Many of the estimated 6 million people in Britain affected by migraines are suffering in silence.  Those who suffer from migraines know that they can be completely debilitating and severely affect both your work and personal life. The question is, what can you do to minimise the likelihood of an attack?

Partners, family and friends of migraine sufferers know that they're likely to be affected too. In fact 87% of sufferers say that they are unable to control their migraines and over two thirds say their migraines even impact on their children, according to new research by Imigran Recovery.

There is however, light at the end of the tunnel. Dr Anne McGregor of the City of London Migraine Clinic and migraine sufferer Jessica Evans will be joining us for a live Web TV show to talk about the difficulties faced by sufferers and will be on hand to answer questions on how to better manage and prepare for migraines. Log on for advice on monitoring the impact of your migraines on your life and those around you and minimising the effects.

For more information visit www.migraineactionplan.co.uk where sufferers can work out the impact of their migraines and create a personalised Migraine Action Plan.

H: Jayne Constantinis, host

A: Dr Anne McGregor, City of London Migraine Clinic

J: Jessica Evans, migraine sufferer

H: Hello and welcome to the Healthcare Show, I'm Jayne Constantinis. Many of the estimated 6 million people who suffer from migraines in this country are in fact suffering in silence. For them a migraine can be completely debilitating and it can severely affect both their home and their work lives. You may well be one of them.  The question is, what can be done to minimise the likelihood of an attack?

Well joining me in the studio today to discuss that and much more is Dr Anne McGregor from the City of London Migraine Clinic and migraine sufferer Jessica Evans. So thank you very much for coming in to the studio, welcome to the show. Can I begin by asking you about this research by Imigran Recovery that's come out recently into migraine sufferers. Tell us about the findings and were there any surprises?

A: There weren't really many surprises other than showing that despite what we feel there's much better control in the medical field, we're still not really effectively controlling migraines, so over 81% of people within the survey that was undertaken said that they still didn't have control of their migraine, and further than that I think when people feel they're suffering alone, the research also showed that two thirds of people felt that the migraine attacks they were experiencing affected their family and their children. So there's a great deal more work that we need to do to help people get control

H: I'm very curious Jessica about this business of suffering in silence, suffering alone as you've just said. Is it that there is some kind of a stigma or an embarrassment about admitting that you get migraines or referring to them?

J: I don't think it's a stigma, I think it's more the fact that people think you're just making it up, that it's almost like we say oh we've got the flu, it's got that sort of ring to it, and a lot of people are quick to say they've got a migraine when in fact they don't actually have one, and I think obviously the more it's used as a term, obviously the less potent it becomes

H: and in fact that brings me to the very first question that's come in from Jimmy Lawson and I was going to ask it too – “what is the difference between a headache, even a severe headache, and a migraine?”

A: I think it's very important that you asked this question because I think one of the reasons why people don't get effective help is they think they've just got a headache and don't realise that they need to take the steps towards more specific migraine treatments. And essentially the difference is a migraine is a sick headache that is disabling, so although people think you've got to have zigzag lines and flashing lights, in reality the most typical type of migraine that people get is a sick headache that stops them being able to carry out their usual daily activities, and in between these episodes when they're stricken with the headache they're absolutely otherwise completely well, so you know as Jessica said, you'll often go into work on a Monday morning having been laid up for the weekend, really not able to function. If you're a little bit late on the Monday morning people will think you've just had too good a time over the weekend, when in fact you've been stuck in bed

H: Yes. What are your particular symptoms Jessica and when did you start getting migraines?

J: I started having migraines at the age of 18 and I've slowly sort of understood my triggers, obviously the length of time's gone on – you can't necessarily factor in what they are straight away, and for me nausea is the main one. As soon as I feel the onset of that I know I've got a migraine coming. Often I'll just have a headache and then the nausea will come and then I know it's developing further. Also periods can be triggers, tiredness, stress, that sort of thing really; very common ones but it takes a while to work out which ones are yours

H: And for you personally how debilitating are they?

J: It depends on the severity of the migraine. Some days I literally can't do anything, where you just have to lie down because the sickness makes you feel very unwell. You need to just sort of be lying there because you can't actually do anything. Even the most simple of steps can actually be quite debilitating itself, and then on other occasions you can just sit there in work, looking at the computer screen pretending everything's ok. It totally depends really

H: And these are classic symptoms are they?

A: Absolutely

H: Is there always sickness, as you say the sick headache, is there always sickness involved?

A: I think sickness is the easiest way – people often don't necessarily vomit, but they will often feel queasy, and it then becomes really important to take any treatment that you're taking for a migraine very, very early because the sickness is actually showing that the gut has shut down, so if you're trying to take a medication and the gut is just not doing anything, the medication's just going to sit in your stomach and not do anything. So this is one of the reasons why the migraine action plan has been developed because it's trying to alert people to these early symptoms, you know for example some people feel a bit nauseous before even the headache starts, and it's trying to get people to recognise the early patterns of symptoms, so that when they get these symptoms together then they know this is the time I've got to take my medication, and hopefully that will give them much better control

H: Was your condition diagnosed straight away or did you suffer for a long time before actually realising that they were migraines?

J: Both my mother and my sister suffer from migraines so I had a good indication of what one was, and I think it did take me a little while, even having a good knowledge of it to sort of realise you know that I need to go and get some help for this and go to my doctor. I think it's sort of – you don't quite know if it is a migraine or if it is a headache, and it takes a while I think to understand them. It took me years to figure out my triggers and you know actually now knowing when a migraine is a migraine and a headache is a headache

H: Talk about the migraine action plan. For those who don't know what it is, and I know you've used it Jessica, and I'll ask you about your actual experience in a second. Can you tell us what it is?

A: Yes it's a very simple web link that you can actually look at that takes you through your migraine, takes you through what a migraine is, the different types of migraine that you may be experiencing, and really comes up with strategies to help you cope.  One of the most important points that we recognise is most people with migraines don't go anywhere near a doctor, and I think that's probably right if they don't, because if it's migraine you're otherwise completely fit and healthy between those attacks. But what we do know is that people under treat their migraine because they're so well in between it takes them, like yourself, a long time to go and do something about it. Now with the migraine action plan it's really giving people more power to recognise that the headaches they have are migraine, and to give them a little bit more information about dealing with their treatment and the triggers, and also when they should be going to do something about it, and what treatments are available from the pharmacy that they can take early and help improve the outcome of the attacks

H: So you did an action plan?

J: Yes

H: What did it reveal and were you surprised by what you learnt?

J: I think the good thing about it, it's just – you know – all of this information in one place that you can actually go and sort of access quite easily, and I think it's got all of the list of triggers, and often raises your awareness of things you wouldn't necessarily think of, you know as you say there's so much sort of out there on all of the common triggers and that sort of thing, but often it's the things that you don't consider, and the action plan's good for highlighting, you know sort of a variety of things, and also the treatments that are available

H: And did you change your behaviours as a result of what you learnt from the action plan?

J: I think it makes you think about your migraine, certainly. I've obviously been suffering for years while I sort of know mine now, but even now, looking at the action plan it did make me sort of consider my migraines and the triggers, and as you said earlier sort of what triggers are coming together and causing the migraine

H: So it gives you a very – very personal, individual profile printout then?

J: Yes that's right.  Aside from giving you a list of sort of points to be aware of and notes with regards to your triggers, it also sort of tries to raise your awareness of the greater impact of migraines, so there's a section on the website that asks you to perhaps calculate the days you've lost over the last 12 months to migraines, and then it also looks then at how many hours overall you've lost and also the financial cost of the migraines to you, if you work or – that sort of thing

H: Because of course it's not just a health issue for the individual, but there is a wider impact isn't there Anne?

A: Much wider, particularly if you consider the financial impact of you know the wife who is laid up, can't pick the children up from school, the husband's got to drop his job, the non-migraine sufferer to come and pick up and do what the wife would otherwise be doing, so it's not just the individual whose losing time with a financial loss, it can have a marked effect on other members of the family too who've got to come in and take over

H: So what was the result of that for you Jessica, what was your personal financial loss?

J: I think it worked out at about 15 hours over the last 12 months, equating to about just over £5000 that I've lost

H: And what else is included in the profile?

J: Basically it provides you with all of this information, and I think the main point of it then is for you to just review everything in full and look at your migraines in relation to what information the website can tell you, looking at different prescriptions and medications

H: And Jessica having suffered since you were 18, what advice can you give to someone who maybe is just beginning to suffer or just recognising that what they have been suffering is in fact migraine? What would your advice to them be?

J: I think first of all to try and ascertain what things are bringing on your migraine, so that's when the action plan's really helpful, for somebody who hasn't got that much knowledge about migraines, its' a good indication of you know, what it's all about and what could be triggers and that sort of thing, so I would say it takes a long time to figure out, certainly it did for me, what my triggers were. But something like the action plan is a good start to sort of just focus really

H: Well thank you very much both of you for coming in to give us your different perspectives, and if you'd like more help and information then go to the website which is www.migraineactionplan.co.uk. Thank you for watching, see you again very soon. Bye bye