A year ago today I had a headache. A big one. This was low point in a continuous migraine that lasted about 5 months. As I was thinking about the whole experience, it occurred to me that I never blogged about the resolution. This might fill in the gaps for any friends that haven’t heard the whole story, but mostly it might help people that are experiencing a similar issue.

In late November of 2008, I visited an Endocrinologist for the first time. I had a family history of hypothyroid, and I was experiencing some symptoms such as fatigue. The doctor drew some blood, determined that I was hypothyroid, and gave me a prescription for Levothroxin. This is a generic version of Synthroid, a popular medication that has a long history of helping people (including my mom and sisters.)

At the beginning of February 2009, I got a headache. The first doctor I saw told me it was a sinus headache and suggested I take pseudophed. I had never gone to the doctor for “a really bad headache” but I learned something important that didn’t make sense until weeks later. If you have a headache, don’t go to the urgent care clinic or ER. They think you are trying to score drugs, and will try to dismiss you as quickly as possible. Hopefully you have a doctor with which you have a relationship so they will take you seriously. On my second visit, the urgent care doc told me “Well, other medication won’t help. Just keep taking Ibuprofen”. That wasn’t true, narcotic pain relievers were a life saver that my real doctor gave me later provided me with a few hours of relief. Just a tip if you ever find yourself in that situation. I was confused that I wasn’t getting help- it never occurred to me until later that they thought I was a junkie.

As the weeks went on and the doctor visits continued, I received several migraine injections such as Toradol and D.H.E. Toradol took the headache to about 50%, DHE got rid of it for a full day! Then it would come back. By mid February, I had logged about 4 urgent care visits, 10 family doctor visits, 3 ER visits including a cat-scan. I had no answers. They suggested I take an anti-seizure medication called Topamax that is known to control frequent migraines. The medication began working rather well. I only had a dull pain, but I had the dull pain all the time. Still, I was ready to go back to work, and I had an appointment to see a neurologist in a few weeks. The Topamax had plenty of side effects though- I couldn’t think clearly, I couldn’t process more than one voice at a time, I couldn’t speak quickly, and I was really anti social.

I was headed to work for the first time in weeks, and I stopped in for a Chiropractor appointment. I had begun to see a chiropractor when the headache started (I was trying everything!) I had considered canceling that visit, but I went. The “doctor” gave me an adjustment and then used a hammer-like tool to supposedly align the vertebrate in my neck. Even though chiropractors go through enough education to call themselves “doctors”, they apparently don’t go through enough to learn that migraine patients have a particular nerve condition that should be carefully handled. The occipital nerve that connects to the upper vertebrate is swollen. When this is irritated further (like if you apply a hammer directly to it) you trigger what is called a “complex migraine”. This is basically a stroke, without the long term brain damage.

Within a few moments my vision was nearly completely gone. A few moments after that (and after a very lucky car ride home) my speech was slurred, my memory was failing, along with my ability to sit or stand upright. I began to blackout and Amber called the ambulance. The medics arrived and asked what medication I was taking. When I showed them my Imitrex (anti-migraine pill) they pushed me to know WHAT ELSE I had taken. Apparently I looked like a junkie to them too. I am pretty sure I am the first person in a long time to have a legitimate medical condition. I guess the town is full of junkies.

At the hospital, I had an MRI, a spinal tap, and a bunch of other tests. Finally they gave the DHE injection. Some unpleasant side effects aside, my vision and full consciousness returned. I went home late that night. The doctor that administered the spinal tap (or more officially, lumbar puncture) did it incorrectly. So, I got to stay in bed for another week. Anytime I sat up, I had what is referred to as a posture headache. This is similar to when you sit up to quickly-

Shortly after this experience, I went to have my blood redrawn as a follow up with the Endocrinology. I was told he would look at my blood work and let me know if there was a problem. I never heard from him. I later requested my records- it turns out that my thyroid was now higher than it should be- outside of the normal range.

I few weeks later I went to see the neurologist. He explained that the chiropractor didn’t know what he was doing. He kept me on the anti-seizure meds, and added some naproxen (Aleve) and Midrin (tylenol 3?) to the cocktail. I kept taking these for months. The dull pain was ever present.

Then, out of the blue one weekend, I forgot to take my thyroid meds. The ever-present dull pain? Gone.

I made an appointment to see a new doctor- one that wouldn’t have any pride in an earlier diagnosis (or lack thereof). I told him my experience, and he instructed me to stop taking the thyroid pill. A few weeks later, I stopped taking the anti seizure pill. I was cured- Cured in the fact that I stopped taking the pill that was giving me the headache. I never went back to address my thyroid issues. I deal with some fatigue occasionally, but at this point that is fine with me.

I had probably seen 20+ doctors between the ERs and clinics. They had all asked me what I was taking, I always told them about the thyroid. I googled it in suspicion. Nothing came up linking migraines to Levothroxin. After I knew there was a link, I searched in more earnest to make sense of it. Finally I came across some research by Dr. Marcelo E. Bigal, M.D., Ph.D*. It was pretty similar to my experience. I contacted him, and he told me that most likely the thyroid doc had put me on too high a dose, and should have ramped me up more slowly.

In summary, here is what I learned:
I am grateful for my health.
I can understand why people with persistent health problems can become depressed.
I have great friends and neighbors that were all willing to help in any way needed.
Chiropractors are quacks- Also, since its not real medicine, you can’t sue them for malpractice.
If you have a headache, people think you are a junkie.
There is a link between thyroid and migraine, but it is not very well researched.

(*Bigal, Marcelo E., Sheftell, Fred D., Rapoport, Alan M., Tepper, Stewart J. “The Woman With the Never Ending Headaches.” from: Purdy, R. Allan, MD, FRCPC; Rapoport, Alan, MD; Sheftell, Fred, MD; Tepper, Stewart, MD. “Advanced Therapy of Headache,” Second Edition. B.C. Decker. 2004. )