Making It Easy
The simplest way to keep a headache diary is to note any headache episodes and the circumstances that surrounded them on your calendar or in your date book. If you already keep a calendar for work and family obligations, using it to log headache information too has the added benefit of providing an environmental context to migraine attacks. You may notice headaches occurring regularly alongside high-pressure meetings at work, after a strenuous aerobic class, or following family outings to the beach.
The drawback to the calendar method is that without a specific checklist of information to include in front of you, you may forget to note some essential details that could be associated with the headache, such as food, changes in temperature, or treatment notes.
One easy mnemonic, or memory device, to remember headache details is the five Ws (and one H) of journalism — who, what, where, why, when, and how. Like an investigative reporter, you're seeking out the facts that will help you determine what causes your headaches, what helps them, and when they're likely to happen again.
Rule number one is to always start with the “how”:
How did it start, and
Who were you with when it occurred? Of course people aren't a migraine trigger, but who you're spending time with when a headache hits may be a clue to its cause. For example, if they happen when you're in a weekly staff meeting with your high-pressure boss, stress may be a trigger. If they only occur when you visit your cologne-loving neighbor, the odor may be causing headache.
What were you doing? This question will also help you identify any headache triggers. Were you eating a particular food, exercising, sunbathing, finishing up a project on deadline, or pumping gas? Don't limit your notes to the moment the head pain starts. Jot down your main activities over the prior twenty-four hours.
Where were you? Another trigger-related question. Were you in a smoke-filled bar, under the bright fluorescent lights in your office, or waking up after a late night party?
When did it start and
Why did it occur? Here's where you take your best guess as to what you think precipitated the migraine using the information available. You may not always know the answer to why, but as you gather diary information on your headaches over time, the patterns that determine “why” will become clearer.
If you feel more comfortable with a more structured way of tracking your headaches, there are many spreadsheets and printed diaries available from organizations such as the National Headache Foundation. There are software programs available for keeping headache diaries, and if you like gadgets, a PDA or wireless smart phone that you always carry with you can also be used to log headache information. You can also find online, Web-based services that provide diaries (see Appendix A for a list of resources).
Your doctor may have a specific headache diary form that he'd like you to work with. If you're looking for an easy and comprehensive headache diary format, Appendix B in the back of this book contains a blank headache log that you can photocopy and carry with you.
Keep copies of a headache log at your office, in your car, and in the other locations you spend your time so that you always have access should a headache strike. You can compile multiple logs into a single diary on a weekly basis.
