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New persistent headache
by Sherrizim, Jun 02, 2007 12:00AM
I'll ask my questions first and then provide some history. I'm concerned about a persistent headache and want to know what you think might be the cause and also if you think it's okay to wait several more days before being able to rule out possible causes and consider alternatives.
I am a 40-yr-old female in otherwise excellent health, but I've had an unremitting throbbing headache (mainly at both sides and the upper back part of my head) that has lasted 3 weeks at this point. It followed a sore throat and cough that I had for about 5 days; I only noticed the headache once the sore throat and cough were gone (without the need for an antibiotic). I also had painful, swollen glands with the headache, clear drainage down my throat (no nasal conjestion), and a full feeling in both ears (not pain, more like they needed to "pop"). The headache did not respond to acetominophen or ibuprofen. 4 days later I experienced nausea and increased sensitivity to sound. Temperature 99.1. I saw my doctor the next day, and she diagnosed a migraine headache, possibly on top of a tension headache. (Note that I have no history of migraine headaches and rarely experience any type of headache at all; when I have had a mild headache in the past, it has been relieved with a single dose of acetominophen or ibuprofen.) My doctor gave me an injection of Toradol and samples of Claritin and advised that I take the Claritin and Excedrin Migraine. I slept for 2 hours after getting home but woke with the same headache and other symptoms, which did not respond to the new medication, either.
4 days after that, with the headache becoming increasingly bothersome (beginning to interfere with my ability to work and study - I am a Master's level psychologist and at the end of my first year of a PhD program), my secretary told me that she had developed strep throat following a headache for 2 weeks. I called my doctor and asked if she would call in a prescription for an antibiotic, just in case, as I had an important exam the following week and could not afford to get sicker. Within about 36-48 hours of starting amoxycillin, my glands were fine and I no longer had the drainage. (Of course, I completed the full course of it.) My ears still felt the same, and I still had the headache. In fact, the day following the antibiotic, I noticed facial tingling as an additional symptom.
I returned to my doctor 3 days after she prescribed the antibiotic because the headache was becoming intolerable (moderate pain), and she again diagnosed a migraine. She gave me samples of Zomig to try, and if the Zomig didn't work, gave me a prescription for fiorinal. She also wrote an order for a CT scan that she wanted me to schedule if the Zomig didn't work. Possibly the Zomig temporarily relieved the tingling, although I can't be certain because within about an hour the throbbing became much worse and I developed horrible neck pain. The fiorinal seemed to take the edge off the headache. I spent the next 4 days in bed, sleeping half the day and otherwise applying heat to the base of my skull (advice of an internist friend, who suggested occipital neuralgia) and shoulders (in case of muscle tension-my neck and back sometimes feel a bit tense and sore) while trying to study. With understanding and supportive professors, I got approval to postpone my exam.
My youngest son, who is 9 now, was diagnosed with pseudotumor cerebri when he was 7 months old, and as his ICP never normalized (although the swelling around the optic nerve and headache remitted), he was given a V-P shunt at 2 years old. With a standing relationship with his neurosurgeon, I exchanged emails with him 4 days ago. AFter going over my symptoms like I have here, he said he doubted somatization (which I said I was willing to consider, given the stress of my upcoming exam, although my studying had been going well before the headache and I was feeling confident about passing it)or that anything was structurally wrong, and said he suspected a viral infection of the CNS that would just have to run its course. He was adament that I schedule the CT, though, and then said I should push for an MRI instead to rule out more possibilities. He suggested I go to the ER if I couldn't get it scheduled that day. He also noted that any diagnosis made through email or even over the phone wasn't fully reliable. My doctor agreed to the MRI but I scheduled it for 2 days later rather than going to the ER. That was 2 days ago. So, at this point, I'm waiting for the results and a bit nervous having to wait to move forward and not having a diagnosis. I asked my doctor's office for a referral to a neurologist but they said it would have to wait until after they got the results of the MRI (which they should get early next week).
For the last several days, the intensity of the throbbing headache has varied on a daily basis, although it's always present. I take medication for the headache rarely, since the pain is mild to moderate. I'm sensitive to sound when the pain is moderate. Have never been sensitive to light. The tingling, which I think is always present, also seems to vary along with the intensity of the headache. I don't even know if I'm describing that symptom correctly, because last week, when I felt worse, the tingling sensation would on occasion intensify briefly and seem to pulse or "wash over" my face. Lately, I notice the tingling more when I'm walking around relative to when I'm sitting down. The dizziness also varies day to day (although my balance is fine), not related to the intensity of the headache, and the dizziness is worse when I turn my head sideways (like to back up my car). The nausea seems related to the dizziness. No vomiting. Moving my eyes from right to left several times seems to accentuate the throbbing while I'm doing it. I just noticed that today. My ears still feel the same. Sometimes my thinking seems slower and last week I felt a bit disoriented, but I think that is related to the intensity of the headache pain. I'm not spending the day in bed any longer, although when my headache or dizziness/nausea is worse, it does feel better to recline and rest. Currently, my temp is 99.3. I think my temp is typically around 98.6 or slightly below. I don't know what my temp has been when I've seen my doctor. My blood pressure has been normal.
So, I'll repeat my questions. What do you think might be causing my headache? Is it okay to wait several more days before learning anything or should I have gone to the ER to get quicker results on the MRI?
I am a 40-yr-old female in otherwise excellent health, but I've had an unremitting throbbing headache (mainly at both sides and the upper back part of my head) that has lasted 3 weeks at this point. It followed a sore throat and cough that I had for about 5 days; I only noticed the headache once the sore throat and cough were gone (without the need for an antibiotic). I also had painful, swollen glands with the headache, clear drainage down my throat (no nasal conjestion), and a full feeling in both ears (not pain, more like they needed to "pop"). The headache did not respond to acetominophen or ibuprofen. 4 days later I experienced nausea and increased sensitivity to sound. Temperature 99.1. I saw my doctor the next day, and she diagnosed a migraine headache, possibly on top of a tension headache. (Note that I have no history of migraine headaches and rarely experience any type of headache at all; when I have had a mild headache in the past, it has been relieved with a single dose of acetominophen or ibuprofen.) My doctor gave me an injection of Toradol and samples of Claritin and advised that I take the Claritin and Excedrin Migraine. I slept for 2 hours after getting home but woke with the same headache and other symptoms, which did not respond to the new medication, either.
4 days after that, with the headache becoming increasingly bothersome (beginning to interfere with my ability to work and study - I am a Master's level psychologist and at the end of my first year of a PhD program), my secretary told me that she had developed strep throat following a headache for 2 weeks. I called my doctor and asked if she would call in a prescription for an antibiotic, just in case, as I had an important exam the following week and could not afford to get sicker. Within about 36-48 hours of starting amoxycillin, my glands were fine and I no longer had the drainage. (Of course, I completed the full course of it.) My ears still felt the same, and I still had the headache. In fact, the day following the antibiotic, I noticed facial tingling as an additional symptom.
I returned to my doctor 3 days after she prescribed the antibiotic because the headache was becoming intolerable (moderate pain), and she again diagnosed a migraine. She gave me samples of Zomig to try, and if the Zomig didn't work, gave me a prescription for fiorinal. She also wrote an order for a CT scan that she wanted me to schedule if the Zomig didn't work. Possibly the Zomig temporarily relieved the tingling, although I can't be certain because within about an hour the throbbing became much worse and I developed horrible neck pain. The fiorinal seemed to take the edge off the headache. I spent the next 4 days in bed, sleeping half the day and otherwise applying heat to the base of my skull (advice of an internist friend, who suggested occipital neuralgia) and shoulders (in case of muscle tension-my neck and back sometimes feel a bit tense and sore) while trying to study. With understanding and supportive professors, I got approval to postpone my exam.
My youngest son, who is 9 now, was diagnosed with pseudotumor cerebri when he was 7 months old, and as his ICP never normalized (although the swelling around the optic nerve and headache remitted), he was given a V-P shunt at 2 years old. With a standing relationship with his neurosurgeon, I exchanged emails with him 4 days ago. AFter going over my symptoms like I have here, he said he doubted somatization (which I said I was willing to consider, given the stress of my upcoming exam, although my studying had been going well before the headache and I was feeling confident about passing it)or that anything was structurally wrong, and said he suspected a viral infection of the CNS that would just have to run its course. He was adament that I schedule the CT, though, and then said I should push for an MRI instead to rule out more possibilities. He suggested I go to the ER if I couldn't get it scheduled that day. He also noted that any diagnosis made through email or even over the phone wasn't fully reliable. My doctor agreed to the MRI but I scheduled it for 2 days later rather than going to the ER. That was 2 days ago. So, at this point, I'm waiting for the results and a bit nervous having to wait to move forward and not having a diagnosis. I asked my doctor's office for a referral to a neurologist but they said it would have to wait until after they got the results of the MRI (which they should get early next week).
For the last several days, the intensity of the throbbing headache has varied on a daily basis, although it's always present. I take medication for the headache rarely, since the pain is mild to moderate. I'm sensitive to sound when the pain is moderate. Have never been sensitive to light. The tingling, which I think is always present, also seems to vary along with the intensity of the headache. I don't even know if I'm describing that symptom correctly, because last week, when I felt worse, the tingling sensation would on occasion intensify briefly and seem to pulse or "wash over" my face. Lately, I notice the tingling more when I'm walking around relative to when I'm sitting down. The dizziness also varies day to day (although my balance is fine), not related to the intensity of the headache, and the dizziness is worse when I turn my head sideways (like to back up my car). The nausea seems related to the dizziness. No vomiting. Moving my eyes from right to left several times seems to accentuate the throbbing while I'm doing it. I just noticed that today. My ears still feel the same. Sometimes my thinking seems slower and last week I felt a bit disoriented, but I think that is related to the intensity of the headache pain. I'm not spending the day in bed any longer, although when my headache or dizziness/nausea is worse, it does feel better to recline and rest. Currently, my temp is 99.3. I think my temp is typically around 98.6 or slightly below. I don't know what my temp has been when I've seen my doctor. My blood pressure has been normal.
So, I'll repeat my questions. What do you think might be causing my headache? Is it okay to wait several more days before learning anything or should I have gone to the ER to get quicker results on the MRI?
Member Comments (1)
by Sherrizim, Jun 02, 2007 12:00AM
To: oops, wrong forum
Sorry, I thought I had posted my question on the doctor's forum (hence the detail).
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