Headache help

[Squiggle]

Hi all,

I am wondering if you could offer any advice or suggestions for me for my headache/migraine problem. I am not looking for a diagnosis, just advice or suggestions from those who have similar experiences as to things to try or to suggest to a doctor...

My family doctor is 5 hours away near Ottawa and I was working with a neurologist there but I moved... so now I have to go to a walk in clinic for any referrals and wait hours to see a doctor who is very rushed. So I find it is best to arm myself with as much info as I can and just ask for a certain medication or referral.

Essentially, I've had a headache since I was at least 12 (I am 24 now)... it is a dull, constant pressure at the top and front of my head. It is always there... it never ever goes away, but sometimes it flares up and becomes pounding, extremely painful or debilitating and I have to go lay down or cannot get up. It can get worse when I stand up, exert myself, bend over, someone touches my head or during hot and sunny weather. I do not see an aura, although sometimes I see sparkly lights for a few seconds in general, not really related. I don't get nauseous, I've only thrown up once because the pain was so bad and my boyfriend said I got really pale and clammy that one time.

I've had a CT scan (no brains in there at all!) , I've tried apo-amitryptaline (twice...mild antidepressant that helps migraines), had my eyes checked for eye-strain, etc. I've tried several very expensive migraine medications that you take when you're having one, and they only worked half the time and were not worth it in my opinion. My dentist did say my jaw is a real mess, not lined up properly and I could be clenching my teeth but that's about it.

Tylenol, advil and aleve help, but I don't like taking so many pills. Basically I'm here because these don't sound like traditional migraine symptoms and I am wondering if anyone has any suggestions as to what I could speak to the doctor about.

 

[Retired]

Sorry to hear about the difficulty you're having with persistent headache. As one who has had migraine all my life, I can appreciate some of of your predicament.

Despite the inconvenience of travel, I would suggest following up with the neurologist. Your dentist may well be on the right track, or there may be facial nerves that need to be looked at.

Are you sensitive to light, smells and sound when having an attack and do your headaches debillitate you to the point where you cannot function or are the headaches in the background causing annoying pain?

For your added information, have a look at this article on Bruxism (teeth grinding) from the Mayo Clinic and see if anything there might be of value, especially the page on treatments.

 

[Squiggle]

Thanks for your reply Steve...

I may speak with my mom and see if she can get my family doctor to give me a referral for a neurologist here (it's a small town near Ottawa and I've known his family personally since I was born so maybe that would work)... the neurologist I was seeing was unfortunately not very good. Missed appointments (to which I was traveling the 5 hours for), prescribing me medications (the apo-amitryptaline) I had already been on without success... not listening to me very well... My grandmother also saw her recently for a very serious issue and it went horribly for her too!

During a very bad headache I seem sensitive to everything because I need a quiet, dark and cool place to be in for a bit... flinching from noise/light seems to make it worse but I've never noticed smells before. There is one constant feeling of pressure that is a dull pain, constantly there. I've become very good at ignoring it over the years (to the point of not noticing serious sinus infections every couple years because I ignore all my head pain)... but every so often it flares up and gives way to a very painful pounding that is debilitating and I can't really do anything. I will normally retreat to bed with something cold on my head which will help within a few hours, or if I HAVE to go do something work related, take Tylenol 1's. These flareups aren't sudden, but slowly build and build... sometimes I may go to bed with a tiny headache and wake up with horrible pounding, or it will slowly wake me up in the early morning.

I also forgot to mention that sometimes I experience what I think are called ice pick headaches. Not when I have a flare up, but just in general... every so often, a very sharp, stabbing pain on the side of my head (different sides sometimes) that literally feels as if I am being stabbed in the head and down my neck. The pain itself lasts a few seconds and repeats on and off for a few minutes, and can generally stop me dead in my tracks and make me sit/stand still for a few minutes.

I think I will look into bruxism a bit more and even try a mouthguard or something to start. My family doctor told me to get one long ago but I kept waking up with it in my hair... lol... I am a very active sleeper.

 

[Retired]

If you felt the previous neurologist did not provide you with satisfactory information or treatments, then when you get a referral to the a different neurologist, ask to have the imaging tests repeated. In fact, try to get the copies of the imaging tests and their interpretations, and bring those to the next neurologist.

What about your general health including things such as blood pressure, bloodwork thyroid function etc. Has your doctor reviewed the medications you currently take (if any) including possibly oral contraceptives to try to explain the basis of your headaches? Have ever had endocrine studies performed to look at hormonal levels?

Consider getting a referral to a neurologist in one of the teaching hospitals where they may be better equipped and have the resources for more elaborate testing.

A condition that has lasted this many years should be followed up and thoroughly investigated, because I can only imaginehow your quality of life is being adversely affected.

mouthguard .........but I kept waking up with it in my hair

:facepalm:

 

[Squiggle]

Hi Steve,

Thanks again for replying. It's a really good suggestion to ask them to repeat everything, I hadn't considered that...as well as asking for all the previous work done. What are your thoughts on migraine/headache clinics? There is one very close by and I'm wondering if they would listen to me a bit more...

I've had my thyroid checked through blood work and an ultrasound because of what I think is a panic issue I was having (I made a post on that in the mental health forum a little while ago but I can't link to it yet). I have high blood pressure now, or at least did a few months ago (I've had it checked recently twice and it was actually normal but still slightly on the high side since coming off oral contraceptives). As far as I know that stuff was all normal when I was younger too. I'm not on any medications and rarely am, save for the test migraine treatments or effexor, which I was on several years ago. Years ago I had blood work done and was low on iron, then a few months ago I had more done and my iron was okay but my b12 was low (I am not a vegetarian). Working on that now.

The only thing I have not done is an endocrine test...never heard of that... I've tried no caffeine, no sugar, no aspartame, etc. for periods of several months at a time with no changes. They were the same on effexor too.

It's not so bad anymore, now that I've gotten better at ignoring/dealing with it. Taking Tylenol 1's helps sometimes but I try not to take them often... I am really sick of taking advil/tylenol/tylenol 1's so frequently which is why I'm looking for answers.

 

[Retired]

What are your thoughts on migraine/headache clinics?

This would be my first choice, as long as it is a clinic staffed by medical professionals, that is, medical doctors (M.D.'s). I would have little confidence in alternative medicine facilities or chiropractors for headache treatment, because it's just too critical. I beleive there are a number of very specific medical conditions that need to be investigated and ruled out and non medical practitioners just don't have the means to do this.

I am really sick of taking advil/tylenol/tylenol 1's so frequently which is why I'm looking for answers

.

You're wise to do so, and in addition, taking over the counter remedies to relieve persistent headache can result in what is referred to as rebound headaches, where the headache is caused by the absence of the pain reliever. Overuse of any relief for headache pain can result in rebound headaches, according to what I have read.

The cause of the headaches should be determined by medical diagnosis and an appropriate treatment should be initiated.