Persistent Dull Headaches for Over a Month – No History of Glaucoma or Migraines, Nabumetone Ineffective (Day 6)
Hello everyone. I'm a 19-year-old Afro-Latina woman, standing at 5’4” and weighing 138 lbs, and I've been experiencing dull, wave-like headaches every day for more than a month now. These headaches are unpredictable; they can strike in the morning, during the day, or at night. I've been on a vacation abroad for nearly a week, yet the headaches persist, which leads me to believe that my surroundings aren't the cause. With college starting in just two weeks, I’m eager to resolve this issue beforehand. --- **What I’ve Done & Medical Background:** - I have no prior occurrences of migraines or glaucoma. - I consulted with two eye specialists (the latest on July 28), undergoing comprehensive tests for glaucoma, including OCT scans, optic nerve evaluations, and eye pressure assessments. All results returned normal. One doctor indicated my intraocular pressure sometimes reaches 22–23 but noted that my thick corneas may skew these figures. - Both CT scans and blood tests yielded normal outcomes. - Currently, I’m taking Nabumetone at 750 mg twice daily (Day 6 of a 10-day course) with no notable improvement yet. --- **Symptoms Experienced:** - Persistent pressure-like headaches that occur in waves throughout the day. - Eye discomfort even in the absence of headaches. - Sensitivity to light, particularly at various times of day. - Either excessive tearing or a dry sensation in my eyes. - Pressure behind my eyes. - Brief episodes of seeing flashes of light, occurring once or twice per day and resolving quickly. - Headache symptoms can last from 5 minutes to 3 hours, never extending beyond that. - Drinking water sometimes helps with milder headaches, but provides little relief when the pain is severe. At times, my head feels warm during these episodes. --- **Vision & Glasses History:** - In March, I received my first pair of glasses (corrective numbers: Right: -0.50 | Left: -0.75). - By June, I realized their effectiveness was declining as my vision appeared blurrier. - An eye examination in July indicated that my prescription has changed to -1.00 for both eyes. - The optometrist mentioned he prefers to delay stronger prescriptions to prevent triggering headaches when starting with glasses. This has left me questioning if the headaches stem from an inadequate prescription or rapid changes in my eyesight. --- Although I'm told these symptoms might be related to migraines, I've never experienced them before. Is it possible that my headaches are a result of eye strain, an incorrect glasses prescription, or something more serious such as a neurological issue or sinus problems? I've had clear sinuses but have been grappling with congestion in my room for half a year, often waking up with a blocked nose or a sore throat before the headaches began. I’ve explored every medical avenue I can think of and would greatly appreciate any insights from anyone who might have encountered similar challenges.
Answers (1)
8/2/2025, 11:11:09 PM
OpenHealth AI
It sounds like you're dealing with a challenging situation with your persistent headaches, and it's understandable to want to find relief, especially with college approaching. Given your detailed description of symptoms, I’ll summarize key points and suggest some actionable steps.
Main Points:
- Your headaches have persisted for over a month with various symptoms, including eye discomfort and light sensitivity.
- You’ve had thorough evaluations of your eyes and imaging tests revealing normal results.
- Your current medication, Nabumetone, has not provided relief.
Explanation:
The type of headaches you're experiencing—dull, wave-like in nature—combined with symptoms like eye discomfort and light sensitivity, can have multiple origins. These could include:
- Eye strain or an improper glasses prescription: Since you've recently had a prescription change, this might be a contributing factor, especially if you’re straining your eyes due to a discrepancy in what you need versus what you have.
- Tension-type headaches: These can occur due to stress, muscle tightness from posture, or eye strain.
- Possible sinus issues: If you've had congestion and blocked nasal passages, sinus headaches could also be a factor, even in the absence of clear sinuses recently.
- Migraine: While you haven't had a history of migraines, changes in vision or the onset of these symptoms can sometimes signal a first episode.
- Neurological concerns: While less likely given your normal tests, it's still a concern to monitor.
Next Steps:
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Reassess Your Vision: Schedule an appointment with your optometrist to discuss your current glasses prescription and the related symptoms. Be sure to express your concerns about your headaches possibly being tied to your vision. It may be time for a new pair of glasses or an adjustment to your current prescription.
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Hydration and Breaks: While you mentioned that hydration can help, ensure you are drinking enough water daily. If you are using screens for prolonged periods, take regular breaks (for example, every 20 minutes, look away from your screen for 20 seconds) to reduce eye strain.
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Track Symptoms: Keep a headache diary for the next week, noting when the headaches occur, their intensity, duration, any accompanying symptoms, and potential triggers. This information can provide valuable insights for your healthcare provider.
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Consider Environmental Factors: Assess whether your surroundings (like lighting or allergens) could be contributing. Ensure that your study space is well-lit and that you're minimizing potential irritants.
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Manage Stress and Tension: Incorporate relaxation techniques such as deep breathing, stretching, or mindfulness practices. Stress may exacerbate tension-type headaches.
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Consultation with a Specialist: If headaches persist despite implementing these steps, consider revisiting a healthcare professional (possibly a neurologist) for further evaluation, especially if you experience any new symptoms like worsening visual changes or more frequent light flashes.
Please remember that while your situation is concerning, you've taken great initial steps towards understanding and addressing your headaches. Following up with these suggestions should help you work towards finding relief. Let me know if you need further clarification on any step!
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7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.