I just recently started getting them myself. I'm lucky that I get the warning sign of the visual weirdness about an hour before the headache starts. I've had three to date, and they get pretty bad. The headache itself isn't so bad, it's the other effects that are awful. Not only do I get the screaming headache, but I get cold and shivering, then hot and sweaty, then back and forth. I can barely stand or talk, I breath shallow and rapid, and I feel like my heart is racing.
The doctor prescribed Maxalt, but since it's from the same people that brought us Vioxx, and I read about the side effects of migraine meds, I just deal with it and try to load up on ibuprofen before it hits. The visual deal before the headache is the worst sometimes...I lose almost all vision, and all I can see are blurry flashing artifacts.
As for caffeine, it can be the trigger, but more often than not, it can help a migraine. Also, an FYI for those that use Excedrin "Migraine"...check the label. It's EXACTLY the same dosage of aspirin, acetaminophen, and caffeine as the normal Excedrin extra strength...don't be suckered.
