Sounds like you are already doing some good work with trigger identification. Regarding the cheeseburger at home vs. at McDonalds, I don't know for sure, but it may be that the cheese you're using at home is real, aged cheese which tends to have higher tyramine levels, a known migraine trigger. The cheese used at McDonald's is probably a "cheese food product" that's not aged. That's one possible explanation, anyway.

I know it can seem like a lot of work, but as Nancy mentions, keeping a detailed, daily migraine diary is highly worthwhile. In my case, not only did I track pain levels, medication and side effects, and what I ate, but the weather conditions and temperature, my menstrual cycle and what activities I did each day. The pay off was being able to see patterns that emerged after several months and what things helped and what did not. Then you have a written record that you can review with your doctor to show if a certain medication or supplement is effective for you or not.

Good luck to you!

Re: Cheese

McDonald's does not serve cheese -- is is the cheese food type product.  I suspect that a switch to Cheese Food Type Burgers built with Velveeta would do the trick.  If aged cheese is triggering migraines there are surely other foods to stay away from.

Weather is a trigger for me.  Rapid changes in barometric pressure, impending thunderstorms, changes to the electrostatic equilibrium that accompanies full moons. The worst though is the really nasty hot dry winds know as the Santa Ana's (or Santanas actually - Spanish for Devil Winds).

Look Walt - you're engaging with people here and particpating in her treatment and being a good husband.  But your protestations that your freedom is taking a big hit -- if shared with your wife -- are not going to help matters.  Trust me on this.  My wife used to complain about how my migraines are dragging her down and to be honest - I've realized she has no idea what I'm expereincing or how profound the pain.  So I had her eat a small bowl of sherbert real quick to get the spike headache (she'd neve had one.) She got the spike and I said, it's like that only much longer.  From that point forward she had a much different attitude.

So consider this: Migraine is a real deal "disease".  So is Lupus.  Both can result in people labeling you as lazy, a hypochondriac, a sissy or a baby and "mental" ... or worse.  Would you feel deprived if your wife had been diagnosed with say, epilepsy or heart disease?  Maybe.  My point - change your thinking about this and you'll change the way you feel.  You guys are just taking the first few steps down this path and there are a lot of things you can do here.  I'm not going to lie to you and say it's absolutley going to get better but what I can promise is that you'll end up dealing with this in a way that makes the best of things.  So yeah, it's a bummer but hang in there.  I encouraged my wife to get into some things that would help her build a community so when I'm out of commission she can have have a life.  (And that had been an issue for us.)  Now she belly dances like a pro and does something called "Zumba" and it's amazing how much better we're both dealing -- and how much healthier she is!

Sage