Diamox isn’t working…

Diamox isn’t working…

The Diamox had been a God-send. After the LP I had been completely headache free for two weeks. I felt great, things were going well, I even bought a new car. Then I ran out of the Diamox and had to skip a dosage. Now…. death headache.

For days I have been in the grips of a death headache. I can barely work again and life in general is taking a huge toll. Things are not well at home because of it and I am getting further and further behind at work. I even bumped myself up from 500mg a day to 1000mg (one 500mg pill every 12 hours) with no relief (I am back down to 500mg because I only have a few left). I started taking the Depakote again with no relief. Ice packs on the head seem to dull it back a bit, but does nothing for my eye pain or ear pain – which is now bilateral and devastating. The buzzing and ticking in my ears are terrible. It hurts so bad. My eyes hurt so much that I can’t wear my contacts, so I HAVE to wear my glasses, but wearing them feels like my head is being crushed from the added pressure – and my ears hate the glasses, too.

I also now have a white, crystallized type of discharge from my left ear… No clue what that is.

Hangover Headache…

Hangover Headache…

10:00 am: That’s the best way I can explain it. It feels like I have a hangover. I had this slight feeling when I woke up yesterday, but it went away by 10 am ish. Today this headache won’t go away… It’s more right-sided than I usually experience. The base of my skull and my neck hurt, too. It feels awful. it’s throbbing and if it gets worse, I may crack. I had been completely headache free since my lumbar puncture, but I skipped a day of Diamox 3 days ago because I had run out. My neuro’s office finally got back to me and got a prescription to me yesterday, and it’s been downhill since then. The RX says to take a pill twice daily, but I only have enough for once daily until I see her again on the 22nd.

Its Mother’s Day and the kids and hubby brought me breakfast in bed. It was super sweet of them. I wish I felt better so we could all do something together today. :(

11:00 am: I took another Diamox. Here’s hoping that I feel better soon.

7:00 pm: Slept from 11 to 3, no relief. Took Tylenol, no relief. Took naproxen and a bath, no relief… Finally gave up and took a Fiorinal. My neuro doesn’t want me taking anything narcotic, but I just can’t take it anymore. I am supposed to be going with my daughter and her kindergarten class to the zoo in the morning. I hope I can make it. :( I am now more depressed and discouraged than ever.

9:00 pm: Head feels a bit better. Still get extreme headache for a bit after standing.

Treatment Continues

Treatment Continues

So, things have been going well since starting the Diamox. I haven’t had a full blown headache while on it. I have had an annoying headache for a few days, but not the type I call the “death headache.” I have slight eye pain and ear pain, with moments of more severe ear pain. Overall, my symptoms are decreased on the Diamox.

The side effects of Diamox aren’t pretty, but right now I prefer them to the headaches. I have been experiencing “tingling” since starting it. It’s in my fingers and toes, lips, tip of nose, and sometimes entire foot and up into leg and thigh. It’s difficult to describe – its tingling, but it’s severe. It feel like the skin has been burned. Other effects have been severe fatigue (likely from the associated low potassium), dry throat and occasional uncontrollable cough, changes in taste, constipation alternating with diarrhea, loss of appetite, sore in mouth (had that checked at urgent care), back pain, and general lack of energy.

I have IIH – What now?

I have IIH – What now?

So, I have Idiopathic Intracrainal Hypertension.

I am so glad to have an actual diagnosis! I almost want to send a nasty letter to my original doc, Dr. H, and let him know what a moron he is and if I had just left it alone, like he suggested, I would have gone blind. I can’t fault the other doctors for not knowing, I mean, it’s rare and the only way to diagnose it is with history and a lumbar puncture. And, it’s rare enough (1 in 100,000) that most people have never heard of it. But at least Dr. S and my current Nurse Practicioner and Neurologist all decided to stick with it and try to figure out what it was.

The past couple of days I have spent my “off” hours researching IIH. I have done a lot of reading on the IIH Support Forum. It is insane how every one of my symptoms can be explained now! I can’t believe how long it took me to find out about this illness. I have searched and searched and searched some more on the internet for almost a year and just found out about IIH a couple of weeks ago. I really hope that my little blog can save someone else all the torment of lengthy suffering without a diagnosis. Everything from my facial flushing to my weird eye problems are explained by this condition.

So, I have a diagnosis; now what?

It starts with the Diamox (acetazolamide). Right now I am on 500 mg extended release capsules once a day. I go back to see my neuro on the 22nd of this month.

In the meantime, I need to focus on losing weight. From what I have read, this MAY lead to a decrease in symptoms, though I have heard that for about 75% of people, it makes no difference at all. But, my neuro wants me to focus on weight loss and then I may be able to go off the Diamox and be just fine. On the other hand, weight loss may not make a difference. In that case, I believe the next step is to continue with the medication, but, I am fairly certain that with the side effects, I wouldn’t want to be on the Diamox for very long. In the worst case, I could have a shunt put into my spinal canal to drain the CSF. Though I have read that this is only successful about 50% of the time, and the other 50% require repeat surgeries. So, I don’t want a shunt. First step first, I need to focus on weight loss and pray that shedding some pounds will relieve my symptoms.

The Internet Saved Me!

The Internet Saved Me!

I had been feeling crummy since leaving the hospital. My headaches were here and there but my ear pain (tinnitus and ticking) and eye pain were back in full force. I started searching the  internet for more information about Depakote and how it affects people to see if I wasn’t the only one. I read many posts about how people couldn’t take it because it made them so sick. I started realizing I was one of those people.

I can’t find the page now, but I stumbled on a post by someone about Depakote and one of the responses asked the poster to look into a thing called IIH. This was something new, so I started reading about it. Boy, was I SHOCKED!

IIH, or Idiopathic Intracranial Hypertension is a neurological disorder that is characterized by increased intracranial pressure (pressure around the brain) in the absence of a tumor or other diseases. The main symptoms are headache, nausea and vomiting, as well as pulsatile tinnitus (buzzing in the ears synchronous with the pulse), double vision and other visual symptoms. If untreated, it may lead to swelling of the optic disc in the eye, which can progress to vision loss.

Holy Cow, those are my main symptoms! Head, ears, eyes! Ding ding ding, we have a winner!

So, in the grips of a death headache for days, I got in touch with my new neurologist via text and let her know I felt like crap. She said she wanted me to go to the ER and get a Depakote level in my blood. I told her I thought I had IIH and that I wanted to get a spinal tap. She said she didn’t think I had IIH, but if I wanted a spinal tap, I could always ask.

At the ER, they ran blood tests and a spinal tap. My CSF opening pressure was 27 cmH2O, above the 25 for diagnostic hypertension. Everything else was normal. I texted my neuro and she said she’s seen much higher normal pressures and was not convinced that IIH was the issue. Still, she had the ER doc put me on acetazolamide (Diamox), a diuretic and the standard first treatment for IIH. After a almost 2 weeks, I sent my neuro an email and also pointed her toward my blog here:

I am almost 100% sure on my end that I have iih. I have been headache free for nearly 2 weeks now – ever since the spinal tap and starting the water pills. I am taking one a day and my family doc gave me ER capsules so I haven’t been able to go down to less than that and I am afraid to anyway.

I stopped taking the depakote 5 days ago. I didn’t take it one night just to see if the headache would come back and it hasn’t. Also, my ear buzzing / ticking and facial pain/ eye pain are all gone on the water pill ( were there on just the depakote). I am back to my regular eye prescription too – no more bifocals.

I feel great, other than the pill side effects (fingers and toes and sometimes mouth feel like they have been burned – also really bad acid feeling in throat). My brain is working, I am getting my short term memory back, and I am working full time again! I feel like a miracle has happened! I feel like I have my life back!

I know you don’t think it’s iih, but I am sooo sure now. I want to come in for a follow-up, so I will call your office :)

The response came back that I have IIH in “excruciating detail”.

Long time, no post

Long time, no post

I haven’t posted in 3 months, wow. Between family, work, helping my cousin Randy Angst with his campaign for State Representative, and being in pain, it’s been about all I can do to get the bare minimum done, let alone post to my blog.

Okay, so, I did get that MRI finally. The report said there was a mild bony growth in the foramen of my C-2 vertebrae and 2 mild bulging discs.

So, my doc wanted to send me back to the neurologist in Columbia. I did not want to do that, since they barely paid attention to me the last time. So, I looked in to it and got my doc to send me a referral to the neurosurgeon who had performed my previous surgery. I had an appointment with him in Fenton, Mo (near St. Louis) on April 16th, 2012. It was a while to wait, but nothing like waiting for July to come around to see someone in Springfield.

So, on the 16th, my dad drove me to Fenton to see Dr. Levy. I brought with me all of my blood tests and the recent c-spine MRI as well as the brain MRI and MRA and my c-spine MRI from 5 years ago. Dr. Levy took a look at my stuff and said that there was nothing neurosurgical. Basically, my scans showed nothing new over the last 5 years, so nothing that would be causing my issues. He said I needed to see a neurologist, and there happened to be one that worked with him walking by. He brought her in, she chatted with us for a bit, then Dr. Levy left us to it.

The neurologist, Dr. Kraus, was very nice and knowledgeable and helpful. She said that based on my current medications (which were a LOT, including 60 mg Cymbalta, Xanax, 1800 mg Gabapentin and many others), there was no way to tell if I was having a rebound headache or what. She said she was almost certain that I had a medication overuse headache. I was in so much pain, that, even though I wasn’t convinced, I was willing to try any new diagnosis. She said the best thing to do would be to detox me off my medications and that my headache should clear. She said I would need to be hospitalized. I opted to be admitted that day and get this thing going.

Sparing you all the details, the detox process gave me a clear head, but terrible headaches. I stayed for 5 days at St. Clare Medical Center in Fenton and when I was discharged, I had one of the worst headaches ever, but I was ready to get out of there. I left with a prescription for 500 mg Depakote and a few other meds to help me sleep and etc, but nothing harsh like I was on before. I left with a diagnosis of “Chronic Daily Migraines / Transformed Migraines“.

I left feeling quite depressed. I was honestly about ready to start taking my other meds again. I mean, yes they can cause dependency and they made me loopy and unfocused, but I had been functioning. The Depakote made me so sick I was ready to die. It was like choosing between 2 ways to die – death by headache or death by medicine.

 

 

Finally on the Right Track

Finally on the Right Track

So, I went on the 2 hour journey to Columbia on February 10th. My parents took me. I saw a neurology resident first and explained all of my symptoms. It took quite a while. Then the resident took the films I brought (MRI, CT, and MRA) to the attending neurologist and after they looked at my films the resident and the attending came in to see me.

The neurologist diagnosed me with migraines. She told me to double my dose of gabapentin and basically live with it. I was floored, too stunned to ask any decent questions. I think I asked if my ear issues could be caused by migraines and how in the world could a migraine be all the time (I always thought migraines were episodic). The only answer she offered was that “migraines can do all sorts of weird things.”

She ordered some blood tests to check on a few things.

I left feeling quite upset. I know it’s not migraines. So, I am no closer to an answer.

I already had an appointment with my doctor in Conway scheduled, so I figured I would just wait until then to see what other avenues could be explored.

Over the next few weeks, my symptoms continued to increase, though initially doubling my dose of gabapentin did seem to help. I had constant headaches, worsening ear pain, electrical shocks across my head and face, increasing tinnitus, numb arms and face, trouble swallowing, and that terrible feeling like my left cheek is made of cold metal.

All of a sudden, one morning I woke up with a completely stiff and painful neck. I was unable to turn my head to the right at all, and when I tried, my left ear tinnitus got so loud I couldn’t bear it. I sat in a chair at home all day. The next day my pain got a little better, and I decided to put on an old cervical collar I had in the closet to stabilize my neck. Surprisingly, my other symptoms started to get better with the collar on. I now have confirmation that my problems are all related to my neck.

A few days later was my appointment with the doc in Conway. They apparently already had a hunch that my issues were my neck. They said they were trying to get me an MRI of my spine, but the insurance company had a lot of questions in order to approve it. They wanted to know if my previous surgery was through the front or back of my neck – I told them front. They told me they would call when they had any news.

In the mean time, I had met a local chiropractor through my web design business in Lebanon, MO, and he suggested I come in to see what was going on in my neck. He did an exam and told me I had circulation issues, neurological deficits, and muscle weakness. No crap, I thought. Anyway, he did x-rays and the results were surprising to me.

Cervical KyphosisThe spinal x-ray showed evidence of at least 2 herniated discs and cervical kyphosis (reverse curvature of the neck). The cervical spine should have a curvature similar to a “C” the opens to the back. My neck shows a “C” that is opening to the front. Now I really need that MRI to see what this mess in my neck is doing to my spinal cord. I don’t want to start physical therapy or chiropractic treatment until I know what’s going on in side there.

Got a letter on Saturday, February 25th stating that my insurance was denying my doctor’s request for an MRI. Unfortunately, i had been stuck in the bed and didn’t get the letter until Tuesday. The letter stated that the information provided did not meet their criteria, and that had my surgery been done through the back, the MRI would be approved. Grrrr….

There was a phone number on the letter to request an expedited appeal. I called Wednesday morning. They told me an expedited appeal would only be performed if my health was at risk if I had to wait. I told them I was worried about permanent nerve damage, including permanent hearing loss. A few hours later they called and said an expedited appeal was approved and they would be calling my doctor and getting records and would make a decision within 72 hours.

Friday morning I got the call that my MRI was approved – the denial had been reversed! Yay! Score one for the patient! Finally!!!  I immediately called Conway and asked to speak with the nurse- no such luck, so I gave the info to the receptionist. I didn’t hear anything back so I called back after lunch. The receptionist was rude and told me their computers were down and that they wouldn’t be able to do anything until Monday. I waited in agony all weekend. Called back Monday morning – the rude receptionist said they hadn’t gotten to it yet. Called again after lunch – very rude receptionist now says they are so busy since the computers were down on Friday that they wouldn’t get to it until tomorrow. I told her I had been bed ridden for a few days, and I needed this ASAP.

I got in touch with the chiropractor who’d said he had a connection with an MRI center in Springfield. He said they take my insurance and they had an available appointment on Tuesday and on Wednesday. I called my doc back right at 5 on Monday and hoped they could get an order over there to get me in Tuesday. No such luck. I called them this morning (Tuesday) and left a message with the rude receptionist again. I got a call back finally from the nurse who said they needed some sort of authorization number from my insurance company in order to get the MRI scheduled. I gave them the phone number to call and am now waiting to hear. Apparently there is still an open appointment for tomorrow (which would be amazing since my husband doesn’t have classes tomorrow and can take me).

I am now unable to drive, plagued with horrific headaches and my other myriad of symptoms. I am ready for a resolution NOW. It has been almost a year since my symptoms started, and I am deteriorating rapidly. My headaches are getting much worse and I am losing motor control in my hands. My balance is completely off and my eyes aren’t working right. I can’t work. I have spent the last week in the bed, only getting out to go to the bathroom. I need help.

Finally seeing a specialist

Finally seeing a specialist

Well, it’s a long story, but I am finally getting in to see a neurologist. Local neurologists are booked up for the next 6 – 8 months (yeah, ridiculous), so I got a referral to a neurology clinic at the University of Missouri in Columbia. I go on Friday. I am looking forward to some answers.

Currently I am on more medications and have been deteriorating rapidly. I have lots of pain in my ears and arms, have even had kidney pain and blood in my urine… New fun symptom, livedo reticularis.

Here’s a fun pic of what I call my “zombie hand.”

 

As to a bit of good news – I quit smoking on January 20th. It has now been 18 days since I had a cigarette. So, there is some hope for me yet :)

Woman on Fire

Woman on Fire

So, my red face has yet to go away..

It’s hard to tell from this pic, but my nose is red, too. It is hot and I feel like I have a fever, but no fever… My chest is red and hot, too.

My ear cyst-thing is still there. It has like mutated into two cysts. My left ear hurts to bad..

Other symptoms still persist, but I am functional with the Gabapentin. Had a bad headache coming on last night and had to take a Fiorinal. I am so ready to figure out what is happening to me.

Here we go again…

Here we go again…

So, the new doc called with results of my blood tests, everything is in normal range, ANA was negate. The only thing out of the ordinary was a high C-reactive protein, at 1.01. She said this means there is inflammation going on. No crap. I had to sleep with my legs up and a wrist brace last night. I tried to cut a piece of cheese for my daughter and couldn’t grip the flipping knife…

I am now being referred to a neurologist. We will see how that goes. In the mean-time, my night time pains are getting worse and I basically go home from work, sit in my chair with my legs up and don’t move at all. Both of my ears hurt now, though I can hear out of the right one. When someone talks near my left ear it really friggin’ hurts and it sounds like they are talking into a can or something. I have moments of severe tinnitus and I want to cry… My face and chest are now red all the time and it feels like I am burning. I honestly thought I had lupus but since the ANA was negative, I have no idea what’s going on…