Keeping a migraine diary even with Chronic Migraines?

A cartoon from the 1800s shows how awful a headache can feel1

What are chronic migraines?

If you are suffering from Chronic Migraines, it means you have migraines that occur at least 15 times a month with headaches lasting 4 hours or longer for at least 3 consecutive months.

Unfortunately there is no cause for Chronic Migraines, just like there's no exact cause for episodic migraines (migraines that occur less than 15 days/month). Still there are people who experience a steady progression in their migraine frequency.
This is where keeping a diary is crucial: it helps by placing the changes you experience in your migraines into the context of your daily activity and life.
It's easier to connect the dots when the data is being stored.

My advice is to never stop trying to identify triggers, therefore never stop keeping track. It can be difficult to spot any patterns when migraines are daily, but it’s a must. If there is the slightest chance you could be reducing the number of migraines you have through avoiding certain triggers, then it should definitely be worth it!

Keeping a diary: printable vs. online

When I first started using a diary, it was a printable one. My husband and I had designed the printable .pdf ourselves, back when Miggy - the online migraine journal - was just in the project phase, we were encouraging people to use a printable diary so that they don't lose any data.

Sometimes it seemed redundant and completely pointless to always have to record my migraines: during one I was too annoyed and felt like writing it down would not make it go away so why bother? and of course, after the migraine had passed I used to feel so relieved that I couldn't see the point in noting it down anymore. 
It's especially hard to be consistent with something that has no short term results.

How the online journal helped me be in control

When I switched from paper to the online Miggy, it finally payed off. After about 6 months of tracking your migraines you can start enjoying the benefits of migraine reports and statistics. 

It's great that now I actually know my average number of migraines/month, I've identified clear patterns in my triggers and I can also show all this to my doctor.
What I still regret though, is not using a migraine diary for the first 7 years. I realized I can't even remember how many migraines I had/month back when they first started. 
So even if now I know my monthly average for example, I still don't know if it progressed or regressed.
Same goes for my triggers: I used to think that weather, cold wind and not drying my hair properly after a shower were my most common triggers, only to find out after one year of keeping the journal, that my first and most common trigger is stress, followed by hormones/menstrual and that cold wind is only rarely the problem.

Should we rely only on memory?

It's funny how our brain works when it comes to memories. Although we like to think that our memory works like a recording equipment, that's not actually the case. Research has revealed that we construct our memories when we encode them and/or when we recall them. A bit worrisome, right?

Chronic Migraine Treatment

Many of the therapies prescribed for chronic migraine are the same as those prescribed for episodic migraine. These include both prescription and over the counter painkillers and as well as migraine specific drugs such as triptans. These are known as abortive or acute medications.
A combination of lifestyle changes and understanding the migraine triggers is important. There are also preventative treatments available for chronic migraine, but these are often associated with side effects, and many people cannot tolerate them for long periods of time.

Neurostimulation: Transcranial magnetic stimulation (TMS) for chronic migraines

"Neurostimulation therapies inaugurate a new era in headache management and offer a promising alternative to medications. Future studies are necessary to provide evidence-based efficacy data, knowledge on their mode of action and information about their pharmaco-economic advantages."2


For the US: 

Advanced Migraine Relief & Treatment Center
-- the latest procedures, techniques, and pain relief treatments for chronic migraines including the revolutionary Transforma ProcedureSM
-- a network of physicians that are experts in these solutions.
-- hosting of free educational seminars to help you learn about new migraine pain relief options.


For the UK:

-- A portable device known as SpringTMS™ Total Migraine System has been developed by eNeura Therapeutics and is being investigated for potential use in the treatment and prevention of migraine.  The hand-held device sends two brief magnetic pulses to the brain at the press of a button.  Data was presented at the recent European Headache and Migraine Trust International Congress (EHMTIC) 2012.
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1 -- headache. [Photograph]. In Britannica Online for Kids. Retrieved from http://kids.britannica.com/elementary/art-169567
2 -- Headache Research Unit, University Departement of Neurology, CHR Citadelle, Li├Ęge, Belgium. June 2012 http://www.ncbi.nlm.nih.gov/pubmed/22543428