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Suggest Treatment For Throbbing Headache

Posted on Wed, 22 Jun 2016

Question: Hi, about twice a week a strong throbbing headache wakes me up from sleep, my face is swollen and round, nose stuffy (but no viral infection or cold). It disappears in 30 minutes after when I sit up or stand up- first the nose clears and then the headache and face swelling disappear, it feels like the fluid from my swollen legs (from varicose veins) when standing up has been drained into head when sleeping. As soon as I get back to sleep headache with stuffed nose returns. My sleeping oxygen level has been monitored and some periods of acute oxygen starvation have been registred earlier. These headaches occur usually at night after the day I have been exposed to heavy traffic fumes, chemical fumes from my work or some food allergens or on days when my feet are more swollen then usually. A small part of my lung is not well vemtilated but waking lung function/oxygen levels have been fine.

Answered by Dr. Drkaushal85 (39 minutes later)

Brief Answer:
Consult ENT doctor and get done endoscopic examination of nose and sinuses.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
In my opinion, we should first rule out obstructive sleep apnea (OSA).
Following points are in favour of this.
1. Day and night time headache.
2. Nasal and sinuses puffiness and blockage
3. Drop of oxygen saturation in night.
So something in your nose or sinuses which is blocking your airways. This thing is more worrisome in supine position, so possibility of nasal polyp or sinuse pathology which is XXXXXXX and obstructing the air passage especially in supine position.
So better to get done CT scan of nose and sinuses, endoscopic examination of nose and sinuses to rule out obstructive cause for OSA.
Hence consult ENT doctor and discuss all these.
Please let me know
1. Have you ever consulted ENT doctor?
2. Have you ever undergone arterial blood gas (ABG) analysis?
Please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further.
Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Drkaushal85 (38 minutes later)

Thanks for your answer. I have not consulted ENT doctor and have not had ABG analysis. When pregnant I had a nasal swab taken for bacterial culture and there was a overgrowth of S aureus, year ago at dermatology/allergy clinic they also looked my nasal cavity with mirror, told that it is inflamed and crusty (I did not had a cold) and recommended nasal irrigation. I do have very dry mouth in the morning and a dry nose. When laying on the side the lover nostril gets blocked, when then turning to other side it clears quickly and another nostril gets stuffy. These headaches are not regular, just a couple times per week, but were daily when I commuted daily to London and worked in the lab. When I changed work headaches became less frequent. Allergy clinic found reaction to black rubber (that is mainly London traffic) and SO2- with sulphites exposure my nose can get blocked within seconds.

Answered by Dr. Drkaushal85 (14 hours later)

Brief Answer:
Have you ever undergone screening for CTD s?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can I can understand your.
Sorry for late reply as I was busy.
Your all symptoms like nasal symptoms, allergic, headache etc can be seen in connective tissue disease (CTD).
It is different group of diseases which are auto immune in nature.
So please let me know
1. Have you ever investigated for CTD? Reports like ANA or ANA profile?
Please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (33 hours later)

Thanks, I have not undergone CTD investigation, ANA test was done and negative but ANA profile has been not done. I do have butterfly rash like red areas on face and am sensitive to UV/sunlight, it triggers flu like feeling

Answered by Dr. Drkaushal85 (1 hour later)

Brief Answer:
Get done Complete evaluation of connective tissue disease.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
In my opinion, you should consult rheumatologist and get done Complete evaluation of connective tissue disease (CTD).
Please let me know
1. Have you ever consulted rheumatologist?
Please reply me answer of above asked question, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar