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Teach the patient to avoid triggers that may lead to headaches. Patients may be sensitive to odors from cigarette or cigar smoke, paint, gasoline, perfume, or aftershave lotion. Explain to the

612 Mitral Insufficiency (Regurgitation)

patient that at the beginning of an attack, he or she may be able to limit pain by resting in a darkened room. If patients sleep uninterrupted with their eyes covered, symptoms may be alleviated.

A combination of complementary therapies may be successful in managing symptoms. Introduce to the patient the possibility of behavior therapy such as biofeedback, exercise therapy, and relaxation techniques. Explore with the patient some techniques for stress reduction and adequate rest. Discuss family- or work-related stress to determine a regimen that may reduce stress and provide for adequate rest and relaxation. Lifestyle management may be essential to control headaches. Ask a dietician to evaluate the patient's food intake and to work with the patient to develop a diet that will minimize exposure to triggers.

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