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Dr. Andrew Rynne

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Suggest treatment for migraine and fever

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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 2850 Questions

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Posted on Thu, 10 May 2018 in General Health
Question: My 19 yr old son is a sailor in the Navy, he is currently on a ship with 5,500 sailors in underway training.
He just told me that he's been getting migranes on and off for 12-16 hrs plus has a bald spot that has no hair follicles whatsoever and it keeps spreading getting bigger. He had a fever yesterday.
Let me explain his environment:
He's in an aircraft, so the environment is very loud and noisy
He's not sleeping well
He works 12-14 hrs a day
They are in the South Sea by S.Korea training, so weather may be a factor for the migraine, I know that I get them when the weather changes due to barimetric pressure.
I hope that its only stress, since he's working alot of hours and is stressed. I suggested he stay away from food that has tyramine like aged cheese, wine, etc. to stay hydrated and to go to the gym to relieve some of the stress.
Any ideas?


doctor
Answered by Dr. Bonnie Berger-Durnbaugh 39 minutes later
Brief Answer:
Information

Detailed Answer:
Hello xxxx,

I read through this and there are a number of things that can be causing or contributing to a migraine headache, or their effects may be cummulative.

I assume he has a history of migraine headaches before and that is how he knows this particular headache is a migraine?

If he has a predisposition to getting migraines, any of the things you mentioned can set it off. There is stress with the new situation and the stress of military training. Loud noises and lights can set off migraines. And I am wondering about the fever. Does he have other symptoms of an infection that would go with the fever? Chills? Neck or back pain? Because fever plus headache can be signs of meningitis.

He really needs to see the medic on the aircraft. Stress alone will not cause a fever. He may have an infection.

In addition about the bald spot - if that just came on, it can be due to a dermatophyte infection of the scalp (fungal). Should also be seen for that.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh 12 minutes later
Hi Dr. Berger-Durnbaugh,
He has never complained of migraines before. I also thought of meningitis and I asked him months ago to make sure he was vaccinated because of the amount of people he lives with, he said he thought he did get vaccinated but not sure, now its more important to know and act. I just emailed him asking whether he had chills, neck or back pain.
The fungal infection makes sense.
I should hear back from him very soon and will come back to you, thank you. I'll instruct him to go to the medic soon as I know more.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 42 minutes later
Brief Answer:
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Detailed Answer:
Hi xxxxx -

The vaccine he might have had covers Meningitis strains A, C, W, and Y (Menactra or Menveo meningitis vaccines). The Meningitis B vaccine is usually only given when there are outbreaks because it's effects don't last long. The ACWY type vaccine is pretty effective but no vaccine is 100% effective.

It is not necessarily meningitis, and in fact that would be a more rare cause, but it always needs to be considered when a person has fever and a headache that they don't normally get when sick.

Just so you know, whenever you write, I am required to write back, so if you want to wait till you have more information to write me, that would be fine.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh 1 hour later
Hi Dr. Berger-Durnbaugh,
The good news is that he doesnt have pain in his back or neck but he does feel sick , is very cold and has chills and says that the bald spot is flat, he cannot send me a picture till he gets to port which wont be till Tuesday.
What do you suggest?
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 22 minutes later
Brief Answer:
Information

Detailed Answer:
Hi xxxxx,

I think the bald spot is something separate unless his hair just suddenly fell out from this current illness.

He most likely has an infection and should be seen, even if he is not having neck pain. Should get his temperature and vitals and look for the source of infection. If it is a high fever an sore throat, can be strep and should be swabbed. If there's a cough, can be pneumonia, or if there are body aches, can be flu. It may not be any of these but rather a virus that is "going around" in which case the medic will likely have seen it. But with feeling very cold and chills, he probably has a fever and needs to be evaluated.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh 12 minutes later
Thanks again, I told him what you mentioned and to go see the Medic and to keep me posted so I dont worry, he knows that if I could I'd go on the ship myself and take him to the doctor.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 3 hours later
Brief Answer:
Thoughts on this

Detailed Answer:
I do hope he did go.

And I know what it's like to have a 19 yr old who isn't at home when they are sick. Makes a mom worried. I hope he is feeling better soon and that this is just a passing virus that is going around.


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