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Getting headache, feeling tired. History of skin cancer removal. Any solution?

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General & Family Physician
Practicing since : 2005
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After playing golf for a few hours I usually get a mild headache. Later, as night falls the headache becomes severe and lasts until the early hours of the morning. I am bed-ridden for the entire evening.
I wear a hat and sunscreen. I am 61 years old - and this problem started several years ago. And I drink plenty of fluids while out in the sun. The problem is worse during summer - but recently in mid-winter it was bad - started with a very mild headache - then as the sun goes down - I start yawning and the headache becomes progressively worse. Next morning I am always good - just tired. I have had some skin cancers removed over the past decade. I have very fair skin.
I have asked Doctors about this but can't get a solution.
Hope you can help me ... ... XXXXXXX
Posted Sat, 28 Jul 2012 in Headache and Migraines
Answered by Dr. Prasad 1 hour later

Thanks for the query.

I have gone through the details with diligence. You seem to be suffering with chronic headache. The most common cause of such headache is migraine.

Since you mentioned you have seen few doctors, I would like to know whether or not migraine headaches were discussed?

Migraine headaches are usually seen in young people, however occasionally they have a delayed onset too. Exact causes of such headaches are not known; however they are speculated to be due to some disturbances in the neurotransmitter chemicals. Exposure to sunlight, lack of good sleep, fasting, a strong aromatic odour and few other factors are known to aggravate such headaches.

Along with the headaches, you may also have nausea, vomiting, flashes of light, photo and phonosensitivity (worsening of headache with light and sound) and other associated symptoms.

Past history of skin cancer doesn't influence in the development of migraine headaches. Neither do I think you have some kind of tumour in the brain causing the headaches. However if you are worried it is related, you can get a Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) scan of brain to rule them out.

As far as solution of this problem is concerned, it can be prevented. Effective treatment constitutes:
1. Avoiding aggravating factors - in your case avoid long exposures to sun. Use a proper cap/hat to cover yourself when you play golf.
2. Analgesics for acute attacks. When acute attacks begin, taking a pain killer such as over the counter ibuprofen or prescription non-steroidal anti-inflammatory agent early will be more beneficial.
3. Preventive drugs. Some group of drugs namely selective serotonin reuptake inhibitors like amitripyline, anticonvulsants like gabapentine, beta blocker such as propronolol, etc are widely used as preventive / prophylactic drugs. A regular use of one such drug in adequate drug can effectively stop such headaches from happening.
4. Lastly lifestyle changes such as regular food, proper sleep, physical exercise, yoga, transcendental meditation and other relaxing techniques have useful effects. You may try it.

A competitive neurologist can be able to streamline any necessary test as well as put you a course of preventive medications to take care of this disturbing problem. So do not lose hope, what you have can be treated.

Hope this reply is informative and serves as guidelines towards your treatment. Let me know if you need any more help.

Wish you good health

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