Ask The Doctor

Dear Ask The Doctor: Hi. I'm a 24 year old female who has had a throbbing headache for the past 48 hours. Its debilitating. I can't concentrate on anything, but when I just lay in bed it hurts and I can't stand it. I've tried taking tylenol and advil, but it doesn't make a difference-I also took half a methadone pill my friend gave me but that didn't help either (I wouldn't normally ever take something that isn't prescribed to me, but I'm desperate). I have other symptoms too: dizziness, general weakness, a fever comes and goes, bright light and shrill noises really bother me, and when I try to eat I get sick to my stomach. Sometimes the headache is dull and sometimes its very sharp and focused. It is concentrated in the right front of my head but moves to the left and sometimes back. I can feel my heartbeat in my head when its really bad. I can't lean or bend over without it becoming more intense. I thought it could be a migraine, but I've never had one before and I don't know how long they could last. I am under a little bit of stress but not an extreme amount, nothing that's too hard to deal with, and I've been under much more stress many more times in my life so I don't think its related to that.. I've been laying in bed the past 2 days and I want to get back to my life, but I can't do anything. I would go to a doctor, but I don't have health insurance-I just graduated college in May and haven't found a job yet... Thanks for your time.

Dear Am: I agree with your initial approach of rest and over the counter medications for the first 24-48 hours.  As you mentioned, I also disagree with taking prescription medications not prescribed to you.  However, any time symptoms that persist for more than 48 hours and are not improving, a thorough history and physical are required to rule out any conditions requiring emergent attention.

I strongly suggest you see your family physician today.  In your case, migraines and stress or both are a possibility but other more serious causes must be ruled out.