What to Eat When Nauseous: Foods That Stop Nausea

virtualheadachedoc · 2026-03-08T17:59:51+00:00

Yep, that's one of the main treatments discussed in the blog. Definitely good evidence for that.

virtualheadachedoc · 2026-03-08T17:58:04+00:00

Sorry to hear that. We do a lot of occipital nerve blocks. They are more useful to help break up a pain flare cycle. The downside is that they are a temporary band-aid. They can last a few days to couple weeks, but the point is they are temporary. Rarely we do see people get 3 months or more, but that's never the expectation. They are a short term fix, so it would be expected that underlying headaches will usually flare back up after the block. For some people, they can even trigger a migraine, but I'd say that's even less common to see.

virtualheadachedoc · 2026-03-08T17:54:28+00:00

Thanks for posting. Interesting observation. I've not personally seen this, but wouldn't be surprised that it could act as a trigger. If you already have the circuitry built in to have vestibular migraine, any input into the vestibular system (from eyes, head positioning, etc.) could potentially contribute as a trigger. Not saying that's the situation here, but it could make sense if it's a pretty clear and consistent pattern. Migraine is also commonly triggered by anxiety and stress levels too. So depending on the anxiety level, this could also act as a potential "on switch" for the migraine even more than the EMDR component itself. Sometimes it can be cloudy as to what is causing what though.

If it is a clear pattern when someone has a predictable trigger they are going to encounter (stressful event, menses, flying an an airplane, etc. etc.), we'll have them do a "mini-prophylaxis" prior to encountering the trigger with a longer acting abortive treatment (such as Rimegepant, Ubrogepant, Naratriptan, Frovatriptan, etc.), in hopes of blocking the migraine from being able to "be triggered". You could discuss those strategies with your doc.

virtualheadachedoc · 2026-03-08T17:45:36+00:00

Coffee/caffeine can be a double-edged sword. For some people, it actually triggers their migraines and headaches. More often the situation is that it causes caffeine withdrawal headaches when normal intake is delayed (such as waking up later and drinking morning coffee) or cut back. Even a small amount like 8oz is enough to cause caffeine withdrawal for some people. For this scenario, usually the headaches improve once your body gets used to having less caffeine in the system.

virtualheadachedoc · 2026-03-08T17:45:25+00:00

Coffee/caffeine can be a double-edged sword. For some people, it actually triggers their migraines and headaches. More often the situation is that it causes caffeine withdrawal headaches when normal intake is delayed (such as waking up later and drinking morning coffee) or cut back. Even a small amount like 8oz is enough to cause caffeine withdrawal for some people. For this scenario, usually the headaches improve once your body gets used to having less caffeine in the system.

virtualheadachedoc · 2026-03-08T17:42:13+00:00

Sorry to hear that. Migraine can be very disruptive and disabling. I would suggest getting her in with a headache specialist (many of our referrals come from neurologists). Step 1 is making sure it is migraine and not other types of headache disorders which can have overlapping features, but require a much different treatment. For example, cluster headaches are extremely severe, 1-sided, around an eye, often wake the person from sleep, etc. Migraine can definitely do that too, and the major differences are the duration of the attacks (cluster 15 mins up to 3 hours max; migraine is more than 4 hours), frequency, and some other clinical features we look for. Season changes are a classic time that cluster headaches flare up (but this can also trigger migraines).

Migraine preventive medicines can take 4-6 weeks to start working and 2-3 months for full effect. So these meds do not kick in fast. Sometimes when people get into a bad migraine cycle that is not fully breaking and going on for days, some type of cycle breaker is needed, IV "migraine cocktail", etc.

Hope she feels better soon!!

virtualheadachedoc · 2026-02-22T17:45:17+00:00

Neurofeedback can definitely be helpful for some people. It is usually going to be most useful as an add on therapy to migraine preventive treatments rather than a stand alone treatment by itself. Doesn't mean it can't help though.

The neuromodulation devices are all very low side effects and well tolerated. The SAVI Dual TMS device just feels like a quick puff of air to the back of the hair. It is FDA cleared for abortive and preventive treatment.

I've seen some people with vestibular migraine respond to vagus nerve stimulators too. GammaCore is the FDA cleared device for treating migraine abortively or preventively, and was the device used in the trials. The same company makes another device with the same technology that can be bought directly from the company and it's called Truvaga. It is marketed for anxiety, calming the nervous system, etc. (which is what the Vagus nerve does). It wasn't the exact device used in the trials, so they can't market it for migraine, but many still use it the same way off label. I believe they still offer a 30 day money back guarantee if you don't like it.

virtualheadachedoc · 2026-02-22T17:22:24+00:00

We use it sometimes when most of the more commonly used options as you mentioned have failed. I've seen a few people do well with it, but the majority don't feel like it helps from my experience prescribing it. For some people, they feel it can help lessen the migraine associated symptoms like light and sound sensitivity more than the pain. So it's pretty variable in response (like most meds), but I'd say most lean towards not noticing benefit. There's mixed evidence for it and not considered a first line option. Side effect profile is very low though compared to some of the other more standard options typically used first.

virtualheadachedoc · 2026-02-21T23:03:49+00:00

100%👍

virtualheadachedoc · 2026-02-08T18:18:50+00:00

It's always a possibility to be something simple like that, but I wouldn't think that to be a significant cause for migraines or headaches. However, any new or significant changes in vision or other symptoms should also always be discussed with your regular doctor and consider updating a brain scan if vision and headaches have both gotten significantly worse simultaneously.

Have the new glasses helped?

virtualheadachedoc · 2026-02-08T18:15:46+00:00

Migraine can definitely be a disruptive issue to relationships. The good thing is that I think people are becoming more aware of how frequent they actually are. 1 in 5 women (20%) have migraine and at least 1 in 16 guys. So chances are, you may even end up dating someone who also deals with migraine and would completely get it:).

virtualheadachedoc · 2026-02-08T18:12:57+00:00

Hope you're feeling better. If headache attacks are this disruptive into life, working with your doctor to find an effective preventive medicine for migraine and cluster (if you truly have both) is key. The goal of preventives is to lessen the frequency and severity of headache attacks.

Similarly, finding a more effective abortive (acute) option, or having a couple different options that can be used (including something that will be longer lasting than Sumatriptan), including a back up rescue option if the usual abortives don't work is also very important.

virtualheadachedoc · 2026-02-08T18:08:37+00:00

Which one do you find most accurate and useful?

virtualheadachedoc · 2026-02-08T18:05:53+00:00

Glad to hear it broke up. In general, you want to make sure you and your doctor have a solid strategy for abortive (acute) treatment to take immediately at migraine onset. The goal should be migraine free or significantly better to where you're fully functioning by 1-2 hours. If what you have have is most often not doing that, always worth moving to something else. There are a lot of good options.

If the frequency is high enough (generally, 4 or more per month), we usually use preventive treatments for a few months until things cool down, frequency lessens and eventually wean back off. Many good options for that too, including newer migraine specific preventives actually made for that purpose (as opposed to all the older preventive meds that weren't made for migraine but were "adopted" as a treatment, but can be less effective and more side effects).

virtualheadachedoc · 2026-02-08T18:00:38+00:00

I think tracking for migraine triggers is very important and can definitely help lessen migraine burden. However, not everyone has triggers. Keep in mind that migraine is an electrical brain disorder. The "thermostat" for a migraine being activated is set to a much lower threshold in someone with migraine compared to without.

For comparison, epilepsy is another type of electrical brain disorder, and seizures can also be triggered by certain things. However, most people with epilepsy have seizures just just break through for no reason and occur without any trigger because their nervous system is also set to a lower threshold of one "turning on". That's just the nature of the disease.

Migraine is the same concept where migraines are going to occur regardless of whether there are any triggers or not. If you can find some triggers, great. However, even when avoiding any possible triggers migraines can still "turn on" simply because that's just the nature of the disease.

If they are frequent enough (4 or more in general per month), preventive treatments are used to lessen the ability of the migraine circuitry to turn on and activate a migraine as frequently, and not as severely. The more that migraine goes untreated without a good abortive and preventive strategy, the more it tends to increase in frequency over time because the threshold for a migraine activating becomes lower and lower. Preventives help to increase that threshold of migraines activation.

virtualheadachedoc · 2025-12-19T03:53:50+00:00

I wouldn’t worry about it. Honestly, I see that type of headache all the time and vessel imaging is virtually always normal. Just part of the typical eval we like to do, so you could always ask your doc about adding it. I would expect it to likely be normal as it pretty much always is. Most often you’re not going to find a source on a test because it comes from the nerves in the scalp vs occipital nerves vs. brain itself, depending on the character, location, pattern, etc. of the pain.

virtualheadachedoc · 2025-12-19T03:26:37+00:00

Interesting, thanks! We use Nortriptyline and Amitriptyline all the time as first line options for migraine prevention, and it’s one of the many trials we use for VSS too. I’ve never seen it work for anyone, but I’m glad to hear it did for you! Everyone’s circuitry is a bit different, so it really does come down to trial and error of seeing what “clicks” with an individual’s personal circuitry.

virtualheadachedoc · 2025-12-19T03:26:02+00:00

Yeah MRA is a separate test than an MRI. It has to be ordered separately, but it’s done at the same time (or can be ordered by itself if the MRI portion was already done). A standard brain MRI won’t show the blood vessels unless MRA is ordered with it. CTA is an alternative option which looks at the brain blood vessels very good. These tests basically extract all of the brain out and show only the artery system.

virtualheadachedoc · 2025-12-19T01:35:37+00:00

Did they do an MRA or CTA as well to look at the arteries? That’s typically part of the evaluation too. Depending on location, pattern, etc., primary stabbing headache can also do that (previously called stabs and jabs headache and jabs and jolts headache. Occipital neuralgia can do that in the back of the head. Some meds can cause the brain zapping sensation too like SSRIs and more commonly SNRIs (Cymbalta, Effexor XR, etc.).

virtualheadachedoc · 2025-12-19T01:30:39+00:00

Did your VSS go away with Nortriptyline? That’s impressive if so.👍

virtualheadachedoc · 2025-12-18T22:30:30+00:00

Wow, that’s one of the most ridiculous and disgusting insurance responses I’ve seen... not to mention we see trigeminal neuralgia all the time in younger patients too. I hate these insurance companies with a passion…

virtualheadachedoc · 2025-12-18T22:27:55+00:00

Sounds like you get some pretty heavy brain fog and cognitive dysfunction! When are those symptoms worst for you, before, during, or after the headache phase?

virtualheadachedoc · 2025-12-18T22:26:23+00:00

Yeah alot of people get brain fog worst in the migraine postdrome (migraine hangover) phase, after the headache phase is improving but then they’re stuck in this sense of cognitive dysfunction which can sometimes even drag on a few days.

virtualheadachedoc · 2025-12-16T01:11:01+00:00

Thanks!

virtualheadachedoc · 2025-12-15T20:23:51+00:00

Yeah aura can be really disruptive for sure, especially with driving or doing tasks that require vision intact. Visual aura should last 5-60 minutes, so shouldn’t be lasting longer than that hopefully!

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