Suggest Treatment For Tension Headache And Severe Anxiety
Let's talk about headaches
Detailed Answer:
Good evening. Many thanks for posing your situation and its description. I understand you've been diagnosed with tension type headaches, given some medication in the form of muscle relaxants and ibuprofen but do not feel any better. You've got an appointment with a psychiatrist to evaluate you for your feelings of anxiousness and nervousness and for that reason you feel that your head may not be altogether back to "100%" normal. You say that the physician felt a couple of "nuts" on the back of your neck. I'm assuming you meant to say, "KNOTS". You were given a prognosis of 2 weeks to feeling better but this has not come to pass.
You've not really posed a question but my assumption is that you are still dealing with headaches, anxiety, and nervousness. I am a neurologist and headache specialist therefore, my comments are going to be necessarily geared toward opining on tension type headaches which have not subsided in 2 weeks being treated with ibuprofen and muscle relaxants. What I can say about nervousness and anxiety is that they are considered COMORBID conditions that we frequently see in association with headaches. However, only the psychiatrist will be able to tell for sure whether your anxiousness/nervousness is a cause or effect of the headaches. Make sense?
You've not described anything having to do with the instructions you were given to take the ibuprofen and muscle relaxants therefore, I will say this...the most common PROBLEM I encounter in headache patients who have ongoing symtoms without relief from the medications they've been given is either they are:
1. not diagnosed with the proper headache type
2. not taking the most appropriate medication for the headache type they have
3. overusing the medications they've been prescribed for the CORRECT headache type.
Which one of the above 3 are you? I can't say simply based upon the information you've provided. But I will say this....if you are taking more than 15 DOSES of ibuprofen and/or muscle relaxants within a 30 day period then, you risk falling into a condition known as MEDICATION OVERUSE HEADACHE. This is an extremely common problem seen in headache patients and one that is unfortunately contributed to by both physicians and patients. Few people are aware of the parameters for counseling patients on avoiding overuse but the number are the following:
1. If medications such as ibuprofen, acetaminophen, aspirin are used then, a total of 15 doses is the limit per 30 days without risking OVERUSE or what used to be called REBOUND headaches.
2. If medications such as Imitrex, Maxalt, other triptans, Midrin, Treximet, etc. are used then, only 10 doses per 30 days should be used otherwise OVERUSE headache may be precipitated.
What I also do in all my headache patients is to solidy the actual headache type through use of a HEADACHE DIARY or LOG which can be obtained from online and filled out over a 2-4 week period so that the physician can easily see the symptoms, the progression, and the possible triggers associated with the headaches. General physicians and internists are typically not the best people to deal with such logs therefore, if your headaches are not being cleared and your physician is not able to help via a headache diary you should ask for a referral to a headache specialist or a neurologist.
By all means see your psychiatrist and get a diagnosis, however, in my opinion I believe it is to your benefit to get a solid diagnosis on the type of headaches you have by filling out a headache diary and being aware of potential medication overuse problems. If necessary get seen by a headache specialist and don't be afraid of speaking up against the use of a lot of drugs in place of more conservative and proactive forms of intervention such as breathing/relaxation techniques, biofeedback therapy, and a good review of risk factors that are not commonly looked at that can cause sleep disorders such as PTSD, insomnia, nightmares, SLEEP APNEA, GERD, and medication induced headaches.
If your question was adequately responded to could you do me a favor and not forget to CLOSE THE QUERY if you've no more questions?
I sincerely hope you start to feel a bit better and are able to take advantage of the information I've mentioned in order to obtain the best treatment possible and start turning things around.
This query has utilized a total of 42 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
I do not think your description suggests a brain tumor
Detailed Answer:
Thank you for the detailed description of your situation. I also can appreciate the amount of stress and anxiety you may be feeling and also understand why your physician may be tempted to call your headaches stress or tension type, however, for the reasons I mentioned above, 2400mg. ibuprofen PLUS muscle relaxants on a daily basis, in my opinion, is a risky regimen which can cause gastric irritation along with opening the patient up to what I told you was a very common situation created sometimes by patients and sometimes by doctors.
First of all, I would not think of tumor as a very likely possibility in your case so my workup would be directed at the headaches in the way I previously described.
Secondly, I would want you to fill out a headache diary which will take a variety of important parameters into consideration and to do this for a minimum of 2-4 weeks using whatever means and prescriptions you've been given to treat and reduce your headaches. I would not necessarily add any new medications in this time period for the headaches. The headache diary then, dictates the most likely class of headache you are suffering from (sounds like tension type, maybe mixed with some migraine features, however, there is also a chance that ibuprofen is being over prescribed and contributory to ongoing headaches.
Thirdly, keep in mind the numbers I gave you. 15 doses of ibuprofen PER MONTH for headaches. At 3 doses daily of the highest dose of ibuprofen that can be given by prescription you will be entering risky territory after 5 days of that regimen.
If your question was adequately responded to could you do me a favor and CLOSE THE QUERY if you've no more questions?
I sincerely hope you start to feel a bit better and are able to take advantage of the information I've mentioned in order to obtain the best treatment possible and start turning things around.
This query has utilized a total of 86 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Patient Patience is important key to success
Detailed Answer:
Nice to hear that you're feeling that much better compared to 2 weeks ago. Please still stay vigilant not just now but in the future what the risks are for headaches becoming even more resilient and refractory to treatment if they become intensified due to OVERUSE of analgesics.
Headache diaries are widely available on the Internet. Check out this link and see which of the diaries may fit your style of documentation. Some are "better" than others in terms of the information they gather but in the end you should choose something that is easy to understand and easy for you to fill out and easy for your doctor to analyze QUICKLY....and don't be too surprised if most doctors won't be as interested in looking at your work as you are in providing the information or doing it....trust me...it's worth doing for many reasons......find a doctor or specialist who believes in this type of documentation and organization. It makes a HUGE difference to treatment when you go based on what the patient relates and put down in black and white as opposed to what they MAY REMEMBER....most of which never goes beyond a few hours in the past....right?
Here's the link:
https://www.yyyyyyy.com/search?q=yyyyyyyy+diary&tbm=isch&tbo=yyyyyyyyy=univ&sa=X&ved=0ahUKEwjGvf-yyyyyyyyyyyyyyyyyyyyyyyy=1024&bih=635
If your question was adequately responded would you do me a favor and CLOSE THE QUERY at this point?
I sincerely hope you start to feel a bit better and are able to take advantage of the information I've mentioned in order to obtain the best treatment possible and start turning things around. I also hope you'll take a serious look at the diary concept and use it not only for headaches but just about for anything where the doctor will be better treating you if they've got a detail of information you've collected over time.
This query has utilized a total of 103 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.