Headaches, advice please?

[omega]

I joined this site due to back problems but have recently had headaches take priority in my life and really need some advice on what to do from someone who will listen.
About 6 weeks ago I got an ear infection. I have had only a couple in my life and this was the worst. After about 2 weeks and 4 doctors visits it cleared up. The last 2 visits were with an ENT doctor who drained my ear, put me on a strong antibiotic and gave me percocet for the pain. Almost everyday since the ear infection cleared up I have had headaches. Most days they are an annoyance early in the day and grow to severe by the end of the day. I have missed about 10 of the last 30 days of work due to these headaches or the ear infection. Some days I just leave early. When they are bad it takes about 10mg of percocet to make them better, but I can't really work well if I take percocet. I have also seen a neurolgist once. The ENT had a CT scan of my sinus's done but I haven't heard back from him. Between the neurologist and the ENT I have tried sumatriptipan and fioricet. Neither have helped. My regular doctor had me start taking 25mg amitripaline(unsure of spelling) as a preventive med but said it could take a week to have any effect. Reading as much as I can about headaches they generally fit the description of chronic tension headaches. I have had 2 days without headaches, both on weekends and both days I took half a percocet(5mg) at the 1st sign of headache starting.
So far the only thing that is effective on the headaches is percocet or DHC 90-120mg. The DHC I had for my back. I am concerned about my job if I don't get my act together. I am also concerned that the doctors aren't taking this as a serious problem. I have also seen an opthamologist but my eyesight is fine. I bought a much larger computer monitor for work but it has not seemed to help. I have been trying to minimize my intake of pain killers, but am about to take a percocet as my head is hurting. Any advice on what to do would be greatly appreciated.

[poocheroo]

@omega , I don't have a lot of experience with migraines and such but I am sure you will get a lot of help and responses from folks here. I just wanted to post because the one thing I thought of immediately upon reading your post is allergies. When I moved to the east coast a few years a ago I came down with the most painful headache that was aggravated by moving my head in certain directions and also to light. I had never experienced anything like it and finally went to the doctor and it turned out to be sinus infection. I did not have a cold or anything so I was surprised by the diagnosis. I know you are waiting for your CAT scan so that might answer that theory but I know in my area the allergens have been especially bad this season and I have been experiencing an on and off headache for a few months. Perhaps trying Clartitin or Zyrtec. I have unpleasant reactions to allergy meds so I just try and tough it out. Or try a neti pot just to see if cleaning out your nasal passages helps. My husband swears by that thing. I do hope you get some relief soon!

[billyboy1965]

When they are bad it takes about 10mg of percocet to make them better, but I can't really work well if I take percocet.

I do not believe percocet is the answer to headache pain.

I suggest you fire your medical team and search the internet for second opinions.

[DevilishOne]

Fioricet is pretty much the med of choice for tension headaches. The butalbital, caffeine, APAP combo are proven out so you might want to consider what the others here have suggested regarding the headache cause being something that to this point has been missed. I wouldn't be surprised if you learn from your CT scan that you have some sinus issues.

[alumni]

Since the ear infection has cleared up, you should probably just stop the Percocet.
One of the absolute most common side effects reported for oxycodone is headaches.
Plus, as noted, even if the dx is tension headaches, oxycodone is not indicated as a treatment.
For whatever it's worth, I think an ENT prescribing Percocet for an ear infection is a little goofy. And now it very well could be that you are suffering new headache pain as an adverse effect of the doctor's treatment.
Stop the Percocet and see if the problem resolves.

[Piper]

@omega, i'm with @alumni. sounds like rebound headaches from the opiates. they're notorious, from what i understand.

[omega]

I was gven the percocet due to pain from the ear infection. My eardrum actually burst from the pressure and it is quite painful. Fiorocet has had zero effect on my headache. I have only been taking percocet after I get home, not continuously. I am seeing the ENT tomorrow so hopefully he will tell me I have a sinus infection. In the last few days my upper teeth have hurt some with the headaches, so it could be a sinus infection. I have been taking Zyrtec since the ear problem started as allergies were thought to be the cause of the ear infection. Thanks everyone for the help.

[dropdeadedd]

It sounds more like the headache is being caused by damage to your ear drum. Do you have any prior injuries (neck/spinal)?

I myself suffer from vision migraines on a daily basis (due to a spinal injury), and a combo of tramadol/fioricet makes the days more manageable.

[tadpol]

@omega- I have tons of experience with freaking headaches, migraines, etc. I also have experience with opiate use, rebound, allergies and the like. I can share my personal 2 cents and hope it helps because I KNOW how bad it sucks to be you right now.
@poocheroo has a great point on allergies. Especially if you've moved or the season's changed. I never suffered so bad from allergies as I did when I moved from the midwest to the west coast. It's horrible. Doctors looked at me like I was insane. But in the end, trying every allergy tab in the world, and Benadryl working (although making me tired) helped A LOT. If Zyretc didn't work, keep at it. Allegra, Claritin, Calritin D, ask the pharmacist. I tried everything before I went back to Beny and felt better.

I've also had chronic sinus infections back in the midwest. Once so bad fluid was collecting over my eye and the pain was as bad as child birth or kidney stones (both I've had). Ended up in the hospital. Antibiotics helped A TON, along with Norco. But you know what else helped? Water. LOTS. Hydration is so important to overcoming any headache. Most docs won't mention it (at least not mine) but even in something as minute as hangover, water- water-water! The more you thin your blood the less the pain. This is part of what tylenol does anyhow.

You mentioned work suffering. This may be impossible or hard, but the less time you spend staring at a monitor the better. Same goes for TV and bright light and noise. If you have to use your monitor turn down the brightness. Lower the volume on the tv or speakers. Don't use headphones. All these small things will help. No one thing is the magic bullet.

And as for rebound. Everyone that jumps in is right. Its a huge factor when you have opiates and then suddenly you don't. That will pass in time. If you weren't on for long, a few days really. Especially if you HYDRATE. I know it sounds so lame, but it's true.

I wish you the best. If there is anything the board can do its be supportive. Glad you're here

[omega]

Saw the ENT today. I have what he thinks is a cyst in my spheroid sinus. He said that is pretty normal, but mine is bigger than usual. He doubt this was causing the headaches but he said it was possible. He put my on a 14 day "stronger"(than augmentin) antibiotic and put me on 16 days of prednisone. He said it was possible(although unlikely) the cyst had infectious fluid in it and if it did these med should shrink it. If that didn't work he said to let the neurologist go through his normal headache checks and if they failed we could discuss removing the cyst. I see the neurologist next week, not sure he will so much until the cyst is ruled out. Thank you everyone for the advice. It is really nice to have this site to keep my head on straight.

[Good Apollo]

Saw a course fioricet recommendations: helped me for a while, but suddenly was getting more migraines and needing more fioricet... Turns out extended use has high propensity for rebound headaches... Just an FYI- might very well help short term but is not a long term regular useable solution, unless it is infrequently used. For a while it was a wonder drug for some debilitating migraines I had...

[cherrybomb]

@omega i would watch with the DHC--i haven't taken the ER pills before but i do take the 40 IR for pain. However, i sometimes get terrible rebound headaches. Just happened to me actually and i had the worst migraine!

The only thing that works for my tension headaches and migraines is codeine mixed with small amounts of APAP. I prefer pure codeine so you can control the amount of APAP as well.
@cajunbulldog should be able to help with this as well.

Cheers xoxo

[TenaciousE]

Since you stated that headaches are a recent occurrence, I suspect that Percocet is causing them.

When I briefly took Percocet after ankle surgery a few years back, as soon as the Percocet wore off BOOM I had a headache.

So I agree with others, stop the Percocet and I bet you will break the cycle.*

Treating headaches with powerful opiates is only a band-aid and will eventually stop working. My recommendation is to stop before you develop a tolerance, dependence or adduction to them an find yourself in the cycle of rebound headaches.

*I have suffered from chronic headaches of various types for 30 years and I only take opiates when the headaches fail to respond to first and second line treatments.

IME many doctors do not take headaches seriously. Some of this is due to the fact that they are difficult to treat. Your best bet is to go to a neurologist who specializes in headaches. There are many preventatives out there and IMO using amitriptyline (this is an old school antidepressant in the Tricyclic class which predates SSRIs) is an ancient method of treating headaches and is like taking a sledgehammer to the problem. But, some doctor's prefer to use older methods of treatment.

But, before running out to specialists see if stopping the Percocet ends the headaches. Yes, you will have rebound headaches after stopping but this should go away in several days.

[halohippe]

@omega

I bloody hate tension headaches. Have suffered from all kinds of headaches in the past and still do but tension headaches i can only beat by getting some sleep. However its difficult to get to sleep when you have a tension headache or most headaches for that matter!

Damn annoying. Sorry not much help mate but i do sympathise and understand how difficult it can be to work looking at a bloody computer screen all day with a tension headache.

As well as your standard meds i actually use these special cooling gel pads you can stick to your forehead or back of your neck, however you look like a bit of an idiot especially if your at work! However it does get you some sympathy from the ladies sometimes!

[omega]

I don't usually get the headaches immediately after the percocet wears off. I typically take it at 7pm so by 1 am I would think it was mostly gone. The next headache usually starts about 9am and gets progressively worse throughout the day. I only took percocet for maybe 4 or 5 days before the headaches started. Can you get headaches from taking it for only 4 or 5 days? I took percocet for over a month when I broke my pelvis and sacrum and never had any headaches or other issues. I was initially taking 15mg every 4 hours and worked my way down over about 6 weeks then to Lortabs for another 2 weeks. I had zero headaches then. Do you guys still think it could just be the percocet? I will be unable to work if I try 3 or 4 days without DHC or percocet. One day last week I didn't take anything and the headache did not go away when I went to bed and the headache was the worst it has been the next day, it was severe as soon as I woke up. It seemed worse I thought because I never stopped it.

[Jeremy Fisher]

I think it could be many other things besides the PKs.

@omega, any chance your headaches are caused by clenching your teeth? I only mention that as you said your upper teeth were hurting.

One way to tell is that your jaw muscle is sore/tight. Feel under your ears to see if the muscle is tight.

Headaches can also be caused by C2 being out of alignment. That could be caused by sleeping wrong. A good chiro could be able to feel your cervical vertebrae and tell you if C2 is out of alignment. I do not like it when one cracks the neck. Seems barbaric and dangerous to me. My chiro can knock my cervicals back in alignment using an activator which is a pop out little hammer like thing. Relief is immediate.

If this is a tension headache, maybe muscle relaxers (at night is my preference) could help. We tend to hold our tension in neck and shoulders.

Stretches and massages help too. Also I read once that 90% of headaches are caused by dehydration so drinking more water will only help. Also one must be ergonomic and avoid 'turtleling' (sp?) one's head. Our heads weigh about 12 lbs and sticking it out all day as we work on computers, etc... just aggravates the neck.

Just some thoughts ...

[omega]

I forgot to mention that I have also been to a chiropractor. He is a friend and had worked on my back many times. He examined my neck and did adjust it but he also said it felt like it was pretty much good and he doubted chiropractic was going to help these headaches.
I have been drinking alot of water especially this week. I don't think I am dehydrated but I am going to keep downing the bottles.

[sinister]

My best guesses would be that they're related to either the percocet use or from your sinus problems. Since the headaches are relatively new onset it makes sense that what is causing them is something that has recently changed. Think Occam's Razor.

I've never had a ruptured eardrum but would think that's enough to cause the HA's. I know for a fact though that percocets cause headaches.

Seeing as the Fioricet didn't give you any relief makes me believe they're not tension HA's.

Hope you find some relief.

[Roswell1947]

@omega
My wife is on SSDI (Disability) for headaches.
It's one of the 12 impairments and was awarded disability
a year ago at a SSA disability hearing.
She's 62yrs.
She tried Fioricet but the caffeine elevated her blood pressure.
They tried Topamax which works for some but had a bad reaction to it.
She also tried that Elavil (Amytriptyline sp?) but didn't work.
Her PCP has had her on #60ct 5/500mg Vicodin & #50 5mg valium per month for 4 years.
For her, the combination of the Valium & Vicodin worked the best so
she has been scripted that since 2008. She has seen 2 neurologists.
On good days, she splits the vicodin into 4 parts and takes 2.5mg
every 6 hrs. On bad days takes a whole 5/500 vicodin and a 5mg valium
simultaneously which gives her relief.
Do you know how you got the ear infection? I've had them from swimming in lakes
and the bacteria got in my ears.
Good luck and hope you get it figured out.

[dar]

Omega--the FDA now approves botox injections for quite a few things, and insurance companies are now going off-label, too, if they see it saving them money down the road (got it approved myself with this logic). It can be amazingly helpful, and needs only be done every 3 months. Some ENTs do it, some neurologists. You might check into it, and even if your insurance doesn't cover, ask them to write a letter in appeal. The injections are basically painless (at least, painless for us pain sufferers) and you'll know if it works in about 2-3 weeks. Maybe worth a shot? Oops, bad pun.