The headache

I’ve had a headache for nine months.

And no, I not a hypochondriac or one of those people who likes to complain about illnesses to elicit sympathy. Just the opposite. I’m the kind of guy who visits a doctor only when I absolutely need to – e.g. if I were to cut off my arm with a chain saw.

The headache started in mid-December. It wasn’t a migraine – I had one of those once in my thirties and it was God-awful – or one of those throbbing headaches you get with the flu or when you’re stressed. It was mild, a low-grade headache but, unlike other headaches, it wouldn’t go away. My vision changed, too. Suddenly computer screens, books, and labels I had always read with ease were blurry. I bought reading glasses. Problem solved. But the headache persisted.

I figured the headache and vision change were allergy related. Here in Florida where the foliage blooms year-round, almost everyone suffers from allergies. The second week of January we were going to Baja, Mexico, where the only vegetation is cacti. I figured that once I was in the desert, the headache would disappear. It didn’t.

The day we got home I saw my doctor. She asked how much time I spend on the computer. “Three or four hours a day,” I admitted.

“It’s probably eye strain,” she said. “When was the last time you had your eyes examined?”

“A couple of years ago,”

“Get an appointment,” she said. “If he says your eyes are fine, we’ll schedule an MRI of your head to see what’s going on.”

I saw the eye doctor the next day. He said my eyes were fine. So the MRI was scheduled for the following week.

In the meantime I came down with a sinus infection I probably picked up on the return flight from Mexico. Every time I coughed the headache intensified ten-fold for a few minutes. I thought my head would explode. The doctor prescribed ten days of antibiotics.

At some point during the first days of the sinus infection, my ears started ringing. They’ve been ringing ever since. Sometimes I hear crickets. Other times it’s radio static. Some nights the ringing is so loud I have trouble falling asleep. And it’s always there.  

I postponed the MRI – no way I could lie still for a half hour without moving when I was coughing every few minutes.

Two weeks later when I finally had the MRI it showed – surprise, surprise – a sinus infection. But everything else looked normal.

My doctor referred me to an Ear, Nose & Throat Specialist who prescribed a second round of antibiotics. He said the ear ringing – tinnitus – had nothing to do with the headaches or sinus infection. I didn’t (and still don’t) believe that. He said to come back in two weeks for a CAT scan which, when I had it, revealed the sinus infection was gone. But the headache wasn’t.

I went to another GP who, after running blood tests and examining me from head to toe, said he couldn’t find a cause for the headaches, vision loss or ear ringing. He said they might be caused by allergies and recommended I try Zyrtec for a month.

Zyrtec did nothing, so he referred me to a neurologist.

When, in early May, I was able to get an appointment, the neurologist asked me to rate my headache on a scale from one to ten -- one being barely noticeable and ten being excruciating. I told her it was somewhere between a two and a three, maybe a five or six for a few minutes after I leaned over to pick up something, coughed or cleared my throat. I said I could live with it – it wasn’t like I was having to spend the day flat on my back in a dark room – but it was annoying enough that I wanted it to go away if possible.

She asked if I took a lot of ibuprofen. “I’ve had a headache nonstop for five months, you bet I do,” I replied. I also told her that for years I’ve taken an Advil at bedtime. I’ve always had trouble getting to sleep and it relaxes me.

She said she thought the headache might be the result of too much ibuprofen. She advised me to lay off it and come back in a month.

I did, but by my next appointment in June, the headache hadn’t abated one whit. She ordered another MRI­ -- a brain scan -- and said she wanted me to see an ophthalmologic neurologist.

In late July I spent a morning in the specialist eye doc’s office undergoing a complete exam. He said both optic nerves were inflamed. “But not inflamed enough to be causing this headache and I think your vision change is age-related. Everyone your age needs reading glasses.”

That afternoon the neurologist’s office manager called and said the doctor wanted to move my next appointment, scheduled for early August, up to the next morning. “Is everything OK?” I asked. “All I know is she told me to call you,” she said.

When I arrived I was shown into her office where, on the computer screen, there were half a dozen images of my brain. While waiting for the doctor to finish up with a patient in the next room, I took a pic of one (above).

The doctor said she had missed it the first time but, on a second examination of my MRI, she found my meninges was inflamed. “What’s a meninges?” I asked. “The lining of your brain.” she said. “An inflamed meninges is a sign of meningitis. You’ve got to get to the hospital right now for a spinal tap and blood tests. It’s most likely caused by a bacterical, viral or fungal infection. You’re also going to have an MRA. It’s like an MRI but it examines your head looking for signs of an aneurism or bleeding from your brain.”

I rushed to the hospital and had the tests. “A lot of patients say they get headaches as a result of this procedure,” the doctor who stuck a needle in my spine warned. “I’ve had one for seven months,” I replied.

I spent the next week reading up online about every possible infection – from AIDS to Zika – that could have caused my swollen meninges. Many were fatal. I was doomed. Then I remembered the neurologist’s office had sent an email inviting me to register for an online service that tracked all the documents relating to my health. I logged on and became obsessed with my blood tests and spinal tap results as they were entered into the system. Everything I was tested for I didn't have.

Once all the spinal fluid and bloodwork reports were in, I spent the week before my next appointment convinced that the MRA, whose results had not been entered, had revealed an inoperable aneurism that could burst at any time and the doctor wanted to break that news to me in person.

But at my next appointment she said everything was normal. No aneurism. No bleeding from the brain. She prescribed a week of heavy steroids. “If your meninges is swollen because of infection, it will reduce the swelling and alleviate the headache.”

But the steroids did nothing for the headache.

Monday the neurologist informed me that was actually a good sign. “If your brain lining was swollen as a result of an infection, the steroids would have helped but they didn’t. As far as I can determine you don’t have any infection anywhere. I think you are one of those rare people – we see it occasionally – for whom some swelling of the brain lining is normal.”

She also said that in retrospect, she had perhaps over-reacted when she discovered the swollen meninges. “But I had to rule out meningitis. It’s not something to take lightly. It can kill you fast.”

She asked how my headache was. “Still between a two and a three,” I told her.

“OK, she said. “Most people claim their headaches are debilitating but you say yours isn’t. My sense is that you have a high tolerance for pain. I’ve never had a patient who has had a headache as long as you’ve had yours without at least some clue as to the cause but I can’t find anything wrong with you. Your blood work and scans are perfect. I don’t need to see you again until November unless the headache gets worse.”

"Good, I was about to suggest we call it a day myself. ” 

Since January, I’ve spent $6,500 – my annual insurance deductible -- on five doctors, two MRIs, an MRA, a CAT scan, blood work and a spinal tap. That’s over and above the $2,200 a month I spend on insurance for my wife and myself. I’ll turn 65 in November and be eligible for Medicare so, if I need more tests, at least I won’t have to pay for them out of pocket. Yay.

“The good news is that, after all those tests and scans, at least you know you’re healthy,” the doctor said as she walked me to the front desk.

“Yeah,” I replied. “Except for one thing.”

“What’s that?”

“I have a headache.”