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Have Continuous Headache, Feeling Empty,nausea. Treatment?

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Posted on Fri, 23 Aug 2013
Question: I have been having headaches for 2 weeks , saw my PCP who referred me to a neurologist, the appt. is not until Sept. 16th !! Is it unreasonable for me to expect an earlier appt, ? I can tell when the HA is coming, my head feels weird, empty, full of air,light.then if I turn my eyes I get a pain and sometimes a flash of light. I feel very nauseous. I must lie down then the pain comes. I have missed some work ,not to mention missing life in general. I cannot go on this way. I am suffering and even worse people think I am faking.
doctor
Answered by Dr. Dr. Prasad J (28 minutes later)
Hi,

Thanks for writing your concerns on XXXXXXX

You have described the headaches very well. I feel this headache represents Migraine type of headache. I am interested to know since how long have you been suffering from this headache. Also, let me know what would be the average duration of each episode.

Migraine is a chronic type of headache and can be managed with medication and life style modification. Though it does not call for immediate medical attention, if the headaches are severe and if you have very frequent headaches, you can request the doctor for early appointment.

If you are unable to get a faster appointment, I would like to give you some tips to keep the pain in control:
1. Do not fast. Hunger can start migraine attacks.
2. Do not stay awake for late hours. A good sleep can keep you free from headache. Lack of sleep is sure to induce pain.
3. Avoid walking in the sun. Use sufficient cover in the form of hat/ sunglasses.
4. Avoid strong aroma - avoid some of the strong perfumes.
5. Smoking and beverages can be a trigger. Restrict them.
6. Keep some painkillers in handy. Simple over the counter painkiller like Tylenol can be effective when consumed early. Take them as you feel you are going down with headache.
7. And during pain, prefer to stay in a soft environment with low lights and low noise.

Hope this helps. Feel free to write back if you have any questions.

Best Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Prasad J (13 minutes later)
thank you Dr. XXXXXXX for the tips. The headaches began 2 weeks ago and I have had them 12 out of 14 days. in the past I have had 3 or 4 episodes of migraine slightly different with more visual disturbance and less nausea. I am worried about taking the prescribed meds because topomax has side effects that are serious and I am taking an anticonvulsant already for the bipolar. The Fioricet can be addictive. How long does it take to become addicted to the butalbital?
doctor
Answered by Dr. Dr. Prasad J (56 minutes later)
There is considerable overlap of the therapeutic potentials of drugs used in treating migraine and bipolar drugs. Infact, topiramate (topomax) which is an anticonvulsant are also used to treat migraine. I understand your apprehension about these prescription drugs; each of these has individual side effects. However, we always weigh the benefits of those with the side effects before writing it. I am sure your doctor would have done it.

Migraine can change its character. The described current set of symptom seem to be related to migraine too. I wish I had an opportunity to examine you and confirm my statement. If an early appointment is not feasible, do consider visiting the ER in times of acute severe headache and repeated vomiting.

The positive that I look in your case is that you are already on some medication, it just needs to be tuned to suit your needs i.e. control migraine as well as bipolar drug. If the current list of medication cannot produce a combined effect, they may be switched or altered accordingly. You should work with your current psychiatrist and the new neurologist to find the right combination of medication. I am sure that can be achieved.

As far as butalbital addiction is concerned, the additive potential is individualized. We do not have a constant figure in terms of dose, frequency or the duration that determines addictive potential. They are determined over a period of time. Therefore I do not have the right answer about the time taken to become addictive to butalbital is concerned.

Hope I am clear to you. Write back for clarification.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Prasad J

General & Family Physician

Practicing since :2005

Answered : 3708 Questions

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Have Continuous Headache, Feeling Empty,nausea. Treatment?

Hi,

Thanks for writing your concerns on XXXXXXX

You have described the headaches very well. I feel this headache represents Migraine type of headache. I am interested to know since how long have you been suffering from this headache. Also, let me know what would be the average duration of each episode.

Migraine is a chronic type of headache and can be managed with medication and life style modification. Though it does not call for immediate medical attention, if the headaches are severe and if you have very frequent headaches, you can request the doctor for early appointment.

If you are unable to get a faster appointment, I would like to give you some tips to keep the pain in control:
1. Do not fast. Hunger can start migraine attacks.
2. Do not stay awake for late hours. A good sleep can keep you free from headache. Lack of sleep is sure to induce pain.
3. Avoid walking in the sun. Use sufficient cover in the form of hat/ sunglasses.
4. Avoid strong aroma - avoid some of the strong perfumes.
5. Smoking and beverages can be a trigger. Restrict them.
6. Keep some painkillers in handy. Simple over the counter painkiller like Tylenol can be effective when consumed early. Take them as you feel you are going down with headache.
7. And during pain, prefer to stay in a soft environment with low lights and low noise.

Hope this helps. Feel free to write back if you have any questions.

Best Regards