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Tension or sinus headache or something else?
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Tension or sinus headache or something else?

by texan279, Feb 18, 2006 12:00AM
I’ll start with a history. Sorry for the long post, just wanting to give all of my history, and this may not seem like a headache question, but it is, the headache part starts near the middle of my post. All started in November of 2005, after helping my dad build a shed. Started having upper right chest pains. Went to GP. Had EKG and bloodwork done. EKG normal, bloodwork showed high cholesterol. Also doc said blood pressure was a little high (130/80). He thought it was a strained muscle. Week or two later, started having upper right abdomen pain. Went back to the GP, he still thought it was a muscle. After researching on the net, my symptoms seemed to be similar to gallbladder symptoms. Found another GP and  he agreed. He scheduled a hida scan. Scan showed gallbladder functioning at 13%. GP scheduled the surgery to remove it. After the scan and before the surgery, started having attacks of shortness of breath, rapid heartbeat, tingling scalp, tingling hands and feet, chest pains, light headedness. Went to ER twice and a cardiologist once in January because I was freaking out over the attacks. Two times at ER had EKG and bloodwork done, all normal. Cardio did an EKG, stress test, and ultra sound of the heart, all normal.  GP thought it was anxiety/stress, prescribed me .5 mg of Niravam (Zanax) twice daily. Seemed to stop the attacks, did not have another attack. Forgot to add, had a sinus infection and 2 ear infections in December, found something swollen in my neck the week before Christmas, freaked out about it, saw 3 different GP’s, they all thought it was a swollen lymph node due to the ear/sinus infection. I saw an ENT last week and she said it was a salivary gland and if it did not reduce in size, she would have a CT scan performed in a month. Two weeks ago had my gallbladder taken out. Before I had the surgery, I ate nothing but fast food and drank 3-4 cokes a day. After the surgery I started eating well, drinking nothing but water and Sprite since it is caffeine free. Quit using smokeless tobacco (snuff) but still smoke. Took Vicodin every four hours for 5 days after the surgery. A day or two after I stopped taking the Vicodin, I woke up with a left sided headache. Went to my GP a few days ago, he thought it was sinus related, gave me decongestants and Flonase. He said if they did not go away he would schedule a CT scan of my head and neck in 3 weeks. I have had this headache now for the last 8 or 9 days with maybe 2 days out of the 9 with no headache. It is not like a pain, but more like constant pressure or someone pushing on my head. It comes and goes, seems to go away if I sleep, but usually get it a few hours after waking up. It lasts throughout the day coming and going, usually the strongest in midday and subsiding to almost nothing in the evening when the sun goes down. Sometimes I have it on one side, sometimes it switches sides, and sometimes I have it on both sides but worse on one side. Right now it is on the left side of my head, in my left temple, in the left side of my head above my ear, in my forehead above my left eye, in my left cheek under my left eye, around my left eye, and in the back left of my head down into the left side of my neck, and my left jaw muscle feels stiff. Also my GP thinks I may have a TMJ problem, both joints pop and grind when I open and close my jaw and sometimes have stiff/sore jaw muscles. I have also grinded my teeth when I sleep since I was about 10. About 3 days ago my left eye started watering and felt like something was in it. Went to optometrist today, did an exam and dialated my eyes. Said I had a tear in my retina in my left eye, but said it was old and already healed, he said it was at least 6 months old. He could not find anything wrong but said he did see irritation in the inside corner of my eye and said there may have been something in my eye.  I think this may be a stress/anxiety/depression related headache due to family history (mother, brother, and sister all on anti depressants, 2 uncles have commited suicide, one diagnosed as bi-polar), and finding out 2 nights ago my father may have Cancer,  but from what I have read on the net, tension headaches are on both sides of the head, which my headache is sometimes on both sides but not always. I have no other symptoms other than the headache and still have a watery left eye. I am  thinking about calling my GP on Monday and telling him to set up the scan sooner or maybe even going to the ER tomorrow morning because I am kind of freaking out. I am just looking for advice on what next step I should take.  

Doctor's Answer

by CCF-Neuro-M.D.-PW, Feb 24, 2006 12:00AM
It is fortunate that despite all your symptoms, you do not have evidence of actual disease pathology.



Headache can be common in the postop setting, when you may withdraw from caffeine, or vocodin (although chronic treatment for 3-4 weeks if more usual for analgesic rebound headache). If you are over 40 and you have never had headaches before, then it warrants further investigation. Likewise if there is neck stiffness, focal neurological signs like weakness or clumsiness on one side of the body, then see your doctor right away.



As long as you stay off the vicodin and caffeine, the headache should resolve in 3-4 weeks. If you remain on them, you have a good chance of developing chronic headaches.



THis advice cannot substitute for a formal opinion so you will have to followup and with your doctor decide on the next course.



Good luck
Member Comments (17)

by texan279, Feb 18, 2006 12:00AM
Just FYI, a little while after making my original post, I took one of my .5 mg Niravam for the first time in almost a month and about 15-20 minutes after taking it my headache was almost completely gone.

by Citizen T, Feb 19, 2006 12:00AM
To: texan
hmm, there are several things that should be checked for.   for one you should have an MRI and MRV of your head and a chest xray.   You may also want to have your blood checked for ANA, AT, ESR, TSH and free t4, Lupus and Lyme disease, Protein C and S, vit. b12   among others...sounds like you need to be seen at a University