Wednesday, April 14, 2010

The 6-Day Headache

For about a week in mid-March, I had a headache. Unfortunately for me, headaches in general are not terribly rare. Having some sort of mild headache a few times a month, especially with all the stress and busy-ness of late, is something I have just learned to deal with. Generally, they only last a few hours and are easily knocked out with over the counter medication. Sometimes, they last all day, and even rarer still into the following day, requiring repeat doses of analgesics, but that's about it. (2-3 times a year, I come down with a full-blown migraine, but that is a whole different beast.)

Thus, when I developed a headache on Thursday, March 18, I didn't think much of it. Take something for it, move on. Thus ended Day 1. Day 2 dawned, and my head still hurt. I think I even made mention of it on Twitter. I knew hormones were likely involved (I had started my "off week" of pills a day or two before), so I wasn't too troubled about it, except that the medicine started wearing off sooner than it should have. Day 3 was Saturday, and my grandfather's birthday party. I took two doses of Excedrin that day, back to back, as the closest interval the package recommended, something I never do because the caffeine gives me the shakes, but I was determined not to hurt the whole day. Once I dropped the Excedrin for Day 4, the pain was constant. It would get better or worse depending on what I took for it, but it was always there. Day 5 was Monday, and work was crazy. Yes, my head hurt all day, but I did not have time at the time to go to the doctor. I had decided that if it still hurt on Tuesday (that would have been Day 6), I would call the doctor.

Well, lo and behold, I was headache free nearly all day Tuesday. I figured the problem had corrected itself. Maybe it was all the traveling. Maybe it was the change in altitude going from Atlanta (about 1000 feet (305 m) above sea level to technically below sea level at my parents' house). Maybe it was the start of allergy season. (I had also restarted my active pills, so maybe that was it.) Who knows! All that mattered to me at the time was that I didn't hurt for the first time in days. As I went to bed, tired from travel and work, I could feel some tension in my head/scalp, but I tried to ignore it. All I need to do is sleep, and all would be well.

Or not. I woke up Wednesday morning with my head hurting just as badly as it had been, and the longer I was awake, the worse the pain got. Up until this point, I had been running somewhere in the 1-4 range on the pain scale (1 being mild discomfort, and 10 being the worst pain you can imagine (and remember, I've had kidney stones, so I truly comprehend a *real* 10! LOL)). By 10 AM, I was up to about a 6, and pain meds were barely taking the edge off. I had now officially had a headache for 6 of the last 7 days. I called the doctor's office to see if my usual medical professional (actually the physician's assistant I've been seeing for 7 or 8 years now) had any slots available for that day or the next day. Apparently, "6-day headache" is the magic password to get you fit in before lunch!

Now, here is where being the daughter of a medical professional can get you into trouble. I knew just enough to have myself very slightly concerned. Not worried, really, but I knew a whole lot more of the possible causes than the typical layman off the street. It could have been a tumor, aneurysm, clot, some type of encephalitis (swelling of the brain), lupus (thanks, Mom, for telling me about a friend's son who was diagnosed with that due to chronic headaches (and other symptoms) just the weekend before), or any one of a bunch of other things. Now, I also knew enough (or knew how to google enough) to know that I didn't think I was showing any of the other classic symptoms of any of those possibilities, but there was still this niggling feeling that it could be something *really* bad, especially when this was so very abnormal for me.

Naturally, the PA asked me a zillion questions, which I expected. As silly as it sounds, she thankfully came to the conclusion that the only thing she could diagnose me with was a headache. There were no other symptoms of any kind that pointed to anything other than a stubborn headache. Now, my blood pressure was up, but that was a "chicken and egg" type problem. Did my head hurt because my blood pressure was high? Or was my blood pressure high because I was in so much pain? There was really no way to know. After consulting with one of the doctors (that's only the second or third time in the 7-8 years I've been seeing her that she has done that, which did alarm me slightly), they decided I was likely caught in some sort of headache cycle. It could also be morphing into a rebound headache where, after taking OTC meds for several days, taking more pain meds actually start to *cause* the headache. They started me on a beta blocker to see if that would break the cycle, and told me to take only Tylenol (no NSAIDs, like Advil, my usual pain med of choice) if I really felt I could not cope with the pain. But they did allow me to go on my trip to Jacksonville (as you saw) as long as I promised to go immediately to the ER if the pain came on suddenly.

It took about 3 days for the pain to fully go away, but I am happy to report that I have had only 2 headaches since then. Both have been mild, only one required use of Tylenol, and it responded immediately to a single dose. They were also much more "normal" headaches, if that makes any sense. I had also been told to watch out for *anything* unusual, especially if it was brain related, and I did end up with two things to report. Nearly every day, I would wake up with very clear memories of that night's dream. Now, remembering my dreams is not necessarily odd in and of itself. I remember them probably 3-4 times a month. But ever since I started the beta blocker, I was remembering them 4 out of 5 nights! Definitely brain related, and definitely unusual for me. They also aren't very restful, varying from simply strange to truly frightening. I don't feel exhausted, really, but just very slightly tired when I wake up. The other thing is that I have had a dramatic increase in the occurrence of ophthalmic migraines. Now, I didn't even know that's what they were called until I talked to my mom last night. I've been having the symptoms ever since I was a teenager, but it's only 2-3 times a year, they go away in less than an hour, they aren't painful, so I'd never bothered to ask about them. But since starting the beta blocker, I've had them about once a week, and one day, I had 3 or 4 back to back. As soon as one would clear (I have the kind that enlarges, like the graphic in the link, except that mine are crescent shaped and they flicker), the next one would start. So strange!

So, I had my follow-up with the PA yesterday, and she has decided to leave me on the beta blocker for a couple more months, but if I continue to have no further issues, she hopes to take me off of it at that point. She is also going to run the symptoms by a neurologist. That statement certainly got my attention! She doesn't think there is anything wrong, but she wants to make sure that it is just my brain reacting to the altered blood flow caused by the medication that is causing the dreams and the increased ophthalmic migraines, and that those symptoms combined with the previous headache don't set off alarm bells of something obscure for the neurologist. Better to ask and be officially told there is nothing wrong than to start having symptoms later and find out we should have mentioned it before. I should hear back from that in the next few days. Either the neuro will say there's nothing to worry about, or I'll be referred. And assuming all is well, I should be able to come off the beta blocker sometime in June. Wish me luck!

Currently feeling: seeing strange things


  1. Hmmmm....


    I hate headaches. This may be because I watch too much House and can think of all kinds of causes...rarely pleasant.

    Take care of yourself ;)

  2. {{{Erin}}} I had no clue about the ocular migraines! I've had them before but never knew they were really anything "named".

    I do hope that you are able to come off of the beta blocker in June and that all will be well in Erin-land. Take care of you!

  3. I have been having a headache for about 6 days now too and it really sucks. i was wondering how exactly you got rid of yous? was it just Tylenol?


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