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Better in the evening?

Nice to find the forums and read about people's experiences.

I used to run a migraine about every two to three months; in the last few months it's been more like one a week, which is a real drag. (I've seen my PCP, who's put me on a couple of the abortive medications for now, and given me a reference to a specialist).

My migraines are worst in the morning by far --- when I have one I usually wake with one, and it gets worse through the late morning and early afternoon.

What seems odd (to me) is that it tends to fade some in the evening, only to recur with a vengeance the next morning, lasting a couple of days until the postdrome. During the evening there's often very little pain, just the brain fog and fatigue.

Am I alone in this? It seems weird. I am beginning to think that when I have one I should just throw in the towel and time-shift work for the day. I'm fortunate to work out of my home for a small firm, and may have some flexibility there.

  1. Thanks so much for sharing some of your journey with migraine with us. Waking up with a migraine can be tricky because we tend to sleep through the warning signs that, if we were awake, we could perhaps treat with rescue medications and stop the attack in its tracks.

    Are you seeing a migraine specialist? I ask because, with the uptick in your attack frequency, it may be time to consider taking preventative medication. There are lots of options out there these days. It could be that having something in your system each day could keep that morning migraine from flaring up in the first place rather than spending the day chasing it.

    It is interesting that the attack seems to improve as the day unfolds. We frequently hear the opposite, that things escalate as the day goes on. That said, you are not alone. Waking up with an attack is fairly common: Everyone is different in terms of how they unfold.

    Again, I would encourage you to get an evaluation with a specialist to think about getting a preventative on board to see if that could help change this dynamic. Here's some more information about preventative options: Another option would be CGRP therapies:

    Finally, here's a link to help you find a specialist in your area, if you are interested:

    Hope this helps to get you started. We are here for you to answer questions and provide support anytime and are so glad you are with us.

    Warmly- Holly team

    1. Thanks, Holly.

      Yeah, my PCP gave me a referral to a neurologist to start with. Not ideal, I know, but apparently she does do a lot for people with migraines, which is helpful. Unfortunately, I don't see her until January, although I'm on a waiting list. Fingers crossed!

      I'm thinking a preventative makes sense too. I take a bunch of other stuff at this point for other (unrelated) ailments, and I'm hoping that some of the stuff can be grouped off-label. We'll see. It'll take getting the various doctors to talk, At least they're all with the same set of clinics.

      I had not heard of CGRPs!! Will definitely check that out. Encouraging.

      I had thought it was odd --- improving by the late afternoon/evening. The only theory I have is that giving up on work and its strain helps, and by then I've had my usual round of coffee and tylenol (I'm allergic to NSAIDs, too!) and just able to shut down for the day.

      We will see! This week's faded today, which I'm grateful for. Here's for a good day!

      1. Such good and interesting points and reflections. You are doing a lot of important thinking about all of this. First, yes, the fact that you are ingesting caffeine and tylenol and decreasing stress could definitely be what's impacting the decrease of your attack frequency: Good detective work on that!
        And so important, as you said, to ensure that your various doctors are communicating. This is a point that I don't think we can stress enough. There are various medications and modalities of treatment that can interact with one another and cause flare-ups. So, again- great thinking and putting puzzle pieces together so that you can uncover what's happening and why.
        We are our own best advocates and know our health and bodies the best. I'm so sorry you have to wait til January to have this appointment! There is a huge shortage of migraine specialists as well. Perhaps there's a shortage of neurologists too? Glad the one you are seeing has experience working with people with migraine. Hope you'll continue to stay in touch here- we're very glad to have you with us and enjoy learning from your well-earned wisdom. Warmly- Holly team.

      2. Hi there! Welcome. It really seems like you are doing everything right in seeking out your doctor and trying to identify triggers and behavioral changes. You are definitely starting out in a positive direction and I will join you in hoping it only gets better from here. 😀 Holly gave you some excellent resources, and there's one more link I want to add to the pile. We have a wealth of content about morning migraines. Some of it will fit you better than others, but I'm sure there are nuggets in here you will find useful. The "3 reasons for morning headache" by Maria DeLeon on this list is one of our more popular articles and might be worth considering with your doc, especially given that your migraine patterns seem to be changing.

        Keep us posted! All the best to you. -Melissa, team

    2. Thanks!! That's a good reminder to check my CPAP, too!

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