Question
Dear Margot,

Today is the 6th day in a row I've been nearly incapacitated by a headache at the back of my head. It throbs in rhythm with my heart and causes a total loss of appetite and vomiting. I have no history of neck (cervical# injury, however, my thoracic spine was diagnosed with Scheurmann's disease by the spinal surgeon who performed a laminectomy at the L3-4 level, along with a posterior fusion at the L5-S1 level in 1987. That was the 4th of 5 spinal operations I had; the first was in 1981 following a fracture at the T12-L1 level after ejecting from the US Navy fighter jet I was piloting #the pilot who "bumped" into me during exercise, unfortunately died). I was very lucky to have not been paralyzed (though the spinal shock initially did paralyze me from the waist down for a relatively short period) by this accident.  I had a series of 3 spinal operations in the Naval hospital, Bethesda Maryland, involving bone fragment removal, laminectomy and stabilization from T11 to L1. Fusion was considered, but not utilized, however, the body cast I had to wear for some 6 months allowed so little movement that the facet joints at the T12-L1 level fused naturally. My career as a pilot in the US Navy was over, so I moved to Australia with my Australian wife.

5 years ago (2004), I started experiencing severe low back pain with "electric shocks" going into my left knee. An MRI confirms that the L4 disc is herniated, and protrudes left-anteriorly resulting in a spinal canal stenosis with left sided sciatic nerve impingement. I was offered surgery some 4 years ago, but I opted out at the last minute - I was genuinely afraid. Surprisingly, my surgeon was not at all displeased by my decision, so he referred me to the pain clinic to try  a "more conservative" approach. I was put on oxycodone which helped tremendously, however, I developed persistent constipation along with itchy rashes from head to toe, so I ceased using it. I now only use aspirin and/or tylenol (sometimes with codeine in the recipe)and have no more rash or constipation.

These headaches have been part of my life from puberty (I'm 54). They all are situated in the back of my head, in fact I've never, ever had a headache anywhere else. I stress again that they incapacitate me. I cannot go out, eat, sleep, or function as a normal human being. I am becoming depressed and introverted to the point of sheer apathy. I even have thoughts of suicide when I'm hit with this horrid pain/nausea. At wits end, I decided to ask here what you recommend. I mentioned these headaches and a more recent development of totally numb hands that wake me up so I can twist my neck into a position that wakes them up again to the pain specialist. He ordered an MRI of the cervical spine which I had over 4 months ago. I still await the promised appointment for a review of same. Every time I call to ask when I would be sent the appointment, I get "soon" as an answer from the receptionist. It's getting worse and worse, and I can't seem to get that point across when I call. Either they don't care, or they are simply too busy. The medical system in Australia is socialized and cost free, by the way. Yours sincerely, William Alexander

Answer
Hi William and thanks for writing,

Wow, you certainly have had a complex history of neuro-spinal symptoms and injuries, it makes it a bit challenging to pinpoint the cause of the headaches.  I am caught by the fact you said you抎 been having these base-of-skull headaches since you were a teenager though, long before any trauma to the spine (unless there was another traumatic incident pre-puberty I抦 not aware of)?  If these are the same headaches (and you抎 be the one to know), were they never investigated before as they were so severe?  I抎 even go out on a limb here to suggest the numbness in the hands is not related to the cause of the headaches as it抯 a new symptom and more likely due to pressure on a cervical nerve due to vertebral deterioration (like arthritis which would not be surprising in your situation).  I worry that the latest MRI may identify the cause of the hand numbness and figure the headaches are caused by this too so I recommend you make sure the doctors know these are two separate events most likely with separate causes.

Has anyone ever ruled out allergic migraines for you?  As the western medical physicians are doing the advance spinal workup, I recommend you also seek alternative routes to identifying the cause of your headaches.  I would suggest you find a good Homeopath or Naturopath in your area and get tested for allergies.  Now a lot of people think 揳llergies?are just what kids get when they eat peanuts or if you get Penicillin and go into anaphylactic shock, but those are only the most severe end of the spectrum, most allergies and intolerances are far milder and often display as GI upset or headaches.

I grew up in a family of doctors and nurses and always believed western medicine was the be all and end all for treating ailments, but my 20+ years of experience as both a practitioner and a patient has taught me differently.  Believe me, if I am in a car accident and have a severed limb, I certainly want to be taken to the ER for all the wonderful treatments western medicine can offer, but I have also come to see how firmly welded on their blinders are when it comes to alternative treatments and therapies.  At the same time, there are still quite a few quacks out there ready to take hard-earned money from people desperate to find a cure for their chronic ailments, so do our due diligence and research to find a reputable practitioner.  My other piece of advice is to get the testing done, but watch out for those people who just want to sell you their vitamins or snake oil.

All this aside, Homeopathic and Eastern Medicine does have a lot to offer and often the 揷ure?is simply deleting a few foods from your diet.  Often the foods were are most allergic to are the same foods we crave ?if you love cheese, or ice cream, they may be the culprit.  Have the allergy tests doe and try to follow their recommendations for three months and see how you feel ?you抳e got nothing to lose!  I also recommend you do buy one thing, some drops called Pollinson (a natural antihistamine).  Keep them with you, and the minute you feel a headache coming on, take 20 drops.  

I used to have debilitating headaches too, 24-36 hours of bed-ridden, heart-pounding, back of the head, excruciating pain which ended with 6-8 hours of nausea and vomiting to the point I would have taken a pill just to make it stop too.  I tried all the remedies my GP suggested (and I like and respect my GP) but nothing worked, I went to a Homeopath and a Naturopath; one gave me a list of dozens of foods to avoid (which in all honesty I found very challenging to follow), and the second recommended the Pollinson drops.  The simple physiology is that when we are exposed to (or eat) something we抮e sensitive to, our body reacts with an immune response and releases histamines which in turn triggers the inflammatory response; this is often the culprit which causes our symptoms (headache, diarrhea, shoulder ache, etc).  If we take the Pollinson as soon as we feel the headache starting, we can often stop the whole response and avoid the headache, or at least decrease it抯 severity.  Now this will not work every time of course, some headaches are just headaches, or at least that is the experience I and several friends/colleagues have had; but I have found that it works probably 75% of the time, and that抯 great in my books.  Some people also find acupuncture and reflexology work for them, but I wasn抰 so fortunate.

I hope these suggestions have helped, and I hope you find a way to treat your headaches soon ?I know how horrible it is to live with this kind of pain.  You might also ask your GP for some anti-depressants to help you stop feeling so blue; your depressed feelings are a legitimate reaction to the pain, but they抮e still treatable and like any other symptom, why suffer if you don抰 have to?  Don抰 be shy or embarrassed, you抳e been through a lot and feeling blue is perfectly natural.  And I would also keep on at the western doctors that the hand pain is new, but the headaches are not, so don抰 lump tem in together.  Just because you seek alternative treatments is not to suggest you stop letting the western doctors from doing whatever they can too.

All my best,
Margot