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About Migraine

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A migraine is a headache that generally affects one side of the head and causes intense pain. These throbbing headaches are usually accompanied by nausea and vomiting. They may also cause acute sensitivity to light and sound. Migraine episodes can last anywhere from hours to days, and the pain might be severe enough to prevent you from going about your normal activities.

A warning sign (known as an aura) may appear before or with the headache. Symptoms of a migraine aura include visual phenomena, such as flashes of light or blind patches, a tingling sensation on one side of the body, or trouble speaking.

Some migraines can be prevented and made less painful with the use of medication. The proper medications, in combination with lifestyle modifications, can help reduce symptoms and ease pain.

Common Medication
Treatment Options

Below is a list of common medications used for the treatment of migraines, which can be prescribed to you by a doctor or provider for just $5 through SesameRx.

Note that all prescriptions are at your provider's discretion.

Migraines can cause extreme pain and serious disruption to your daily functions. Luckily, there are several options that help treat and prevent migraines including:

FAQs

Migraine

What is a migraine?

A migraine is a headache disorder that generally affects one side of the head and causes intense pain. These throbbing, severe headaches are usually accompanied by nausea and vomiting. They may also cause acute sensitivity to light and sound. Migraine headache episodes can last anywhere from hours to days, and the pain might be severe enough to prevent you from going about your normal activities.

A warning sign (known as an aura) may appear before or with the headache. Symptoms of a migraine aura include visual phenomena, such as flashes of light or blind patches, a tingling sensation on one side of the body, or trouble speaking.

What are the symptoms of a migraine?

Migraines are broken into four stages - also known as phases - that correspond with various symptoms. Not everyone who experiences migraines experiences all four phases. Every migraine episode is different and may vary in severity. The four stages of migraine are detailed below.

Prodrome

This preliminary stage - also known as preheadache - may last for several hours or days prior to the migraine. You may experience symptoms such as:
- Mood changes
- Difficulty concentrating
- Nausea
- Fatigue
- Frequent yawning
- Muscle stiffness
- Increased urination


Aura

An aura may occur before or during a migraine and may last for 5-60 minutes. Most individuals do not experience an aura, or, if they do, it occurs simultaneously with the headache. Common symptoms of the aura stage include:
- Visual phenomena such as bright spots, flashing lights, or blind spots in your vision
- Tingling or needling sensations in your arms or legs
- Facial pain or weakness
- Difficulty with speech
- Tinnitus (ringing in the ears)


Attack

The headache symptoms of migraines usually last for 4 to 72 hours. The severity of these symptoms will vary from person to person and attack to attack, but common effects include:
- Pain on one or both sides of the head
- Sensitivity to light, sound, and smell
- Nausea and vomiting
- Loss of appetite
- Fatigue
- Dizziness or blurred vision


Post-drome

Also known as a migraine hangover, the post-drome stage begins after the major symptoms of the headache attack have dissipated. Common feelings associated with the post-drome stage include:
- Fatigue
- Difficulty concentrating
- Feelings of depression
- Feelings of euphoria or elation
- Recurring pain after sudden head movements

Are there different types of migraines?

Neurologists have divided headaches into two distinct categories: primary and secondary. A primary headache is not caused by another medical condition. Secondary headaches may occur as a result of another condition, or trigger. Primary headaches are considered a genetic disorder. 80% of individuals who experience migraines not caused by another condition also have a family member who struggles with migraines.

Common types of headaches include:
- Cluster headaches (headaches that occur in patterns or in recurring episodes)
- Chronic migraines (chronic daily headaches that occur at least 15 times per month)
- Silent migraines (migraines that occur with aura symptoms but no headache)
- Common migraines (migraines that occur without an aura)

What causes migraines?

There is no singular cause of migraines. Neurology researchers continue to study the role that various brain chemicals and hormones play in causing migraines. Some triggers that may cause a migraine episode include:
- Hormone changes in women
- Daily use of pain management medication or headache medication
- Stress
- Caffeine use
- Sensitivity to light or loud sounds
- Sensitivity to food additives or ingredients (such as aged cheese, nitrates, or alcohol)
- Changes in weather conditions
- Exhaustion or physical overexertion
- Dieting or missing meals
- Dehydration


This is not a complete list of all triggers. Some migraine patients may experience symptoms without exposure to any of these triggers. Work with your primary care provider or a migraine specialist (such as a neurologist) to help determine what triggers may cause your headaches and craft a treatment plan to reduce your risk of migraine episodes.

Who is at risk of developing migraines?

Just as there is no common cause of migraines, there is also no singular risk factor that determines whether or not you may experience migraines. However, headache specialists and health care providers believe that certain circumstances might make you more at risk for developing migraine headaches. These risk factors include:

- Genetics: 80% of individuals who experience migraines also have a blood relative (such as a parent or sibling) who also experiences this headache disorder.

- Sex: According to the Mayo Clinic, women are three times more likely than men to experience migraines. Additionally, hormone changes that occur in women before or after menstruation, as well as those during pregnancy and menopause, can lead to migraine symptoms.

- Age: Migraines often peak when an individual is in their mid-30s. Early episodes of migraines may appear in adolescence. As an individual grows older, these symptoms tend to become less severe and frequent.

How common are migraines?

The American Migraine Foundation estimates that nearly 39 million Americans deal with migraines. This case number may be even greater, however, as many people do not receive a diagnosis for migraines - believing that they are just susceptible to headaches.

How are migraines treated?

Migraine care primarily revolves around pain management and preventative treatment. Exact treatment options may vary depending on the severity of a patient’s symptoms and their age (as well as any pre-existing medical conditions or medication usage).

Common forms of migraine/ headache treatment include:

Self-care

Along with medication and other preventative treatments, lifestyle changes have been shown to help relieve the symptoms of migraines. These include:

- Relaxation techniques: Because migraines can be caused by stress, developing relaxation techniques, such as biofeedback, can help reduce the amount of stress-induced migraines you experience.

- Maintain a consistent sleeping and eating routine

- Stay hydrated

- Maintain a headache/migraine diary: Keeping a headache journal will help you figure out what causes your migraines and which treatments are the most helpful. It will also assist your doctor in diagnosing and tracking your illness between appointments.

- Exercise regularly: Regular aerobic exercise can help prevent migraines by reducing stress. Talk with your doctor and choose an aerobic exercise you love, such as walking, swimming, or cycling. Warm-up gradually, as quick, hard activity might result in headaches. Obesity is considered to be a role in migraines, therefore regular exercise can help you reduce weight or maintain a healthy body weight.

- Avoid triggering foods.

Medication

Migraine treatments aim to alleviate symptoms and prevent attacks in the future. The frequency and intensity of your headaches, whether you experience nausea and vomiting with your headaches, how disabling your headaches are, and any other medical problems you have will all influence your treatment options.

There are two types of headache medicine used to treat migraines:

- Medication for immediate pain relief. These medications are used during migraine attacks and are intended to relieve symptoms. Migraine pain relievers work best when used at the first sign of an impending migraine. These medications include pain relievers (such as aspirin, ibuprofen, and Advil), triptans (such as sumatriptan and rizatriptan), and ergotamine drugs (commonly sold as Migranal).

- Medications for prevention. To lessen the severity or frequency of migraines, these medications are used often used daily. Drugs used to prevent migraines include blood pressure medication, antidepressants, and anti-seizure medication. A Botox injection every 12 weeks has also been shown to prevent migraines in adults.

Alternative therapies and stress management

A number of other treatment options have anecdotally helped patients suffering from migraines. These are generally not medically-tested solutions. Always consult with your doctor before pursuing a treatment plan.

- Acupuncture: Acupuncture has been proven to be effective in the treatment of headache pain in clinical trials. During an acupuncture session, a practitioner inserts several tiny, disposable needles into different regions of your skin at specific points.

- Biofeedback: This relaxation technique has been effective for some people in relieving migraine pain. This relaxation method employs specialized technology to teach you how to track and regulate stress-related bodily reactions like muscular tension.

- Cognitive-behavioral therapy (CBT): This form of psychotherapy teaches you how your actions and ideas influence your perception of pain.

- Meditation and yoga: If stress is a trigger for migraines, yoga and meditation may help reduce the frequency and duration of migraines, when done regularly.

How are migraines diagnosed?

New patients seeking treatment for migraines should seek care from a primary care physician. During this preliminary consultation, you may be asked about your medical history, as well as any allergies or sensitivities you may have, and any medication you may be currently taking.

After this, your provider will likely ask you about your symptoms and your history of headaches. This may help determine the cause of the headaches.

Finally, the provider might order diagnostic imaging tests (such as a CT scan) and blood work to rule out any medical causes of your headaches. You may also be asked to take an electroencephalogram test (EEG) to determine whether or not your symptoms may be caused by seizures.

How does booking care on Sesame work?

Sesame makes it easier than ever to find and pay doctors online directly - allowing you to book an in-person or telehealth appointment in less than two minutes. To get care today, follow these easy steps:
- Search for telehealth or in-person appointments by specialty, condition, or doctor
- Choose a doctor at the right price and time for you.
- Pay for your appointment online at direct-discount prices.
- Before your appointment begins, complete a brief medical history form.
- If you’re seeing a doctor online, click the link sent to your email to join a secure online telehealth appointment. If you’re seeing a doctor in person, go to their office at the time of your appointment.
- If you are prescribed medication and choose medication delivery, it is usually delivered to your home within 2-3 business days. Otherwise, you can select a local pharmacy often with same-day pick-up. Providers on Sesame can prescribe anything medically appropriate, except for the limited set of controlled substances (as defined under the Controlled Substances Act).

Should I see a doctor in-person or online?

It depends. Telehealth platforms like Sesame make it easier than ever to see a doctor online from the comfort of your home through virtual visits. These are real-time video chats with doctors and providers that are used to address symptoms, discuss prescriptions, and screen for health care conditions. Telehealth (also known as telemedicine) is a convenient way to see a health care provider without requiring the commute and waiting rooms of office visits.

In-person visits, however, are vital health services. Certain conditions and specialty care services cannot be diagnosed or performed via a telehealth visit. Lab testing, for instance, often requires an in-person appointment at a doctor's office. Similarly, some physical exams, chronic condition consultations, and urgent care needs require in-person care. Some patients feel more comfortable receiving their care through in-person doctor visits, and many telehealth services require in-person visits before a condition can be definitively diagnosed.

Health care marketplaces like Sesame offer both in-person and virtual care options. If you're unsure whether or not you need to see a provider face-to-face, we recommend that you book a video doctor visit to discuss your concerns and talk through any symptoms you may be experiencing. If an in-person doctor appointment is required, you can easily book a visit through Sesame's scheduling platform.

What is primary care?

The term primary care refers to the kind of medical care you need first — before you get sick, before you need to see a specialist, before you need to go to a hospital.

What do you see a primary care provider for?

Primary care providers can treat all sorts of conditions and issues. From women's health to sports medicine, PCPs have the training and experience to be able to address a number of health concerns.

Primary care providers can offer:
- Routine checkups
- Annual physical exams
- Immunizations
- Urgent care
- Blood pressure testing (to check for hypertension and heart disease)
- Injury treatment (stitches, casting, splinting)
- Medication prescription
- Medical advice for general wellness


Primary care providers can usually answer most medical questions you may have. If you need a specialist, a PCP can offer a referral for a qualified doctor with the knowledge and expertise to treat you.

What types of telehealth care can I book through Sesame?

It is up to the provider to determine what services they offer through a virtual appointment. Examples of care you can find on marketplaces like Sesame include:
- Primary care
- Urgent care (for conditions such as rashes, sore throat, migraines, UTIs, and more)
- Sexual health consultations
- Mental health consultations
- Chronic condition management
- Dermatology consultations
- Prescription refills
- Pediatric care


If you are experiencing a medical emergency, do not use telehealth. Instead, call 9-1-1 or go to your nearest emergency room immediately.

Can the provider prescribe medication?

Yes, physicians on Sesame are able to prescribe a wide range of medications, which can be useful for infections, allergies and other acute ailments.

Please note that they will not prescribe certain drugs, such as narcotics or medications that have been designated controlled substances.

Otherwise, many of the prescriptions available in an office setting or urgent care can be prescribed if your physician deems it’s appropriate.

Can you get a prescription online?

Sesame makes it easier than ever to get a prescription or refill a prescription from the comfort of your own home! To discuss a new prescription or refill, book a video visit with a doctor on Sesame. Physicians on Sesame can prescribe drugs that help treat infections, allergies, high blood pressure, and more.

Note that doctors on Sesame cannot prescribe controlled substances.

Plus, because Sesame works to set prices directly with doctors, you can find visits with doctors at rates up to 60% less than what you’ll find through insurance networks.

Book a video visit on Sesamecare.com based on the health care you need, and pick up a new prescription or existing prescription refill at a pharmacy of your choice. If you don’t want to go pick up a prescription in-person, many pharmacies offer a prescription mail service for home delivery. Your medication will be shipped directly to you. Browse services on Sesame, set up an appointment with a real doctor at your convenience, and get the care you need. It’s simple, convenient, and affordable. Book a visit today!

What if I don't have a camera for a video conference?

After you book your virtual appointment, your confirmation email will contain the health care provider's phone number. Call the provider ahead of the appointment to let them know that you'd prefer to have your visit over the phone.

Can I get quality treatment during my telehealth appointment?

Yes! Providers on Sesame meet the highest standards of quality. Many medical conditions can be immediately and conveniently diagnosed during a telehealth appointment.

What are the benefits of telehealth and video visits?

Over the past few years, telehealth has transformed the healthcare landscape giving patients better access to quality doctors and providers. Still, some may be unfamiliar with telehealth and its benefits.

In the simplest terms, telehealth is a means of managing your health with the use of digital platforms, video, and virtual consults with online doctors and providers. This includes:

- Virtual appointments: the ability to see your doctor virtually with video consultations. This is perfect for both new patients and those with ongoing appointments that don’t require an in-person visit. Despite what you may have heard, many conditions can actually be treated over video, including toothaches, moles, warts, UTIs and other vaginal infections, and more.

- Correspondence between doctors: By promoting faster, more efficient means of communication, telehealth allows for doctors to better coordinate and address patient needs.

- Virtual health records: Apps, sometimes called personal health record systems (PHRs) allow for the viewing of health care records from a web-enabled device.

- Remote Monitoring: Apps that upload medical information, such as lung function, blood pressure, and blood glucose readings, so that your doctor can monitor you virtually.

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