Constant Migraine, please help!

[shayna_lee]

I am a 23 year old female who, before this, was extremely active and I have a very clean diet. 2 Weeks ago it started with just a constant dull headache, which then progressed to a full on migraine. I went to the ER where they did a CT, LP, urine sample, and bloodwork, all of which came back normal. They released me. For the next 3 days it remained a dull headache, and then hit like a freight train. I went to our local walkin and they drugged me up thinking I could sleep it off. It didn't work, I sleep fine every night, and when I wake up the pain is still there. It has never left. I haven't been able to identify any triggers. The last Dr I went to found fluid in my ears and is not sure whether that is part of the cause or has developed since the migraine because of all the pain medication. I am currently on amoxicillin and muscle relaxers along with ibuprofen as needed. Tried imitrex, doesn't work for me. The pain is in front and on the right, and more of an intense pressure feeling with occasional sharp pain. I have dark spots in my vision which tend to go away and come back depending on pain level. Someone please help. They want to refer me to a neurologist but I cannot afford it, so i am trying to find help elsewhere...

[Dr Santos]

Hi,
How are you? It is good that the underlying cause was identified. Factors that usually predispose to otitis externa including otomycosis or fungal infection, include absence of cerumen, high humidity, increased temperature, and local trauma from use of cotton swabs. Cerumen, surprisingly, because of its  pH, suppresses both bacterial and fungal growth.Take care always.

[shayna_lee]

Had my follow up with the good doctor yesterday. She did a thourogh look in my ears and found that the fluid is gone and the eardrum is visible again, but i have a fungus growing on my eardrum, which explains the headaches not being totally gone. She prescribed Ciprodex eardrops and gave me a kenalog shot. Lets hope this works!


motox320-  I live in Ca in the central valley. No, laying flat makes no difference.

[motox320]

shayna_lee

What state do you live in?

And do these headaches go away when you lay flat>?

[shayna_lee]

Update: Headaches still aren't too bad, but over the weekend something new developed. I now have swollen lymphnodes in my armpits and neck and they are kind of tender. I go back to the doctor that helped me with the ear fluid previously so I will update again after that. I am kind of glad to have a new symptom just because now its not such a phantom issue and there is actual physical eveidence of something going on, so maybe i'll get some answers.

[Dr Santos]

Hi Shayna,
I'm sorry to hear what you went through today. I do understand what you are feeling right now. Do not feel defeated, just hang on. It is better that you are proactive  and you are taking steps to determine the underlying cause by ruling out other possible causes. If he didn't help much, there are others who may be able to help more. If you are taking birth control pills, the possibility of hormonal fluctuation can also be ruled out. Try going back to your primary care physician, one who is aware of your complete medical history which is very essential in determining the underlying cause. Take care and do keep us posted.

[shayna_lee]

Had my follow up today, which got me absolutely nowhere. The guy walked in, looked at me and said theres really nothing I can do because they already did a CT and Lp, and tried to refer me out. I told him I didnt have the money for something like that, and his response was "you don't have to go then."   I'm feeling extremely defeated and quite angry with how I was treated today. I feel like everyone thinks its all in my head or something and no one is listening to me or seems to care.  

I honestly don't feel that it is a neurology problem, because its not always a full on migraine. Its now a headache that ranges from almost gone to a little painful, but its still never gone away.

The antibiotics helped, so I suggested a Kenalog shot since it may further help my ears. He refused that idea and said that Kenalog is not a recognized treatment for allergies.

I am also wondering if it could be my birth control suddenly deciding to not agree with me, so might try a couple days off that. I'm running out of ideas, but so are the doctors. At this point I think I am better off trying to find the cause myself, because I am making no progress with the docs and just digging myself a big money pit.

(I apologize for the intense negativity, its been a rough few weeks)

[Dr Santos]

Hi,
The red blood cell (RBC) count determines the total number of red cells in a sample of blood  while alkaline phosphatase indicates the possibility of bone or liver disease.
Low RBC count may indicate anemia or nutritional deficiencies such as vitamin B 12   , iron or  folic acid and other medical conditions such as kidney diseases and excessive IV fluids. On the other hand, a decreased serum alkaline phosphatase may also be due to nutritional deficiencies also ( zinc, vitamin C, folic acid, and vitamin B6). Discuss this with your doctor and correlation to your symptoms is highly recommended. Take care always.  

[shayna_lee]

I have my follow up appt tomorrow. I was looking over my ER paperwork this morning and noticed that a couple numbers were low. My RBC was 3.87 and my alk p-tase was only 25. Is this significant at all? Thanks

[Dr Santos]

Hi,
How are you?  It is good that your eyes were cleared from any pathological cause. If you can not get an appointment with a neurologist, evaluation by an internist will also be very helpful. At this point, a headache journal will also help determine the possible triggers that may be causing these headaches. This will also assist your doctor in your next appointment. The trigger may be food, an activity or even from weather or environmental causes.  Take care always and hope to hear from you soon.

[shayna_lee]

Update: Got my eyes checked and everything is fine. Still 20/20 vision, nothing going on inside with my retina or anything that would cause the floaters, so they are completely headache related. Can't wait for my follow up appt with the internist on Tuesday... Maybe he'll find something. The Internist is at the clinic that I can afford, so thats why they set me up with him. Its the highest up I can get without having to sell everything I own.

[Dr Santos]

Hi,
How are you? Thank you for  your update. It is good to hear that you are feeling better. The amoxicillin may have helped with the infection in your ear. If there is still pressure around your eyes and the floaters are still present, you may indeed benefit from a visit with your eye doctor or opthalmologist. Take care and do keep us posted.

[shayna_lee]

Just an update: Feeling a bit better, headaches have calmed down to just a dull headache. I am thinking that a lot of the pain was associated with my ear problems.

I am still having eye floaters and some pain and pressure around my eyes. Thinking I might go get my eyes checked just to mark that off the list.

[Eddie1994]

Shayna,

I would agree with Dr. Santos about a Neurology consult especially since your funds are limited.  Given this constraint a Neurologist would be a better choice over the Internist.  Your chief complaints relate to headache and spinal manipulation so this would be a Neurology domain.  Good luck and be well!

[shayna_lee]

Hi Rowena. There was no previous trauma to my head. I did have a few bike accidents last year, but none that I hit my head in. I do think its possible though that my back may have gotten tweaked. I saw a chiropracter this past Saturday and Monday for an adjustment and it did help a little bit for the first few hours after. The main symptoms are the headache, a feeling of pressure inside my head, mostly toward the front and sides, eye floaters (which vary on size and number throughout the day with the pain level), and muscle tension in my neck and face (some of which could possibly be self inflicted from tensing during headaches).

I have no doubt that a neurologist's opinion would be very helpful to me, but unfortunately it is not a possibility with my financial status. The last Dr that I saw at the cheaper clinic in town did refer me to an Internest for my next appointment, but that isn't until July 6. Any other thoughts or suggestions would be greatly appreciated, and thank you for your response!

Shayna

[Dr Santos]

Hi,
How are you? Are there other symptoms present? Was there a previous trauma or injury to your head and neck? It is good that the CT, LP, urine sample, and blood work were all normal. If there us an infection present, try to finish the course of the prescribed antibiotic and see if there is relief. However, if the pain persists, you really can benefit from a neurologist's evaluation to determine the possible cause. Take care and do keep us posted.

[shayna_lee]

Thank you for your reply. They did do an LP on me and my opening pressure was normal, so that rules out IIH. Thanks for the thought though, I appreciate the response.

[mommies4]

I have a suggestion,altho I'm not a Dr. or Nurse,and this could be one of many things.Does this effect your vision ? Ice packs help me . This might seem out there to you but have you considered going to a Opthomologist ?  I have IIH witch means I have CSF build up ( Fluid on Brain )  I take meds for .It was the last thing I thought the Dr. would say , however it stoped my headaches that lasted upward of 27 days.
   And your right It hurts and meds IE : tylenol didnt work ..
          Good luck      I hope you get relief soon !                       mommies4