Brief Answer:
Multiple factors causing his headaches most likely

Detailed Answer:
Good afternoon. My name is Dr. Saghafi and I am a headache specialist from XXXXXXX Ohio. I'm sorry that your fiance is having such issues with headaches and would like to make a few recommendations. I believe that his headaches are a reflection of a number of different processes occurring at once include what sounds to be significant arthritic disease in the neck coupled with whatever process is going on medically which makes him "look bad" as you describe. He is also fatigued a lot which puts him at additional risk for headaches and has poor vision...this also doesn't help headaches.

I can tell you that headaches such as what he has 99% of the time turn out to be what we call MULTIFACTORIAL. In other words, there is not just ONE SINGLE cause but rather multiple triggers or precipitating factors and therefore, there will not be just one single pill or tablet likely to help him. I help people with these types of headaches all the time through the VA Hospital and believe me...if you want to talk about people who have the WORST OF THE WORST headaches.....talk about the soldiers here......

The fact is though if we approach the headaches from an organized and logical basis and gather important information in the form of a headache diary or log then, there is a much better chance that we will be able to isolate a few important features of the headaches which will let us tease out factors that can then, be addressed either by specific medication or other intervention.

I have a HEADACHE DIARY that I give all my patients and ask them to fill out for a full 30 days so that we can get a good solid baseline on their headaches and by this strategy figure out THE TYPE OF HEADACHES they have and their specific features which then, will often suggest specific types of treatments or medications.

Of course, on this network no physician is capable of prescribing medications or ordering tests, etc. All that work is done by patients' primary doctors...sometimes with the cooperation of the Healthcaremagic specialist's concerns.

I would be willing to send you my clinic's HEADACHE LOG by email if you supply that to me and then, have a session with you here where I can explain the details of how to use the headache log properly and optimally. Based upon what we find I can recommend consideration be given to certain types of treatments or interventions. I cannot prescribe medications through this network, nor can any physician.

Please let me know if you'd like me to send the LOG and if he'd be the type of person to really fill them out diligently because otherwise, we lose information and really can't make as much progress compared to folks who keep the logs faithfully.

If you've found any of this information helpful then, I'd greatly appreciate your STAR RATING and some brief commentary or feedback on how my information may have helped your and your fiance.

This query required 22 minutes to read, research, and then, respond for future reference on the network.

In order to directly contact me on this platform to send specific questions on this topic and others please look me up @:

bit.ly/drdariushsaghafi

All the best to the both of you.

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Brief Answer:
Polypharmacy

Detailed Answer:
Hello again.

I've reread your history and other information and the thing that strikes me is that he has a lot of generalized symptoms that don't seem to have relationships to one other...such as his coloring....declining condition with all tests and imaging studies coming back without findings. The medication list you describe is the following:

"takes many pain killers and muscle relaxers for his back conditions and has taken those for 6 years or more with none of these symptoms till now."

In my headache patients or neurology patients in general often times when I run into a XXXXXXX wall as what it seems is happening here I tend to start from scratch....which means the medication list is the first thing that gets scrutinized and chopped down...WAY DOWN. It doesn't really matter that he's had these drugs or not for 6 years, "why now?" the fact is he takes "many" pain killers and muscle relaxers and has done so for years. People are saying he looks back. I can't tell you how many people literally look like different people when they stop taking just a few of the medications that nobody has really taken the time to look at to see whether or not they're really helping or not.

That's one of the first places I would start. I don't think a whole lot of "testing" needs to be done because he's probably had all of the usual and standard things and I don't believe he's got something so rare that 21st century Docs can't find it. I believe there is MORE than 1 cause for his problems and it's not going to turn out to be disease such as stroke, cancer, MS, or ALS (I'm being facetious with the ALS....it's just that everybody and his brother has been asking about ALS that I thought I'd just throw that in----).

So the bottom line is the doctors (in my opinion) need to step back and re-examine his case....starting with a good time line as to when things started going wrong and how he evolved from not having ANY meds for his back to having "MANY." I don't know what his level of physical conditioning is right now but I'm just gong to guess that it's probably substandard and no where near what his capabilities are when he is feeling perfectly normal (how many years ago is that???). He needs to get MORE ACTIVE....even though it's GOING TO HURT some.....he is not going to be better in all honesty without going through a little bit of pain...and I'm not talking about getting stuck for more vials of blood.

Forget about more testing, more tests, more pills.....let's change the paradigm and let's recruit your fiance in leading the mission to get his health better but putting more responsibility on his shoulders to actively make moves toward getting better as opposed to being the experimental puppy in the cage and expecting the DOCTORS, the EXPERTS to miraculously discover what's wrong...because they've already tried.....ain't gonna happen if you keep bangin on the door in the same place. You gotta try another angle.

I hope that makes sense to you and I wish you and he the best. If you wanted to drive just a little farther East than Iowa City.....you could hit XXXXXXX in about 9 hrs. and you'd be in my town...along with the XXXXXXX Clinic, Case Western Reserve University, LeBron XXXXXXX and XXXXXXX Football.....oh I almost forgot....I'm here as well and I don't want to sound terribly presumptious...but if I were to suggest for you to bring your fiance to see either MYSELF or THE XXXXXXX CLINIC? I'm going to say that the choice should be ME, hands down.

I think a headache log is still a very good suggestion so that he can start documenting SOMETHING objective about his condition and so that he can be more proactive in his own care. But perhaps, it would be just as well to wait until he's had a good solid revision of his medications and have some time to get off of some of the stuff he really doesn't need then, we can start developing a headache baseline using LOG ENTRIES.

If you've found any of this information helpful then, I'd greatly appreciate your STAR RATING and some brief commentary or feedback on how my information may have helped your and your fiance.

This query required 60 minutes to read, research, and then, respond for future reference on the network.

In order to directly contact me on this platform to send specific questions on this topic and others please look me up @:

bit.ly/drdariushsaghafi

All the best to the both of you. Happy Holiday Season!

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