I have suffered from migraine headaches for 29 years now, chronic and nearly daily for the past several years, usually they awaken me in the middle of the night full blown with vomiting, so too late for the triptans to have optimal effect. I have tried everything out there for prevention. I am a nurse practitioner, and many of the meds for migraine prevention I was unable to take, due to needing to be be able to function with a clear mind in my job. Currently I am on depakote which doesn't prevent the migraines but initially did somewhat reduce the severity and incidence. It doesn't any longer but I am afraid if I stop it, it will be worse.
I do exercise regularly and always have, if I can keep from throwing up, light cardio exercise does help give some reprieve. I also use supplements to reduce migraines- B2 and magnesium, butterbur and feverfew daily.
The Botox injections need to be given at least 3 separate injections, exactly 13 weeks apart, before you can determine they are not effective. I have now had 3. The pattern of the injections is also crucial and individual. I was very fortunate that the first injection drastically reduced my migraines, although it gave me severe neck muscle weakness and head drop. My neurologist wanted to change the pattern the second time because of this, as a result it didn't work. In fact, I had a migraine that was there night and day for over 1 month, triptans and IV steroids didn't help. So, with my last injection almost 12 weeks ago, I made sure she used the pattern of injection from the first time and have had very good results. I also was 13 weeks to the day last time, and had a 3 week delay due to my insurance company between the 1st and 2nd injections. So be certain to time the injections for precisely 13 weeks apart.
Also, I have tried every holistic therapy there is, Accupuncture, biofeedback, chiropractor, herbal remedies, massage- none has made a bit of difference. And I am a believer in alternative therapies.
However I have had MIRACULOUS results with a book my neurologist recommended. It is called "understanding your migraine triggers". Written by a nurse who suffered chronic daily migraines and went on a quest for relief. She has gone from daily migraines that are debilitating and ruin family and social life, to perhaps once a year!
The chapter I found most helpful is on diet. I knew oranges and bananas and chocolate and caffeine are triggers for me, but there were many others I had not considered. I eat an extremely healthy diet with a lot of fresh fruits and veggies, and learned that many of those- avocadoes, nuts, dried fruits, spinach, strawberries, and yes, bananas and oranges, even salmon and shellfish, can be triggers for migraines. I never thought I would be one of "those people" on a special diet, but it has been life altering in combo with the Botox injections.
The book says you can try an elimination diet, but with so many triggers I figured I would just dive in and I cut all potential triggers from my idiot, including the vitamins I take that are made from fresh fruits and veggies. Proof positive is I have been doing this since April and 2 weeks ago for the first time I decided to try some fresh ground peanut butter to see if I could have it. Nothing but peanuts, no salt or sugar. All I had was about a tablespoon before bedtime. I was awakened in the middle of the night by a monster of a migraine with vomiting, that lasted for 4 days. We all know what 4 days in a dark room with no phone or TV or reading and pain so bad you cannot go to sleep to "sleep it off" feels like , and just praying none of your neighbors will mow their grass!
Needless to say, I am a believer in this diet thing now,and will NEVER try to eat peanut butter again so long as I live! Other triggers are MSG, nitrites (these I knew), balsamic vinegar, soy sauce, anything fermented including sourdough bread....
This book has changed my life for he better and I would highly recommend it to everyone who suffers from migraines.
It feels very restrictive at first but I just focus on all the good things I can have.