Persistent Headache for Six Days
Hello, I’m a 25-year-old female experiencing a persistent headache that has fluctuated continuously for the past six days. My history includes migraines, but I typically manage them effectively with Tylenol and rizatriptan. It's important to mention that I am allergic to NSAIDs, and I haven’t encountered a severe migraine in the last six years. On the 19th, the headache began and did not subside, leading up to my doctor’s appointment on the 20th. During this visit, my primary care physician prescribed a methylprednisolone steroid pack. On the first day of the regimen, I took all six pills along with Reglan, which provided relief. The following day, I continued with five pills of the steroid and Reglan, and thankfully there was no headache. However, on the 22nd, the relief was short-lived as the pain returned with full intensity once I arrived at work. Consequently, I checked into the emergency room where I finally received significant relief through IV Benadryl and Reglan. A head CT scan appeared normal, but I was noted to be hypertensive in the ER (with readings of 200/140) while later it stabilized at 140/70 upon discharge. It's worth noting that I have no previous history of high blood pressure. By the 23rd, while I enjoyed a headache-free morning, it returned around noon and has persisted since then. Additionally, I have been dealing with spells of dizziness, nausea, and tunnel vision, accompanied by night sweats and chills, although these symptoms momentarily fade away. I’ve exhausted all remedies within my knowledge without finding any relief and am currently awaiting my PCP appointment, which is just 20 minutes away. I’m reaching out in hopes that someone here might have suggestions! I plan to inquire about more steroids, given their previous effectiveness, or whether a return to the ER is advisable. I'm open to both options because I'm eager to find a solution and end this ordeal!
Answers (1)
8/25/2025, 2:32:39 PM
OpenHealth AI
It sounds like you've been experiencing a very challenging situation with your persistent headache and associated symptoms. It's great that you're seeking help and being proactive about your health. Here’s a breakdown of the key points and some actionable guidance.
Main Points:
- Persistent Headache: Lasting six days with fluctuating intensity, potentially linked to your migraine history.
- Associated Symptoms: Dizziness, nausea, tunnel vision, night sweats, and chills.
- Hypertension Episode: High blood pressure noted during your emergency visit, but stabilized afterward.
- Current Medications: You've responded well to steroids and Reglan, but relief has been temporary.
Explanation:
Your history of migraines can make headaches particularly tricky to manage, especially when accompanied by new or worsening symptoms like dizziness and vision changes. The increased blood pressure you experienced could be a response to pain or stress, but given that it's not a previous concern for you, it's worth monitoring. Night sweats and chills may indicate something beyond a migraine, and it’s prudent to investigate them further, especially since they seem to accompany your headaches.
Next Steps:
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Monitor Symptoms: Keep a detailed record of your headaches, including intensity, duration, and any associated symptoms like dizziness or nausea. This can provide valuable insights for your healthcare provider.
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Hydration and Rest: Make sure you stay well-hydrated and try to rest as much as possible. Stress can exacerbate headaches, so creating a calm environment may help.
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Inquire About Additional Treatments: At your PCP appointment, inquire specifically about:
- Continuing or adjusting the steroid treatment based on your previous response.
- Options for preventive migraine medications, considering your history.
- Possible assessments for the dizziness and vision issues. This may include blood tests or referrals to a specialist if necessary.
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Consider Emergency Care If Needed: If your headaches become unmanageable or if new symptoms arise (e.g., worsening vision changes, pronounced dizziness, or further episodes of high blood pressure), don’t hesitate to return to the ER. Your comfort and safety are paramount.
Remember, you're taking the right steps in addressing your health concerns, and collaboration with your healthcare team will be key in finding the relief you need. Wishing you a quick resolution to this ordeal!
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