Brief Answer:
Have you seen a headache specialist?

Detailed Answer:
Good morning. I am a neurologist for adults and a headache specialist as well from the XXXXXXX Ohio region of the world. Of course, when I read a story like this my first impression is that there is a form of a headache syndrome that may be occurring.

I don't know exactly how to interpret your statement of "they think I'm making it up" simply because that would imply that there have been a number of intents to work with you, try different interventions, make a diagnosis that is clear and concisely that embodies the symptoms in a cohesive way which would then, direct a particular treatment or set of alternatives. It would also imply that they've done all the proper diagnostic testing to rule out things that I'm going to talk about below.

So I would need more information before being able to objectively evaluate that statement for validity.

In my case, I almost never would think of a patient as "making up" symptoms or diseases except in the setting of there being some monetary or other types of gain for them. Headaches can be due to stress, conflict, and as frequently many internal chemical or structural derangements that are going on that need to be looked at before concluding that the patient is either "making it up" or otherwise, not really feeling pain or having disability except for attention seeking or psychiatric reasons.

Therefore, in your case, a workup would obviously include precise history as to when your symptoms actually began (even if back in childhood...that counts) and how they've evolved. What is your weight? What medications do you take? Do your headaches get better with rest? Is there any type of complex of extreme light, sound, or smell sensitivity that can make the headaches escalate a notch or two in their intensity? Do you see sparkling or fleeting lights especially when bending over or changing head position? Do you lose your vision when bending over or changing head positions? Does the tinnitus (the pulsations in the ears) get significantly worse when bending over? Have you had any testing done for the tinnitus itself including audiograms to check hearing? Have your ears been looked at? Have the optic nerves been evaluated and looked at carefully by an ophthalmologist or at least a good optometrist? Is your visual acuity normal? Is your peripheral vision normal?

Have you had any type of imaging studies and if so, can you upload the reports to this system in the form of .PDF files so I may read them? Have you been to a neurologist? Your symptoms could be pointing toward any number of problems from pure MIGRAINE with aura types of headaches to a CHIARI malformation of the brain to something called IDIOPATHIC INTRACRANIAL HYPERTENSION (IIH) whose old term was "pseudotumor cerebri." Although the latter is more frequently seen in women who are obese and use substances such as retinol or Vitamin A in megadoses for things such as acne and skin care the disorder can be seen in males with obesity being one of the prime risk factors. Age of onset of the disorder is generally in the 30's and 40's and symptoms are very similar to yours.

I have had several patients in my career with this diagnosis and the treatment strategies can be simple or complex but the proper studies must be done to rule this entity out. Most medications that are typically used for treating headaches are ineffective when used in IIH patients and special imaging studies as well as spinal taps are needed in order to confirm the diagnosis. Sometimes neurosurgical surgical procedures are undertaken to resolve the problem but that is in the last instance of attempts after all else has failed.

My suggestion is that you locate a good HEADACHE SPECIALIST to whom you can be referred who can review the workup that has been done to date and suggest the next steps. Of course, if you'd not mind taking a bit of a holiday from Down Under and catching a Big Bird over her to the Colonies....I'd be more than happy to sit down with you (or stick a long needle in your back! LOL) to properly ferret out your problem and at the same time introduce you to the marvels of XXXXXXX Ohio which is clearly an up and coming XXXXXXX Metropolis.

It's a bit coincidental that I have a young lady that I take care of as well from Wales, UK with IIH who was also told that she was just being a pain in everyone's side and to just not be such a depressed and needy person by her doctors before we really moved them to get the imaging studies of the brain which clearly showed increased intracranial pressure. Now, the problem is to get them to DO ANYTHING about it....this socialized medicine thing is not a good thing at all if we are trying to cure people with REAL DISEASES. I'd love to be the doctors on the other side of that equation though.....everything turns out to be a cold, flu, sinus congestion, or imaginary and just attention getting. Sometimes it seems that the only things that ever get expert attention come walking into ER's as they bleed out from car accidents or gunshot wounds since nobody can reasonably deny those as causes for faintness and pain! Sheesh! Everything else exists in the medical texts for good reading but not much more! It's terrible the way some people are treated in the name of "medicine for all"--- I doubt that was the true intent of those who devised the system....on the other hand, maybe it was....

By the way, do send along any and all lab studies or serum testing you've had done that would show the levels of your electrolytes, your thyroid gland function, your kidney, and liver functions, and urine results if any.

I hope these suggestions and opinions satisfactorily address your question and give even more information that you can discuss with your doctor for consideration. If so, may I ask your favor of a HIGH STAR RATING with some written feedback?

Also, if there are no other comments, may I ask you not forget to CLOSE THE QUERY on your end so the question can be transacted and archived for further reference by colleagues as necessary?

You are invited to direct more comments or inquiries to me in the future by going to my web address at:

bit.ly/drdariushsaghafi

I would be honored to answer you quickly and comprehensively.

Please keep me informed as to the outcome of your situation.

The query has required a total of 34 minutes of physician specific time to read, research, and compile a return envoy to the patient.

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