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Migraine Prevention and Errors in Living:
Dr. Grahamís Lessons for Patients and Physicians
Egilius L.H. Spierings, MD, PhD.
Posted May 2002
Headache 2002;42:152-153

Ten Commandments of Migraine Prevention:
  1. At present, there is no magic medicine or formula of treatment that universally "cures" headaches.
  2. The patient is not to "blame" for having inherited the migraine trait.
  3. The pain and misery of the migraine attack are very real and not "imaginary."
  4. Neither the patient, doctor, nor patientís spouse should be intolerant, but rather all should work for a better understanding of one another.
  5. The patient and the family have the greater burden in therapy, with the doctor to serve as a friendly guide rather than as a "miracle man."
  6. The management program will require a considerable period of time, with frequent reviews of progress, temporary setbacks, changes in therapy, and re-education.
  7. The most rewarding long-term therapy will result from an adjustment in patientís means of living within his or her capacities, rather than an endless round of medication.
  8. The patient cannot be expected to make all the necessary adjustments overnight.
  9. Changes in psychological attitudes become real only through actual practice, not through repetitive verbal instruction.
  10. There is definite hope for improvement through conscientious effort by both patient and physician, but complete freedom from migraine is rarely achieved by any therapeutic program.
Errors in Living for Migraineurs to Heed
  1. Poor Meals: skimpy breakfasts and lunches and large dinners eaten in a state of fatigue.
  2. Irregular Hours for Meals: postponing lunch for an hour can give anyone a mild headache but may produce a sick headache for the individual with migraine.
  3. Morning Deadlines: too little time allowed between the rising hour and the scramble for school and office.
  4. Sleeping Late: (on Saturdays, Sundays, Holidays): the patient with migraine needs a good deal of sleep - but not in the morning.
  5. Lack of Breaks: a short rest in the morning and afternoon, regularly obtained, is helpful.
  6. Overcrowded Schedules: migraineurs often try to work in too many events within a single day. They need to spread those activities more evenly over several days.
  7. Failure to Take Proper Vacations.
  8. Failure to Get Away from Their Children Periodically.
  9. Excessive Participation in Community and Church Activities.
  10. Overanxiety Regarding Preparations for Guests, Shopping Trips, and Vacations.
  11. Long Automobile Trips: the patient with migraine who wishes to push for 500 miles in 1 day often ends up with a headache.
  12. Acting the Chairman ("Because Nobody Else Will"): migraineurs often will not delegate work to others - they do it all themselves.
  13. Making up for Lost Time: as soon as the patients are over an attack, they may rush to repair losses. Consequently, the next attack comes sooner.
  14. Suffering Petty Wrongs in Silence: to settle differences while they are small.
  15. Aiming for Impossible Goals and worrying when they cannot be attained.
  16. Lack of Exercise.
  17. Lack of Recreation.