When my doctor asks how I have been, I a

Right now, in the waiting room, write three sentences and read them out. That is the whole answer to "how do I describe what this is doing to my life": the clinician needs frequency plus consequence, not "fine" and not a diagnosis from you.

The three examples (one line each, fill and go)

1. A school-week task that slipped — "On ___ I could not ___. It was done by ___, or it did not happen."
2. A household or elder-care task that moved to someone else — "On ___ I could not ___. ___ took it over."
3. A day that was lost — "On ___ I was in a dark room from ___ to ___, and ___ did not happen."

The two numbers (count only; the limit itself is the doctor's, not yours): headaches in the last 30 days = ___ days; days in the last 30 days you took any pain relief at all = ___ days.

The opening sentence to say out loud

> "Over the last 30 days I've had headache on ___ days, and I've taken pain relief on ___ days. Three things that actually happened: ___, ___, ___. During an attack I need a dark quiet room and I can't manage much for ___ hours. I've also noticed ___. What I'd like from this visit: is this still the same pattern, is something else overlapping, and what plan actually works for a school week?"

Four questions to ask, and ask for the answers in writing

1. What exactly should bring me back, and what must I not do at home?
2. Given how many days I use pain relief, does that need reviewing — and who sets that limit?
3. Is there a preventive option for someone who has to cover a school week, and how is attack medicine different from prevention?
4. What should I do tonight if an attack starts?

Bring: your diary page, every medicine box including anything bought without a prescription (your blood-pressure tablet, your thyroid tablet, anything you finished recently), and one line of family history.

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1. What you already tried, and the better version

You already wrote a handover line that works; use it as it is: "I've been carrying the whole list and it's too much for one person. I want to hand over three whole things this week — not just steps. For each one: you decide, you do it, and you tell me when it's done. I won't re-check them. Which three would you rather take?"

2. Constraints and what to avoid

• No medicine changes at home: dose, interval, type and when you start something new all belong to the prescriber or pharmacist. Keep taking what was prescribed, even if the headaches are frequent.
• Do not borrow anyone else's migraine tablet, and do not stack over-the-counter painkillers with overlapping ingredients — read the ingredient line on the box.
• No prescription medicine bought online, no powders, tonics or herbal mixes.
• Your medicines stay yours: nothing of yours goes to the child, the pet, or the elder; the elder's diet stays as it is.
• Do not wait out a first-ever one-sided weakness, speech change or vision change as if it were "just an aura".
• Do not put a feverish, drowsy person with a headache to bed to "see how they are in the morning".
• Through the school week: do not skip lunch, do not shorten sleep to push through, and do not become the fallback for every attack — three whole tasks move, and you do not re-check them.

3. Red flags: when to stop the home routine and get clinical or urgent help

Call your local emergency number now, or go to an emergency department (tell me your city and country and I can point you to the local urgent line):

• The pain reached its worst within seconds, or it is the worst headache you have ever had.
• Fever with headache, a stiff neck, confusion, drowsiness, or hard to rouse.
• One-sided weakness or numbness, speech changed, vision lost or double, a first fit.
• A red eye with rainbow rings around lights.
• A severe headache in pregnancy or shortly after birth, with any change in your vision.
• Getting sleepier after a knock to the head.
• Several people in the house with headache and nausea at the same time — get outside and ventilate first, then call emergency services.

Book a clinician review sooner rather than later (not the emergency route, but do not let the school week push it back):

• The pattern has changed — different shape, different frequency, or it no longer settles the way it used to.
• The pain relief you already use helps less, or its effect is shorter than it was.
• You are in pain on most days, or taking pain relief on most days.
• You wake with the headache, or it is much worse on coughing or bending.
• A new headache after age 50 with jaw pain when chewing, a tender temple, or vision flickering in one eye.
• A whooshing pulse in the ears, double vision, or a daily headache with vision dimming.
• Severe one-sided pain around the eye with a watering eye, and you cannot keep still.

Decision tree for tonight

1. Any sign from the emergency list? → emergency now. Do not manage it at home.
2. No emergency sign, and it is your usual attack? → dark quiet room, water, only the medicine already advised for you, one line in the diary, and one ask to the household (below).
3. No emergency sign, but the pattern has changed? → contact the clinic within days and say it plainly: the pattern has changed, here is my diary. Do not wait for the next school week to pass.

Tonight's steps (about 20 minutes total, in three 5-minute blocks)

Now, waiting room (5 min) — the three examples, the two numbers, the opening sentence, the four questions. Nothing else.

Block 1, after you get home (5 min) — one diary row for today, the 30-day counts, and the visit answers kept in the same place as the diary.

Block 2 (5 min) — hand over three whole tasks, with an owner, a "done means" line and "you decide" filled in: school-week logistics; meals on two nights including shopping; one hour with the elder or sibling (a call, a meal, company). Say the handover line once, then do not re-check.

Block 3 (5 min) — set up the attack-night corner before the next attack: water within reach, the darkest quiet room identified, one no-cook meal already in the kitchen from what you have, phone charged. Then send one message to whoever covers at home:

> "接下来两三天我可能会偏头痛发作，可能整天都在暗房。帮忙接一下：____（比如周三接送／买菜）。做好了跟我说一声，我不复查。我发作时需要：暗、安静、水、不用说话。药我自己按原来的吃，你不用操心。"

If whoever covers at home reads Japanese more easily, show them the Japanese one-pager dated 23 Oct from your files instead of typing.

Tomorrow (5 min) — one diary row even on a pain-free day; the pattern the clinician reads includes the days nothing happened.

What success looks like in 24 hours

Not "the headache stopped" — that is not in your hands today. Success is:

• Three sentences written that name three real consequences, and said out loud to the clinician.
• Two numbers on paper: headache days and pain-relief days in the last 30 days.
• The doctor's answers to your four questions written down, including what should bring you back.
• Three whole tasks with a name on them, and the handover said once.
• The attack-night corner set up before the next attack.

One honest limit: nothing here changes a diagnosis or a medicine, and I can't promise a better week — the clinician decides both. What I can promise is that the visit will contain the information that decides them.