Migraineurs ask a multitude of excellent questions on quite a range of topics from the cause of Migraine disease to triggers, medications, new treatments, comorbid conditions, and much more.

There is one question, however, that stands out as the all-time most freuqently asked question. In the four years that we've been doing this column, not a week has gone by that this question hasn't been submitted for Ask the Clinician and asked on our forum, usually multiple times. Here it is as most recently submitted:

I have been on every kind of prevention medication available and am still having bad and frequent migraines. My doctors said they have tried everything and they don't know what else to do with me. I'm feeling very helpless and need to know if there is anything else out there or if there is anything coming out that may be able to help me and give me a normal life?

Here's our answer to this question:

Although you may have tried the medications with which your doctor is familiar, it is literally impossible for you to have tried every preventive medication. There are now over 100 medications and supplements that can be used for the prevention of headaches and migraine attacks and virtually endless combinations of them. Effective preventive regimens can be found for at least 95% of migraineurs, so the odds are on your side. See:

Do you know what your triggers are? It's never too late to work on trigger management to try to reduce your migraines. If you're not keeping a migraine diary, try it. It's one of the best tools you and your doctor will have for spotting patterns in your migraines. Not all migraineurs have food triggers, but it's well worth investigating. Here's information about trigger foods and a link to download a free food trigger identification workbook:

Identifying and Managing Migraine Food Triggers
Not everyone has food triggers, but it's well worth checking into. Some migraineurs will identify food triggers fairly easily by noticing that every time they eat something, they have a migraine. Other migraineurs employ an elimination diet to investigate food triggers.

If your doctor is out of ideas and "doesn't know what else to do with you," it's time to find a doctor with more experience and expertise in treating migraine disease and headaches. You should find the following helpful:

• Quiz: Is Your Doctor Right for You?
• Questions To Ask a New Doctor
• Directory of Patient-Recommended Migraine Specialists
  

Bottom line? Don't give up! It's unfortunate that it can take so much time and patience to find an effective treatment regimen, but with that time and patience, it does happen for the vast majority of migraineurs. I certainly felt like giving up many times, but I'm so glad I didn't. Even driving eight hours each direction to my doctor was well worth every mile and every minute. With his help, I've gone from an average of five major migraines a week to getting up to four months between migraines. There was a time I didn't believe that possible, but when I got frustrated and angry enough to fight to get my life back, found a good migraine specialist, and refused to give up, I found that it can be done.