will be followed by an ‘aura’. This would typically happen up to an hour before the attack. Someone might notice flashing lights, changes to their vision or speech, or other neurological features such as tingling or numbness. Migraine aura’s do not happen with every migraine, and it is estimated around one-fifth of migraines are associated with an aura.

I suffer with migraines – thankfully very rare these days, but when I get one they wipe me out. I don’t usually suffer with an aura when I do have a migraine  – but it has happened. If I do get one, it will be flashing lights – strange flickering light towards the edge of my vision – just enough to make me wonder if I have seen it at all – and I get a bit muddled – almost as if my brain is suddenly wading through thick treacle and I feel I have to work hard just to think. 

The main stage of the migraine is the ‘attack’ phase – this is when a headache (if present) will occur and can last up to 72 hours.

In the resolution and recovery phases, the headache and any other symptoms start to ebb away but patients will often say they feel particularly tired or wiped out, sometimes for a couple of days.

So if you suffer with migraines, what can you do about them? First off, it’s really important that if you are experiencing new, changing or worsening headaches you get these checked out by your doctor. If your doctor agrees that you are suffering with migraines you might then want to think about ‘triggers’.

Many migraine sufferers have triggers unique to them and there are so many possible triggers out there. To be able to start working out what might be setting your migraine off, a headache diary can be a great tool. You can download pre-set diaries or just use your calendar on your phone. Do this for a month or so and then look back over the information you have collected and see if any patterns jump out at you.  For me, it’s lack of sleep – every time!

Common triggers are: emotional upheaval whether that be happy or sad, worry or anger, poor sleep or over tiredness, changes to environment, periods for women (as well as contraceptive pills and the menopause), dehydration, citrus, caffeine, cheeses, chocolate, alcohol, pork and monosodium glutamate.

Treatments vary depending on the type of migraine, how often they happen and your medical history, Broadly speaking these can be divided into ‘acute’ treatments – ones you take when an attack is happening and ‘preventative’ treatments – ones to take to try and stop attacks from happening. Simple measures such as paracetamol, anti-inflammatories such as ibuprofen and rest in a darkened, quiet room can be enough for some people. A word of warning about using codeine containing medications though – codeine and other opiates can can worsen or even cause headaches so should be avoided unless your doctor has advised you specifically to use them.

So if you’re one of the one in seven people in the UK who are thought to suffer from migraines, first off I feel for you and share your (head) pain. Secondly, don’t suffer in silence.

Migraines cannot be cured, but they can be managed. To talk about treatments that might help, speak with your doctor. As with so many medical conditions, there is a lot we can do to help ourselves – so why not consider keeping a headache diary and see what you can learn about your migraines.

Time to hydrate

All this week we’re focusing on Nutrition and Hydration Week, an awareness campaign that could be custom made for us. It’s aim is to spread the important message of maintaining health by considering our nutrition and hydration.

Today we’re looking at the most basic and yet the most vital aspect of nutrition and hydration: Water.

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Why not try infusing your water with fresh fruits or herbs for extra flavour?

Aqua. H2O. Whether you take it still, sparkling, tap or bottled, infused or iced there is no escaping the importance of water to our bodies.

Our bodies are roughly two thirds water and it role is crucial. It can be incredibly difficult to know how much to drink, especially once you start to consider the impact of the exercise, weather and general state of health.

Water is not just important for the normal functioning of our bodies. It can have a crucial role in weight loss. Drinking with your meal or between meals can help to increase your sense of fullness. Those hunger pangs might not be hunger, often it’s thirst.

The human body has evolved to be a highly sophisticated filtration system. A series of chemical reactions and responses triggering further reactions and responses to maintain as steady state as possible (homeostasis).

The amount we drink is triggered by our thirst response. We drink when we’re thirsty, our body utilises the fluid it needs and any excess is eliminated by the kidneys or bowels. To counteract this loss, the thirst cycle starts again.

 

The actual amounts we are recommended to drink can vary depending on what study you read. In general terms, the European Food Safety Authority suggest 2L for men and 1.6L for women. Within the UK, the average bottle of water is about 500ml – so a man would need around four of these and women just over three.

However, it starts to get more complicated when you factor in the level of activity that you engage in, your physical health, your size and weight and whether it’s a hot day or not.

I often find I am encouraging my patients to drink more, and there seems to be some confusion over what we should be drinking. Water is always going to be the best option. Alcohol may feel like it quenches your thirst but it’s a diuretic meaning you’ll pass urine more frequently which may actually dehydrate you. The hangover effect and the ubiquitous headache with alcohol, in part, is due to this dehydration mechanism. One option is to alternate your alcoholic drinks with a glass of water to help counteract the dehydration.

Fruit juices and soft drinks are also options, but these can contain high amounts of sugars so should be drunk in moderation.

The vast majority of tea and coffee, unless you choose a de-caffeinated option, contain some caffeine. Caffeine can also have a mild diuretic effect and can hinder your hydration.

Dehydration, a state whereby the body lacks fluid, may cause you to feel thirsty or pass urine which is darker in colour or stronger smelling. You might also feel sluggish, light headed and or have a dry mouth.

Children and the elderly, are more at risk of becoming dehydrated. Signs that might give your doctor cause for concern is if children are becoming drowsy, having fewer wet nappies or if they are breathing more quickly. Older people often may not realise that they are dehydrated and confusion is a common presentation of dehydration in the elderly.

Patients experiencing vomiting, diarrhoea or sweats as a result of a fever can become dehydrated quickly unless they are able to replace the extra water lost from the body.

*Originally written for The Independent July 2015, rewritten for blog post March 2017.