Wednesday 20 May 2020

5 reasons you should keep a headache diary

A recent poll on my Instagram page showed that 41% of you don’t keep a headache diary. Some of the most common reasons for not keeping one were the following;
· Forgetting to do it.
· Not having enough time.
· Not sure how to do it/what to record.
· A lot of you said that you have kept one in the past but now have stopped/ don’t see the point 

Personally, I’m a big fan of keeping a headache diary and thought I would share with you some of the reasons why.

1.    Keep track of how you are REALLY doing: It’s so hard when you have daily pain to know if it’s been a bad week/month etc if you don’t record anything. It can seem all doom and gloom when in reality it might just have been a bad few days or weeks. Similarly, it’s so useful to look back over several months or even years and compare how you are doing now, compared to then. My headache diary gives me a really clear insight into how I was doing, months or even years ago. Keeping a headache diary massively improves accuracy. People tend to under or over estimate the number of headache days and migraine attacks they experience. It’s just as important to know how many headache free days you have per month, as it is number of migraine attacks.

2.     Access to treatment: Headache specialists stress the importance of keeping a detailed headache diary and for good reason. Not only does it provide your doctor with a greater insight to what is going on day to day, it also allows them to make informed decisions about your treatment plan. Certain treatment options such as Botox for example require you to have several months of headache diary data before you will be approved for treatment. With the costs involved in the new anti- CGRP drugs, I expect there will be similar criteria to Botox for these new drugs. Keeping a detailed headache diary is only going to help you gain access to these new treatments.

3.     Help your doctor help you: Sadly, there is no simple test for migraine. Doctors largely have to rely on what you tell them about your history and symptoms. A headache diary should be your best friend in appointments. One of the first questions they might ask you is “how have you been?” or” what’s your head been like over the last 3 months?”.  I’ve been told by headache specialists that it can be incredibly frustrating and difficult to get a clear picture of what’s been going on with a patient when they haven’t kept a diary. They are likely to answer with “bad every day”. The chances of it being exactly the same level of “bad” every day, at all times of the day, is highly unlikely. Help your doctor help you by keeping a detailed diary that you can go through together at appointments. Try and record what information you find useful and also don’t be afraid to ask your doctor for ideas of what they would like you to record. Some headache specialists have headache diary templates they like their patients to use. Remember it’s a two-way relationship between doctor and patient. To get the most out of your appointments it helps if you’re working together.

4.     Keep an eye on medication intake: I know all too well how easy it is for painkiller days to rack up throughout the month. Medication is a key component of most headache diaries. It allows you to keep track of what you are taking and how often you’re taking it. I don’t like paying too much attention to painkiller days throughout the month as it can create a lot of anxiety and stress about “whether I have enough painkiller days left”, but it’s important to note down when you do take pain meds in order to keep track and minimise the risk of medication overuse headache (MOH). It can also be useful to look back retrospectively to see if certain triptans, or combinations of pain meds have worked more effectively than others.

5.     Spot patterns: Any data you can record that might shed light on your migraines and any patterns or trends that they follow is so helpful. It can help you discover triggers, along with patterns associated with menstrual cycle, sleep and activity levels for example.

I recently shared a blog post all about how I like to do my migraine diary, which you can read here.

If you feel overwhelmed or confused by starting one yourself, there are some good apps out there such as MigraineBuddy and N1-Headache that might be a good option for you. I’m happy to send you a template or give some suggestions if you’re still struggling.

Do one that works for you. If you find apps take too long or you always forget to write it down in a diary, then just record a few notes on your phone each day. Some is better than none!

*Photo by Jonny Caspari on unsplash


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