Redefining Resolutions: My Chronic Migraine New Year’s Ritual

Instead of trying to become someone new, what if you simply improve on what’s already working this New Year? When it comes to a migraine treatment plan, little tweaks can go a long way.

It’s that time of year when people start planning for their New Year’s resolutions to start on January first — second for some.

Many of these New Year’s resolutions are a firm decision to create a ‘new you.’ Start a new diet, get organized, start exercising, stop drinking alcohol, read more, give up caffeine — you get it.

It’s a turning point to change a certain behavior or to adopt a new lifestyle habit. I applaud these efforts and cheer my friends on, usually from the sidelines.

Why the sidelines? Because I live with chronic migraine. Read on to learn more about how I redefine resolutions each New Year.

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Resolutions are hard when you have a chronic illness

I love the idea of forging ahead with new plans and adopting new habits. But in the past few years, I’ve given myself a pass on joining in on the resolution bandwagon for one simple reason.

Managing a chronic illness is a full-time job for many of us, and I don’t have the extra energy or mental bandwidth for a new me each year. I just want the current one to work a little better!

How I do the New Year differently

With that in mind, I’ve adopted a slightly different approach. I’ve implemented a year-end reflection instead of a resolution.

This is a time I take to look back at my migraine management for the last year to see how well it’s been working. I evaluate where I am and if I need to make any adjustments.

I consider two things:

1. How well is my treatment plan keeping my migraine attacks under control?
2. How well are my care team and I working together?

It’s easy to get stuck in the status quo of any treatment plan. It’s hard to make changes, especially without knowing if something is really working or not.

If I never look back to see where I’ve been, how will I know what changes need to be made to get to where I want to go?

Reflecting on where I’ve been

Back in 1997, I was diagnosed with chronic migraine.

What I didn’t know then was that was the beginning of an 18-year attack that would only stop during my pregnancies with our two children.

When I wasn’t pregnant, my attack was ever-present, and I was always looking for some way to get relief.

I went through several doctors, a headache clinic at a well-known hospital, and an untold number of treatment therapies. Nothing made a dent in my migraine attack for any length of time.

Finally finding relief

I found my current headache specialist in 2013, and it took 2 years of trying different treatments with him before I finally got a break from that very long attack.

While I’m ecstatic to finally have relief from the daily skirmish with migraine attacks, I’m still chronic. Remaining chronic rather than daily takes a concentrated effort to reevaluate frequently where I am and where I want to be.

I do this every 3 months with my headache specialist and once again at the end of each year.

Why evaluate my migraine treatment plan so often?

Life changes as we grow and age. So do our goals for our treatment plans.

The things I wanted and valued for myself 5 years ago are not the same things I want as I head into this new year. Sometimes, our goals change within the same year based on new jobs, opportunities, and how we’re living our lives.

Migraine disease is unique and challenging to each of us. Its symptoms vary for every individual. No two people will experience it the same way, so each of us needs to have a unique treatment plan to treat and manage our attacks successfully.

Migraine doesn’t stay the same

Migraine will change over time. This can be based on a number of things, including age and where you are in life.

Life changes require treatment plan changes. Things that worked in the past don’t always work like they did before. My doctor and I have had to get creative.

I had to learn to be proactive and make changes when I felt my attacks becoming more difficult to treat or more frequent.

I told my doctor when my symptoms — things like light/sound sensitivity, dizziness, tinnitus, and nausea — started to increase during my attacks but also in between my attacks.

For me, this was an indication that my overall migraine burden was starting to get worse.

By staying on top of the increasing symptoms, I was able to make sure my attacks didn’t get out of control again. When I ignored those increasing symptoms, I had periods of increased attacks that took extra work to decrease.

Reflecting on your own treatment plan

If you’re trying to figure out if your plan is effective, you’re not alone. I ask this question all the time.

It’s the first step in building the most effective and personal plan for you.

The following questions are a start to help you figure out how effective your plan has been this past year:

• Have you had a reduction in the severity of symptoms?
• Have you had a reduction in the frequency of attacks?
• Does your acute medication provide complete relief of your migraine attack symptoms? How often? How quickly?
• Have you missed fewer days of work in the last 3 months than the previous 3 months?
• Have you been experiencing fewer symptoms in between your attacks?
• Have your attacks been decreasing lately?

If you answered most of those questions in the affirmative, then your treatment plan may be working well for you. You can now decide if a few tweaks are needed or if you’re satisfied with your current plan.

If you answered most of the questions in the negative, this is an opportunity to look more deeply into what could make your treatment plan more effective.

Let your doctor know if your acute medication isn’t getting the job done anymore. It’s also important that they know if your preventive medication hasn’t helped to reduce the severity of symptoms or frequency of attacks.

Evaluating your care team

As important as your treatment plan is, it’s likely only as good as your care team.

If you have chronic migraine and are struggling to find a treatment plan that works for you, finding a headache specialist is likely your best bet.

Usually, a headache specialist is a neurologist who has an additional year of training, called a fellowship, where they study all things headache-related.

These doctors are highly educated when it comes to headaches and migraine and are more creative when it comes to treatment.

Some questions to ask yourself about your care team:

• Did your care team work well with you? Were they supportive?
• Were you treated as a partner in your care?
• How well did you communicate your needs and issues with your care team? Was that communication pathway easy?
• At what point is it time to seek a second opinion? Consider this if your doctor indicates that they’re running out of ideas or feel they can’t help you anymore. And especially if you feel belittled or gaslighted.
• Is it time to move on from a general practitioner or general neurologist to a headache specialist? Look into a specialized headache clinic or hospital if you feel like your treatment plan is stalled.

A new year for migraine relief

I hope this year-end reflection gives you an opportunity to look back on your migraine treatment plan to see what is and isn’t working.

Whether making a few tweaks in your plan or even overhauling the whole thing, I hope this year brings you a reduction in migraine symptoms.