Information

2 May 2013

Why some people don’t recognize post-concussion syndrome symptoms

Sometimes it can be challenging to diagnose post-concussion syndrome symptoms. And without a proper diagnosis, proper treatment can be hard to find.

As we’ve mentioned before, a concussion is actually a form of brain injury. To say “It’s just a mild concussion” as if it won’t have any lasting consequences is a misleading.

Symptoms of post-concussion syndrome (PCS) can vary. The common ones include headache, dizziness, fatigue, insomnia, and anxiety. There are also rarer symptoms such as hearing loss, impaired judgment, and trouble speaking. Here’s more on post concussion syndrome symptoms.

But here’s the problem. First, it’s not easy to just do a test and find out if you have PCS. Yes, your doctor may call for a CT scan, and that may help with he diagnosis. But it may not confirm that you have PCS.

Second, as you may have noticed, many of these symptoms are common in other types of headache. PCS can look very much like migraine, or like tension-type headache.

So how can you help your doctor properly diagnose your symptoms?

First, your doctor will want to know how things have changed and when they changed. Symptoms like these will probably appear within a few days to up to four weeks after your injury. Thankfully, the symptoms usually do go away fairly soon, especially if you can get to a doctor and get them diagnosed early on.

Your doctor will also need to know your medical history. Other conditions and diseases may be impacting your symptoms – things like migraine, depression, insomnia, and so on.

So do pay attention to symptoms and timing as much as you can while you’re preparing for your visit to the doctor. Your doctor will ask you some questions and may call for some tests. Treatment can involve several different things depending on your symptoms.

30 April 2013

Help! I have a Headache!

James Information, Tips 2

It’s probably one of the most common questions I hear (or see). Basically, someone has a headache – maybe it’s getting worse and worse – and they don’t know what to do.

A lot of different people fit into this category. Maybe they’ve had something similar a few times, and they’re getting fed up. Maybe it feels like it’s the worst headache they’ve ever had. Maybe they get headaches all the time, but have never really taken the time to stop and look for answers.

So you have a headache – a bad headache. What should you do?

What to do when you get a headache…

Recognize that this is not “normal”. You should not “just live with it”. It’s not “just your imagination”. It’s not something “everyone just has to deal with”.
See a doctor. If this is something that has happened many times, you could schedule an appointment for next week and discuss your symptoms with your doctor. If it’s the worst headache you’ve ever had, or the symptoms have changed, or it’s the first headache of its kind that you’ve ever had, get to a doctor now. Pay attention to your symptoms and tell the doctor anything you can. Yes, a headache can be a sign of something very serious.
Do NOT take someone else’s prescription medication. Medications and even dosages can vary drastically based on your weight, your age, your medical history, your symptoms, and other factors. Medication that is considered “safe” for one person can be dangerous for someone else. Resist the temptation.
Be very cautious with “over the counter” medications, and supplements. It’s usually not a bad thing, in rare cases, to take an Advil (ibuprofen) or Tylenol (paracetamol/acetaminophen) while you’re waiting to see the doctor. However, recognize that almost any medication – and many supplements – have the potential to make your symptoms worse over time. Herbal supplements and vitamin treatments can be dangerous because they’re not regulated in the same way as drugs usually are. Taking a couple of painkillers before going to the doctor isn’t usually a problem. Avoiding the doctor and taking painkillers every week is.
Cautiously consider “home remedies”. I’ve already talked about vitamins and herbs and things like that. Here I’m talking about other things you can do to soothe your headache (while you’re waiting to see a doctor). This may mean lying down in a dark room. A cold pack on the head. Breathing exercises. A warm bath. A cup of tea. There are many things you can try, depending on the type of headache you have. There’s no magic formula for everyone, but there are a number of things that can help you feel better. There may come a time to get a friend to watch the kids, to take the day off work, and deal with the pain. Sometimes you have to keep going, but many of us keep going to the detriment of our future health. (PS – don’t spend two hours scouring the internet for home remedies. Just do something now that will help you feel a little better.)
Make a note of your symptoms. The more you can do this, the better your doctor can help you. How bad is the pain on a scale of 1 to 10? When did it start? Does light bother you? Is the pain pounding, or sharp, or a constant pressure? What makes it worse? What helps you feel better? All these details can help you get the treatment you need.
Don’t be overwhelmed with information. There’s a lot of information on this site and elsewhere that can be a lot of help as time goes by. But be careful about printing off too much information before you’ve even talked to your doctor. A headache can be caused be a lot of different things, and there are countless treatments. Take things one step at a time.

Yes, but my Doctor isn’t helping Me!

Sadly, there are times when this initial visit to the doctor is less than helpful. I’ll write more about that situation later. But in the mean time, here are a couple of things to keep in mind…

If your doctor says it’s not “serious” – she may actually be telling you that she’s fairly certain that your condition is not life-threatening. And that’s not a bad thing. Ok, maybe she doesn’t realize the pain you’re going through, or maybe she’s taking it too lightly. But she does have a lot of training, and she has seen a lot of patients, and it’s possible that she’s not just trying to get you out of her office. Don’t assume immediately that your doctor doesn’t know what she’s talking about.
At the same time – don’t be afraid to find another doctor. If you really feel that your doctor isn’t listening, or simply that you need another opinion – take the time to go to someone else. I know it’s frustrating, and that you shouldn’t have to go through all this trouble when you already feel terrible. But your health is important. And this is something to take seriously.

Conclusion

I know you’re in pain, and I know it was a pain to read all of this, and I know you want to relieve the pain NOW. Trust me, I’ve been there. And I’m trying to save you a lot of pain down the road.

This post doesn’t answer all of your questions. That’s because I want you to focus on what you need to focus on first – noting your symptoms, and getting to a doctor. It’s not a solution, but it’s critical to start there.

29 April 2013

Feverfew for Migraine

James Information, Treatments 7

Herbs for Migraine Highlight: Feverfew (tanacetum parthenium L.)

Class: Migraine Preventative

Possible Benefits:

General migraine attack preventative
Reduce Pain
Anti-inflamatory
Reduce sensitivity to light/noise

Suggested dose: 100mg – 300mg / day

Tips: Look for a supplement which contains 0.2% or higher parthenolides.

Warnings: If you’re using blood thinners or other prescription medications, talk to your doctor.

For more information, read Can you get feverfew migraine relief?

15 April 2013

What is Allodynia?

James Information 3

Cutaneous (skin) allodynia (skin sensitive/painful to the the touch)
Most often on the scalp (hurts to comb your hair!)
Also on other parts of the body (hurts to wear a shirt!)
A common symptom of migraine and cluster headache
May occur during a headache, or as a “warning signal”

For more information, read My Hair Hurts! Migraine and Allodynia

8 April 2013

5 Migraine Aura Myths

James Information 5

(Click image for a larger version)

Anytime you try to summarize anything in a graphic like this, there’s a lot you’re going to miss. I decided to make this graphic about Migraine Aura Myths anyway, but below is a bit more information.

Migraine Aura: Neurologic symptoms that often precede a Migraine Headache, typically by about 60 minutes.

Part of the challenge with migraine aura is the definition. If you include every symptom that may come before migraine (including symptoms that may occur 2-3 days ahead of time), that’s a lot different than the more classic definition of a very short-term symptom (20-30 minutes) (typically) right before a headache. Early symptoms of a migraine attack can be divided into various categories, or all lumped together.

Myth: Migraine Aura is always a visual disturbance.
Reality: Visual disturbances are the most common Auras, but there are other Aura warning signs.

This is a whole topic of its own, but an example of a non-visual aura would be a tingling feeling (“pins and needles”) and numbness.

Myth: If your attacks are preceded by Aura, they will always will be preceded by Aura.
Reality: If you experience Migraine Attacks with Aura you will usually experience Migraine Attacks without Aura.

Myth: A true Migraine attack always involves some kind of Aura.
Reality: Only about 20% of Migraine Attacks include Aura.

This is an important one. Most migraine attacks do not include aura. Many people with migraine will never experience aura.

The 20% statistic will vary with age and gender. Some have suggested that this number is too high, because doctors may use a broader definition of aura than what we’re using here, or may diagnose any kind of visual issue that happens to occur around a migraine attack as “aura”.

Myth: Migraine Aura is always followed by a severe headache.
Reality: Aura may be followed by a severe headache, or a mild headache, or no headache.

Yes, just a reminder: many migraineurs do get aura and no headache at all.

Myth: Migraine Aura can be disturbing but never disabling.
Reality: Migraine Aura may be only an annoyance, or it can be disabling.

Migraine aura can be extremely disabling, even when there is no pain at all in the migraine attack.

The symbol is a proposed international symbol for hidden disability. For more information, please visit the Hidden Disability Facebook page.

Most of this information is pretty well known, but special thanks to the following books: Migraine and Other Headaches, Migraine and Your Child, The Migraine Brain, Menstrual Migraine, Imitators of Epilepsy, Second Edition