I have chronic migraines but since catch

A clinician needs to hear from you today — a phone call or urgent appointment today, not after the weekend — because this headache is not behaving like your usual migraine, and daily painkillers for a week are part of the story they need to hear.

Which country and city are you in? That is the one thing I still need: it decides which out-of-hours line, which urgent-care door and which pharmacy cover you actually have tonight.

1) What you have tried, and what tends to work better tonight

Extra painkillers every day for a week. This is not a failure — it is one of the most common reasons a migraine turns into a headache that never switches off. I am not going to tell you to stop or to change anything, and there is no home rule about how many days is too many. Write down *which* tablet, *how many days*, *how many times a day* — that is exactly the fact the clinician needs, and it is the first thing to say on the call.

Better levers tonight, all of them free and all of them usable while you wait:

• A dark, quiet, cool room. Lamps off, phone face down, notifications off. Do not use a bright cool-blue light at the eyes.
• Fluids on a schedule, not on thirst. Small sips every time you wake, or when the person next brings the kids past. Being dehydrated by day 6 of a virus makes the headache worse and is the most common thing to fix.
• Something to eat. Migraine usually arrives on an empty stomach. Ordinary food already in the kitchen: rice or bread, soup, eggs, banana, yoghurt. Small and easy.
• Cool compress, not a cold bath. A cool damp cloth on the forehead or the back of the neck for 10–15 minutes. Not ice-cold, and never alcohol on the skin.
• Sleep if sleep comes, in a dark room. Do not force it, and do not stay awake "fighting it" — the room is the treatment.
• A one-line diary, in the phone, right now: time the pain started, how it built (slow ramp or hit full force in seconds), what you took and when, whether you ate, and whether you vomited. Five lines. This is the most valuable thing you can hand the clinician.
• Move the load. Ask the one person at home to take tomorrow's school run and breakfast. "I have to be reachable for a call" is a complete reason and you do not owe a medical essay.

Keep each step under a few minutes. Total tonight's active care: about 15 minutes of actual doing, then rest.

2) What to avoid

• Do not add a second painkiller "on top", and do not combine products that contain the same ingredient under different names — that duplication is exactly what turns a week of pills into a headache that stays.
• Do not take anyone else's migraine tablet, and do not start a new migraine medicine from anything you read online tonight.
• No opioids.
• Keep alcohol off. Also avoid going caffeine-heavy or suddenly stopping your usual coffee — both directions can trigger.
• Do not let the "wait and see" plan stand: no deciding to reassess in the morning if any of the signs below show up.
• Do not drive yourself if you are the one with the headache and any of those signs appear — call, don't drive.

3) Decision tree — when to stop home care

Call your local emergency number now, and say the words "worst-ever headache", if any of these are true:

• The pain reached its maximum within seconds or a minute, or it is the worst headache of your life by a clear margin.
• A stiff neck, or neck pain that will not settle, together with the fever.
• Fever plus confusion, drowsiness, being hard to rouse, or not making sense — you or your words seem strange to the other adult in the home.
• One side going weak or numb, slurred speech, new vision loss or double vision, or a fit.
• A rash that does not fade when you press a clear glass against it.
• Repeated vomiting, or not keeping fluids down.
• Red, painful eye with rainbow rings around lights, or feeling briefly light-headed and passing out.
• Breathing fast or hard, chest pain, or simply going downhill fast while you have an active infection.

Do not wait for a stiff neck — not everyone gets one, and a soft neck is not reassurance. If you call, note the time it started and say it on the phone. Dim the lights on the way.

If none of those are present, but the pain is this bad: you still need to be seen today, and the call is what gets the ball moving. Say: *"I'm a migraine sufferer, day 6 of a viral illness, the pain is the worst it's ever been, my usual plan isn't touching it, and I've been taking painkillers daily for a week. What should I do tonight, and what should bring me back to you?"*

Also worth saying: fever duration and the highest reading with times, any medicines you take regularly, and any other person at home who is unwell.

What success looks like in the next 24 hours

Not "the pain is gone" — that is not mine to promise. Success is:

• A clinician has spoken to you or seen you today, and you have a written rescue plan: what is already yours to use, for how long, and what must not be repeated.
• The diary exists, so the next decision is faster.
• Fluids and one small meal are in, and the room is dark and quiet.
• The school run and the meals are off your plate tomorrow.
• You know exactly which three signs would make you call rather than wait — the ones above, not a vague feeling.

A one-page sheet to fill in tonight and hand over or read down the phone is attached: headache-visit-sheet-6ef25d2f.pdf

You are carrying a viral illness, a migraine that has changed character, a week of painkillers, and everyone else's week at the same time. The call today is the move that makes the rest of it lighter — it is not you being difficult.