Can't Find My Trigger

Hi, I am a 47-year-old female who has had migraines for 25 years.

I used to get only 3 or 4 attacks a year with about 1 or 2 sending me to the ER because they wouldn't respond to my prescription medication but now they are happening 6-8 a month. I can't find my trigger. I thought it was sugar, but that's not it. They happen at different times, and sometimes I wake up with them.

What's new about my migraine attacks?

Just recently, they started causing extreme (lay in the bed for days) fatigue that would last for days afterward. My vision is always affected with them, and sometimes nausea. I get so frustrated because people think it's an excuse to call in from work or something.

I am an RN and a martial artist, so I can take some pain, but these lately are just over the top.