To expect an emergency referral to hospital?

[breaksinthedayforyou]

Unsure what department exactly but I've got some worrying symptoms.

Headaches, every day. Not migraines, although I'm getting those a lot more, but headaches with nausea. No appetite and being sick because of it, always having a slight nausea about me all the time.

I have become more emotional and snappy, very much something I don't do. And my vision has become more blurred at times.

I am really tired, and sometimes want to have a cry with just how tired I am, despite a good nights sleep.

For starters, I have suffered with migraines with aura (where I'd lose my eyesight and feeling in the left hand side), since about age 13.

By my late teens, these developed into hemaplegic migraines. They mirror a stroke - facial drooping, unable to string a sentence together, slurred speech, paralysis on one side, dizziness and clumsiness during at attack. I was referred to neurology who did an MRI. It was then ruled out as anything serious and diagnosed with hemaplegic migraines. I can't take meds for it due to a form of a minor heart problem I have that could have serious side effects on it

GP says there's no need to refer in as it's probably a side effect of having more frequent migraines. I said something feels off with it though, it's seperate from the migraines

He really seemed to disagree and said worrying would be giving me headaches too

He did agree to do a run of blood tests which all came back normal so tiredness not linked to anaemia for example, although I'm taking good supplements anyway

AIBU to expect a referral? I've tried getting an appointment with a different GP and got one today, who said he was a locum so couldn't refer but to try mindful breathing

The locum said as the bloods are all normal there's no need to panic and wait it out for a while and return if no change

I'm probably suggesting things that you've done before, but have you had your eyes tested? Have you found anything that triggers these attacks? Food/drink/screen/physical activity?

I've tried keeping a diary and no, nothing.

But the migraines are different to the headaches I'm getting daily at the moment, and feel very different. It's just the GP that made the connection

I do wear glasses to drive but my prescription has been the same for years and last checked 2 months ago, it was just routine and all the same

Sorry if I've missed it but are you peri menopausal?

My migraines are nauseous ones, are you sure it’s not just a different type of migraine

I will hazard a guess at no, I'm 28. But my periods have got further and further apart. One cycle they'll be 30 days, the next cycle 52 days! Then 40 days, then 38...

Bloods for all of that were normal and GP just said it can be a temporary hormonal shift

Not sure if relevant but last smear all clear and that was 5 months ago so nothing like cervical cancer etc causing odd periods

I'm not sure but they feel very different to my usual migraines

Not as severe, granted, but ads really getting me down because it's constant (the headaches) and I've gone from a size 16 to a 12 in about 3 months

It isn't unexplained weight loss, as the GP agreed, because I'm just not eating much. I constantly feel sick

Look into idiopathic intracranial hypertension. It fits your symptoms.

How dismissive of your doctor to say worrying will give you headaches. You had a headache before the worrying about the headache! Why is that so hard to believe?! Worrying can cause tension headaches but if you've already got a headache then why can't he treat that rather than saying your worrying is causing the headache??

They do sound awful and debilitating. Perhaps seeing a different doctor would help?

Thank you. Think I'm just going to push for a different GP

I look so much slimmer which is nice, but I am beyond miserable. I can't even drink a cup of tea, I want to vomit

It's just awful and it is every day without fail now.

I am a carer so being constantly nauseous and naturally then not wanting to eat much takes it's toll

My migraines have changed a number of times over the years and it's often seems to be progressive for some.

You may not be able to take triptains with your heart problems but a new drug called rimegepant has been approved by NICE this year and is safe for people with heart issues.

Have you tried any preventative medication at all? This could be helpful. Start keeping a diary as they will want to see one if you are referred. Normally for a referral you'd need to have tried and failed 3 medications, these are the NICE guidelines. You could maybe ask for one under the issue that this is new for you and that it's difficult for you to take certain drugs due to other issues.

But you don't want to see a neurologist anyway you need to see a headache specialist, sometimes these are in pain clinics. A neurologist doesn't always have anymore interest in headache then a GP, hence why you need a very specific specialist. I did see a neurologist before the pain clinc but all they did was send me for a scan to rule anything else out.

@MigGirl I agree with all that you have said there and I've heard of the new medication (I've seen some on my FB group say it's been a game changer)

However I am really wanted to see a neurologist as I am a tad worried this is something sinister like a brain tumour, however unlikely. This is due to the symptoms being every single day, unlike even the most persistent of migraines which usually aren't every day for most people, the symptoms being different to all my migraines and the fact my vision and personality in parts has changed

I've had hemiplegic migraine since puberty and been through similar to you. I was even prevented from driving for 6 months whilst the NHS worked on a proper diagnosis. MRI scans, neurological investigations etc. Nothing worked, BUT since becoming menopausal and getting a good HRT treatment I have had maybe 1 a year instead of 1 a week.

This is lovely news for my migraines! You are about the 5th person to say they've become so much less frequent with menopause

They've honestly ruined so much of my bloody time and life as a whole. I have often fantasised about a hysterectomy to get the fuckers under control

Agree with PP that it could be idiopathic intracranial hypertension.

Yes I agree that with the change they should really check you out. But I have had periods months/years with pain every single day and have come across many others with chronic migraine who have experience this to. Although they always say changes should be investigated.

Maybe a referral to a headache clinic might help.

@breaksinthedayforyou see another GP. If their response is the same as the others, smile sweetly and politely note that you understand but could they please note in your records that you have expressed concern and would like something sinister ruled out but three GPs have now refused. Then watch howbfast it is until they hit the refer button and ask you to whom you'd like to be referred.

Or you pay privately.

I’m a GP and I would refer you for an MRI brain scan. See a different doctor and explain that you’re really worried about a brain tumour and ask for a scan.

How long has this recent episode being going on? Not to dismiss your worry, but how sure are you you're not pregnant?

You need to get your sex hormones profiled.
Like you, my headaches were awful, I ended up going to A&E and being given codeine just to make the pain stop for a few days.
GP took me seriously after that and some tests revealed i had pcos. Referred to gynae endocrinologist who saw my progesterone was non existent, oestrogen high and testosterone double the highest level for a woman.
Hormone therapy cured my headaches practically overnight. I now occasionally get a headache once a month, usually a week before my period.

I’d be concerned re the vision issues coupled with headaches and nausea.
if you’ve had a recent eye test and an OCT scan which can be done at opticians and normal I think I’d want a head scan too.

I'm a GP too and would also get you an MRI of your brain. Speak to someone else.

Are you by any chance taking iron tablets? I had these exact same symptoms and it was the iron tablets I was taking. Symptoms went as soon as I stopped taking them.

What's your blood pressure?

Was you ever under a neuro consultant for your migranes?

Different thing completely but I was suffering with pain more than ache in my head and was referred to neurology, a specialist who deals with headaches and was diagnosed with cluster headaches. She done mri ect and gave me medication and wrote to my GP ect. Last year I had to have cranial steroid injections after that she asked me to keep on my medication and keep the oxygen tanks at home and tell my GP I know more than he does and if I get worse at any time to call her secretary that was last October and I called on Friday to say I was in a cluster attack can I have injections and I've been in today and had them because as a sufferer you are never clear and GP's just don't get it really. If you were ever under neuro definitely try and get in touch.

I'd been going to my Gp for months begging for help, seen every doctor in there and one day wanted to end it, I couldn't live like this and seen a locum doctor who done an urgent referral to neurology, as hard as it is cos they don't know you or the surgery I think they will do more as they aren't budgeting or saving costs I've had 2 major illnesses flagged by a locum. Hope you find a solution soon.