Will it stop hurting if I cut the right side of my head off?

June 8, 2007 9:36 PM

So, I'm pretty sure that I'm on the tail end of what fits the definition of a migraine. It hurts a lot less than it did. What do I say when I call the doctor's office?

For the past 4 days I have had a pretty bad headache on the right side of my head. Most of that area hurts, but right behind my ear, behind my right eye and the inside of my right nostril hurt worse than anywhere else. The pain has luckily not been enough to put me totally out of commission, but I am definitely operating at much less than full capacity. I didn't get any of the 'aura' that some other people describe, but I did have a few nights of really weird vivid dreams before hand.

During two years of almost constant stress, this happened anywhere from once/month to once/3 months (always in the same areas). I'm not experiencing stress like that now and it has been 10 months since it last happened. As far as I know, I'm not allergic to anything.

So, what do I say when I call up the doctor's office? Do I just make an appointment, and bring a typed list in with me, or will that make me look like a hypochondriac/drug scammer?

posted by ArgentCorvid to health & fitness (14 comments total)

Do you mean bringing a typed list of your symptoms and when you experienced them? I think that's a very good idea.

I get migraines, and your headache doesn't sound like one - maybe more of a tension headache, but IANAD. I do know that when I have a migrane, it lasts 24 hours or less, and I can't even function until it goes away.
posted by Liosliath at 9:44 PM on June 8, 2007

Just tell them that you believe you are suffering from migraines but have not been diagnosed. Definitely have a list of all the symptoms (and when they occurred -- that's pretty important, too). The doctor will know the right questions to ask to correctly diagnose your headaches, but the more information you record, the better your answers will be.
posted by Ms. Saint at 9:54 PM on June 8, 2007

IANAD. The four days is slightly troubling. Are you sure there's no stimulus in your house, like a bad flickering light or such? Migraines for me leave me almost entirely unable to think, to the point that I have trouble with arithmatic, although if I catch them early a combination of acetaminophen, ibuprofin and caffeine will usually decrease them to a regular headache level (after it gets going nothing will really stop them until I go to bed).

Something about where it was hurting and the length makes me think that you should call someone oncall and just describe those symptoms to see if its something more serious. People call in reporting "the worst headache of their life," which this doesn't sound like it is, but ERs will often interpret it as a possible hematoma.
posted by devilsbrigade at 10:17 PM on June 8, 2007

IANAD either, but your symptoms could indicate anything from migraines, to a low grade recurring sinus infection to something more serious. Just tell the doctor your symptoms and as Ms. Saint says... make sure you tell him that it has not been correctly diagnosed to date. But yeah, your symptoms match what I had this past winter during the worst sinus infection ever.
posted by |n$eCur3 at 11:41 PM on June 8, 2007

Maybe migraines, maybe not - what everyone else says. I did want to add that I suffer from weather/barometric pressure related migraines (I can predict storms better than the weather channel), and they can last for several days, from before the storm until it hits.

Many different things can cause migraines, and the pain and debilitating effects can vary on the scale from mild to severe. You're right to be looking at stress, allergies and your diet, and you're right to bring a list of symptoms. Your doctor won't think you're a drug scammer - migraine meds aren't high on that list.
posted by LadyBonita at 11:58 PM on June 8, 2007

IANAD but having suffered migraines my whole life and having chronic sinus issues, I have to say that both the location and duration of the pain screams sinus headache to me. Given the time of year, it seems twice as likely.

If you're taking Advil, Neurofen, etc and finding they don't help (which they won't, if its a sinus thing), try taking Sudafed - the red one used to manufacture meth that require all kinds of OTC paperwork at the pharmacy is the only reason I have not surgically removed my own brain by now.

OTOH if it is a migraine, T3s or 222s or Neurofen in the highest recommended dose plus a full-fat Coke for the caffeine can help take the "please kill me" edge off the pain while you wait to get hooked up with the real deal. Cafergot is old-school but has worked consistantly for me for 20 years now.
posted by DarlingBri at 5:22 AM on June 9, 2007

Sinus infection, ear infection, or tooth ache (probably also some kind of infection)... those'll give you that kind of pain exactly. Personally my bet is on the teeth, but your doctor should be able to either sort you out or send you onwards to a dentist.

And, well, yes, make an appointment and bring a list of why you're there with you. Try and go while you're still feeling a little pain, so that, e.g., if there's fluid some place there shouldn't be, they'll be able to detect it.
posted by anaelith at 6:34 AM on June 9, 2007

I've had migraines all my life. They've shifted from behind my right ear, to all different positions in my head, unilateral, bilateral; different auras, different symptoms- your best bet is to head to the doctor to find out what kind of headache it is. (In the meantime, pop a couple of Excedrin and slam it with some Coca Cola, plus two pseudoephedrine. Then you have migraine and sinus somewhat covered, and it might help.)

I've been to a lot of doctors. Write up your symptoms and experiences, tell them you suspect migraine. If you're going to your regular doctor, I wouldn't worry about them thinking you're drug seeking, but family doctor or doc in the box, it's okay to emphasize to the doctor that you're not looking for narcotics and would prefer to avoid them.
posted by headspace at 8:37 AM on June 9, 2007

I have always gotten bad headaches. It's been something that I've had since about second grade, I had to start taking regular Tylenol because children's Tylenol did nothing for me then.
They checked my glasses prescription and found that wasn't the cause. It was just something that whenever I'd get a headache, I'd take a pain killer for it.

However, in March I was at the doctor and I brought up the headache thing. She sent me to Headaches.org and had me keep a "headache diary" for a month. I had to record when I had a headache, the severity, any triggers, what I took for it, and how it helped. After a month I sent it to her, she looked it over and got me a prescription for Amitriptyline. I take it every night before I go to sleep and it has significantly cut down on the amount of headaches, and the severity of them.

I think that your doctor may require you to do something along the same lines as keeping a headache diary. But it is definitely something I wish I would have brought up sooner.
posted by Becko at 8:54 AM on June 9, 2007

Migraines are different for everyone. I get daily brutal headaches that I have a hard time classifying as migraines (to me, they feel more like "tension headaches" as well) but my neurologist disagrees. He's the guy who went to med school, so I trust him.

A typed list of symptoms is definitely a good thing. Pay attention to when it started, when it ended (or eased off), where it hurts, what kind of pain it is (throbbing, shooting, etc), whether bright lights or noises make it worse, if it's keeping you from sleeping, and anything else you can come up with. Write it down. You will forget almost all of it unless you bring it with you; at least I do.
posted by cgg at 9:54 AM on June 9, 2007

You should always see a doctor immediately for new onset headaches, because they will be able to make sure you're not having a bleed in your brain. IE: Go to a doctor. Now.

That being said, answering your original question, just call the doctor's office and tell them your symptoms, and ask that you be seen urgently. Since no one has yet mentioned it, I'll point you to cluster headaches instead of migraines since it's unilateral, severe pain, lasting for several days, around the eye, and you're male.

Again, I am not a doctor, I am not your doctor, you are not my patient. Seek medical attention immediately.
posted by gramcracker at 8:02 PM on June 9, 2007

I agree with your idea of keeping a diary or record of symptoms. Headaches can be primary (migraines, cluster, tension) or secondary (a symptom of another health issue or medication). History is usually the key to diagnosing them, though you should have an exam in the office as well, including a neuro exam. Fancy imaging tests are rarely needed, though they might be used if you have alarm symptoms. Your list of symptoms and triggers will likely give a health care provider much more insight into the diagnosis than any simple office test or exam. Some points to write down/make note of in addition to what you wrote above:

quality and severity of pain (0-10 scale, where 10 is the worst you could imagine)
any associated symptoms (sensitivity to light and sounds, nausea, vomiting, weakness, numbness, visual changes, itchy/runny nose, decreased sense of smell, fever, etc.)
medications you tried, whether or not they helped
any past medical history (headaches, head trauma, etc.) and what medications you are on now
any family history of primary headache disorder such as migraine

The above info would give a provider a great starting point and cut the visit time down, getting you to a diagnosis faster.

I am not going to try to diagnose you or anything like that (insert usual disclaimer here), but cluster headaches don't fit with your description. They usually involve eye tearing/runny nose on the affected side, and are described as icepick or hot poker-like pain in the eye socket. People don't function well without treatment if they have them as they are excruciating. Like your eye is going to come out of your head. They also don't last for days - a few hours at most. They are also relatively uncommon.

The triage nurse at your doctor's office will help determine the urgency of the appointment. Just tell him or her that you have had a headache for a few days, s/he will ask you more questions, and get you an appointment. While you should see someone about this, I am not convinced of the immediate urgency gramcracker suggests unless there are other symptoms involved, since you said this is not a new onset of this type of headache, just that you haven't had one in 10 months. Good luck - headaches are awful and I hope you feel better soon.
posted by tuff at 10:59 PM on June 9, 2007

FWIW, migraines can cause both tooth pain and sinus pain because of the vascular pressure element of a migraine. In fact some headache specialists believe that most, if not all, head pain originates from migraines. Don't let the internet diagnose you. Migraines *can* last for days, and their symptoms can vary quite a bit from one person to another.

The best drugs for migraines are actually not terribly useful for drug-seekers, so you shouldn't have to worry much about being suspected of fibbing. The first thing I reach for is Imitrix, which is a sumatriptan rather than a pain killer, and will not be at all helpful to someone addicted to narcotics.

If your GP can't help, you want a referral to a neurologist. Keep a headache diary (pdf forms to use are here) in the meantime.
posted by happyturtle at 8:26 AM on June 10, 2007

1 in 6 people will suffer from debilitating migraine at some point in their lives; it's not exactly as though you'll be the first headache patient your doc has ever encountered. (Headache may in fact be the most common disabling condition in the populace, although back pain gives it a pretty good run for the money.)

As a doc who frequently encounters folks who complain of headaches, I can say I find a typed up headache diary useful. It's also good to keep track of your caffeine intake, your analgesic use, other medical conditions and medicines you take, recreational drugs if any. And being able to explain what the headaches are like - when they happen, what triggers them, how bad the pain is, what it feels like, where it hurts, how it comes on, how long it lasts - is useful sometimes too.

Don't overthink this - it's new to you but if your doc isn't a still-wet tyro just dropped from the medical-school doc factory, it will not be new to her.
posted by ikkyu2 at 5:23 PM on June 10, 2007