Migraines. I have them. More than 50 percent of the women I know have them, and even a few men I know suffer from migraines.

If you’ve never had a migraine, you have no idea what your migraine enduring friends are going through. Migraines have driven people to suicide because they just couldn’t take the pain any longer. This article, I hope, will enlighten those who don’t have migraines and give additional options to those who do.

First of all, don’t deal with migraine headaches yourself. Select a health care provider who is familiar with headaches and knows how to treat them.

I have selected a neurologist who deals only with migraines and sleep disorders. If you’ve been to doctors, nurse practitioners, physician assistants or fringe non-medical clinics and have not gotten a long lasting solution, don’t stop there. Keep trying. There are solutions out there. When you call for an appointment, ask the receptionist if the practitioner has had success with treating migraines. Once you’ve found a good, knowledgeable doctor, you’re halfway home.

Your doctor will first try to identify the type of headaches you’re having so she or he can determine the best treatment regimen.

Tension headaches: The most common type of headache is a tension headache. This is often confused with migraine. A tension headache will be mild to moderate and will usually begin in the forehead, temples or back of the neck. It feels like a band that is tightening around your head. You will feel pressure and tightness in the head and neck muscles. Stress, feeling anxious, feeling angry or even being tired can bring these on. Sometimes these headaches can progress into migraines.

Migraine headaches: A migraine can have a variety of symptoms including prodromal warnings, an aura phase, the actual attack, and a postdromal phase. (These are discussed in the next section.) The migraine itself usually starts as a dull ache that becomes a heavy throbbing pain. It is usually located in either the front, back, or one side of the head but can involve both sides, as well. It is often accompanied by nausea and vomiting, and sensitivity to light and noise.

Chronic migraines: If you have migraines for more than 15 days per month, each of which lasts four hours or more, you probably have chronic migraine.

Sinus headaches: These headaches usually occur when the sinuses are swollen due to allergies or a sinus infection. The sinuses can be blocked, so breathing may be difficult, and you may notice that your senses of taste and smell are diminished. With this type of a headache, you might find you have a throbbing pain or pressure in you sinus cavities including your forehead, eyes and cheeks. If you bend over, you will notice the pain will usually become worse.

Rebound headaches: These headaches are caused by taking too many pain relievers. If you use more than the prescribed or recommended dosage of a medication, or you use it too often (more than twice a week), you will be susceptible to rebound headaches. As soon as the medication wears off, your headache will come back. So you take more and more medicine, it keeps coming back, and you are in a rebound cycle. Typical symptoms include neck pain, irritability, depression and lack of concentration. You need to wean yourself off of the medication and get back to a better regime. Your doctor might suggest you stop taking the medication immediately and let your body settle down without it for a brief time.

Cluster headaches: Cluster headaches come in clusters, and usually there are no prodromal symptoms. It used to be believed that cluster headaches only affected men. However, both sexes are affected by them. The pain is usually severe, will usually affect one side of the head and may cause tearing, a bloodshot eye and a runny nose on the affected side of the head. These headaches can last for months if not treated. It is believed that a chemical reaction in the brain is responsible.

Migraine headaches have four stages:

Prodromal stage: The prodromal stage is the early warning period. This can be hours, days or immediately before the headache begins. Not all migraines will begin with a prodromal stage, but it is believed that about 60 percent do. Typical prodromal symptoms might include anxiety, euphoria, high immediate energy, irritability, a sudden sensitivity to light, smells, noise, frequent yawning, difficulty concentrating, food cravings and other, less common warnings. When you discover your prodromal symptoms, this is the time you should be heading for your migraine medication. If you take your medication at this point, you might be able to avoid a full-blown migraine.

Aura phase: This is the pre-migraine phase which occurs after any prodromal symptoms you may have and before the actual migraine begins. It can happen within an hour to immediately before your migraine. Only about 20 percent of migraines will have the aura phase. In the aura phase, you might have changes in vision which could include flashes of color, flashes of light, zig-zag lines, tunnel vision, spots or difficulty focusing your eyes. You might also experience numbness, tingling, muscle weakness and in some cases a difficulty speaking, writing and understanding words. If you haven’t yet taken your migraine medication, do so now. Don’t wait.

Attack phase: This is the period during the headache. When the headache strikes, there will be no doubt that you are having a migraine. The pain is intense, and it can last for hours or days. You will experience intense throbbing in your head, sensitivity to light, sounds and smells, and experience nausea and vomiting. You might have blurred vision, a feeling of being light-headed, and you might faint. You may also experience dizziness, fatigue, sleepiness, sweating, cold hands and diarrhea. Seek out a dark place that is cool, quiet and away from smells. Smells can increase the effect of the nausea.

Postdromal: This is the period of time after the headache. You might feel extreme fatigue, lethargy and some head pain, especially if you move about, confusion, sluggishness, and weakness.

If you have migraines, keep a diary of your triggers. A trigger can be food, food additives, dehydration, smells, skipping a meal, sun or light glare, schedule changes, hormonal changes, eyestrain, stress, intense exercise, smoke, temperature changes and pressure (weather) changes.

Typical food triggers can include aged cheese, processed meats, anything with nitrates or nitrites, MSG, artificial sweeteners, alcohol (especially red wine), sources of caffeine including coffee, tea, colas, etc. Your list is apt to be longer. Keep track of what you eat. After a while, you will see a pattern emerge, and you will know which items to eliminate from your diet. Keep track also of how you slept the night before a migraine. Keep track of your activities, and weather. It will also help your health care provider to know the severity of your pain, your symptoms, the effectiveness of your treatment and the duration of the headache,

There are a lot of medications available that have helped migraine patients. Classes of drugs include anti-epileptics, anti-depressants, beta-blockers, NSAIDS, triptans, anti-nausea drugs, DHE, a combination of triptan and NSAIDS, and Botox. Your health care provider can choose the type of drug that is right for you, help you to identify your triggers and symptoms, and help you to lead a better, migraine free life.

Don’t hesitate. Fight back and get your life back.

Dianne Erskine-Hellrigel is executive director of the Community Hiking Club and president of the Santa Clara River Watershed Conservancy. If you’d like to be part of the solution, join the Community Hiking Club’s Stewardship Committee. Contact Dianne through communityhikingclub.org or at zuliebear@aol.com.