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“In the worst case, I can’t get out of bed. I need to lie down without lights on,” she said.
Natbony explains that not all migraine attacks are alike.
She said that “each of my migraine patients is unique, and each one requires a unique treatment plan.”
The treatment for migraine is not one size fits all.
Treatment of migraines
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Natbony suggests that a “comprehensive strategy” for migraine prevention is “vital”. This could include lifestyle changes, preventative treatments and rescue steps.
She said that it may take some time to find the best combination of treatments. “I tell my patient that we should keep trying different strategies such as medication, lifestyle modifications and alternative therapies until we find the best one.”
She said that lifestyle modifications include getting regular rest, drinking at least 64 ounces per day of water, eating a meal or snack rich in protein every three to four hour, and doing cardio exercise for 30 to 45 minutes at least four days a week.
The neurologist stressed that preventative treatment is necessary when headaches are experienced six days or more per month, or if they are “debilitating”.
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She explained that the goal of preventative treatment is to reduce the frequency and severity migraine attacks.
“Preventative treatments include vitamin supplements and prescription medications as well as medical devices, acupuncture, and biofeedback, among others,” Natbony said.
Nasal sprays can be used to relieve migraine symptoms. These sprays deliver the medication directly into the upper nasal cavity, avoiding the GI system — a route ideal for central nervous systems drugs, according a review by the U.S. Neurology in 2020.
“This allows for fast pain relief, no matter when the spray was used during a headache,” she said.
“It’s effective both at the beginning and after central sensitization is established,” she added.
“With this medication, patients do not need to worry about missed treatment windows.”
The Journal of Head and Face Pain published a survey in 2017 that revealed 96% of respondents who took oral acute prescription medications for migraines were not satisfied with their treatment.
Natbony explained that oral medications take longer to reach therapeutic blood levels due to the breakdown of the medication in the stomach and the absorption into the intestines.
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She said that nasal sprays are also useful for people who experience nausea and vomiting during migraine attacks. They bypass the digestive system.
Natbony said that it’s important to discuss side effects with your doctor before you try nasal treatments.
Prepare your “migraine toolbox”
Migraine sufferers may want to consider creating a “migraine-toolbox” that includes multiple tools and techniques for tackling a migraine as soon as it begins.
Natbony says that an ideal toolbox should include preventative treatments, noninvasive medical devices, and non-pharmaceutical treatment options such as supplements, biotherapies, acupuncture, and supplements.
You can also use over-the-counter products like ice and heating packs, and essential oils.
Natbony explained that a migraine toolbox contains everything a patient might need in the event of an attack.
“It’s important to have treatment options that are effective because a headache can ruin your day in an instant,” she said.
Daufenbach, a migraine sufferer, revealed that she has a number of oral medications in her migraine toolbox. However, she uses her “rescue treatment” nasal spray in severe cases.
She said, “My neurologist suggested I try the Trudhesa nasal spray because of its flexibility and its ability to provide me with fast pain relief within 15 minutes.”
She said that when she feels a migraine coming on, her left arm becomes numb and I get auras. “That’s when I know my pills won’t give me the relief I’m looking for, and I can count [on the spray] if I have an important exam or plans that I must not miss.”
According to the American Migraine Foundation, more than 37 millions Americans suffer from migraine pain.
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