I know I’ve been MIA from the blogging world lately, and here’s why:
Six weeks ago I suffered a migraine while on call. I don’t get migraines very often, but when I do they are horrible and debilitating. Luckily, I had a great medical student and senior resident working with me and I was able to take some painkillers and take a nap in my call room. It didn’t quite go away.
It still hasn’t completely gone away.
After a week of headache, nausea, photophobia, tearing, facial allodynia, and other annoying symptoms, I went to see my doctor. Was this a prolonged (chronic) migraine, or something else? All the tests form that appointment came back normal. Eventually, the pain began to subside, but it was replaced by a sensation of pressure (like an elastic band around my head) that was unrelenting. I found it difficult, if not impossible, to wear my contact lenses because they bothered my eyes too much. The discomfort would progress through the day and peak in the evenings when I would be nauseous, unable to focus, and the headache pain would creep back in. I tried NSAIDS, gravol, massage, exercise, rest, “therapy“… Nothing was working to make this better.
Two weeks ago I noticed a significant worsening in the pressure, pain and nausea. I also started feeling an odd dizziness that was worse when I moved my head – especially to the right. I was not confident in my perceptive abilities and feared that maybe I had some right sided visual neglect/defect. I felt like my proprioceptive abilities were decreased because I would take steps and feel like the floor wasn’t where it should be. I started having “electrical” sensations travelling down my right arm and into my fingers, especially if I moved quickly. Then I started getting the feelings down my legs too. All of these symptoms would get worse throughout the day. I was beginning to feel like I was having a TIA…
I made sure I was hydrated, I made sure I was eating a good number of calories, I continued massage, I even started cutting back on my anxiety medications, just incase that was causing problems. Last Sunday, I woke up and I could hardly move my head without experiencing all of these symptoms in excess. I felt unsafe to drive because if I shoulder checked, my whole mind would spin and I was disoriented. I wanted to leave work early because I felt like I wasn’t able to adequately focus on the information in front of me. As I drove home from work, I almost detoured to another hospital to pay a visit to their emergency department.
The next day I went to see my doctor again. I didn’t know how to describe my symptoms. My screening neuro exam was normal. Cerebellar testing – normal. Dix-Hallpike maneuver – negative. The only thing that was “suspicious” was the amount of tension in my neck, even though my cervical range of motion was normal. My doctor joked that she needed to be a CIA agent to decipher all these symptoms; she needed to get into my head to feel it for herself (but even in my own head, I don’t even know how to describe it).
We came up with a plan: I was to continue tapering my medications. I was to start going to physiotherapy for my neck, and if none of that made a difference, we would get a head CT scan. Given the long waits for imaging, we decided to get my name on the waiting list and then cancel it if I didn’t need the test. It all seemed very reasonable (after all, what is the likely hood that I would actually have some kind of intracranial pathology?)
I have been off my medications for a week now. I have seen a physiotherapist for an assessment and one neck treatment. I am feeling a little better, I think. However, I am far from feeling normal. I got a phone call yesterday saying that my CT scan is scheduled for today… That was fast.
I don’t know if I’m ready to expose myself to that much radiation when I really have no idea what’s going on. Despite the ongoing pressure, pain, and uncertainty, I’ve decided to forgo the CT scan today. I’ll keep you all posted on what happens from here…