Brief Answer:
So sorry you're having this discomfort

Detailed Answer:
Good afternoon. My name is Dr. Saghafi and I'm a neurologist and headache specialist practicing here in XXXXXXX OH.

I don't think it will be very easy to catch the "culprit" since that train left the station about 6 weeks ago but let me tell you that the majority of my patients over the age of about 60-65 who have headaches that "come out of nowhere" are either suffering from a recrudescence of a previous severe headache history from their "back in the day" youth...in other words, people who suffer from migraine types of headaches in their 20's and 30's frequently recrudesce after age 60-65 (i.e. menopause DOES NOT CURE migraines by any stretch of the imagination!). OR....there is something metabolic that is going on for which the headaches are merely the reflection of some other disorder which could be infectious, residual trauma, or as may very well be in this case a systemic illness.

If your doctor wants you to see a hematologist due to an elevated hemoglobin/hematocrit (and I'm sure they've already ruled out DEHYDRATION as the cause of that problem) then, you have to think about a certain set of disorders that can cause hemoconcentration (elevated Hb and Hct) almost all of which come with headaches as part of their picture.

Now, believe it or not-- hemoconcentration types of disorders can be induced by PSYCHOLOGICAL STRESSORS and so we need to put that into our list of possible culprits if all else fails to pan out as an explanation. In other words, you can literally STRESS YOURSELF out into having the condition of elevated hemoconcentration which we believe is primarily due to a overdrive that the stress places on your autonomic nervous system (primarily the FIGHT OR FLIGHT part of things). Autonomic overdrive essentially puts the bone marrow into hyperdrive and you start pumping out red cells like mad....which under nonurgent circumstances is unnecessary. Trick is to trun off that system.....well, if you can turn off the stress you've got it done.

However, to begin with other considerations have to be looked at such as endocrine problems (most notably adrenal gland abnormalities and ovarian hyperstimulation disorders), viral diseases, abnormalities of the bone marrow which could include tumors, and then, may other things.

Headaches of a severe nature can be related to any and all of these problems which should be methodically looked at and ruled out one at a time depending upon what else is going on in your case. Lab testing should include (among other things) blood smears, blood cultures, thyroid hormones, cortisol testing, and metanephrines in blood and urine, and serum osmolality.

If you've recently developed a crazy need to drink like there's no tomorrow (diabetes insipidus) then, that is a very good reason to have the POLYCYTHEMIC STATE (elevated Hct and Hb)....of course, there is the polycythemia of pregnancy when women become eclamptic....but you would've mentioned to me if you were pregnant or not, right? LOL!

At any rate, I would like you NOT TO TAKE ANY MORE ANTIBIOTICS for sinus infections because that is one of the least likely diagnoses for someone (anyone) with prolonged or severe headaches....I don't care where the headache is LOCATED....sinus headaches are frequently misdiagnosed. So please no more antibiotics....also, if you're taking lots of OTC medications daily for these headahes thinking that they're helping.....I must warn you that you're playing with fire and in fact, the more OTC medication you could be using the more likely you are of actually CAUSING MORE HEADACHES on top of whatever baseline you started with to begin with 6 weeks ago.

If these are truly 6 weeks of chronic daily headaches which you've never had before in your LIFE....then, we should clearly get an imaging study of the head and we should be keeping track of these headaches on a HEADACHE DIARY which I can provide to you if you'd like to really keep track of each headache so that we may be able to map its characteristic features and decide where these headaches are being brought on by something not right with the body .....or perhaps, they represent an entirely separate and different problem from the polycythemia (though I doubt it).

Good afternoon. My name is Dr. Saghafi and I am a neurologist from XXXXXXX OH, USA

Unfortunately, your picture is rather typical for how Brown-Sequard patients can progress when the elements of complex regional pain syndrome begin to set in. This is known by the more antiquated name of REFLEX SYMPATHETIC DYSTROPHY which is a painful syndrome that comes about after some type of traumatic injury to the peripheral nerves in a limb or wherever.

I believe that the motor function in the right leg (while it was good at one time) began to deteriorate based upon worsening sensory function. In other words, the less you were able to feel that right leg, the less easy it became to use it in a motor type of way. This then, would lead to a form of disuse atrophy which would simply become worse and with worsening sensory issues leading to pain and discomfort you would be less inclined to try and use that limb which would lead to more motor disuse hence weakness, and possibly atrophy (loss of muscle bulk). The burning sensations are part of a neuropathic picture which comes from disruption of the sensory tracts from T5-T8 that were compromised due to the operations.

The pain in the tibia may be due to a loss of calcium (osteopenia or osteoporosis) which is likely coming about because of lack of use, muscle atrophy, and eventually pain due to increasing fragility of the skeleton and less ability to bear weight.

If you are not receiving any type of calcium support which includes an aggressive exercise rehab program then, these are the expected symptoms of progression that one would see as one with Brown Sequard survives longer and longer.

I'd appreciate the favor of your providing a STAR RATING and some brief written feedback if your questions have been satisfactorily answered. In addition, CLOSING THE QUERY on your end will also be most helpful.

Don't forget that my webpage to keep me abreast as to how you're doing is:

bit.ly/drdariushsaghafi

All the Best

This query has required a total of 53 minutes of physician specific time to read, research, and compile the return envoy to the patient.

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