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Headache days before Friday — start tonight

If today is not your usual headache — the worst-ever one that hit at full force within seconds, new weakness or speech or vision change, fever with a stiff neck or unusual sleepiness — call your local emergency number now and stop reading. If it is your usual attack in someone who is otherwise well, tonight's one job is the calendar: put it on the fridge with two columns — "headache day, any pain, mild included" and "worst it got: mild / moderate / bad" — and tick the days already gone this month. No new medicine, no diet, nothing to buy.

I'm not a clinician and can't diagnose this, and nothing here changes a medicine — the count and the naming are your neurologist's on Friday. The numbers below are the classification they work from, not a verdict on you.

1. What you've tried vs what helps more

Counting only the worst attacks is the one thing to change. Your neurologist asked for *days*, not severity, so a mild day is a tick — the mild/moderate/bad column is what makes the diary useful, not what makes the day count.

Add these four short columns to the calendar (names on the packet, never doses):

1. Headache day? yes / no
2. Worst it got: mild / moderate / bad
3. Did it stop you doing a normal thing (work, school run, house)? yes / no
4. What you already took, or "nothing" — the name on the packet only

Keep it to 60 seconds, tied to an anchor that already exists: after the last person is in bed, after brushing teeth. If you miss a day, fill it in next morning and mark it as an estimate rather than leaving it blank.

Two weeks is the minimum that helps; a month is better. Bring the calendar to Friday — a photo of it is fine.

Does a mild headache count? For the day count, yes — any headache gets a tick, because the count is of days, not of how bad it was. Severity goes in its own column.

When does that count become chronic migraine? Not a call I make — it is your neurologist's. The definition on the standard classification list they use counts headache on 15 or more days a month, for more than 3 months, with at least 8 of those days carrying migraine features (throbbing, nausea, light or sound bothering you, or stopping normal activity). Two things to hold at once: it is a yardstick, not a target to aim for, and the label only lands if a clinician examines you and reads your diary — a count on a calendar does not diagnose anything. Your job this week is an honest count.

2. Constraints and the avoid list

• No new headache medicine, no leftover pills from another person, no online prescription, no mystery powders or "natural" mixes. Bring the packets instead.
• No changes to the medicines you already take (including your blood-pressure tablet and your morning thyroid tablet) because of a headache day. That decision sits with your prescriber.
• Don't ration or set yourself a painkiller limit at home. *How many* days you use something is a fact for Friday, not a quota to self-impose tonight.
• Don't skip a day off the calendar because it was mild, and don't delete a day that a good day followed.
• Don't turn this into a job for the elder or sibling near you. It's your page, one minute, at bedtime.
• Kitchen and home levers only: meals at roughly the same times, water within reach of your bed, a dark quiet room for attacks, screen breaks, and alcohol skipped during a bad stretch. Nothing here promises to stop a headache.

3. Decision tree — stop counting and get help

Is it the same as your usual attacks, in a well person? → diary + tonight's routine (dark quiet room, water, sleep if you can, only what you have already been advised to take).

Is any of these true?

• Peaked at full force within seconds, worst ever → emergency services now
• New weakness or numbness on one side, speech change, vision change or double vision, confusion or unusual sleepiness, a first-ever aura unlike your usual, a seizure → emergency services now, and write down the time they were last known well
• Fever with a bad headache, stiff neck, vomiting, or hard to rouse → emergency services now
• After a knock to the head and getting sleepier → emergency services now
• Red eye with rainbow rings around lights, or severe pain in one eye → emergency services now
• Several people in the house have headache and nausea at once → get everyone out to fresh air now
• Severe headache in pregnancy or just after birth with blurry/flashing vision or sudden swelling → emergency services now
• New headache over 50 with jaw pain on chewing, tender scalp, or flickering vision → same-day urgent, don't wait for Friday

Is the pattern new or changed (different site, more frequent, no longer easing, a headache most mornings)? → book an earlier appointment rather than waiting for Friday.

Scripts you can screenshot

At Friday's visit (about 60 seconds):
"I've tracked my headache days. This month it's X days out of the calendar. On Y of those it was bad enough to stop something normal. On Z days I took [name on the packet]. Nights I slept badly: [number]. Meals I skipped: [number]."

To the household tonight:
"I'm counting my headache days for the neurologist on Friday. It's one tick a night, on the calendar by the fridge. If you see me tick it before you turn in, that's all I need."

What success looks like in 24 hours

The calendar is on the fridge with this month's days already filled in, mild days included, and one tick added tonight. That's it — no cure promised, nothing bought, nobody else's routine changed.

A printable month grid with the four columns and the red-flag list is on one page here, ready to fill in and bring: headache-day-calendar-onepager-52f343ff.pdf

No coverage / not decided by me: any dose or any medicine to take for a headache day, and any home limit on how many days you may use pain relief — that limit belongs to your neurologist, and asking them for it on Friday is the right move.

Source: Royal Children's Hospital headache guideline (rch.org.au) for the red-flag list and the diary advice; ICHD-3 (ihs-headache.org) for the day-count classification; Merck Manual professional (merckmanuals.com) for the headache approach. Checked against your neurologist's advice on Friday.