EPTAs most of you know, I'm an ER doctor, so I know my way around a headache quite well. But not only as a doctor... as a patient, too...
You see, I've been under treatment for migraines for over 4 years. Migraines are a very specific kind of headache, in which the pain presents itself on only one side of the head, and may or may not be preceded by random symptoms called 'auras'.
But this pain was different.
![[image loading]](http://farm3.staticflickr.com/2150/2189803492_8ef3b28667_z.jpg?zz=1)
Yeah, I know I don't look like Barbie, and I'm a dude, and that's not the most accurate depiction of a migraine...
My headaches are usually on the left side of my head, and before one, I always have a symptom called 'photopsia'; that means I see lights on my visual field, always on the same side in which the pain presents.
![[image loading]](http://www.alsurinforma.com/wp-content/uploads/2010/03/fotopsia_.jpg)
An 'almost' accurate depiction of what photopsiae are
This time, I didn't have any of that. And the pain was on my right side, right behind my eye socket.
Being on the ER, I asked the attending EMT to put me on a saline sollution with Ketorolac and some Hydrocortisone for my pain. He quickly gave me an IV access and started the saline drip with the meds. I called a colleague to cover the ER for me for a few minutes while I recovered... So I went straight to our residency, and laid down on the couch, covering my eyes because the light was just unbereable. So I stood there, trying to rest, waiting for it all to go away...
Or so I thought.
![[image loading]](http://3.bp.blogspot.com/-0-6esYIOAmE/T4Qwpq5kzdI/AAAAAAAAAE4/29vNKaos71w/s1600/30-minutes-660x360.png)
Thirty minutes later...
... My colleague came into the residency to see if I was ok. I was still in pain, and he lifted the blanket off of my face and asked "how you doin' mat... What the fuck???..."
![[image loading]](http://media.tumblr.com/tumblr_m7mp8qChY31rttxvx.jpg)
My colleague's face. It wasn't a very comforting thing to see...But wait, there's a twist on this...
... I instantly noticed there were only not one, but TWO colleagues of mine. Yes, I was seeing double. That's called dyplopia. He said "dude, your right eye is pointing up and outwards and your right eyelid is partly shut... Are you feeling ok?"
![[image loading]](http://usmlegalaxy.files.wordpress.com/2011/07/face.jpg)
That's sort of how I looked. Only the patient on this picture has her left eye partly shut and with a lateral deviation of the stare... Mine was upwards and outwards, and it was on the right eye.
He gave me a quick neurological examination. I happen to like neurology quite a lot (I want to do my residency on neuro)... So my mind was racing thinking of possible diagnosis:
"Carotid synus anneurysm... Carotid synus dissection... Carotid synus thrombosis... Multiple Sclerosis debut... Giant cell artheritis... Encephalitis... Tolosa-Hunt syndrome... Internuclear ophthalmoplegia... Brain tumor... An ophtalmoplegical migraine..."
My colleague then shouted loudly "HEY DUDE! PAY ATTENTION! WE'VE GOT TO GET YOU TO THE CLINIC, YOU'RE GONNA NEED AN MRI, I'M CALLING A NEUROLOGIST I KNOW!..."
For the first time in my life, I became a patient being the attending physician at the ER. And a patient of something that could be potentially, very, very bad... For the first time in my life I felt real fear, actual fear. I knew I could die of some of the things that could be my actual diagnosis.
My colleague hopped into the ambulance with the ER's EMT and rushed me to a private hospital 20 miles away.
Got my neurological consult as soon as I got in the clinic's ER. 10 minutes later I was getting my MRI. An MRI is actually a machine consisting in a giant magnet which generates a magnetic field (duh) of 1.5 teslas, and without using radiation in any way, provides with very high resolution images of whatever you might need. In this case, my fucking scumbag brain.
![[image loading]](http://web.securityinnovation.com/Portals/49125/images/MRI-machine.jpg)
This is an MRI machine. It's kind of a giant sarcophagus, very tight in the tunnel. And very noisy and loud too, you have to wear ear protection in it...
20 minutes later, I was admitted into the NEICU (neurological intensive care unit), and I was getting a lumbar puncture. Now, as an intern and as an ER doctor I've performed HUNDREDS of them, but never got one myself. I now look at the procedure with different eyes, since it's the MOST FUCKING PAINFUL THING I've ever been through.
![[image loading]](http://www.umm.edu/graphics/images/en/19078.jpg)
A lumbar puncture depiction. It's basically when a doctor puts a giant needle through your spine and extracts a bit of cerebrospinal fluid... Yeah, very nice. Very fucking nice indeed... Ouch.
A few minutes later, nurses came into my room to draw some blood for multiple tests.
And here I am, hospitalized. With my right eye covered in order to see the world in a single image (seeing double is the most hideous thing ever!)... With my mom and dad, which brought my my laptop for me to keep studying and writing and to stay in touch with my friends...
I try to keep them calm, because they're scared of what's going on. They don't know a lot of medicine (my mom is a nutritionist, my dad is an agronomical engineer) so I'm kind of feeding them data along with my attending doctors to keep them calm...
Although I'm scared shitless myself. The two worst things were already put out of the question, and that is calming. But there are also bad things which are still on the table. And I'm waiting for the last exam results to come in to be sure...
Being a patient is tough. I forgot how it was like. And being ill of something which nobody is sure of what it is, trying as fast as they can to exclude all the worst possible ones, isn't really comforting at all...
So I'm scared, guys.
What are you supposed to do when you're a doctor who needs another doctor?
Life is very strange indeed. The bitch puts you on a paradox when she's in the mood.
I'll update later when I know what the fuck is wrong with me, as soon as the neurologist and my treating team pay a visit to me with the latest test results... I just thought I should let you guys know... :/
UPDATE:
So my neurologist came this morning to pay me a visit.
Spinal tap turned out OK, all blood tests were OK. He brought my MRI pictures along for me to watch with him, since he heard I'm into neuro...
The first thing I noticed was my right 3rd cranial nerve (the oculomotor nerve) was kind of fuzzy and crushed in my right eye socket. It was precisely that: I have an ophtalmoplegic migraine, which compromised my right 3rd cranial nerve.
So he put me on corticosteroids, upped my Topamax dose, and discharged me with 1 week-leave and rest.
![[image loading]](http://i93.photobucket.com/albums/l42/winters_host/scumbagnerve.png)
Scumbag oculomotor nerve...
Afterwards my mom and dad came in to listen to the good news. I'm not a very expresive dude, so giving a long hug to my mom and dad was a really nice, calming thing for all of us.
Luckily, there's nothing so incredibly bad wrong with me. I just happen to be one of those people who have bizarre medical conditions that are very annoying, very painful, but benign.
Thanks to everyone who has expressed their support either here or on my Facebook page, or those here in Chile who have been worried about me. It really warms my heart to know that so many people care for my well-being.
Thank you guys. This is why TeamLiquid is so goddam awesome ♥ ♥ ♥
Just make sure you lay flat for a little while so it doesn't suck even more!
. I had my arm frequently fall off the socket, they called it "luxação recidivante" in Portuguese. Is "recurrent discolocation" the correct English medical term?
