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Suggest Treatment For Headache Despite Taking Excedrin
Question: My friend has a bad headache, and she is very worried that it could be a sign of a serious medical problem. She has been getting lots of headaches over the past month. She is from Uzbekistan, and has been in the USA since XXXXXXX I think she is very cautious about taking OTC medicine for her headaches. Today, I told her to take 2 Excedrin For Migraine tablets (each tablet contains 250 mg Acetaminophen, 250mg Aspirin, and 65mg of Caffeine). She took those at 4:00pm with a glass of water, and took a 3.5 hr nap. She still feels terrible. I think she should take 2 more Excedrin for Migraines now, 4.5 hours after the last dose. And I think she should keep drinking fluids, put a cold washcloth on her forehead and the back of her neck. Her temperature is 99.1. Please tell me what you recommend. She does not yet have health insurance.
Brief Answer:
There is always GOOD news and then just "news"
Detailed Answer:
Good evening. The Good news about your friend's headache is that if she's had bad headaches since January without anything serious happening to this point then, the likelihood that there is something truly dangerous in her head or elsewhere is extremely LOW.....VERY VERY LOW indeed. Having said that.....I firmly believe that headaches almost always signify the presence some type of PROBLEM in the body....whether it's metabolic, psychological, a combination of both, or simply a primary headache for which no clear explanation exists (aberrant brain wiring) for lack of a better term. Your recommendations are reasonable except she has a low grade fever. I believe she runs the risk of having an infectious....quite possibly a low grade or even sub-clinical meningitis. For that reason she really needs to get in to see someone.....in my opinion as a neurologist and headache specialist I would be sending your friend over to the ER right now for an evaluation. I understand she doesn't have insurance coverage. There are hospital and health care facilities that will see patients who are un- or under- insured. These are typically COUNTY HOSPITALS. She cannot be refused for service on the basis of no insurance for a problem like this.....also BE VERY CAREFUL about HOW MUCH over the counter medication she gets. If a person takes more than 15 DOSES of an acute abortive such as Excedrin, Tylenol, Motrin, or other similar agents then, the patient runs a real risk of suffering from headaches that are actually CAUSED BY and/or WORSENED by the medication being used. It's called MEDICATION OVERUSE HEADACHE (MOH) and it is very common. She must limit her intake of simple analgesics to no more than 15 doses per month.
If I've adequately answered your questions could you do me a huge favor by CLOSING THE QUERY and being sure to include some fine words of feedback along with a 5 STAR rating if you feel my answers/suggestions have helped? Again, many thanks for posing your questions and please let me know how things turn out.
Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.
This query has utilized a total of 15 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
There is always GOOD news and then just "news"
Detailed Answer:
Good evening. The Good news about your friend's headache is that if she's had bad headaches since January without anything serious happening to this point then, the likelihood that there is something truly dangerous in her head or elsewhere is extremely LOW.....VERY VERY LOW indeed. Having said that.....I firmly believe that headaches almost always signify the presence some type of PROBLEM in the body....whether it's metabolic, psychological, a combination of both, or simply a primary headache for which no clear explanation exists (aberrant brain wiring) for lack of a better term. Your recommendations are reasonable except she has a low grade fever. I believe she runs the risk of having an infectious....quite possibly a low grade or even sub-clinical meningitis. For that reason she really needs to get in to see someone.....in my opinion as a neurologist and headache specialist I would be sending your friend over to the ER right now for an evaluation. I understand she doesn't have insurance coverage. There are hospital and health care facilities that will see patients who are un- or under- insured. These are typically COUNTY HOSPITALS. She cannot be refused for service on the basis of no insurance for a problem like this.....also BE VERY CAREFUL about HOW MUCH over the counter medication she gets. If a person takes more than 15 DOSES of an acute abortive such as Excedrin, Tylenol, Motrin, or other similar agents then, the patient runs a real risk of suffering from headaches that are actually CAUSED BY and/or WORSENED by the medication being used. It's called MEDICATION OVERUSE HEADACHE (MOH) and it is very common. She must limit her intake of simple analgesics to no more than 15 doses per month.
If I've adequately answered your questions could you do me a huge favor by CLOSING THE QUERY and being sure to include some fine words of feedback along with a 5 STAR rating if you feel my answers/suggestions have helped? Again, many thanks for posing your questions and please let me know how things turn out.
Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.
This query has utilized a total of 15 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much Dr. Saghafi, for your very thoughtful response. I think that my initial question was a little confusing. While trying to give you a clear idea of my friend's situation, I mentioned that she had been in the USA since January, however her headaches have been a problem for about one month. Do you think that this further reduces the possibility of something truly medically dangerous going on within her head/body? Do you still recommend that I take her for an evaluation? I very much appreciate all your encouragement and kind suggestions.
Respectfully,
XXXXX
Respectfully,
XXXXX
Brief Answer:
Gravity of headaches
Detailed Answer:
Thank you for the clarification.
As a headache specialist and neurologist I can tell you that severe headaches that are 1 month in duration in young people who have ZERO history for previous headaches......which is a very high bar to reach when you think about it.....are considered potentially concerning in my mind if the patient has things such as unremitting vomiting, numbness and tingling or paralysis of part of their face or a limb, changes in their ability to speak or comprehend people, loss of balance and equilibrium.
These symptoms should be taken notice of immediately and looked at and an imaging study of the brain done right away. Anything else is still IMPORTANT and SHOULD BE TAKEN CARE OF but that is for the improvement of the quality of life and also to avoid what happens to many people who fall into chronic usage of medications such as OTC drugs which simply perpetuate the headaches and do not even take away the ones for which medicine is being taken.
Again, even without insurance there are ways to get her help such as FREE clinics, Social Security benefits for disability, etc. set up in most major metropolitan areas......just google one in your area and see what comes up.
I'd recommend finding a good headache specialist for her or at least a doctor with a headache interest who will appreciate the value in trying to understand the underlying cause of her headaches first before launching into treatments that are either not likely to help or complicate matters.
Let me add this statistic (which is only a number...remember I've not examined your friend)....Only 0.18% of all headaches seen by ER's and outpatient consulting physicians are believed to be present as the result of some serious INTRACRANIAL (in the head) PATHOLOGY......0.18% So the odds are clearly in her favor that she doesn't have anything SERIOUS or life threatening just based on that number but that's not a reason for her to avoid treating herself properly....if she doesn't they will simply get worse then, chronic then, she will be miserable on a daily basis....not a good prognosis. Have her get treated PROPERLY is my advice.
If I've adequately answered your questions could you do me a huge favor by CLOSING THE QUERY and being sure to include some fine words of feedback along with a 5 STAR rating if you feel my answers/suggestions have helped? Again, many thanks for posing your questions and please let me know how things turn out.
Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.
This query has utilized a total of 36 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Gravity of headaches
Detailed Answer:
Thank you for the clarification.
As a headache specialist and neurologist I can tell you that severe headaches that are 1 month in duration in young people who have ZERO history for previous headaches......which is a very high bar to reach when you think about it.....are considered potentially concerning in my mind if the patient has things such as unremitting vomiting, numbness and tingling or paralysis of part of their face or a limb, changes in their ability to speak or comprehend people, loss of balance and equilibrium.
These symptoms should be taken notice of immediately and looked at and an imaging study of the brain done right away. Anything else is still IMPORTANT and SHOULD BE TAKEN CARE OF but that is for the improvement of the quality of life and also to avoid what happens to many people who fall into chronic usage of medications such as OTC drugs which simply perpetuate the headaches and do not even take away the ones for which medicine is being taken.
Again, even without insurance there are ways to get her help such as FREE clinics, Social Security benefits for disability, etc. set up in most major metropolitan areas......just google one in your area and see what comes up.
I'd recommend finding a good headache specialist for her or at least a doctor with a headache interest who will appreciate the value in trying to understand the underlying cause of her headaches first before launching into treatments that are either not likely to help or complicate matters.
Let me add this statistic (which is only a number...remember I've not examined your friend)....Only 0.18% of all headaches seen by ER's and outpatient consulting physicians are believed to be present as the result of some serious INTRACRANIAL (in the head) PATHOLOGY......0.18% So the odds are clearly in her favor that she doesn't have anything SERIOUS or life threatening just based on that number but that's not a reason for her to avoid treating herself properly....if she doesn't they will simply get worse then, chronic then, she will be miserable on a daily basis....not a good prognosis. Have her get treated PROPERLY is my advice.
If I've adequately answered your questions could you do me a huge favor by CLOSING THE QUERY and being sure to include some fine words of feedback along with a 5 STAR rating if you feel my answers/suggestions have helped? Again, many thanks for posing your questions and please let me know how things turn out.
Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.
This query has utilized a total of 36 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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