If you want to know the background on why I even started compiling this list, check out My Migraine Saga: All the Tricks I Learned Beginning to (Hopefully) End – Part 1 (Background).  In short, I was struck down by debilitating migraines in September of 2016.  After a twisty, turny diagnostic process, mine turned out to be a relatively obscure condition called CONCHA BULLOSA.  As if that weren’t unheard of it, my situation was also complicated by overgrowth of a type of mold called Aspergillus in my laundry room, but I’m getting ahead of myself.  I was telling my sob story in post after post about migraines on Facebook, and my friends, a concerning number of which have experienced migraines themselves, came to my rescue with a really long list of tips and tricks on what professionals to see and what to do to keep migraines at a minimum.  I wrote them all down.  Word of caution, this is the longest blog in the history of man.  Here goes in no particular order:

1. Take Care of Yourself. I’m going to put this first and last. I cannot emphasize enough how important it is to eat right, sleep right, drink enough water, exercise enough and keep your stress low. If your migraines disappear when you go on vacation, your brain is desperately trying to tell you that your lifestyle is not working. I know, I know – lifestyle changes are easier talked about than made, but still, please take a look at where you can introduce balance and calm for your brain and do it. Most of all, your brain wants predictability – so try to establish a routine that includes a calm wake up routine, predictable breakfast, snack, lunch, snack, dinner, snack, calm wind down routine, bedtime about the same time each night and physical activity of some sort. I know, it seems like a lot – but your brain will thank you – and your migraines just might get better :-).
2. Get a Comprehensive Work-Up. So, before I started going through this, I had no idea what this meant. And believe you me – if I didn’t have a bajillion Facebook friends who’d also had migraines, I still wouldn’t have gotten to the right specialist to get my diagnosis and treatment. You know why? Because, even though I am a physician, I had no idea that ENT doctors even treat migraines. So, based on what I’ve learned about the different causes of migraines on what has been a long and arduous journey over the last 7 months, here is what I consider a COMPREHENSIVE WORK-UP. Basically, let your symptoms decide in which order you see these specialists, and don’t stop seeing specialists until you feel satisfied that every rock has been turned and every nook has been crannied.
   • Primary Care Physician. Start here. I made the mistake of not starting here and instead going straight to a specialist. Your PCP, Family Practitioner or Pediatrician has a fantastic ability to examine you as a total organism from head to toe. There are many ailments seen and unseen, both in your head and not in your head that can cause headaches. They will do a complete history, physical exam and initial laboratory examination that will help point you in the next right direction. They will also emphasize #1 (Take Care of Yourself).
   • Ophthalmologist. This was one of the first stops on my long list of specialist visits because I specifically felt that my eyes were causing my migraines. Please note that I wrote OPHTHALMOLOGIST not OPTOMETRIST. It is important that you get examined by a physician because, while eyestrain from needing glasses or a bad prescription can certainly cause headaches, there are many, many other reasons for headaches that originate either from the eye, or from medical conditions affecting the eye. Those are outside the expertise of an optometrist’s ability to identify.
   • Neurologist. This was my second stop. I was already under the care of a neurologist for a tremor I’d developed a year before, so that made it easier to get in quickly. Any new onset of debilitating headaches needs to be worked up quickly to rule out super scary things – and pretty much anything that happens in the brain in the specialty of Neurology or Psychiatry.   And that leads to me to…
   • Psychiatrist. I started this blog out with TAKE CARE OF YOURSELF. Migraines are known to be a common symptom of depressive and anxiety disorders. Do not hesitate to see a Psychiatrist for evaluation if you think these may be contributing.
   • Dentist. Now I never would have thought of this one but for my Facebook friends. And even when literally it kept coming up over and over, I was like, whatevs!   I didn’t have any tooth pain at all. But lo and behold, it was a trip to the dentist, that ultimately led me down the road which led me to my ENT which led me to what I think will be my cure. My path to migraine freedom included a root canal on my left front tooth which led to a full 2 months of complete freedom from migraines on zero medications! If you are looking for an amazing endodontist, and you are in the metro Atlanta area, look no further than Dr. Bobby Slosberg of Atlanta Endodontics.
   • ENT. You have no idea how many people I’ve told to go see ENT since I got my diagnosis of Concha Bullosa. Concha Buh-WHAT-sa? Exactly. Nobody has ever heard of it that isn’t an ENT doctor or Radiologist. Even my Neurologist, a specialist that treats migraines, had never heard of it. But even though my diagnosis is not common, apparently there are several common ENT things that can cause and/or contribute to headaches – many of which have medication fixes, and many of which have surgical fixes. One is a deviated septum. You’ve heard of that one, right? I’m telling you – if your migraines are not responding to anything, definitely go see an ENT. My super amazing ENT is Dr. Malaika Witter-Hewitt of ENT of GA. I am typing this blog only one-week out from surgery - bilateral middle turbinate concha bullosectomy (basically she fixed it), and I have already noticed a difference in the quality of my migraines!
   • Naturopathic Physician. These guys have a complete and utter expertise in the dietary and lifestyle contributions to migraines, as well as the nutritional deficiencies that need to be evaluated (like Magnesium) and corrected. I was so lucky to have access to Dr. Samm Pryce of Balanced Integration who is a Family Practitioner and Naturopathic Physician (I know, like a unicorn, right?!) who crafted me a personalized, comprehensive dietary plan.
3. If you have an Apple device, you can put it on NIGHT SHIFT. This filters out blue light which is particularly hard on the eyes and known to increase eye strain and headaches. Staring into the blue light also makes it hard to fall asleep. I keep my phone on night shift 24 hours per day.
4. If you don’t have an Apple device, there are apps you can download that will filter out blue light. One such app is called F. Lux. See #1 for why filtering out blue light from your backlight electronic devices is the right thing to do! Hey, when I was on the internet to get the link for you guys, I just found out this also works for Windows! Guess who is downloading it right now… this girl!!
5. Blue-Light Filter Glasses known to the younger generation as gamer glasses. Are you noticing a theme here? Blue light is not good for your eyes! I found these glasses that filter blue light and reduce eye-strain on Amazon. I bought them for my entire family, and now the rule is – if you are looking at a computer or device screen of any type, you must be wearing your gamer glasses. I have mine on right now, I promise!
6. Get a UV Screen for your computer, phone and tablet. Now – just like filtering out blue light is important, filtering out UV rays is important. These things are hard on the eyeballs! And that which is hard on the eyeballs is putting you at risk for headaches of all sorts, migraines included. Good news is that you can kill two birds with one stone – you can actually find screen protectors for your phones and tablets that filter UV light while protecting.   I didn’t put a link here because obviously there are a jillion different computers, phones and tablets. But if you just go to Amazon.com, (there’s your link!), and type in the search box UV protector screen and whatever type of device/computer you have, your options will come up.
7. HYDRATE HYDRATE HYDRATE!! I cannot emphasize this enough. Dehydration is known to be a very common trigger for those who are at risk for developing migraines. So we should aim to over-hydrate ourselves as prevention. Here is a great straight-forward article on why: Understanding Dehydration as a Headache Trigger
8. Acupuncture. Now I have to admit I put this on the list and then I never actually went. But tons of my friends vouched for acupuncture making a HUGE improvement in their migraines, and there is medical research data to suggest that acupuncture in addition to routine migraine care can reduce the frequency and severity of migraine headaches. I am hoping that my surgery took care of my migraine situation, but if not, best believe I will be making an acupuncture appointment.
9. Avoid rebound headaches. Well I got myself into a world of trouble with this. If you read the background blog, you’ll remember that September 28 kicked off a 13 day marathon of daily migraines for me. Well part of the reason I kept having migraines was because I kept pouring migraine medications on top of the migraines. I started a rebound phenomenon – each time the medications would wear off, I would feel the headache coming back and I would immediately take more meds. The more I reinforced that vicious cycle, the more vicious the headaches became. On one thankful day, I went to see my Chiropractor, Dr. Pat Gibson of Gibson Chiropractic Clinic, P.C., and she said – “You have got to stop the meds.” I nearly choked on my spit. But I trust her, and I knew pharmacologically that what she said made sense. I mean really, I spend my days telling patients about rebound anxiety from benzodiazepines – and so I stopped the meds. And guess what, the migraines broke. For a little while anyway!   That mention of my super smart Chiropractor gives me an easy segue to number 7…
10. Chiropractor. I have been so amazingly lucky to be under the care of a phenomenal chiropractor for the last six years (my how time flies!). If you are in the metropolitan Atlanta area, don’t go anywhere else but Gibson Chiropractic Clinic! If you are outside metro Atlanta, someone you know has had a good experience with a chiropractor. Go to theirs! I was seeing my Dr. Pat for back pain as a result of scoliosis and literally never even knew she would be able to help me with migraines until I just happened to have one on the day of an appointment. I left that appointment with no headache. Like, for real!!
11. Essential Oils. I cannot say enough about how my essential oils have helped me through the last several months. Seriously, there were times when I had no Migraine Relief tabs, and I was stuck in a foreign city with no Uber. But you know what I did have? My essential oils and my diffuser! Peppermint Oil, Lavender Oil, Rosemary Oil and Frankincense Oil have all been indicated as helpful for migraines. You can take a drop and apply it directly to the temples, behind the ears, middle of the forehead, back of the neck and bellybutton or put a few drops in an air diffuser. Check out this blog I wrote before for more details: Essential Oils for Migraines and More.  AND, if you're interested in buying the highest quality essential oils on the market (in my opinion), you can get them straight from my website.  YES, they made such a difference in my life that I became a rep.  Mostly so I could get wholesale pricing, but hey, why not share the love!  Purchase Doterra Essential Oils HERE.
12. Ice Pack on the Neck. God bless this old school remedy. This link to the Mayo Clinic website says that ice packs may have a numbing effect. Makes sense to me! All I know is that it helped.
13. Ice Pack across the Eyeballs. Like #9, this was like one of the cheapest, most effective remedies for me. It really, really worked. One night, I was struck down by a migraine in the car on the way to eat dinner with one of my best friends (it was the headlights that got me). By the time I arrived, I was tremulous, tearful, nauseas – you know the deal. I sat down and croaked out the word migraine. Well, the waitress had a history of migraines and immediately brought me a bowl of ice water with a towel in it. Although I ordered no food or drink for the 15 minutes I was there, I left her a huge tip!
14. Melatonin. This is another one of the options I didn’t try, but several people told me that Melatonin as a preventive medication significantly decreased the frequency and severity of their migraines. Melatonin is not meant to be taken once the migraine already starts – but rather everyday as a prevention strategy. Indeed, a small medical study gave great results. Of the 32 participants completing the study, more than two-thirds said their migraine frequency was reduced by half or better after taking 3mg of melatonin at bedtime for three months.
15. Menopause. Now this one cracked me up. I don’t think you have too much control over this one, and if you’re a man, especially good luck making it happen, but apparently, menopause cures migraines for many. So, set your countdown clock and wait for it…
16. Migralief is a natural supplement that contains Magnesium, Riboflavin (Vitamin B2) and Feverfew.  You can pick it up on Amazon here - MIGRALIEF.  Feverfew is a plant native that is native to Asia Minor and the Balkans and contains a chemical called parthenolide that may decrease factors in the body that cause migraines.  You can purchase Feverfew, guess where - AMAZON!  At this link:  FEVERFEW.
17. B Vitamins supplement. Research has shown that Vitamins B6, B12, and folic acid (B1) may reduce the frequency, severity and disability of migraines as much as half. That is a lot! Here’s a quick article with more details: B Vitamins Offer Migraine Relief. Especially for my people who are a bit wary of medications and would much rather go the prevention route (highly recommended!), adding a B-vitamin supplement is an easy, easy thing to do. Matter of fact, here’s one on Amazon. Just click here and add it to your cart lol!
18. Avoid Nitrites. Now if you’re a clueless eater like me, you're like, what are nitrites?  They are food additives that are used to keep meats from spoiling, mostly found in processed meats like bacon and lunch meat.  If you're sensitive to them, they can expand the blood vessels in your brain and give you a migraine. As I was looking up a good link to give you guys about nitrites/nitrates, I came across this one, which gives a nice overview of food triggers for migraines in general, so here you go: Food Triggers for Migraines.
19. Petadolex This is another remedy I didn't actually try, as I’d already started Topamax, by the time it was recommended.  But, it is a dietary supplement whose main ingredient is pure Butterbur.   Apparently, it has great results for migraine treatment and prevention. Click here to get it on Amazon.
20. Craniosacral Massage. Cranio = head and sacral = lower back and tailbone.  Sign. Me. Up.  I don’t even need to see any data that says this helps with migraines. Lolol!! Seriously though, after reading about it, I think this might be what my Chiropractor has been doing for my migraines. I’ll have to ask her next time I go… Looks like Massage Envy offers this by special request.
21. Blood Type-Based Diet. Who even knew your blood type had anything to do with what you should eat?!  Dr. Pryce did, that's who!  Lol!  Anyway, when I found out Type O – should avoid dairy and grains, let’s just say I was more than a little resistant. Well, staying sick has a way of wearing a person down, and so now I’ve downloaded the dos and don’ts of the O-type diet and will be starting it following a cleanse. Check out the book. You can find it on Amazon. Eat Right 4 Your Blood Type.

Well, that officially took me forever to write and it's a thousand miles long, but I hope it will help someone.  All of these ideas certainly helped me in what has been my greatest time of need in a while.  Now, I will go do my sinus rinse and finish recovering from by bilateral middle turbinate concha bullosectomy so hopefully my migraines can be a thing of the mostly past!