Hi again. I was sort of waiting for a response to the last couple of questions, but your main question has been answered, at least to the point where you discuss it with aviation orientated specialists.
I have no magic bullet, and the following is just food for thought. It is little more than an unqualified blog, but it's worth some consideration it think. Indeed, I have almost scrapped it a couple of times, but with a certain amount of hesitation, I have put into words what I have come to [almost] believe over the last 40 years or so. Some of the patterns for migraine triggers happen time and time again. Deep underlying worry is the big one. Other triggers may be real, but are blurred because of the difficulty in making any form of controlled experiment. I have often mentioned cheese and chocolate, and am fairly convinced that these can be a trigger, but the patient may be susceptible due to deeper processing of fear.
I am not mentioning the dilation phase, because by then it is too late, the main thrust must be to stop the initial spasm.
My whole line of thinking–on several types of headaches–is the same. The gist is about the mind's perceived threat to its well-being. There seems to be a tendency for muscles to go into spasm–in a quite counter-productive way. The clamping of blood vessels is to save life following trauma, but there seems to be a way in which this happens because of some misinterpretation of a threat. An example might be where muscles round the throat suddenly lock up after a certain food or drink. There have been a lot of people leave a restaurant before eating, because of sherry. The ‘locked up throat' is very painful and of course the suffer has no idea what is happening.
I have to say at this point, that I have long pondered the idea about multiple-sentience being the norm in healthy people, and deep internal processing that really is behaving like a systems manager. However, it is though in certain tasks, it is woefully untrained. How could it be trained for the traces of Strontium 90 in our bodies for example. There was none until the first atomic explosions, and now every single mortal on Earth has traces. If it is self-analyzed, there is no program to handle the mixed messages that the mind receives from this new chemistry. It has not evolved yet.
One of my kids, who is highly qualified to research this type of problem, always cries ‘lack of empiricism!' a whole chunk of his life is spent steering his graduate students away from untested data. That's where the layman can have the advantage of thinking laterally. There is a chance that it will do some good, and with caution...and coupling with professional help, it is unlikely to do any harm.
Searching for a cause is not easy, the trigger may be chemical/hormonal or buried deep in the subconscious, but I feel sure that it is very specific. The type of asthma that is of this nature, is very difficult to stop. Some very fit people are suddenly disabled by broncho-spasm. It may have been caused by a reaction to perfectly clean, but cold, air. In some cases they are rendered virtually helpless in a few seconds, but the strange thing is that the clock starts ticking. At a very similar elapsed time each time, the spasm eases. That's a puzzle, and I can only liken it to a programed ‘procedure' and not a hard-to-control quantity of hormone.
It would be wonderful to be able to stop the mechanism that causes the problem, from triggering in the first place. I know to my cost that it is not easy. After weeks of pain in my eyes, and several visits to eye surgeons, I suddenly realized that it might be caused by a spasm in extra-ocular muscles. While I waited for a doctor's appointment, I tried very, very hard to make them relax. I failed totally, yet a significant attention-grabber, like someone pulling out in front of us while my wife was driving, would cause them to unlock for a moment. [This is what gave me the clue.] That story ended when I persuaded my GP to give me some Valium...a drug I'm passionately against being prescribed under normal circumstances. Within 30 mins, the pain had gone and my eyes focused again.
The main point of mentioning this is not that there may be a magic drug that will take away the problem...though there could be...but when I knew what was happening, I did not have to resort to Valium again more than a couple of times. I often speculate what goes on in the mind to suddenly stop bothering the sufferer with the reaction. Sometimes I think that somewhere deep down the mind says ‘okay, the game's up, I'll give up on that...for a while.'
There are a lot of cases where asthma sufferers are ‘cured' by starting to smoke very strong tobacco. ‘Never bothered me again.' they would say, but it's a shame that they had to be jumping into the metaphorical fire. But it was almost as though the mind said, ‘Well, if you're going to do that...there's no reason I should bother protecting you from cold air.'
Researchers would look carefully at the tobacco's effect on the lungs...but not into the mind's reaction to the smokey onslaught.
In your case, the end of year might be chill night air in those latter months, or some medication that you would take for a cold that often happens about that time of year. It might even just be the depressing loss of daylight heralding the end of the summer, never discount the mind's part in headaches.
Apart from the miserable pain, your career hopes are directly affected by this problem. There should be no limit on the detective work to find a cure, amelioration is not really good enough.
Extremely carful records of food/medication intake should be undertaken. Actions and thoughts listed just as meticulously. Just as with depression, the patient may think themselves into a altered condition. Depressive people often torture their own minds dozens of times a day with black thoughts. You should analyze your thinking at the critical times. Money, relationships, anything...get it down in strip form so that peaks will show against headaches.
If you do find significant peaks, it will be a beginning to beating it. At the very least, the action of the detective work will help with a bolstered state of mind in critical times.