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Throbbing headache, high bilirubin - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: Liver and Gall Bladder
Answered by

General & Family Physician
Practicing since : 2004
Answered : 37 Questions
Doctor :   Hi
Doctor :  
How can i help you
User :   Hi
User :   i have high bilirubin
User :   not sure if it is direct or indirect
Doctor :   ok

User :  
Doctor :   no

Doctor :  

User :   ok
User :   i have had a throbbing headache for 3 years
User :   no pain just pulsating sensation
Doctor :  
ok
User :   i've recently been diagnosed with high bilirubin (88) and wonder whether it is related
Doctor :   ok

Doctor :  
i will help you in this
User :   thankyou
User :   i have had ct scan, mri, ekg, urine all negative
Doctor :  
ok
User :   recent bloodwork showed bilirubin levels of 45, 55, and now 88
Doctor :  
ok
Doctor :   i am assesing your previous records
Doctor :  
wait for a while please
User :   no problem
Doctor :   ok
Doctor :   hi

Doctor :  
sorry for the delay
Doctor :  
i understood the problem
User :   ok
Doctor :   you have been diagnosed to be suffering from gilberts syndrome
User :   not by my gp
User :   i have to go to the hospital soon for an ultrasound
User :   do you think this is what i have
Doctor :   ok

Doctor :   it cannot be diagnosed with ultrasound

Doctor :  
there is some thing called post phenobarbitone assay of the biluribin
Doctor :  
was it done?
User :   no, i've only had a blood test
User :   but im going to the hospital soon for other conditions to be ruled out
Doctor :   ok
Doctor :  
let me tell you
Doctor :  
gilberts syndrome is not dangerous at all
User :   ok, is it causing my headaches?
Doctor :   this syndrome will cause raised unconjugated biluribin

Doctor :   and clinically you will have only little yellow colour of urine and eye
Doctor :  
head ache usually not
User :   ok
User :   what may be the cause of my headache
Doctor :   you said throbbing type of head ache

User :   its a painless pulsating that gets worse when i stand, exercise or bend down
User :   yes, and it has not gone away for 3 years
User :   i wake up and go to sleep with it
User :   everyday
User :   i have no other symptoms
Doctor :   yes and all your investigations like CT, MRI. and EKG are normal

Doctor :   it goes more so in favour of migrane type of headache
Doctor :  
what medication you consumed and what is the effect of those drugs on the headache
User :   the only medication i have taken is paracetamol
User :   medications have absolutley no effect on the headache whatsoever
Doctor :   you have described dizziness episode in the previous chat

Doctor :  
the description shows more so in favour of postural hypotension
Doctor :  
that is when a person stand up from lying position there will be dizzines
Doctor :   and with in few minutes the dizziness will disappear
User :   i don't suffer from dizziness anymore
User :   just the headache
User :   i suffered from dizziness 3 years ago, before the headache started
Doctor :   ok
User :   also i am 19 years old and fit, does this condition not affect older people?
Doctor :   was there any pain in the jaw of eye when you had the headache
User :   sometimes i get a stabbing pain in the eye, but that goes away very quickly
User :   about 3 weeks ago i had very bad pain in my jaw that lasted a week or so
Doctor :   ok

Doctor :  
now what diagnostic test you are been advised to undergo?
User :   i do not know
User :   i have been to my doctor this morning and he has referred me to the hospital
Doctor :  
i believe the symptoms you have suggests migrane type of headache
Doctor :  
the differential diagnosis i have is gaint cell arteritis
Doctor :  
but more i believe it has migrane type
Doctor :   i will suggest you the following
Doctor :  
avoid coffee
Doctor :   avoid fluorescent light
Doctor :  
avoid noise and bright light
User :   these factors make no difference
User :   i have had this for three years, constant
Doctor :   ok
User :   i can feel my heartbeat in my head every second of every day
Doctor :   ok

Doctor :   can you tell me whether it is pain or pulsation in the head

Doctor :  
which is more worrying?
User :   i have no pain
User :   so pulsation
Doctor :   so it is not pulsating headache

Doctor :  
it is the feel of pulsation in the head
Doctor :  
may i know your height and weight
User :   my height is 5ft 8"
User :   weight is 11st
Doctor :   I didnt get your weight can you express it in pounds

User :   154 pounds
Doctor :  
i shall ask you some personal details
Doctor :  
Do you smoke or chew tobacco/drink alcohol/Any illicit drugs.
User :   no, nothing
User :   i drink occasionally
User :   very occasionally
Doctor :   Please mention about the Sleep, Stools and Appetite, any specific problems with them.
User :   sleep is fine, no problems at all
User :   stools as far as i know is normal and of normal colour
User :   appetite is great no problems at all
Doctor :   was any time ECG of chest done, if so what was the report
User :   yes, normal
Doctor :  
and chest X ray what it says?
User :   i have not had a chest x-ray
Doctor :  
ok
Doctor :   can you provide me brief details of the content of your diet
User :   its very varied
User :   i dont usually have breakfast, but when i do its normally toast
Doctor :   ok
User :   for lunch i will have a salad
User :   and a nutritionally balanced dinner
Doctor :   do you have any worries?
User :   not really
User :   i used to worry that i had an illness, but its gone on for that long its now more of a nuisance
Doctor :  
did you suffer any head injury in the past
User :   no, none at all
Doctor :  
any infection in the ear leading to pus formation in the child hood
User :   infections yes but no pus
Doctor :  
when it was?
User :   i have had two or three in my childhool
User :   i'd say around the ages of 5-10
User :   but nothing of concern
Doctor :   in which ear it was?
User :   i cannot remember sorry
Doctor :  
now your feeling of pulsation in head is in which side?
User :   both
User :   it is deep in the head
Doctor :  
you feel any sound in the ear?
User :   no none at all
Doctor :  
any imblance in any of the movement?
User :   no
Doctor :  
any numbiness or tingiling sensation in any part of the body
User :   no, i have no other symptoms
Doctor :  
ok
Doctor :  
the increase level of the bilirubin
Doctor :  
is it conjugated
Doctor :  
of unconjuated?
User :   i am not sure sorry
Doctor :  
can you please get the investigation done for the conjugated or unconjugated type of bilirubin...
User :   yes
User :   could this be the cause of my headache
Doctor :   it seems like that
User :   should i have anything to worry about in terms or headache and high bilirubin?
Doctor :   absolutely not
Doctor :  
the biluribin level is not alarmingly high
Doctor :  
and in gilberts type
Doctor :  
it is not going to cause any significant abnormality
User :   ok
Doctor :  
so you need not worry at all
User :   Thankyou so much for your help
Doctor :  
please fill the feed back form
Doctor :  
you need not worry at any point of the time regarding the biluribin
User :   i have completed it
User :   what about the headache?
User :   need i worry about that?
Doctor :   need not worry
Doctor :  
as all investigation are normally
Doctor :  
it is your fear of this high bilirubin level
Doctor :  
that is making you feel pulsation like feeling in head
Doctor :  
remove the fear of biluribin levels
Doctor :  
indulge in all your normal activity
Doctor :  
no restrictions in your activity
Doctor :  
you will see this pulsation also will disappear in due course of time
Doctor :  
by the by which is your favorute game
User :   ok, my favourite game is football
User :   or soccer
Doctor :  
would you like to play with your friends
User :   yes
Doctor :  
are you playing now a days
User :   yes, i try not to let the headache interfere with normal activities as you siggested
User :   it does help!
Doctor :   you go out and play initially you may feel little discomfort

Doctor :  
dont leave continue to play
Doctor :  
the head ache also will go and you will start enjoying the life much better than what it is now
User :   thankyou so much for your advice
User :   i really appreciate it
User :   and thankyou for your time
Doctor :  
thanks for consulting health care magic
User :   we don't get anything like this in our country the UK!
Doctor :  
take good care
Doctor :   you can get back to us any time
Doctor :  
we are available 24/7
Doctor :  
bye for now
User :   and yourself, i will take your advice and will consult again should i need to
User :   goodbye
Doctor :  
good bye
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