Over the years, Metzger says she's tried pretty much every standard migraine treatment available -- from triptan medications to anticonvulsant drugs and Botox -- and most of the alternative options, including acupuncture, biofeedback, and herbs such as feverfew.
But she's also found that if she doesn't focus on managing the triggers that seem to set off her migraines, medications and other therapies don't work nearly as well.
That's common for many people who get migraines. So what are the most important lifestyle changes to make in order to get your migraines under control?
They're not always the same for everyone. What helps one person with migraine may have no effect on someone else.
But some of the things you can try to keep migraines under control include:
1. Regiment your life.
If migraine were a person, it'd be the cranky guy next door yelling, "You rotten kids, get off my lawn!"
Migraine doesn't like excitement. When your life gets eventful and unpredictable, migraine flares up.
"Be boring," says neurologist Gretchen Tietjen, MD, director of the University of Toledo's Headache Treatment and Research Program.
"Keep a regular schedule. Make sure you go to bed at the same time every night and get up at the same time in the morning. Get an adequate amount of sleep, but don't oversleep. Eat your meals on a regular schedule."
You can't always do that, of course. So if you know that an upcoming event -- like a red-eye flight that will leave you jet-lagged -- is likely to throw off your schedule, plan accordingly so that your "migraine brain" won't rebel.
"If I'm flying to the West Coast for a few days, I'll get up at 4:30 a.m. instead of 7:30 a.m. when I'm there, and go to bed at 8:30 or 9 if I can," Tietjen says.
2. Nourish your body.
"When I get dehydrated or skip meals, that's a huge migraine trigger," Metzger says.
That's not unusual, Tietjen says. "People with headache tend to be much more vulnerable to the effects of dehydration."
Always keep a bottle of water and a snack handy: Peanut butter and an apple, or mild cheese and crackers, are good protein-carb combos.
3. Watch what you eat.
Some experts say that there's no such thing as a dietary trigger for migraines.
But headache specialist Deborah Friedman, MD, professor of neurology and neurotherapeutics at the University of Texas-Southwestern, says probably half of her migraine patients can identify foods that bring on their migraines.