Mystery headache, mistaken identity
It’s 5:30 a.m. on Tuesday morning.
I awake with what appears to be the early signs of a Cluster Headache attack. It’s the right location (my right eye), the right intensity (about a 7 and climbing), my eye is watering, and the right side of my nose is all clogged up. I grab my essential oil blend nasal spray and sink back into a fitful stupor.
“Mom,” the lilting song of my daughter’s voice gently rouses me from sleep, “it’s ten o’clock.” I’ve overslept. Mija and Baby Girl are waiting for me to get up.
Lifting my eyes slowly, I force my face and voice to hide the searing pain. One direct gaze is all it takes. My 8 month-old granddaughter bounces with excitement, reaching out to me. I sit up to take her in my arms as my head clears away the last cobwebs of sleep. Baby Girl needs me. I must get up.
A piercing flame burrows its way behind my eye.
Exaggerating my expressions, I scoop spoonfuls of spiced apple oatmeal into Baby Girl’s open, hungry mouth. She is smiling and oblivious to my pain. So far my disguise is working. A few quick wipes to Baby Girl’s face and hands, “snap”, “snap”, slide the tray, and up we both climb the stairs to find some toys. She is distracted by brightly colored balls just long enough for me to grab my oxygen tank. I twist the knob, “Pop, hiss…” the tank responds. Baby Girl looks up to find the source of the noise just in time to see Grandma’s face disappear behind the mask. She crawls over and reaches for the tank, trying to stand up. Unable to speak, I make silly face and offer her the flashlight and plastic key that are hooked to the tank by a carabiner. Satisfied with the trade, she smiles and lets go of the tank.
Twenty minutes later…
The flame still burns white-hot behind my eye. Determined to win, I hunt down my Amerge. Knowing the medicine will take some time to work, I grab a cold grape-flavored AMP from the refrigerator, apply some Tiger Balm above my eyebrow, and try to relax. Sheer willpower sustains me for two hours until Baby Girl’s nap time. Mjia gets off early and takes charge of Baby Girl while I tend to the blaze now out of control in my head. Mentally adding up the hours, it occurs to me that the pain has lasted way too long. Cluster Headache attacks never last more than 3 hours. There should have been a break in the pain, even without treatment. Yet the boring eye pain still burns strong at an 8.5 out of 10…too long to be Cluster and too high to be Migraine. The absence of nausea, light sensitivity, or sound intolerance also mean this isn’t a migraine. Unrelenting, it burns despite all attempts to extinguish it.
The darkness of night falls.
Mija and Baby Girl went home hours ago. Hubby and #1 Son are fast asleep while I pace the floor in search of relief. Wiped out, yet held prisoner by “painsomnia” (pain-induced insomnia), I am only vaguely aware of the passage of time. I swap out ice packs, hot packs, Tiger Balm, essential oils, and vibration in a vain attempt to get ahead of the pain.
The 5:30 alarm signals it is safe to enter the bedroom without risk of waking Hubby. It has been 24 hours and I am desperate for relief. Grabbing a fresh ice pack and a dose of Phenergan from the mini-fridge, I swallow a Tramadol left over from last month’s orthopedic surgery with a wishful prayer for sweet relief. I climb into bed hoping that sleep will finally come. The pain medicine is a bitter disappointment. If strong painkillers can’t even slow the raging fire, an ER trip is looking more and more likely.
There are still two more options yet to try. I stare at an unused bottle of Hydrocodone debating the odds of a bad reaction. Experience has shown that Hydrocodone and I do not get along. Exhausted from searing pain and lack of sleep, I steel myself for the inevitable side effects. After all what’s uncontrollable itching, cold sweats, and non-stop vomiting compared to raging forest fire in my eye?
“I think I’ll risk it,” muttering, I swallow the pill.
There’s only one more card left to play.
Two hours later, shaking and irrational, I browse the ICHD looking for anything that matches my symptoms. In a brief moment of clarity, I relent and call the neurologist. His nurse answers the phone and I recite the shortened, clinical version of this story.
She puts me on hold for just a minute and returns with a stern “mother” tone to her voice, “Doc thinks you have a sinus infection. Get in to see your family doctor right away. If that’s not the problem, then call me back in the morning.”
THIS is a sinus headache?
My thoughts start racing.
I hadn’t even considered that.
I know I have a cold, but surely not a sinus infection.
I never get sinus infections.
I thought the headache experts say that most sinus headaches are actually migraines.
This sure doesn’t feel like any migraine I’ve ever had.
The pain and location scream “Cluster!” but nobody ever has a 36-hour Cluster attack.
Sheesh, now I feel really stupid.
Here I was going straight for strong pain medicines when what I need is some Sudafed and a round of antibiotics.
The clinic is about to close.
Hubby and I arrive just in time. The nurse practitioner on duty confirm my neurologist’s suspicions. Before we leave, she comments that she’s never treated me for anything except a migraine attack. Nothing has ever been bad enough to warrant an after-hours visit except an uncontrollable migraine attack…until today. I didn’t think anything could hurt as bad as a Cluster attack, but this sinus headache comes very close.
It’s been 48 hours.
Thanks to a dose of Sudafed, some hot packs, and Vicks in the vaporizer, my nose is almost clear and the boring pain is almost gone. My ears are still ringing and the room is still spinning, but at least the fire is out. Ten days worth of Augmentin and I’ll be good as new.
I’m so accustomed to head pain being the result of Migraine or Cluster Headache. I didn’t even consider an infection. Talk about tunnel vision! Winter is only half over, so learn from my experience. If you get a headache that doesn’t respond to pain medicine, get it checked out. I know we’re tough, but there’s no need to suffer when the fix is so simple. As much as we’d like to think we’re invincible, Migraineurs and Clusterheads are apparently not immune to sinus infections.