Tension or sinus headache or something else?

[texan279]

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.  

[CCF-Neuro-M.D.-PW]

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

[texan279]

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.

[Citizen T]

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

[Citizen T]

ahh, i also noticed the shortness of breath and rapid heart beat.   get an ABG and tests to rule out pheochromocytoma (an adrenal tumor) as well.  pulmonary functions testing may also be warranted, maybe an echo too..

[texan279]

I forgot to mention the two times I went to the emergency room in January both times chest XRays were done and came back normal.

[texan279]

Forgot to mention also, I have not had any problems with the chest pains or shortness of breath in about 3 or 4 weeks now, just the headaches for the last almost 2 weeks. And also I have been taking my Niravam regularly since Friday night and have not had a headache since.

[flyin2006]

As one smoker to another, smoking causes headaches! Maybe your're smoking more because of all the stress. Plus you have an outstanding issue over your salivary glands. Maybe when that gets resolved you can wean off the Xanax. Otherwise, just see what the neuro says on here. Good luck to you. ( sounds like you have been checked out pretty well ..speaking as a nurse on this one! LOL )

[texan279]

Thanks for your post. Now that you mention it, the headache did start the same time I quit using the smokeless tobacco which in turn caused me to smoke more often. I am beginning to think most of my problems are all anxiety related now. Yesterday I started feeling not dizzy but off balance I guess you could say and then last night my left leg from the knee down started tingling as well as my left arm from the elbow down right before I had a real emotional breakdown. Also my neck hurts when I turn my head one way or the other on the left side down into my shoulder. After I calmed down and stopped thinking about it, it went away for the most part. I still have not had anymore headaches and have been taking my Niravam. I scheduled a doctor's appointment with my wife's doctor for Thursday because she is a very thorough doctor and takes what my wife says seriously.My doctor now just gives me a bag of meds and literally laughs me out of the office each time I see him for something. The doc I see now I had to diagnose my self with gallbladder disease. And at the end of last year for about 6 weeks I had a sore, flat, red tongue and food didn't taste right to me. I told him maybe it was a B12 deficiency but he didn't think so and never really looked into it. He has never done any bloodwork on me except for a blood sugar test (which was normal). I am beginning to think I either have a B12 deficiency or maybe some kind of nerve damage in my neck or maybe it is all anxiety. I have no clue, but I am going to try and get it all sorted out with my new doc on Thursday.

[flyin2006]

P.S I know I should know better to not smoke...so shame on me!!! Unfortunately, medical people have their problems too. ;-)
And smoking not only causes headaches but sinus too ( but you already knew that! ). And no doctor should laugh at you ( unless ofcourse that kind of feels comforting to you. :-)

[flyin2006]

Good to hear you saw your GP. I just wanted to give you some advise , if you don't mind. Don't take your Xanax, antidepressant, and muscle relaxant all together with your alcoholic beverage(s) ( If you have any alcoholic daily beverages ) . You might have headaches now but the problems connected with bombarding your system with medications will be much worse than any headache. Sorry if that sounds a little somber to you. I just like you and want you to be okay.
  Also, did you get the test on the salivary gland? You might want to give up cigarettes and go to nicorette gum. Otherwise, let us know how you are doing.

[texan279]

I only drink about twice a month, and when I do I do not take any medicine. The doc and I both think that the salivary gland has actually gotten smaller, but he wants me to come back in 2 weeks and he is going to make a decision on whether or not to have it scanned.

[texan279]

FYI saw my regular GP today. Told him about the tingling in the lower left leg and lower left arm and feeling off balance for the day or two after finding out my dad might have cancer, my family history of depression and suicide, and how the Niravam is helping my headaches but my anxiety and stress has been getting worse and I have been getting anxiety attacks again. After telling him all of this his whole demeanor changed and he seemed really concerned. He still does not think my problems are neurological, he said my symptoms were "classic" anxiety symptoms. He said since the Niravam was still helping, but not as much, he would prescribe me 50mg of Zoloft, which he did, and he told me to keep taking the Niravam only when needed for attacks. He also gave me a muscle relaxer, Skelaxin I think it was, for the pain I have been having in my shoulder lately that goes up into my neck/head. Basically he thinks all of my problems are stress/anxiety related which I am starting to believe more and more.

[mad4mustangs]

I have read your thread- have had long standing headaches too.  I see you mentioned that you grind your teeth.  Have you seen your dentist to have him make a mouth guard?  I think I paid about $65.00 for mine, and it does help some types of headaches.  Clench your teeth tightly then feel the muscles at the side of your temple and back of your neck- painful?  this might be contributing to your ongoing headaches.  It may also save your molars from  expensive damage and crowns down the road.  Your dentist too is a good consult for the salivary gland. Sometimes the duct may be blocked, and the gland enlarges when it gets backed up.  Some relief may come from eating sour foods which stimulate the gland to release it's contents- try some of that sour candy like sour Jolly Ranchers or sour ropes, or even sour dill pickles.  Gentle heat to the area may also help it open if it is indeed just blocked.  Nicotine may be making it worse as well- not easy to quit, but you seem interested in getting well, and it may help slow your anxiety attacks too.  Hope this might help you in some way, good luck.

[texan279]

Thanks for the post. I went yesterday to get a second opinion on everything from my wife's GP. Sat down with the doc, talked to her for about 30 minutes. Gave her my complete history. When I got to the headache part, I told her "For about 2 weeks straight I have been having this headache" she stopped me before I could finish and said "It's not a tumor and I am not sending you to have a CT scan or MRI." Then I told her about the gland in my neck, told her that an ENT wanted it scanned in a few weeks just to rule out cancer or something serious. She felt it and told me "It's not cancer, don't worry about it." Then when I was leaving I asked her about the gland again and she "It's nothing to worry about, it doesn't need to be scanned, it's not cancer, I wouldn't even blink an eye over it." She did give me a prescription for 200mg of Zoloft. I don't know if she is just blowing me off as a hypochondriac or if she is just assuring me nothing is wrong.

[mad4mustangs]

Sounds like you did get to spend a good amount of time with your wife's doc.  It's always good to get a second opinion.  I would still encourage you to try the mouthguard if you can, plus the sour foods- neither will hurt and you may be surprised how much it helps.  I believe many of us don't even realize what stress does to our bodies.  I don't know what your health coverage is like, but if it covers it, you may see if you can get a therapeutic deep tissue massage to break up that spasm in your neck.  As the muscle group in our necks attach to the base of the skull, when there is spasm, we may feel it as a headache.  Been there, done that, and in the right massage therapist's hands, it can be so helpful.  I'm in PT now for headahce, neck pain and spasm due to protruding disc with nerve impingment of my C-4, not sure how much it is helping.  You could look up some stretching exercises for your trapezius if that is where the pain is.  I use a hot pack on that area which helps some.  Hard to use it at work, but good for morning and evening.  I'll check back later.

[babcakes2002]

I have pressure in my head and neck, i get off balance and was wondering what to do about it. been gretting real  bad headaches and the doctor just put me on a antibotic (antibiotic). what can I do to get the neck tension away and the balance problem taken care of. my ears feel full. I have been poping then every hour, the pain the head gets worse in the mornging when I get up.

[MyCatz2]

Dont know if this works, but here my pathetic history goes.  Last week I woke up very sore all over.  My arms hurt, my legs, everything felt like I ran a marathon when I hadn't.  I brushed it off took some asprin and went on.  The next two days I was even more sore.  So I thought I was getting a cold.  The day progressed and I started to feel physically sick.  Ya know, runny nose, headache, couldn't stop coughing.  I also felt like I had a fever, which I couldn't prove because I didn't have anything to test it with.  I live in a dorm.  But, over the weekend my head felt like it was buzzing.  I felt like someone had given me drugs (when no one had, trust me).  I almost felt like I was on autopilot, kinda outside of myself, this made me feel shaky.  I couldn't concentrate and constantly felt nauseous, which is weird because I am typically always hungry with my diet.  The thought of any food for 5 days made me sick to my stomach thereafter, so I only ate a little here and there.  But, what started to get to me were the headaches.  I kept getting headaches in the lower left side of my head, that hurt at the base of my neck almost hurt on my left shoulder.  This has been happening for over a week.  It's strange for me though because I dont usually get headaches.  My heart feels like its also beating a little bit faster and I swear (who knows I'm probably paranoid) that I smell something burning right now when nothing can be because Im a college student living in a small dorm.