I'm probably going to call into work because of this headache. Yeah, I feel pretty small when I say that, but this headache is bad.
I think I've mentioned that I have a lot of headaches. It's not as though I have one every day, but it's more than every other day. Most often they come in series... I'll have a headache for several days in a row. They range from small annoying headaches that don't really stop me from doing or enjoying anything to ones like today that make me stop and just unable to continue doing what I started, to ones that are truly debilitating. And when I say debilitating, I mean debilitating... I mean going to bed at two in the afternoon and crying because I the extreme pain in my head is keeping me from the one thing that will give me peace... sleep.
I'm not at that 'cry on my pillow' stage, but it's still bad. I guess what makes it bad is the fact that it's always there. It stops every train of thought, it stops every unconscious action making things like pouring a cup of coffee a sudden and terrible exercise in futility.
Seriously... I failed at pouring coffee this morning. I failed at putting bread into the toaster, buttering said badly toasted bread, and clicking off a notification on my phone. These aren't brain surgery tasks. I shouldn't have to concentrate to tilt a carafe of warm liquid into a firmly planted on the counter mug. And it's not as though my stream of consciousness is simply being interrupted by thoughts of "ow ow ow OW" (I just misspelled "ow" five times in a row). It simply interrupts muscle memory.
Now if the headache was limited to screwing up pouring coffee or burning bread, that would be one thing. But those minor tasks are mirrors of larger, far more important, tasks. Like setting up appointments for incoming patients with their doctors. Like giving an inmate that's just been diagnosed with kidney stones enough over the counter pain medication to make it through the night until he sees the doctor that can order him a prescription of narcotics. I screwed up both of those tasks last night when the headache was just building steam.
I don't know when I started having headaches like this. It feels like 'forever', but I don't really remember having them this bad while in photo school. At that time I didn't carry around a pill bottle full of acetaminophen and ibuprofen the same way that Dr House carried around his Vicodin. I know I grew a sensitivity to bright light while in photo school (a friend fired a high powered studio flash while my face was inches away from it as a joke). When I have a headache like this I AM sensitive to light... but I'm also sensitive to sound and stress. All of those make the headache worse.
Let's see if I can write this headache out as if I were writing up a nursing document.
They are no specific in location. They can vary from immediately behind my eyes, to the top of my head, to circling the crown of my head, to focused in the back and bottom of my head. This current headache is both behind my eyes and at the top of my head. They can range in severity from a 3 to an 8 on the pain scale (0 meaning no pain whatsoever, 10 meaning the worst pain imaginable). I've had a single headache that I would classify as a 9. The pain could best be described as a throbbing dull ache with occasional sharp stabbing moments. The headache is slightly alleviated by position (how I"m holding my head), darkness, quiet, and a combination of acetaminophen (2 grams) and ibuprofen (200 mg). They are aggravated by bright or flashing light, sudden noises, loud noises, or position. Low level headaches (pain between 2 and 5) happen often (average of two every three days) but are easily managed and dealt with. Middle level headaches (pain between 4 and 6) occur on average once a week and are manageable only with medicine and only until the medicine wears off. Severe headaches (between 6 and 8) are only minimized by medication and will only go away fully upon sleeping. Middle and severe headaches can last for days at a time. No action can be traced to source the headaches.
OK.. so that's a horrible nursing writeup, but I believe it gives the information that I would consider documenting if someone told me about their headaches.
For the most part, I can deal with the headaches. This is one of those rare occasions where I simply can't. I've taken my meds (and at those doses I can only safely take that much acetaminophen twice a day... I'll burn through my second dose in about an hour and a half. Ten AM), and it's merely dulled the ache. It hasn't touched the lack of focus.
If you are wondering about the dosing on the meds, I've worked out that formula over years of experimentation. I started out with a similar dose of acetaminophen, but quickly realized that if I only get two doses in a day that I'm often left for hours on end with no medicinal help. So I lowered it to 500mg (a quarter of my current dose). I found out that that does would help the smallest headaches, but wouldn't even touch the worse ones. 1 gram wound handle all lower level headaches, but still didn't touch the larger headaches. So I ended up at the larger 2 gram dose. Even then it seemed to help randomly for the larger headaches. Intensity didn't seem to make a huge difference once it was above a 5. So I tried ibuprofen alone... nothing. I tried naproxen alone... nothing. I tried aspirin alone... nothing. I'd find myself downing my four Tylenol an hour after taking those meds. Later I looked into Excedrin migraine (so far as I know, I these aren't migraines) and found that it's simply a combination of acetaminophen, aspirin, and caffeine. I'm constantly on caffeine, so I figured I'd add the other two ingredients at the same time. It worked. It worked better than the acetaminophen alone. I didn't have much aspirin, so once I ran out I replaced it with ibuprofen... and that worked just as good.
A few years ago I thought I would improve the formula by going back to acetaminophen and aspirin instead of ibuprofen. I kept that up for several months when hell struck. The meds completely stopped working. I received NO relief from the meds. After two straight days of a headache at 7/10 pain and an intense internet research session, I found that any med (yes even acetaminophen, ibuprofen, aspirin, and/or naproxen) can get accustomed too. This effect is more pronounced with narcotics, but it can happen with others. Several headache sites said that this was more common with aspirin rather than acetaminophen and ibuprofen. The remedy? A med vacation.
Stop taking any and all pain relief medications for a week.
I was at the end of my own rope so i gave that a try. The headache finally burned itself out after 5 days. 5 days of a constant never ending hell on earth headache. I learned my lesson (or randomly got unlucky then lucky again) and went back to the acetaminophen/ibuprofen combination. That's the only time that the meds haven't helped.
I've tried other non medicinal methods of reducing or eliminating the headaches with almost no success. I've tried meditation. I've tried visualizations. I've tried diet. I've tried massage (both body and scalp). I've tried distraction. I've tried steam. I've tried focus.
Bleh.
Most of the techniques made the headache worse. The body massage was nice, but didn't touch the headache (yes, even when it was focused on my shoulders and neck, both of which get tense with my headaches). I've told my doctor about the headaches and was completely honest with him. His opinion is that so long as they are more or less well controlled with the medicine I'm using (and so long as I don't start taking more than 4 grams of acetaminophen a day) that it would be folly to diagnose them further than a common headache. The next step, if I were to look into them, would be imaging. X-Rays, MRI, possibly a CT scan. These would need to be done while I was having a headache, so they would be expensive as I couldn't schedule them out days in advance. Even then he though it unlikely that there was a physical cause to the headaches. He thought it unlikely because they've been part of me for so long without getting significantly worse. So we're not talking about a tumor that's growing or changing. And even if there WERE a physical cause, it would probably take surgery to repair it. One side effect of inner cranial surgery? Common repeating headaches.
My aunt, about a decade ago, had to have surgery to repair a small leak in her brain. She'd probably had the leaky artery for years, and they only found it by accident while looking for another problem. As it was a pretty big risk to leave alone (it could expand at any time and kill her in minutes) they had to go in and repair it. She never had a headache before that surgery. Sure, she had headaches from colds or hangovers, but never had she had a 'out of the blue' headache without direct cause.
She has them often now. Not as often as I have mine, but she has headaches each and every week.
So in case you were wondering, that's why I don't go further into diagnosing and 'curing' my headaches.
Well.. I was hoping that by writing this out I may 'think' my way out of this headache. That didn't work. In fact I'd say that my headache is getting worse. But then again it's been three hours since I took my meds and they may just be wearing off. Either way, the headache is still here. So... I have to call into work. I'd just be a danger to others if I went into work.
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