March 18, 2014 6:42 AM Subscribe
About 3 years ago, my health started falling apart. 2 and half years ago I asked this question
. Some of my symptoms at that time were side effects from Wellbutrin (which resolved when I stopped taking it), and the others were diagnosed as migraines. My treatment for migraines has been less than successful and I'm beginning to doubt the diagnosis, especially since the intensity of the headaches has ramped up so severely in the last couple of weeks.
posted by altopower to Health & Fitness (27 answers total) 2 users marked this as a favorite
List of important info:
1. I have a headache literally every day. There is no time when the pain goes below a 3 and most often it hangs out around a 5. It feels like a giant fiery hand grabbing the top of my head, forehead, eyes, and cheekbones and squeezing. It hurts least first thing in the morning and the pain increases throughout the day. When I go in to see the headache specialist and have to answer the questionnaire about how often I have headaches and how long it takes for a migraine to become full-blown, I *can't answer* because it's always there. I also get the "ice-pick" headaches at two or three specific points on my head.
2. I'm very sensitive to light all the time...it seems like my pupils don't contract enough and constantly let in too much light. During eye exams, the optometrist has commented on my "large pupils."
3. I don't experience any nausea with my headaches. The only exception to this is in the last couple of weeks where I have had a vague nausea with them, but nothing even close to vomit-level.
4. I can't identify whether I experience an aura or not. I know that an aura isn't required for a headache to be a migraine, though.
5. My headache always worsens when I sneeze or strain in any way (Valsalva, I think?) I'm mostly able to run without problem, though afterwards is sometimes rough.
6. I've gone into the ER twice for treatment for severe headache. My blood pressure both of those times had the top number much higher than normal and the bottom number much lower than normal (for instance this last time it was 150/65). After the IV treatment (Toradol, Reglan, and Benadryl, effective enough to get me back to my baseline pain level), my blood pressure reading was 100/65. My normal blood pressure is on the low side, but not that low.
7. I have failed every migraine preventive they've tried: Topamax, amitriptyline, nortriptyline, and tizanidine. They have not tried any beta-blockers, presumably due to my low-ish BP.
8. My abortive meds are naproxen, Relpax, and hydroxyzine. Naproxen sometimes tamps the pain down to a manageable level again, but I canNOT take it every time my head hurts or I wouldn't do anything else. Plus I'd probably put myself into rebound territory or medication overuse headache. Relpax is the fourth triptan I've tried (the others were Imitrex, Amerge, and Maxalt) and I've given up on trying any others because they do nothing. Hydroxyzine I take when I just want to go to sleep.
9. In the last few months I've also started getting pulsatile tinnitus, where all of a sudden my ears feel very full and all I can hear is the whooshing sound of my pulse. I feel sort of dizzy when that happens, but it passes eventually.
10. I have constant pain in my sinus areas, both the frontal and maxillary sinuses. I had sinus surgery several years ago, but a very recent CT confirmed that my sinuses are totally clear. No explanation for the continued pain.
11. As you may or may not see in my linked previous question, I had an MRI in July 2011 that showed multiple "non-specific" white-matter lesions in my frontal lobe. They attributed those to the migraines eventually, but again, I have doubts.
I'm 35, female, and in good health otherwise. I've lost 70 pounds in the last year and run 3x a week (doing Couch to 5K). I take Lamictal for what may be bipolar depression but I'm seeking a second opinion on that.
I'm posting this now partly because our insurance is changing at the end of the month and I'll be starting with an entirely new set of providers. I'm also posting partly because things have gotten so much worse in the last couple of weeks. The headaches are terrible but I have to suck it up and still go to work and take care of my kids. My eyes aren't focusing very well without great effort on my part.
My questions are: do these sound like migraines? If not, thoughts on what they could be? Is it worth having the whole thing completely re-evaluated (new MRI and everything) with the new headache person on the new insurance?