migraine ACTION PLAN Take this sheet to the doctor’s office with you

My doctor’s name is: Phone: My Personal Goals:

Fewer headaches Avoid Emergency room Be pain free Enjoy life Signs that I have a headache coming on are:

Vision changes Weakness Trouble talking Mood changes Fatigue Increase in energy Numbness/tingling Food cravings Nausea Vomiting Other:______________________

Things that trigger my migraines: Certain foods or Drinks:

MSG Alcohol Breads Caffeine Salty snacks Artificial Sweeteners Chocolate Vegetables Sweets/desserts Meats Spices/seasoning Diary products Fruits

Exposure to: Weather changes Perfumes/strong smells Bright lights Loud noise

Feelings: Angry Tired Stress

Other: Hormone change Eating habits Allergies Skipping meals Too much sleep Too little sleep Motion sickness

What to do if I get a Migraine:

Take my relief meds at first sign of pain Lie down in dark room Deep breathing/relaxation/meditation Cold compress to forehead

My Medicine list is: Name: _______________________________________ Dose: _________________________ Name: _______________________________________ Dose: _________________________ Name: _______________________________________ Dose: _________________________ Things I can do to manage my headaches:

Muscle relaxation Stay away from triggers Reduce stress Meditation Positive thinking Medications on hand Deep breathing Moderate activity Avoid caffeine Eat at regular time Sleep and wake at same time Exercise regularly

Call my doctor if:

Headache is worse or last longer Headache is different Side effects don’t go away

Reminder: Take your medicine at first sign of headache pain. Plan ahead to avoid a trip to the emergency room. Have your medications on hand. Early treatment can help reduce having a full blown migraine or impact they may have.