This is true, but be very careful with Topomax and know the reported side-effects. My wife took the drug for about a month and had horrible problems with forgetting words mid-sentence (a known side effect) and generally not being very sharp. Although it did manage to lessen the overall intensity of her migraines she found that she started to suffer from near daily lower grade migraines as well as what she described as pressure headaches.

The real problem was that she couldn't just stop taking the drug as that would lead to withdrawls and other problems. It took over a month to taper her off of it and on to something else.

Sinus is my trigger too. The other cause is if I sleep badly and have my neck in an awkward position, which triggers the sinus, and so on.

Thankfully I have only once had a migraine while flying. 4 hour flight, total agony. For me, my usual pain-management routine is anti-histamine, asprin, hot hot shower, hot buckweat pillow, black tea and sleep. Can't do all of those on a plane! Luckily, I don't get migraines bad enough or often enough to use stronger medication. Mine usually last a day but no more than two, which is manageable.

Pre-flight I take a strong asprin (as well as my daily anti-histamine) and use FESS nasal spray and my asthma meds. I read that they've got a special 'flight FESS' out now so I might try that too.

That's a great idea... I'm a heat person too. I have a buckweat pillow that works wonders but I've never travelled with it because I wasn't sure if I would have access to a microwave to heat it up. I'll try the ziploc thing next time.

Usually I find that a prescription strength dose of Motrin (say 600 mg) does it for me. Oddly Motrin seems to work faster than Advil for my migraines.

I'm pretty sure that my migraines are caused by barometric pressure changes (among other things). I also get migraines when I ascend to high altitude. I can often avoid a migraine if I take a couple of Aleve tablets before I get on a plane or go into the mountains, before I experience any symptoms.

At risk of getting off topic, I use Advil liqui-gels if I have afternoon migraines. And have you ever noticed these "migraine" versions of OTC medicines? They have the exact same thing as the regular versions but in different packages. Next time you're in the store, look at Excedrin vs. Excedrin Migraine. They both have 250 mg aspirin, 250 mg acetominophen, and 25 mg (?) caffeine. What's the difference, then? Same thing with Advil Migraine vs. Advil Liqui-Gels. Both have the same concentration of solubilized ibuprofen. One is amber and one is blue. I have used both versions of Excedrin and both versions of Advil, and they've both worked the same for me. I usually just buy whichever is less expensive.

No difference at all. What they did was got FDA approval to market it for migraine use. SO they repackage it under a new name, and charge a buck extra until people catch on.

(The caffeine is a vasoconstrictor...shrinks the blood vessels in your head, essentially. Pretty effective for headaches - except that caffeine is a migraine trigger for some.)

Just to summarize the basic types of medicines in treating migraines --

1. Acute Treatment - used once a migraine has started; examples are Motrin and Alleve (OTC), Tylenol #3, Fiornal, Imitrex (all Rx)

2. Abortive Treatment - used before the migraine has started; most people have a 'premonition' that a headache is on its way; examples include Imitrex and Cafergot (both Rx)

3. Suppressive Treatment - used if someone has frequent migraines or predictable migraine (peri-menstrual, even travel-related); these medicines need to be taken ever day whether or not the person has a migraine; if the migraine is predictable, sometimes the meds can be taken starting a few days to a week before the expected migraine period.

Examples for #3 include most epilepsy medicines, including Topamax, Neurontin, Tegretol. As noted, they -- like all meds, whether OTC or Rx -- can affect people differently.

Remember that the list of side effects are based on relatively large # of people, but it does not mean that a specific person will get a specific side effect or even develop something not listed. And depending on your own medical history and other meds you are taking, your options change.

Conclusion: Discuss with your doctor, and try the med before you take it while travelling -- no use having any surprises while away from home!

(I play a physician in real life, but limit to very general recommendations on-line. As always, discuss with your own physician)

I also get some pretty rough migraines. I've also had a few at work. This is the worst! I can't say whether the cabin pressure has affected them or not because I've been getting them long before I was flying for a living. I personally have found that plain aspirin, taken with coffee, works best for dulling the pain, taken as soon as the vision interference starts. About an hour later, I take two advils. I've learned that avoiding chocolate, for some strange reason, helps also. I remember hearing somewhere that this was a trigger for the headaches, and so far, so good. Also, sufficient sleep is essential. I've noticed that being tired triggers them also. So much for jumpseat medical advice, huh? LOL Take care

Chocolates are, for many people, migraine triggers. Other foods to watch out for:

Dairy products of any kind, but particularly cheese.
Nuts.
Red wine (the tannin is the problem).

Your mileage may vary.

For me lack of sleep can trigger one, as can too much sleep (go figure ;) ). I don't get them from stress, but from a sudden release at stress, a phenomena which has been documented as "Saturday migraines".

Coffee contains caffeine, which is an abortive. This is why some people like analgesics which are compounded with caffeine (I think Excedrin may be one one).

You're lucky that Advil works for your. OTC analgesics don't touch mine. Imitrex, which is an abortive, not a painkiller, works 99% of the time for me, but when it doesn't I take oxycodone, which is the generic for Percodan -- and THAT barely works.

For anyone who hasn't read it, "Migraine" by British neurologist Oliver Sacks (author of "Awakenings" and "The Man Who Mistook his Wife for a Hat") is compulsory reading. It's a little dated now, as it was written before triptans were discovered (Imitrex, etc.), but it's an entertaining explanation of the "aesthetics" of migraines. Though I have had migraines since I was a very young child, I learned a lot I never knew after reading the book, including what aura was and why I sometimes get . . . uh . . . what's the word? . . . oh, yeah, aphasic when I get a migraine.

I, too, was diagnosed with migraines when I was around 12, but I also complained of headaches a lot when I was very young. At the time, the conventional wisdom was that children did not get migraines -- who knew?

If it is any consolation, people tend to 'grow out' of them in middle age. For me, I could count on 4-5 per month until I hit 40, then all of a sudden they stopped -- I think I have had 5 in the past 5 years. (yeah!!!) And for women, migraines very often stop with menopause, which I guess is at least some compenasation for hot flashes, irritability, etc. ;)

I had noticed the same thing -- the older I got, the less the frequency, and also the milder the migraine (if it makes any sense at all to use the words "mild" and "migraine" in the same sentence). However, for some reason, for the last two years or so, the number and intensity has slowly started to increase again (and I'm in my 50s). I'm sure it has something to do with stress which, for me, increased dramatically two years ago and hasn't let up yet.

Alternating hot and cold works for me. In flight I've used a cup of coffee and a bag of ice. I use Vicks under my nose - for some reason the smell doesn't bother me and it blocks other odors.

SOME people. Unfortunately not me. But Imitrex works pretty well for me.
R.

*chortlechortle*

Don't forget about:

Cured/smoked meats
Nutrasweet (lots of people don't realize this might be a trigger and continue to drink diet soda while having migraines)
MSG - still in lots of foods, especially Chinese food.

I need Goldilocks sleep, too. Not too little, not too much. This is why migraines are a problem for me while travelling. Until recently, I was completely unable to sleep on planes. Even in Raffles Class on SQ flying SFO-HKG for 12 hours! I then get off my sleep cycle at my destination and run a sleep deficit for a few days until I catch up. Nothing like 4 straight days of migraines after arriving in China!