It's All in Your Head

If you don't count the dozens of doctor's appointments I've been to while pregnant or recovering from childbirth over the past few years, I have been to the doctor only twice in 4 years - for a bout of tonsilitis 2 years ago and a physical this spring. I also have a pretty high pain tolerance. I am fairly dramatic when in pain, but the older I get, the less I rely on medications to mask pain.Not only that, but Sundays are fiercely guarded as quiet, introspective days spent recharging and being with family.

 

So the sheer fact that I was sitting in an urgent care facility on Sunday afternoon for The. Worst. Headache. Ever. should say something.

 

I couldn't think. I couldn't process. I really wasn't in the best condition to drive, but I did - it's a straight shot from my house to the urgent care clinic 8 miles away - involving only one stop light (and a 7.5 mile portion of interstate). And I was in more pain than I've been other than during childbirth.

 

I've had a lot of headaches in my life. I am pretty good at figuring out their triggers and avoiding/treating based on that knowledge. But this headache was different - much worse than even my typical migraines.

 

To be truthful, I only went to urgent care because I've had three of these headaches over a very short period of time (with increasing frequency), the nature of its onset (very quickly) and the severity of the pain. And because Himself said I was crazy if I didn't at least make sure I wasn't dying - particularly with my newly discovered clotting disorder, the severity of the pain and the rapid onset. In retrospect, I probably should have gone to the ER - at least they could have then run the tests during the headache. But I was worried that a severe headache didn't qualify as an emergency, and I'd be stuck with the whole "slightly under $1k bill" just for showing up.

 

The urgent care our insurance covers isn't a typical doc-in-a-box situation. It is one of the largest physician clinics in the valley, connected to a major teaching hospital, and the doctors take turns rotating for urgent care shifts on nights/weekends. The nurse was excellent.

 

Then, the doctor showed up.

 

I left, 90 minutes later, with a shot of the equivalent of a super non-steroidal anti-inflamatory (that did nothing but take the edge off) and 6 pills of a pain killer I can't take while nursing - even though I had repeatedly told the doctor that I was nursing (and there ARE pain medications that are safe - or as safe as one gets when using painkillers) and more frustrated than I've ever been at a doctor in my life.

 

In short, the doctor didn't listen. That much was clear even in the 2-line sentence he wrote on the MRI order - one that he said, "just schedule sometime in the next couple of weeks" and "patient has a history of migraines and stress headaches [I never mentioned the words "stress headaches"] and feels they are becoming more severe." Throughout the "consult", he implied multiple times that the severity of the headache was all in my head.

 

He never seemed to grasp (or note on my chart) that this (and the other two I've had in recent days) ARE TOTALLY DIFFERENT than any other headache I can remember having - more severe pain, faster onset, non-respondant to any medications I've taken.

 

The doctor also uttered a couple of fabulous gems: "So nothing like Imatrix or Topamax (or several other migraine drugs I can't remember the names of) work on these?" To which I wanted to respond (but was in too much pain to be snarky): "1. This is not like a migraine - maybe it's a-typical, but this has none of the hallmark symptoms of a migraine and 2. The above named drugs require a PRESCRIPTION, so no I have no idea if this headache would respond to those drugs."

 

And, "Well, the pain must not be too bad. You're handing it remarkably well." Again, I just sat there and responded that the pain was, in fact, quite severe, but being hysterical would do neither one of us any good. What I wanted to say, however, was: "I've had an epidural-free childbirth, and I've recovered from gallbladder surgery on nothing more than 800 mg of Motrin a day, and I'm here for a HEADACHE. That should give you a clue as to how bad the pain is."

 

I came in with a headache that was a 10 on the pain scale and left full of one of the strongest non-narcotic meds that knocked it down to an 8.

I know headaches are almost impossible to diagnose. I know that treatment often takes awhile to find. I know that the symptoms are hard to convey. I know that everyone has different pain threshholds and so it's hard to place a universal line as to when one should consult a physician.

 

But I also know that a doctor's first responsibility to his/her patients is to LISTEN and to accurately capture what they are saying.

 

Let's just say it will be a 90-degree day in January before I ever see that doctor again.

 

Meanwhile, I'm grudgingly scheduling the MRI and an appointment with my regular doctor - whose first reaction will hopefully be something other than drug peddaling.

 

Should I ever decide to become an opiate addict, however, I know right where to go.