All About Telehealth for Migraine Telehealth allows doctors to care for people virtually over a phone call, text message, or most commonly, video chat. Although some situations require an in-person visit, telehealth is a great option when you can't get to the doctor's office for your migraines. If you're new to telehealth, here's what you need to know. Medicare will cover telehealth visits just like in-person visits, but state Medicaid programs and private insurers vary, so confirm your coverage in advance. With telehealth, even though you're not in the doctor's office, your private health information is still covered by HIPAA, so it will remain confidential and secure. Although your neurologist can't give you a physical exam via telehealth, they can write prescriptions and offer quality care, especially if you prepare in advance. Before your telehealth appointment:- Keep a "headache diary," listing any migraine symptoms, like pain, nausea, or visual disturbances-and notice what triggered them- Document any side effects from your migraine medications or therapies- Note any recent life changes or stresses- Record your vital signs if you own a thermometer, blood pressure monitor, or another device- Compile a list of your health conditions and all medications, including supplements- Write down questions you have for your neurologist- Charge your computer or phone- Make sure your internet is reliable- Download any telehealth apps your specific provider may require- Find a quiet, private space to conduct the call- Be prepared with pen and paper or a note-taking app Turn to Healthgrades to connect with the right neurologist to treat migraine via telehealth. And share this video to spread the word!

Hi, my name is Natalie and my condition is chronic migraine. Living with chronic migraine, almost every single aspect of my life has been impacted, but I think across work, school, hobbies, exercise, vacations, even grocery shopping, what has been impacted most has been adapting to life with so much unpredictability. I really never know from one hour to the next or day to the next, how I'm going to feel. I've had to get used to waking up every morning and going through the day with a really flexible, adaptable mindset. What scares me the most about living with chronic migraine and migraine in general is all of the lost time associated with this condition. There are so many days and events and hours that are simply taken from me because I can't do anything besides manage the pain. When I think about my twenties and the experience I've had, there are some things that I definitely saw myself doing that I have been unable to do, such as traveling and basic things like going out with friends. So it's easy to get lost in a rabbit hole and spiral about worrying how the future might look. Without a doubt the biggest silver lining of this experience and living with this condition has been developing a gratitude practice. I have learned to be very deeply aware of and grateful for the things that are going right in my world, instead of focusing on the things that might be going wrong or not unfolding in the way I would like them to. I have also been able to develop and grow a commitment to really love my life more than I hate my pain. It's taken a lot of time, a lot of hard work, a lot of resources and support to get there, but I really am in a place where I'm so committed to making this one chance I have to be alive beautiful. If it has chronic migraine or migraine as a part of it, then that's just something I'm going to learn to deal with. The other thing that has been a major silver lining has been uncovering my own resilience and courage. I've proven to myself time and time again that I can do things I feel like I can't do and that is a journey that has completely changed the way I see myself and the way I see the world. So, as much pain as there is, both of those things have been absolute gifts.

Mayra: It's like the worst pain you've ever experienced, times 10. Liz: Misery. Cara: Debilitating. Liz: Torture. Cara: Terrible. Liz: Sadness. Cara: Annoying. Mayra: And it sucks. It sucks. Liz: I was diagnosed probably two years into college, officially. Growing up, I just called them really bad headaches. My mom and my grandma and her brother also all had migraines, so it's the hereditary factor. Cara: I usually have a pounding sensation in the back of my head and I can predict like, if I don't take medication within the next 20 minutes, it's going to be really bad. Jenny: My migraines always have a tendency to, like, flip. Like, they'll start in one place and then move and then move back. Liz: Yup. It's usually almost always on the right side of my head and it's the front part right here and it feels like somebody's taken a nail gun and just maybe shot me like four or five times around that part of my brain. I can't move. I can't open my eyes. I just want to lay there. Mayra: Mine have gotten so bad that even the medicine that I'm on doesn't work anymore. Every day it's like a learning process for me. Jenny: I've had a few auras. They're usually... like a spot in my field of vision will be out of focus, like kind of shimmering. Mayra: My migraines can last anywhere from a couple hours to days. It's never just one day. It's two or three. Cara: For me, the most it was about three days. But I couldn't move. I literally had to lay, like, under my covers and be like, "Nobody, just don't come near me." Liz: Yeah. It's kind of like light-hearted when you say that, but when you're in the moment, it's so depressing because it's like I want to live, you know. I want to go have fun, I want to go be outside. Cara: I feel like people really don't understand how bad it can get. I basically have to eat really well and I know like if I have anything with nitrates, it will trigger it off immediately. Liz: I can't drink alcohol. I can't eat chocolate. Jenny: I would die if I couldn't eat chocolate. Like, literally, you're very strong. Liz: Thank you. Jenny: So my triggers are stress and also sleep is such a big factor. Liz: Another thing that triggers them for me are really strong smells. If somebody's got really strong perfume or, like, you walk down the street and there's really strong car exhaust fumes. I have like a little rollerball of perfume, I guess, but it's essential oils and it's peppermint. If I get that nausea that's coming on with the onset of a migraine because of a really strong odor, I'll try to smell that. Jenny: I always have my pills and my injector pen. Liz: I remember I took a diary. I had a headache diary when I was going through the initial stages and like trying to track, okay, this the day that it's happening. This is what I ate that day. Jenny: People just assume not being in pain is like, the default. We shouldn't think of that as the default. I try to really appreciate any time that I am not in physical pain. Cara: I feel like it's so important to not take every day for granted, because you never know what tomorrow may bring. Liz: Surround yourself with people who understand, and it's hard because there is that stigma. Are we exaggerating how much pain we're in? I would do anything to be "normal" and if you have to let a few people go that are too judgmental, let them go. Mayra: It's always okay to take a day off. We're so used to working or so used to accommodating other people, we forget about us. Live your life as it is and try to work around it, and if you need a day off, take the day off.

Jenny: While I'm eating ice cream, the world is kind of okay. Liz: Rest. Jenny: Herbal tea. Liz: Coffee. Mayra: Chocolate, sleep, chocolate. Jenny: I take a few different things for migraines. I take an antidepressant, an anti-seizure medication. Whenever my migraines act up, I take these sumatriptan injectors. I get about one migraine a week, so that manages where I'm at right now. Liz: For me, I take a triptan and I take it at the onset. It will stop the pain, which is awesome; but it might take anywhere from an hour, maybe 45 minutes for it to even do anything. Then suddenly I feel really floaty. The pain just sort of lifts, but then I get into that zombie mode. Mayra: I've been on about three different actual migraine meds. They help but they all have different side effects. Cara: I feel like that happens to me too sometimes. I get a really bad side effect, like tingling sensation. Mayra: I have to sleep just the right amount. It has to be anywhere between six and eight. If I sleep less than six, I'm done. If I sleep more than eight, I'm burned. Liz: Another thing I use are face masks, like sleeping masks almost. Cara: I use a humidifier as well and it helps. Mayra: I may have a piece of chocolate or a piece of candy, and the caffeine will actually help it a little bit. Jenny: Hot showers, too. Mayra: It's funny 'cause for you the hot showers work. For me, they actually make it worse. Cold showers, or ice cubes in back of my neck, they help so much. Cara: I used to always eat a lot of nitrates and I didn't realize that eating nitrates caused migraines. I decided to go vegan six months ago. My migraines just completely subsided and my life has changed for the better. I also started kickboxing and I love it. So I feel like diet and exercise is so important and it will help migraines as well. Liz: I found that I need the low impact, like yoga or Pilates. I'm 29 right now and when I was 22, the things that worked for me don't necessarily work right now. It's just kind of like the nature of the beast. Mayra: You have to learn how to accommodate. You have to learn to like new things, or let go of the things you've liked before and just take it one day at a time. Liz: I think one thing I've noticed, just talking to all of you, is we're all so different. One thing that triggers a migraine for you, doesn't do it for you. The hot and the cold shower situation. I think it's important for other people that are out there to not compare themselves to other people. Jenny: You have to see a doctor. It is not something that you can solve by yourself. Cara: It's just so important that you take care of your health. Your mind, your body, your spirit.

Danielle: I have chronic migraine, so that means I haven't had a moment's break for over five years. Raquel: I start to feel really tired, fogginess that I can't explain. Danielle: I'm not making sense when I'm speaking. Raquel: I start to get the aura. I start to feel like my vision is not clear. Heloisa: The first symptom I have is nausea, and the next day, the pain comes. It feels like, honestly, a contraction in my brain. Carly: It's this pain that just won't go away for three or four days, and I can't sleep, I can't find a position to take the pain away. Danielle: There have been times where I had to completely cut out my social life. There have been times I've had to quit my job and completely check out of life entirely because I was in too much pain to function or take care of myself. There's judgment that you're not really sick and you're making it up. Heloisa: It's very difficult when you come across family and friends that don't understand what a migraine is. They feel like you're just not being strong enough. It's difficult to prove to them that migraine is actually a disease. Carly: I started getting my migraines when I was 12 years old in middle school. And my doctor at the time didn't really give me the right course of treatment so I started seeing a headache specialist. Heloisa: I've seen a neurologist since I was nine. I have done MRIs, CAT scans, blood tests, and everything to figure out what it could be. Carly: Right away, he started me on a different course of treatment and suggested that I get nerve blockers injections. Danielle: I get trigger point injections all throughout my shoulders. Carly: I'm okay with injections in my forehead and in my neck because the pain that I feel for a few minutes is worth not having tension headaches for six months. Raquel: I usually get migraines, I would say, once or twice a month now. When I first feel it coming on, I immediately take medications to prevent the migraine from getting even worse. Danielle: I'm injecting CGRP blockers into my legs. I know a lot of my friends have seen results, but I'm still waiting and hopeful. Heloisa: I try to keep my life going as everyday life, and I still go to work. I still go to the gym. Danielle: With time, I figured out that I just have to coach myself through everything. It's really just saying you can do it. You can get out of bed. Heloisa: It took me a long time to understand how to deal. Danielle: It almost took time for me to convince myself that a migraine is a real illness. Carly: I really try hard not to let it affect me, but I mean, it took a while. Danielle: The pain-free me is still in here. It's just been a while since I've been able to be that person completely. I'm going to keep trying everything I can. I'm hopeful that I can experience a day without pain.

Dr. Ravitz: The interesting thing about migraine is that it's not just a headache. Dr. Halpern: Migraine is actually a disorder of the brain. Dr. Natbony: We know that in migraine, the brain is more able to be hyper-stimulated or more able to send off pain signals inappropriately. I think if we're looking towards treatments, that's why we haven't had any cures, because there's not one thing that's wrong. Dr. Halpern: An acute treatment is what you do or take when you have a migraine to relieve yourself of the pain and suffering and the associated symptoms like nausea. Dr. Ravitz: Preventative medicine you take every single day to reduce the frequency and severity of the headache. You take the medicine whether you have a headache or not. Dr. Natbony: To treat migraine acutely, there's a bunch of different strategies. Heloisa: When I feel a migraine coming on, I immediately take my pain reliever and my nausea medication. Danielle: Sometimes I can have caffeine to help. They have pills of caffeine that I can take, as well. Dr. Natbony: But as patients have more and more migraines, they tend to become less effective. The bread and butter treatment for acute treatment of migraine is triptans. Dr. Ravitz: They squeeze down blood vessels and they reduce inflammation, so you take it at the onset of the headache. Dr. Natbony: The goal is pain freedom within two hours. The long-term treatment strategy is prevention. Dr. Mauskop: The oldest migraine preventive medicine is propranolol, medicine that was originally developed for the treatment of high blood pressure. Second category of medications are antidepressants. Now, you do not have to be depressed to benefit from an antidepressant. Dr. Mauskop: The third category of preventive medicines are epilepsy drugs. And now we have three drugs on the market that treat migraines by blocking either CGRP receptor or CGRP molecule. And then, we also use Botox injections. Carly: I started seeing a headache specialist and right away, he suggested that I get nerve blocker injections that are injected into two points in my forehead and then on either side of my neck. And they last about six to eight months. Carly: The pain that I feel for a few minutes with getting the injections is worth not having tension headaches for six months. Danielle: I'm injecting CGRP blockers into my legs. I do one injection on the right leg and one injection on the left leg. Dr. Natbony: They're the first migraine-specific preventative treatments. Everybody has CGRP in their body. Those with migraine have elevations of CGRP during migraine attacks. What the medication is, it's a monoclonal antibody, so an antibody that binds to the CGRP and basically flushes the excess out of the body. Dr. Halpern: For many patients, they need a multifaceted approach to treating their migraines; things like bio-feedback, cognitive behavioral therapy. Dr. Natbony: Biofeedback is basically training your brain to calm down its own pain signals. You learn how to modify your breathing to calm these over-stimulated nerves. Dr. Mauskop: We have many good, very effective therapies that allows us to help our patients. Dr. Natbony: I just feel like the future is so bright in the migraine world, and I want to be there to help patients to realize how great things can be when they look so terrible in the moment.

Dr. Mauskop: The management of migraines begins with lifestyle changes. Dr. Natbony: Preventative medications can only do so much. If you're not taking out the triggers and the contributors, you're not going to be able to change the overall course of migraine. Dr. Ravitz: Patients with migraine need to keep a regular sleep schedule. They need to go to bed at the same time every day and wake up the same time every morning. Dr. Natbony: So the brain in migraine wants everything as regulated, controlled, consistent as possible. Dr. Halpern: Make sure that you are eating regular meals, not skipping meals, eating a healthy well-balanced diet, and avoiding processed foods and foods that are high in sugar. Raquel: I try to stick to whole plant-based foods and just natural foods, nothing preserved. Danielle: I've worked very hard in doing elimination diets to try to figure out what could be triggering my pain. Dr. Natbony: Caffeine in the moment can be helpful but caffeine also used too much is not helpful. We think that having one to two cups or less than 200 milligrams of caffeine a day should be okay as long as you have it every day. Dr. Mauskop: Half of migraine sufferers are deficient in magnesium. If you are deficient, your migraines dramatically improve just by taking a supplement. Dr. Halpern: Regular exercise is a very important aspect to managing migraines. Dr. Ravitz: It's recommended to do four to five days of mild to moderate cardiovascular exercise. Heloisa: I daily do yoga, meditation. Dr. Natbony: Then lastly, hydration. Carly: Try to drink enough water, which is something I'm really bad at. Dr. Mauskop: Dehydration is a common and very easily treatable cause of migraines. Have a glass of water four, five, six times a day and your headaches will improve. Dr. Natbony: Mapping out triggers, keeping a good headache diary is really important to find out what triggers you as an individual. Carly: I love wine so I know that if I drink wine, I'm probably going to have a headache the next day, but that's something I'm willing to deal with because I love wine. Dr. Halpern: I'm still often surprised at how few of my patients actually talk about their migraines with their families and their friends. It is really important that migraine sufferers find other people who are suffering in the same way that they are. Carly: It's very important to be seeing the best doctor and be on the best course of treatment. Dr. Natbony: It's a recipe, it's an art. It's not all a science. It's really making combinations, making lifestyle changes. And I tell my patients, "We can get you there, we just have to work together to do it and find what's right for you." Because migraine treatment is extremely individualized and there is no one recipe for everyone.

Dr. Natbony: Migraines are one of the most disabling conditions. Dr. Mauskop: Migraines are a neurological disorder. It's not just a headache. Dr. Natbony: It affects about 39 million people in the US and about 1 billion people worldwide. Dr. Mauskop: About 18% of women in this country suffer from migraines and about 6% of men. Dr. Ravitz: I actually suffer from migraines, and migraine still remains a big mystery. We know that certain things may trigger it, but we don't know the real root cause of migraine headaches. There is definitively a hormonal component to migraine. And one of those hormones that we think is a very potent trigger for migraine is estrogen withdrawal. So men have less estrogen in general and women have big fluctuations in estrogen during their cycle. Dr. Natbony: The migraine brain wants everything stable, including hormones. So when hormones fluctuate, it causes this instability and causes the brain to trigger more pain. Not with everyone, but we do think that's why women are more prone to migraines. Dr. Halpern: Migraines often begin for girls in their early teens up through their 20s. Boys often have migraines when they're very young, but then they outgrow them during their teenage years. And girls then start to get them. Dr. Mauskop: Many women will have worse headaches during their menstrual cycle. For most women, it's right before their period. And we think it has something to do with a drop in the estrogen level. Just before the menstruation the estrogen drops and also before the ovulation. That's when women are more susceptible to get a migraine. And that is why also, while you're pregnant, your levels of estrogen are stable, you don't get as many migraines, if any. Dr. Natbony: About one-third of patients will outgrow migraines by the time that they are in their 20s. We think that migraines are a younger disease. Usually from puberty to peaking in about the 20s, 30s, and then sort of decreasing around the time of menopause. Dr. Ravitz: Through menopause, as the hormones fluctuate even more, sometimes migraines are worse, but migraines over time tend to get better. Dr. Mauskop: So the good news is that migraine is not a permanent condition. Dr. Halpern: I have never met a patient who I didn't think that I can help in some way. There's always hope.

5 Things You Didn’t Know About Migraine 1. Migraine is the third most prevalent illness in the world.One billion people suffer from migraines worldwide, including 38 million Americans. 2. Migraine affects three times as many women as men.About 70% of migraine patients are women. Researchers aren’t sure why, but changes in hormone levels may play a role. 3. Everyone experiences migraines differently.Symptoms may include head pain, nausea, light and sound sensitivity, and even light flashes and blind spots. 4. Migraine is often hereditary.Ninety percent of people who suffer from migraines have a family history of the condition. 5. Most people with migraines don’t ever get diagnosed or properly treated.Of those who do see a doctor, only 4% see headache and pain specialists who are best equipped to help them. Share this video to help educate others about migraine!

A tasty meal, low in fat, high in protein: introducing the Greek Chicken Bar, served family style. It's flavorful and healthy and will have you feeling energized and satisfied. Let's dig in. In a bowl, combine lemon juice, oil, dried oregano and garlic. The lemon juice in this recipe gets you one step closer to meeting your daily vitamin C requirements, aiding your immune system as well as collagen production, helping to keep your skin looking radiant and bright. Pour the marinade into a reusable zip top, then add chicken and smush around to thoroughly combine. Let everything sit and soak together for 20 minutes to one hour. Here's the deal with the oils. Avocado oil can withstand higher cooking temperatures than olive oil, but some prefer the taste of olive oil over avocado oil. So it's totally up to you. Preheat your grill or stove top grill pan to medium heat. Grill roughly five minutes on each side or until a meat thermometer measures the internal temperature at 165 degrees. Now for the low fat cucumber herb yogurt sauce. In a medium bowl, stir one seeded and grated English cucumber, one cup of non-fat Greek yogurt, one tablespoon of lemon zest, one tablespoon of lemon juice, two tablespoons of chopped mint leaves, two tablespoons of chopped dill, and one teaspoon of salt. Beyond the yummy crunch and fiber that cucumbers provide, it's also one of the most hydrating foods out there. So, it may even quench your thirst. Both dill and mint are booming with antioxidants, which have been shown to have anti-inflammatory effects on the body. You may not realize it, but this meal can actually benefit your gut thanks to the probiotics and the Greek yogurt. These healthy probiotics found in the sauce help to calm stress, ease moodiness, and can even boost the immune system. So I certainly recommend you generously drizzle that yogurt sauce. Arrange your Greek Chicken Bar family style and build as you wish. This low fat and light option can be combined in so many different ways. A bowl, plate, wrap, or even a salad, you can't lose. This meal has it all, the lean protein from the chicken mixed with the Greek yogurt sauce, herbs and spices lend both health and low fat nutrition to your lunch or dinner.

Avocado toast is an easy meal to put together. It provides the perfect combo of healthy fats, satisfying protein, and slow-digesting carbohydrates that help keep your blood sugar low and stable. Start with a small bowl. Pick a ripe avocado, cut open and mash the avocado with a fork, leaving it slightly chunky into the bowl. Stir in one tablespoon of lemon juice, a quarter teaspoon of ground white pepper, one teaspoon of salt, a quarter teaspoon of garlic powder, and a quarter teaspoon of sweet paprika. Avocados are still one of the most popular fruits out there. It's also one of the most nutrient-dense fruits, too, aiding in weight and cholesterol management and hormonal balance. Drizzle a small amount of oil in a non-stick sizzling pan and let that egg fry to perfection. An egg, no matter how it's cooked, is packed with antioxidants, vitamins, and protein. Toast one piece of wholegrain bread until it's brown and crisped. Top the avocado mixture and then add your fried egg. Between the avocado and fried egg, sriracha, pickled red onion, pumpkin seeds, and scallions, you have a meal that's overloaded with beneficial antioxidants that help keep the body healthy while fighting off diseases and certain cancers.