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Before leaving for a safari in Africa about three weeks ago, I worried terribly about getting migraine attacks in such remote places. I had followed all the regulations (getting letters from my doctors explaining the purpose of each of the prescriptions and keeping medications in their original bottles, with the prescription labels prominently displayed), but I knew there was a stringent weight limit for all of my baggage of 35 pounds and was quite concerned about the room and the weight for my migraine treatments: the many prescription bottles, the large packaging for Trudesa, my Cefaly device, a special pillow for the plane and my neck, my night mask, and sunglasses.

Even more, I knew the stigma of migraine here was difficult enough, but I had no idea what to expect in the tents and lodges of the Serengeti and other parts of Tanzania.

Then, of course, there are the usual travel triggers for migraine: “Unfortunately, travel is a notorious migraine trigger. Traveling can mean changes in sleep, weather, and diet—all common migraine triggers,” according to the American Migraine Foundation (AMF). Even the sheer stress of getting to your final destination can bring on an attack; stress is a trigger for almost 70 percent of people with migraine, notes the AMF.

We all know that the time leading up to the travel is terribly stressful, with concerns about leaving enough time for flights, transfers, and even cancelations. Then, there are issues with coordinating lodging, pet boarding, getting someone to take care of the gardens, and so much more. Each of these, in itself, increases levels of stress hormones that can trigger migraines.

Once you get to your destination, if you have so far been fortunate enough to avoid an attack, you could then suffer from the “let-down” migraine as the stress fades. Dr. Cynthia Armand, a neurologist at Montefiore Medical Center in New York City, reports: “In order to decrease the chances of having a stress let-down migraine or even a migraine associated with stress with planning vacations, it’s really important to be prepared and plan ahead… In other words, get organized early:

• Buy flight tickets well in advance.
• Book your lodging.
• Start interviewing dog or cat sitters.
• Plan for your absence at work (Montefiore).

When we think of airplane travel, we inevitably worry about migraine. Talk with your doctor about possibly pre-medicating for your flight, particularly if you are susceptible to airplane headaches or migraine attacks during flight. Keep in mind, however, that this dose goes towards your total for the week or month, so if you are towards the chronic end of the migraine spectrum, use this option with that in mind.

Eileen Zollinger, in an article for Migraine Strong, suggests keeping an emergency kit with you in your on-flight bag that includes:

• Dramamine
• Perhaps a sedative
• Ginger
• Ear plugs
• Earbuds
• Sunglasses
• An ice bag or empty Ziploc for emergency ice packs
• An eye mask for darkness

Once you arrive at your destination and hopefully have avoided a “let-down” attack, take note of other possible triggers, depending on your location, the weather, and the physical demands. Wear sunglasses, stay hydrated, and be aware that your diet will likely change, as may your alcohol intake and sleep patterns.

Tanzania brought incredible beauty and thrilling sightings of animals living in their own habitats—breathtaking. However, I did have to contend with the bad roads for the land rovers and the toll the rides took on my neck (I have significant cervical involvement with my chronic migraine), and I had to be cognizant of many of the changes I’ve mentioned.

Nonetheless, I’m glad to say after learning the hard way on some earlier trips, I was well-prepared.

Since this is peak travel season, take your time to prepare as much as you can in advance. Work with your medical professionals, and pack for any of your possible migraine triggers that could arise.

Safe travels!