VenessaMD - please answer

[LifesAHeadache]

I have severe migraine, lupus, and RA.  The headaches are practically daily and I know for a fact they are not rebound.

Terrible headache, nausea, 6 ft but with 220 due to medicines.  Now on nothing but pain med (percocet) today but blood pressure (using the store machine) keeps going from 143/105 to 139/91 to 135/90 then jumps back up.  I have anxiety really bad with chest pain.  Had an ultrasound of heart and EKG not too long ago - they were fine but my head is killing me.  One pupil is always bigger than the other mainly in darkened room, reacts normally to light.  I'm scared because the pain is so bad and I've never had high blood pressure.  I have been eating a lot of salt which I normally never do.  Please respond if you can.

[Vanessa Lacuesta]

Hi,

How are you feeling?

Since this is just verbal communication online and you might need immediate help due to the severity of the headache and your associated condition of SLE and a history of chest pains, it is always best that you seek consult with a physician so that a complete assessment be done.

Headaches have been associated with SLE and yet most of these headaches are not directly caused by SLE. The common migraine, tension headaches are still the more common cause of headaches in the general population. However, some studies do show that migraine with aura ( seeing lights for instance prior to migraine attack) are more common or prevalent in SLE patients than those without.Do you experience this?

High blood pressure may also cause headaches. However, you mentioned you never had high blood pressure before. Is this true or is this because there was really no monitoring of your blood pressure until lately?

Are you a known hypertensive?When was the last time you had your EKG?

Being overly anxious over something may cause increase in blood pressure. I suggest you stay calm, improve your diet and decrease salt intake.

I suggest that you have a thorough assessment with your primary physician. Have an EKG done preferably at the time when you have your chest pains. Cardiac enzyme levels within 6 to 12 hours of the onset of chest pain may be requested.

Do your chest pains appear when you are in a state of excessive emotion? When you start worrying too much?

Watch out for any weakness or numbness in the body, vomiting and vision problems which may warrant emergent medical intervention in persons with a history of headaches and chest pains.

I suggest you discuss with your physician a complete cardiac work up  and follow up with your rheumatolgist for further assessment of your SLE.

I hope this helps.