First Name: Samantha

 Age: 32

Location: Reno, NV

Years with Migraines: ~20

Occupation: Student

How long have you had migraines? I’ve had migraines for about 20 years. They started when I was going through puberty. I can still vividly remember the dream I had before waking up with my first migraine: I dreamed a carpenter was drilling a hole in my forehead.

When do you usually get migraines?  I am more prone to get migraines when I am dehydrated, exhausted, over-stimulated by intense smells or bright light (including light from electronics), or going through hormonal shifts. I avoid excess muscle tension and stress as much as possible, and the idea of red wine with dinner is a nonstarter.

What have you tried pre-Cefaly? Before CEFALY I was primarily using prescriptions to prevent and treat my migraines: between two and five prophylactic medications, including hormonal birth control to smooth out major swings in hormone levels; and four to six prescription options for migraine treatment, in addition to over-the-counter pain relievers. Going to summer camp when I was a teenager required being equipped with my migraine treatment algorithm and a bag of pills.   

What does your migraine feel like? My migraines are usually preceded by aura: a strange smell, numbness in my fingers, and/or bright flickering lights at the edge of my vision. Between 2 minutes and an hour later the intense pulsating pain starts, right behind my eyebrow on one side. Occasionally I will have a headache that gets out of control and intensifies into a migraine. During migraines I am acutely sensitive to light, sound, and smells. During my worst migraines I focus on avoiding the nausea more than the pain, because the nausea makes my pain and the migraine snowball. 

How did you hear about CEFALY? I learned of CEFALY in October 2016 in some reading material at my neurologist’s office, and I asked him about whether I was a good candidate. He wrote me a prescription and I think I filled it right away, but it took me almost a year before I was using my CEFALY consistently. When the Dual came out in 2017 I immediately enrolled in the exchange program so that I could try the new acute treatment program. I’ve had great success with the Dual. 

What’s your CEFALY experience like? My personal experience with CEFALY’s preventive program is that I use it every night – it is part of my bedtime routine. I experience a gentle buzzing and tingling in my forehead during the treatment. Sometimes I fall asleep before the program is finished. I wipe the electrodes down with alcohol wipes when I feel like they’re not sticking well. This seems to help revive the adhesive, and I notice a difference in how intense the program is when the electrode is not well adhered to my skin. I’m very happy with how long the battery life is; the only time I’ve noticed it is a problem is when I need more than one acute treatment program within a period of a few days. I use the acute treatment program 2-5 times per month, most often when I feel a headache escalating and I’m concerned about it turning into a migraine. When I get aura and know a migraine is coming I take my abortive migraine medications, lay down as soon as possible in a dark room, and put my Cefaly on the acute treatment program. 

Thankfully my migraines are well controlled now with prophylactic medication and CEFALY. I take my CEFALY with me if I’m going to be farther than an hour from home, or if I know I won’t be able to return home during the day. I think CEFALY has helped me decrease the number of medications I use prophylactically or for treatment; it has also decreased the number of migraines I experience every year and the number of hours I spend consumed by migraine pain. I spend less time now visiting my neurologist than I ever have, and my most recent neurologist has been very supportive of incorporating CEFALY into my treatment plan. CEFALY has been a life-changer for me because it has given me the courage to do things that previously I wouldn’t have considered because of the potential for a migraine to ruin the experience. Armed with my CEFALY, I am empowered to address a migraine quickly rather than wait for a drug (and its side effects) to take the edge off. I understand some individuals hesitancy to pay for the CEFALY device up front, but it has proved a worthwhile investment for me.

Want to share your story too? We’d love to hear from you! Please send an email to m.coder@cefaly.us. Please include your name, contact information, and let us know where you’re located so we can set up a good time to talk.

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Did you hear about the woman whose employer of 20+ years fired her for taking medication for her migraine headaches?

A drug screening revealed the presence of opioids in her system (from prescribed Dilaudid injections). Even though the woman’s doctor had already explained her medical condition, and had told the employer that she was not impaired and could carry out her job duties, she lost her job. 

There’s a happy ending to this story: A court found the employer had failed to reasonably accommodate the woman’s disability (migraine), and awarded her $1.8 million in damages. But there are many people out there who experience discrimination or even termination at their jobs due to migraine — without ever getting any satisfaction in court. If you’re facing a situation like this one, what can you do?

First, you should consult an attorney if you think your employer is violating the Americans with Disabilities Act (ADA) or another law. This post is no substitute for legal advice. But “in general, employees have a protected right to use prescribed controlled substances and come to work unless such use creates an undue risk of harm or safety issue,” according to the Society for Human Resource Management. This means that if your employer is giving you a hard time for taking medications prescribed for migraine, and you otherwise meet the conditions of the ADA, then you may be able to push back.

Learn more about migraine discrimination in the workplace

Professions that Restrict Migraine Medication

In some jobs, having migraine and using migraine medication can be considered a barrier to  effective job performance. Examples include:

  • Airline Pilot: The Federal Aviation Administration requires a physician’s assessment for any person with migraine to determine if they can meet certification requirements. In order to be certified, a pilot must have only mild symptoms, controlled with certain medications. Approved preventive medications are limited to calcium channel blockers or beta blockers; abortive medications are limited to over-the-counter painkillers. Using triptans, metoclopramide, or promethazine all require no-fly periods of varying length.
  • Military Service Member: Migraine headaches may disqualify someone from enlisting, if they are severe or frequent enough to interfere with normal functioning, and/or require prescription medication.
  • Truck Driver/Commercial Driver: The Department of Transportation doesn’t specifically say that people with migraine can’t get their CDL and be certified to drive. Its Medical Examiner Handbook, however, flags migraine as a condition that may interfere with someone’s ability to drive safely. Examiners are instructed to consider headache frequency and severity, as well as symptoms that can affect driving (such as visual disturbances), and the treatment used to relieve headaches: “Do the effects or side effects of treatment interfere with safe driving?”

So what can you do if your employer places restrictions on how you treat migraine? For some people, CEFALY may be the answer. 

CEFALY is the first FDA-cleared medical technology of its kind for the treatment of migraine headaches. A non-invasive device placed on the forehead, CEFALY DUAL uses two programs (ACUTE and PREVENT) to stimulate and desensitize the Trigeminal nerve, which research identifies as a key pathway for migraine pain.

CEFALY DUAL is a drug-free migraine treatment that has minimal side effects. Its ACUTE program is used to relieve migraine pain, while its PREVENT program is clinically proven to reduce migraine frequency and severity with compliant daily use. Many people have found that CEFALY allows them to reduce or even cease the use of certain migraine medications.

Are you ready to meet life head on? Obtaining a prescription for CEFALY DUAL is easier than ever. Schedule a free online medical appointment today with our partner, the AZOVA Telemedicine Provider Network. Here’s how it works.

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Finding Relief for Vestibular Migraine

Vestibular migraine is a condition defined as having vertigo or dizziness when you also have migraine symptoms. Unlike typical migraine, a headache may not always accompany these symptoms; but vestibular migraine is no less debilitating.

Symptoms of vestibular migraine may include sensitivity to motion, feeling unsteady or dizzy, feeling disoriented, problems balancing, anxiety, and nausea or vomiting. In the words of one young woman who has a severe case, “I wasn’t able to walk in a straight line, and I had very much trouble concentrating, whether it be a person in front of me or an idea.”

How to Treat and Prevent Vestibular Migraine

Doctors aren’t sure what causes vestibular migraine. “Treatment options for vestibular migraine are extremely limited, so current treatment is focused primarily on reducing the frequency of migraine attacks,” writes Dr. William Renthal, PhD, in the Harvard Health Blog. Some preventive measures include:

Changes to diet: The best-known advocate for a nutritional approach to preventing vestibular migraine is Alicia Wolf, author of “The Dizzy Cook” cookbook. Diagnosed in 2016 after having no history of migraine or vertigo, Wolf found relief in following the migraine diet developed by Dr. David Buchholz, MD, at the Johns Hopkins University School of Medicine.

The list of prohibited foods (most containing tyramine or histamine) is long, Wolf acknowledges. The key is using the list as a starting point and then testing potential trigger foods for 4-5 days in a row. “This can be tricky because one day your threshold for a migraine could be much lower due to stress, weather, hormones, etc. and you could instantly get a migraine, whereas on good days where your threshold is higher, you could eat the trigger food and get by with it, not even realizing it’s a trigger,” she explains. Thanks to the diet, and limited medication use, Wolf says feels like “90-95%” of herself again.

Medications: Frequently prescribed medications for vestibular migraine include:

  • Beta-blockers
  • Calcium channel blockers
  • Tricyclic antidepressants
  • Serotonin or serotonin/norepinephrine reuptake inhibitors (SSRIs or SNRIs)
  • Topiramate

Supplements: Many people with vestibular migraine find some relief in over-the-counter supplements, such as riboflavin (B2) and magnesium.

Vestibular rehabilitation: This is a specialized type of physical therapy for people who experience dizziness or vertigo. It might include posture and balance training, vision stability training, stretching and exercise.

What about acute treatment for vestibular migraine? Doctors may prescribe the triptans often used for migraine attacks, even if headache symptoms aren’t experienced. Antihistamines and other vestibular suppressants may be prescribed as well.

For a drug-free vestibular migraine treatment option, CEFALY DUAL has shown promise. A recent study published in the Journal of the Neurological Sciences showed that 19 out of 19 patients “reported improvement in vertigo severity” after using the CEFALY device to treat acute vestibular migraine attacks. This suggests that external trigeminal nerve stimulation (eTNS), the technology that drives CEFALY, may be an effective rescue therapy. “This study provides preliminary evidence that eTNS is a novel, non-invasive, safe and effective treatment for acute VM attacks,” Dr. Shin C. Beh reported.

This study is small, of course, and every person with vestibular migraine needs to try different treatment regimens to discover what works best for them. The Vestibular Disorders Association is a great resource for more information, with an active community that can offer support.

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Summer means long days, warm nights, relaxing vacations — and, for many people, more migraine attacks.

A survey by the National Headache Foundation found that three out of four people with chronic headache or migraine said weather was a trigger for headache pain. Specific triggers include changes in humidity or temperature, storms, and dry or dusty conditions.

If your migraine attacks become more severe or more frequent in the summer, the first step is to identify exactly which triggers are affecting you. Keep a headache diary for at least three months that includes weather conditions, your activities, symptoms and details of migraine attacks. Once you detect a pattern, you can develop an action plan for migraine relief. Some tips include: 

  • Keep sleep patterns steady. In summer, you might rise earlier, go to sleep later, or even take a midday siesta. It feels so relaxing — but erratic sleep patterns can trigger a migraine attack. Try to stick to a regular bedtime and get up at the same hour each morning. If you’re not sleeping well, avoid too much artificial light in the evening, and keep your bedroom cool and dark.
  • Stay hydrated. There’s a clearly defined connection between dehydration and migraine attacks — and drinking extra water may reduce the frequency of attacks. In one study, a group of people with migraine were told to drink six extra cups of water per day. While they averaged only four cups, those participants reported 21 fewer hours of pain in a two-week period, compared to the control group.
  • Beat the heat. A study published in Neurology found a definite connection between summer heat and migraines: a 9-degree (Fahrenheit) increase in temperature correlated with a 7.5 percent increase in the likelihood of a serious migraine attack. To prevent migraines, it’s best to avoid the hottest part of the day, seek out cooler spaces and (again) drink lots of water. 
  • Monitor your stress levels. Have you ever experienced a “let-down migraine”? These attacks follow a period of stress or anxiety in life. Shortly after the stress eases, a migraine attack ensues. The only good thing about let-down migraines is that they can be predicted, which means you can plan around them. Your contingency plan for stress-induced migraines might include taking paid time off, lining up additional childcare, or simply practicing stress-reducing techniques. If you’re planning a big summer vacation, try not to schedule it immediately after a big project wraps up — or, if you must, then build in a buffer of a few days to let your body and brain decompress. 
  • Maintain your migraine prevention practice. Schedules have a way of fraying in the summer. Just remember that the migraine brain thrives on routine! Practice headache hygiene every week: moderate exercise, regular mealtimes, and predictable sleep.

CEFALY DUAL’s PREVENT program can become part of your summer migraine prevention plan, too. Use the 20-minute PREVENT program each day to desensitize the trigeminal nerve, which is heavily involved in the sensation of migraine pain. Compliant daily use is clinically proven to help prevent migraine attacks.

Curious about CEFALY? It’s now easier to get a prescription: Just schedule a secure, free telemedicine consultation with AZOVA Telemedicine. Learn more.

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“So many of us live in the dark, trying our best to navigate through life with an unpredictable and life-stealing illness,” writes migraine advocate Jaime Sanders. “It is important that the world sees the true impact migraine has on the millions of people living with it, not only in this country but across the globe.”

As all people living with migraine know, having an invisible disability is hard. Well-meaning friends, colleagues and family just don’t understand that a migraine attack is not equivalent to a bad headache. One way to be seen and heard is to recruit migraine allies: people who understand what you’re dealing with, who support you and who can speak on your behalf.

Migraine Allies at Work 

Work colleagues may fail to understand that a person with migraine is really suffering intense, chronic pain, or may think they’re exaggerating. A study on migraine stigma found that people with migraine feel this pressure internally as well: “Migraine sufferers often anticipate that their headaches will elicit a negative reaction from friends and colleagues, or that they’ll be less productive because they have to miss work so often.”

Recruiting allies at work can help. Describe your migraine symptoms and the supports you need in a matter-of-fact — not apologetic — way to your manager and trusted co-workers. Workplace expert Alison Green offers a simple script: “Here’s the situation, I’m working to resolve it, until then it’s probably realistic to expect occasional sick days and occasional fogginess, and please let me know if this raises any concerns for you, now or in the future.”

Ask work friends for help in explaining migraine to other colleagues, so you don’t have to bear the burden of doing so over and over again. Once your coworkers understand that migraine is a serious condition, they’ll be more likely to comply with requests for accommodations, such as a fragrance-free policy.

Migraine Allies Among Friends and Family 

Friends and relatives often offer well-meaning but unhelpful advice to people with migraine. “Can’t you just take some medicine?” they might say. “Are you sure you can’t come over tonight? Maybe you’ll feel better by then.”

You know they care about you; they just don’t know how to express it. Recruiting certain people to be your advocates can help. Explain how a migraine attack affects you, or point them to online resources. Tell them what they can do to support you, such as helping you avoid triggers, or explaining to other friends what’s going on when you need to cancel plans. 

Migraine Allies Online  

If you feel unseen or unheard, just know that you’re not alone. You can connect with thousands of other people with migraine on social media and other platforms. Some popular options:

  • The Move Against Migraine Facebook group, run by the American Migraine Foundation, connects migraine patients and their loved ones with professional advice, treatment options, information on clinical trials, and other helpful resources. 
  • Migraine Buddy is an app used by millions to track migraine symptoms and connect with other people with migraine.
  • The CEFALY Users’ Group is a global community of people who use the CEFALY device to prevent and treat migraine. (A smaller group, CEFALY Users USA, is for people in the U.S.) Both groups are organic; we don’t own or moderate them, although we do pop in to answer questions! 

Learn more about CEFALY

Get a prescription for CEFALY DUAL with a telemedicine consultation from AZOVA Health.

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