*Sample context. Ask Nessie "Compile what I've learned about [my condition]" to generate one of your own.*

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## What This Is

I've had migraines for about four years now. The last eighteen months I've been tracking patterns across conversations with my neurologist, two primary care doctors, a functional medicine practitioner (briefly), my therapist, Reddit threads, and Claude when I'm trying to make sense of it all at 2am. Pulling it together here because I keep re-explaining it from scratch to every new provider.

## The Triggers I've Actually Confirmed

- **Sleep disruption >90 minutes from baseline.** Not total hours — variance. Two late nights in a row usually lands me with a migraine on day three. Took about a year to isolate because I thought it was stress.
- **Red wine, but not other alcohol.** One glass is enough. Confirmed across twenty-plus data points by now.
- **Barometric pressure drops >10mb within 12 hours.** My neurologist was skeptical, then she looked at my log and said "okay, you're in the 20-30% of patients where this is real."
- **Skipping a meal during hormonal phase.** Combination matters; neither alone is sufficient.

## The Triggers I Used to Think Mattered (But Don't)

- Chocolate. Years of avoiding it for no reason.
- Caffeine. Actually helps me when I'm in prodrome. I had this backwards for three years.
- Screen time. Confounded with stress and posture — when I control for those, screens don't matter.

## What Actually Works When One Hits

- Sumatriptan within 20 minutes of aura onset. Beyond 45 minutes it's significantly less effective. I've tested this more than I'd like.
- Dark room, ice pack at the base of the skull, no screens. Tried every "you should try" suggestion; this combo is the only one that holds up.
- Do not try to push through a meeting. I've lost entire days after "I'll just finish this call." Two providers have told me the same thing independently.

## Open Questions

- Whether the functional medicine lead on histamine was worth more exploration. My neurologist thought no. I'm still not sure.
- Whether the low-dose preventive I'm on is still the right call. Side effects have ticked up this year.
- Whether I should push harder on the hormonal pattern with an OB-GYN. I keep putting this one off.

## What I'm Doing Next

Next neurology appointment is May 14. Bringing the full trigger log. Specifically want to discuss: (1) the preventive side effects, (2) whether the hormonal angle is worth a referral, (3) whether the increase in frequency this spring could be allergy-related (new variable).
