Proactive Planning and Pacing: Managing Chronic Migraine

By Holly Harding

1 min read

When we experience migraine, it can be easy to respond to the condition in a reactive way. The pain arises, we react.

How can we manage chronic migraine?

However, with chronic migraine, it may help to consider putting migraine management first in life. While the disease doesn’t have to BE our lives, it can make a difference when we proactively plan our schedules around it and proactively pace ourselves each day in hopes of slowing its frequency and severity. In this video, Holly shares how she is embracing this approach in her life and ways it is working for her.

Does the idea of proactively planning and pacing your life around migraine sound feasible or of interest to you? While many of us don’t have the flexibility in our lives to slow our pace, perhaps there are ways we might consider scheduling smaller breaks throughout the day and ways we can reset to lower the chances of a flare-up. Let us hear your thoughts in the comment section below – we look forward to learning from you.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Join the conversation

Please read our rules before commenting.

kateymac Member
 <inline-mention username="Holly Harding" user-id="3755969"/> Hi Holly - Actually, pacing out my day sounds like a good thing to try. I do live very reactively since my migraines became daily and I became disabled. I still try to run around and do things when I can, because of how much time I lose to migraines. At first the word “planning“ always seems absurd to me because I never know what’s going to happen with the migraine. Just today I had an appointment for my car, and had to cancel it a half an hour beforehand because I got a migraine. I can be on my way out the door when the migraine hits, and then my plans end. So I think I’ve been living in a very frantic reactive pattern for most of my 20+ years of chronic migraine. I’m not sure how to begin but some sort of pacing like you described, Holly, would probably be a good idea. Migraine is the center of my life. Ironically, it might have a little less control if I accept that it’s central to anything else. I need to slow down in general. I’m always hurrying to get something done while I can, and I don’t think that’s helping me. Thanks, Holly. ❤️
1. Holly Harding Moderator & Contributor
 <inline-mention username="kateymac" user-id="3784217"/> Hey sweetie! The best-laid plans... I did my pacing as usual this morning, rested, and then had to pick my mom up from the airport in the early afternoon (a 1.5 round trip drive). I was doing well but right before getting in the car I noticed that all-too-familiar wave of nausea hit. Halfway there I had to pull over to vomit on the side of the road. I had to have my mom drive me home and have my sister pick her up from there as I had completely devolved into a terrible attack enroute. Ugh! I share this to say that even when one does plan life proactively around migraine- embracing rather than resisting it- we can still get hit hard and randomly. Still, I have really come to stick with my midday rest- I think overall it's a good tactic to managing life with migraine. Let me know if you give it a try and if it works for you. Sounds like it would be a big change for you. Sending love- Holly (migraine.com team).
kateymac Member
Oh Holly! What an awful trip that turned into! I’m so sorry you went through that! That’s what so many people don’t understand. We might be “fine” to BEGIN a task or outing, but then what? - We don’t ever know. In addition to our bodies throwing up roadblocks, the surprises happen from “out there” too. Eg.: this morning my car didn’t pass inspection. Yesterday I had to meet another new doctor, at a pain clinic that only left me more stressed me out than before. Is there a doctor left on earth that understands how to prescribe pain meds? Uh-oh… this has become a rant. Sorry. This morning I ran two other errands, because I COULD. Now I’m wrecked. Yes! - I need to get some kind of slower pacing. Got to go back home before it’s already making me sick to be running around. It’s overwhelming, and I’d like it not to be. Frankly, I don’t quite know how to begin. Any tips on how you all pace yourselves would be much appreciated! Thanks, Kate 🌷
1. Holly Harding Moderator & Contributor
 Hi <inline-mention username="kateymac" user-id="3784217"/> - You are so sweet to commiserate and relate to my horror ride to the airport yesterday! You are so right to point out the 'surprises' of life and how we cannot plan for them. And in my experience, migraine attacks thrive on surprises. Sorry about the car inspection, btw... a headache in itself! Are you changing doctors altogether or did you just go in for a consult? Finding a good fit with a specialist is SO key and yet SO hard, too! Ugh. Why? If you need a referral to a migraine specialist, we have some, so let me know. As to how to turn toward embracing pacing... my suggestion as to how to start would be to carve out a window of time each day (especially if you have a pattern in which your pain escalates throughout the day... this is the case for me). I block a time each day when I don't schedule any meetings or appointments. It's like making an appointment with myself. I've learned that it's best for me to be in rest-mode- lying down in a dark room by 11am every day and to stay quiet for at least an hour to two hours depending on my head. If needed, I take a rescue medication right before and then lay down to help it work. But, I wonder if it would work for you to schedule a break in your day? Or at least try it for a week and see if it helps at all? Let me know if you find this helpful. Sending love to you, Kate. Warmly- Holly <a href='http://-migraine.com' target='_blank' rel='noopener noreferrer ugc'>-migraine.com</a> team
kateymac Member
<inline-mention username="Holly Harding" user-id="3755969"/> Hi Holly - The funny thing about pacing, for me, is that I barely ever manage to leave my apartment most days. But somehow, even when I’m home all day, I still feel like I’m rushing around. Talk about “haste makes waste” - you never saw anyone drop everything on the floor like I do. I try to do things fast-fast-fast, without realizing it until I drop or break something! What am I trying to do- outrun myself? Outrun the pain? So anyway - I need to pace when I do get out. But I may need to do the same when I’m in all day. I have to slow my mind. I’m going to set an alarm for twice-a-day resting sessions, probably in a dark room like you do, and see if it helps. I’ll keep you posted. Your video about this is so helpful. Sometimes I just wonder “how am I going to stop being so nuts?” Then a seemingly simple suggestion opens a new sense of possibility. Anyhoo, I’m gonna give it a whirl.💃 Thanks! Kate🌷
1. Holly Harding Moderator & Contributor
 Hi sweet Kate <inline-mention username="kateymac" user-id="3784217"/> . I hope this might work for you. I think you're asking such great questions of yourself about why you often feel you are rushing around. I know that when my pain is low, I tend to have a hard time avoiding the urge to catch up and overdo - which of course sets me up for an attack. I'm learning to do a little at a time (not clean the whole house, like I used to - but instead wiping down the counters one day, vacuuming another, cleaning the bathrooms on another, and so on). I love your statement "outrunning the pain"- very apt. I often keep the tv on and turn down the brightness and close my eyes to get my mind off focusing on the pain. That distraction works for me. Let me know how this goes for you- I'm most interested to hear and so glad you found this topic helpful. Sending love- Holly (migraine.com team).
2. Melissa Arnold Community Admin
 <inline-mention username="kateymac" user-id="3784217"/> I am right there with you, friend! Why is resting SO hard? I find that even when relaxing I catch myself doing two things at once. I often say to my husband, "But there's always something that needs doing." My therapist has been working with me on planning intentional rest time. I feel absolutely crazy for needing help with this, sometimes. BUT ... slowly the restlessness is subsiding and it's getting easier to slow my body down... Have you ever done anything with mindfulness? I was not a fan when I first started, but over time I have come to see the value of just letting things be. There are even meditations out there for mindful walking, which might be useful to accompany you during your pacing sessions (you too, Holly). I will be thinking of you tonight as I work on resting. You're not alone! Hopefully we will all get better at honoring our bodies and minds. Hugs! -Melissa, migraine team
kateymac Member
ps: i just set the alarm, to play The Rolling Stones’ “Time Is On My Side.” Here’s hoping.🤞
kateymac Member
Hi <inline-mention username="Melissa Arnold" user-id="3827796"/> Thanks so much for this reply. I used to meditate regularly, before I had a migraine every day. So at 36, when it all went daily, meditation was just too difficult. Even though there are a zillion studies that prove it helps with pain, I just couldn’t do it anymore. However, the years of mindfulness meditation serves me well - sometimes What I like about the resting is that it’s a much easier way to do the same. And who says I have to sit up straight with my arthritic knees crossed? I’m the boss of me.😆 I tried it yesterday, and I did find myself casually using mindfulness in order to pull my mind out of the spinning.😵‍💫 I used an eye mask for total darkness, as well as for the nice feeling on my weary migraine eyes. I only did 20 minutes, but even that really settled me down. Maybe I can try to see it like just another part of medical treatment for this crazy illness,illness. Mindfulness was as helpful as the letting my body rest. Thanks again, Melissa! Kate 🌷
1. Holly Harding Moderator & Contributor
 <inline-mention username="kateymac" user-id="3784217"/> Hi Kate- good to hear that your trial run seemed to go okay. Sounds lovely- the full darkness. I agree that this is just another treatment approach. I think there is a lot to explore related to the idea of turning toward the condition rather than turning our backs on it and getting hit repeatedly. This is all, of course, also tied to acceptance. I have found it so helpful to work on accepting migraine as doing so frees up a lot of energy I used to spend on resisting and fighting it and being angry about it. I'm impressed by the meditation piece. This has always been hard for me as I seem to spin out in my brain focusing more on my pain rather than relaxing. This is why I find it helpful to listen to something else (podcast, music, tv) to distract me from the pain as it helps me just kind of float along as I go. Keep in touch about how this is working for you. Sending love! Holly <a href='http://-migraine.com' target='_blank' rel='noopener noreferrer ugc'>-migraine.com</a> team 
2. Melissa Arnold Community Admin
 <inline-mention username="kateymac" user-id="3784217"/> 20 minutes is more than I usually do, but then again, I tend to meditate while cozy in my bed, so it doesn't last long! I use guided meditations, which give me something else to focus on beyond the 700 thoughts bouncing around in my head. Whatever works to help soothe! I love the idea of the eye mask. I've never used one, but have you ever tried the ones with cooling gel inside them? I bet that would be heavenly when you're having an attack or your eyes are just tired. -Melissa, migraine team
azreynolds Member
Hi everyone! I truly believe the reason we have such a hard time relaxing and just stopping in the middle of the day is obviously because we always have too much to do. If y'all are like me, it seems like my house is never clean, and there's always meals to cook, therefore always tons of dishes to wash. Then when you start thinking about all the work we have to do outside just to maintain the yard so they look decent, not to mention if you have gardens or vegetable gardens, how much more work there is involved in trying to take care of those plants? And of course most of us have pets. Not saying we don't love our pets, because we do! They're part of our family and we truly do love them to death, but they add such a mess to my house! Sometimes I wonder if I'll ever get another pet after my dog passes. I truly cannot stay on top of the dog hair! But I did get me a robotic vacuum cleaner and that helps because it sets itself off every day and runs around the house and picks up some of the dog hair. But back to relaxing..... PainTrainer.org suggests that you have a set time two or three times a day to take a break for at least 10 minutes. Now 10 minutes doesn't sound like a very long time, does it? But I have a heck of a hard time doing that unless I set the alarm on my phone or my watch to remind me to do it. When I was doing it regularly and carefully, I found that I was feeling at least 70% better. So I do think it's a great idea! But I'm just not good at doing it anymore. I guess it has to be a habit and we all know it takes 3 weeks to form a habit. Y'all mentioned mindfulness meditation. That is a great way to spend that 10 minutes! And you don't necessarily have to be sitting there with your eyes closed. You can be enjoying a cup of tea, focusing on the flavor and scents. For the 10 minutes for could also read a book or magazine article. What I used to spend a lot of my time doing was searching for recipes for what I wanted to cook for dinner next week. Pacing ourselves is very important! Holly, I agree with you 100% on that. I pace myself by only cleaning part of my house when I clean. I clean only bedrooms on Monday, bathroom Tuesday. I clean the living room on two days later on Thursday, and I clean the den and kitchen towards the end of the week, Friday or Saturday. Wash is done on Sundays. My house is very small so this works really well for me, but my house is seldom 100% clean. If I got to give up something, I guess I'll give up a clean house because that's much easier to tolerate than a severe migraine. Holly, I do love the idea of taking a break once you've done something that is strenuous. I think I sort of accidentally do that when I'm cleaning house, but it's because my back hurts so bad I have to wrap myself in my heating blanket. Lol! Great topic once again Holly as usual. Y'all take care!
1. Nancy Harris Bonk Moderator
 <inline-mention username="azreynolds" user-id="3677307"/> So nice to hear how you navigate living with migraine and self care. Pacing is so important when living with any chronic illness and I've found it to be a constant battler. I like the idea of setting an alarm on my phone to remind myself it's time to rest! A quick 10 minute rest can make a huge difference. Clean house - what's that, LOL! Your timetable on cleaning is brilliant and something I'm going to consider. I hope today is a low pain day and as always I look forward to hearing from you, Nancy Harris Bonk, Patient Leader/Moderator <a href='http://Migraine.com' target='_blank'>Migraine.com</a> Team 
2. Holly Harding Moderator & Contributor
 <inline-mention username="azreynolds" user-id="3677307"/> - Hi Annzie! So great hearing from you. Your points are spot on relevant - and your suggestions are so helpful, as always. Yes, I like the idea of using this rest time as a reset - either after something that might cause the pain to rise- or even as a built-in set time that occurs no matter the case. On the topic of pups and shedding, I had to mention that my sweet Gracie Mae is a goldendoodle and my first non-shedding dog! What a dream. Just wanted to mention it as I know how much you love your sweet boy- and how much animals mean to you. Warmly- Holly <a href='http://-migraine.com' target='_blank' rel='noopener noreferrer ugc'>-migraine.com</a> team
azreynolds Member
Holly, If I could afford another dog, it would be a Goldendoodle! Gorgeous and big enough that I could pet it without bending over. And this will sound crazy, but big dogs have shorter life spans. At my age I need a dog that will pass within 10 years or so. I would hate to die and my pet be put in a shelter. But another cleaning tip which I posted on another article this week...wipe up water! Everytime you wash your hands, use your sink, take a shower, take the few seconds or minutes it takes to wipe up the water. Even your tooth brush; wipe it down. We have special old hand towels at every sink just for wiping the sinks and faucets off. This goes to your floors too. The Dutch have a special floor cloth called dwiels. I learned decades ago to leave an old rag on the corner of my kitchen to wipe up tiny drips on the floor because they attract dirt and create dirty spots. Now I have a name for it! 👍 But what does this have to do with resting? Try it for 1 week and you'll be shocked at how much easier it is to clean the sinks, faucets and shower when you clean next. A few seconds spent upfront, saves lots of scrubbing time down the road. Plus, your house will look cleaner in between cleanings. 
1. Cody Leach Community Admin
 Love this cleaning mentality <inline-mention username="azreynolds" user-id="3677307"/>. It emphasizes how much of a difference a small amount of effort can make in the long run. This is something I try to embody myself, however as with anyone, I'm not always perfect. But by being mindful about what I can quickly tackle a few times each day, it prevents my house from devolving into total chaos as I get back on my feet! Thanks for sharing 😀, - Cody (Team Member) PS. I hope that you are able to get a goldendoodle one day. They are SO CUTE!
cvphvp Member
It’s been a while since I’ve gone through chronic migraines. I usually get them quarterly at change of seasons but now it’s more often. I’m on preventive meds and use ice and headache cap at home. I’m on blood thinners so no NSAIDs. I work so I can’t stay home. Emgality is too expensive. They cycle constantly. I’m on week 3. Any suggestions!
1. Cheryl Picerno Moderator
 <inline-mention username="cvphvp" user-id="3720444"/>, I'm sorry you are having a rough time right now. I understand how that can impact your life, especially if you must head off to work. Keeping your attacks well-managed is challenging. Do you currently have health insurance that is not through a governmental plan? If so, you can take advantage of the manufacturer's co-pay assistance program for Emgality. Many drug companies offer assistance programs for patients who would benefit from their medications but can't due to the cost. Here is a link for the assistance program. https://www.emgality.com/savings?utm_source=google&utm_medium=ppc&campaign=6506846301&adgroup=79794805164&ad=461349574768&utm_keyword=kwd-531753709621&utm_id=go_cmp-6506846301_adg-79794805164_ad-461349574768_kwd-531753709621_dev-c_ext-_prd-_mca-_sig-EAIaIQobChMIteCm46LBggMVQJ9aBR0gDwI_EAAYASAAEgKpifD_BwE&gclid=EAIaIQobChMIteCm46LBggMVQJ9aBR0gDwI_EAAYASAAEgKpifD_BwE Here is another link to some information on tips to cover healthcare gaps. https://migraine.com/resources-cost Many people have found the CGRP class of medications has helped them, but cost and how your body reacts to any drug can be stumbling blocks for us. I hope you find this information helpful. I'll be praying that your three-week-long cycle breaks. Let us know how you are doing moving forward. Warmly, Cheryl <a href='http://migraine.com' target='_blank'>migraine.com</a> team
cvphvp Member
Thanks Cheryl, I’m on Medicare so Icant take advantage of the savings programs.I’ve had migraines since I’m 9.
1. Cheryl Picerno Moderator
 <inline-mention username="cvphvp" user-id="3720444"/>, I'm sorry you've had to fight with migraine from such an early age. Mine started in my teens. They have changed over time, but they are still an awful thing to have to live with. I hope government insurance, like Medicare, will cover these medications one day. The hurdles people have with this are disheartening. If your treating doctor feels the medicine will help the patient, they should make the approvals on this basis at a minimum. I work just to have commercial insurance so my husband can get his medications for migraine. In my opinion, the whole insurance approval process is counter-productive in so many cases! Depending on your medication needs, you may be able to save using a program such as GoodRx. Lilly also has plans you may qualify for, but you need to check. The website and phone number are <a href='http://lillycares.com' target='_blank' rel='noopener noreferrer ugc'>lillycares.com</a> and 800-545-6962. I'm always cautiously optimistic. Warmly, Cheryl <a href='http://migraine.com' target='_blank'>migraine.com</a> team
cvphvp Member
The insurance covers it at a prohibitive cost! Originally, with insurance it was over $600 a month, now it’s down to $300s
Rebecca C Moderator
<inline-mention username="cvphvp" user-id="3720444"/> - I have been reading more and more comments such as yours recently where individuals must decide and who are struggling to get meds vs buying food. It is disheartening. I wanted to stop by and drop a link (or two) that may be of help. <a href='https://headachemigraine.org/emgality/' target='_blank' rel='noopener noreferrer ugc'>https://headachemigraine.org/emgality/</a> (CHAMP) - click on I HAVE MEDICARE and it gives you information. There also might be something on this webpage to help - <a href='https://www.patientadvocate.org/migrainematters/' target='_blank' rel='noopener noreferrer ugc'>https://www.patientadvocate.org/migrainematters/</a> Or programs such as this one can help - https://www.lundbeck.com/content/dam/lundbeck-com/americas/united-states/about-us/patient-assistance/migraine_patient_assistance_form.pdf.coredownload.pdf I am terribly sorry you've been going through this struggle. Thoughtfully, Rebecca (community moderator)
kateymac Member
<inline-mention username="Holly Harding" user-id="3755969"/> & <inline-mention username="Melissa Arnold" user-id="3827796"/> : Hey Y’all - So I’ve been resting twice a day since reading Holly’s original essay, above. I don’t manage it every day, but I almost always do it if I’m home. I have an alarm on my phone to remind me, at 11:30am & 3pm. I rest for about 20 minutes. I put on an eye mask and leave my phone in another room. My mind wanders, but I bring it back as in meditation. I bring it back to focus on how nice it feels to not see anything with my tired migraine eyes, and I really become aware of how happy my ears are to hear nothing. I listen to podcasts to fall asleep at night, but for the rest times, I focus on the lovely lack of stimulation. Later, as the day proceeds, I can go back in my mind to that peaceful place. I used to get that same benefit from formal sitting meditation. The practice gives me a way to get grounded throughout the day, when inevitable stress comes along. I’m really happy with this addition to my migraine care. Thanks!!! Kate 🌷
1. Holly Harding Moderator & Contributor
 <inline-mention username="kateymac" user-id="3784217"/> - Thank you so much for tuning in to let us know how this is working for you! I like picturing you at 11:30 and three because those are my rest times too! It sounds like you are being much more focused on the lack of stimulation during that time. Really helpful for me to hear this approach as well. You are right that our eyes are so tired and our brains are so stimulated that clearing the decks of stimuli would actually be a brilliant idea for anyone, but especially for those of us who are living with pain and sensory overload challenges. I tend to keep my eyes closed, but do continue listening to things like podcast or music. I think I’m going to try your approach and experiment with how it might work for me. Always love hearing from you and appreciate you being in touch. How was your Thanksgiving? Warmly- Holly <a href='http://-migraine.com' target='_blank' rel='noopener noreferrer ugc'>-migraine.com</a> team 
2. Melissa Arnold Community Admin
 <inline-mention username="kateymac" user-id="3784217"/> AMAZING. I love the idea of setting an alarm. I always say I want to do something at x time but then get absorbed in something else, like being here ... and then I say, "I'll get to it in a bit." ... and then the day is over. Maybe an alarm could be useful for me. I also love the idea of physically blocking out all that sensory input with an eye mask. An excellent way to say, "This is my time to be quiet." It makes my whole week to know you're finding comfort and enjoyment in this intentional rest. It encourages me to keep at it, too. Glad to help!!! Hugs, Melissa (migraine team)
kateymac Member
Thanks to all three of you who’ve responded to me! I really appreciate it! Thanks so much for your help and support! Regular earthlings just can’t usually understand migraine the way all of you can. This site is often a real lifeline for me! Kate 🌷❤️❤️
1. Alene L. Brennan, RYT Moderator & Contributor
 <inline-mention username="kateymac" user-id="3784217"/> we're so glad that you feel the support that we're sending your way! Thank YOU for being part of this community too! - Alene, moderator

Community Poll

Do you feel comfortable advocating for yourself to your healthcare provider?