What You Should Track
It's important to track not just your headaches, but also the events and circumstances that surround them. You should also note any other physical or mental symptoms you experience, even if they don't seem to be related to your headache. Things like excessive fatigue may turn out to be an early warning sign of an impending migraine. Think of your headache diary as a health and lifestyle journal, and note all food, sleep, exercise, activities, and emotional situations (such as unusual stress).
You should also note when headache episodes prevent you from participating in everyday activities, such as work, school, family time, social outings, household chores, and other responsibilities. When a headache strikes, many migraineurs withdraw into a dark, quiet, and comfortable place for recovery. And even the fear of developing a migraine may prevent you from taking part in activities you enjoy, such as going to the beach, or from planning trips. All of these things have a negative impact on your quality of life. Your doctor will use this information to help determine a course of therapy that fits your lifestyle, such as preventative migraine drugs.
If you're just getting started, it's worthwhile to take some time to think about the progression of your headaches before now. If you haven't yet seen your doctor about your head pain, these details will be useful when your doctor interviews you about your medical history. This is especially true if you tend to feel anxious or pressured for time when visiting your health care provider. So gathering this information now in an unhurried and relaxed atmosphere will ensure that you have all the details your doctor needs to assist in making a diagnosis.
Some questions to consider are:
When do you first remember the headaches starting?
How frequent are your headaches and how long do they last?
Is there any noticeable pattern to the timing and frequency of your headaches?
Where is the head pain located?
How would you describe it (e.g., throbbing, pulsating, knifelike)?
Do you have any other symptoms along with the headache?
Are there any signs that a headache is coming before it arrives?
Do you notice changes in your vision before the headache begins?
Are your headaches always the same?
If you're a woman, do you tend to get headaches at certain points in your menstrual cycle?
Have you noticed if specific foods, medications, stressful situations, weather changes, changes in sleep patterns, or other factors seem to trigger a headache?
Does your headache get worse with physical activity?
What do you do to relieve the headache, and does it work?
If you're unable to keep a headache diary prior to your appointment, or only have several days or weeks worth of diary data, it's particularly important to spend some time thinking about and answering these questions.
At the least, your headache diary should track the date and time of your headache (and when it stopped), the location and nature of the head pain, any other symptoms that occurred with or before the headache, and what you were doing when the first signs of headache began. It's also useful to include food eaten, any exercise, and a notation of the weather, as bright light and temperature change can be migraine triggers.
For women, indicating your menstrual cycle on your headache diary or calendar is important. You should do this even when you don't experience headache during that time of the month. You may discover that the hormonal changes that take place during premen-struation or ovulation are associated with your headache.
I keep losing track of my headache diary. Any advice?
One sure-fire way to remember to document your headaches is to keep your diary inside a “migraine relief kit.” Get a waterproof plastic box or bag and stock it with all of your migraine medications, your headache diary, compresses, an eye mask, and any other items you find helpful during migraine, such as peppermint tea for nausea.
If you've already received a diagnosis of migraine or another primary headache disorder, tracking your headaches with a diary is a key part of fine-tuning your treatment plan and uncovering any new headache triggers. In addition to tracking your headaches, you should note medication and any other treatment measures (such as retiring to a darkened room), when they took effect, and how successful they were in relieving migraine pain.
Sometimes signs of a migraine attack can appear as early as twenty-four hours prior to the actual headache, so documenting not just headache days but every day can be particularly helpful in uncovering trends. Things to note daily include any physical and emotional symptoms (even if they don't seem to be headache related); medication; beverages (including caffeine and alcohol); meals and snacks; sleep; sex; exercise; changes in weather; and home, social, and workrelated activities.