History from May

I thought to start it might be helpful to have a completed history since I have to have a starting point.

Symptoms:
Tuesday May 29th, 2007
Began having issues with balance and dizziness.

Wednesday May 30th, 2007
Issues with balance and dizziness.

Thursday May 31st, 2007
Issues with balance and dizziness.

Friday June 1st , 2007
Issues with balance and dizziness. In the evening begin to get a headache on right side above right eye brow. Very tired.
Saturday June 2nd, 2007
Issues with balance and dizziness. Fuzzy/groggy feeling like I just woke up doesn’t go away. Very tired. Continued to have headache on right side above right eye brow. Balance so bad by 10:00pm don’t feel safe walking.

Sunday June 3rd, 2007
Issues with balance and dizziness. Continued to have headache on right side above right eye brow. Fuzzy/groggy feeling like I just woke up doesn’t go away. Very tired.

Monday June 4th, 2007
Issues with balance and dizziness. Continued to have headache on right side above right eye brow. Fuzzy/groggy feeling like I just woke up doesn’t go away. Pain in my left forearm down to ring finger. Difficulty speaking and putting thoughts together. Left eyelid twitching in the morning. Blurry vision and unable to focus in the afternoon. Went home from work called and made doctor appointment for next day. Itching all over no rash. Very tired.

Tuesday June 5th, 2007
Issues with balance and dizziness. Continued to have headache on right side above right eye brow. Fuzzy/groggy feeling like I just woke up doesn’t go away. Pain in both forearms from elbow to ring finger. Itching all over no rash. Very tired. Went to doctor (Dr. Fadi Yacoub, Internist). Ordered basic blood work and CT with and w/o contrast (wanted MRI, but thought could not because of plate in my neck from a spinal fusion in September of 2006).




Wednesday June 6th , 2007
Issues with balance and dizziness. Continued to have headache on right side above right eyebrow. Fuzzy/groggy feeling getting better. Pain in arms better, still having problems with motor skills/dexterity especially with small objects like a stylus. Itching all over, no rash. Very tired. Contacted surgeon, Dr William Roberts who did the spinal fusion-says plate in my neck is titanium and can have MRI and would recommend it as symptoms would not relate to fusion surgery. Had follow up appointment with Dr Yacoub. Nothing showing on CT, blood work fine. Ordered MRI at RCI for next day.

Thursday June 7th, 2007
Issues with balance, dizziness, headache, fuzzy/groggy feeling all feeling better-but not gone. Pain in arms gone. Itching all over, no rash. Very tired. Have MRI at RCI.

Friday June 8th, 2007
Issues with balance, dizziness, headache, fuzzy/groggy feeling all feeling even better-but not gone. Dexterity issues almost normal. Speech better as well. Itching all over, no rash. Not as tired. No results back from MRI.

Saturday June 9th , 2007
Issues with balance, dizziness, headache, fuzzy/groggy feeling all feeling even better-but not gone. Dexterity issues almost normal. Speech better as well. Itching all over, no rash. Not as tired.

Sunday June 10th, 2007
Some nausea, slight headache in same spot on right side. Loss of appitite. Vision problems with tracking, balance issues come back. Itching all over, no rash. Very tired again.


Monday June 11th, 2007
Issues with balance and dizziness (almost fell twice). Headache on right side above right eyebrow returns as well as vision tracking issues. Itching all over, no rash. Very tired. Report from Dr. Yacoub’s backup; MRI looks normal, not comfortable prescribing migraine medicine based on symptoms, suggests Excedrin Migraine - refers me to Neurologist, Dr. Laurence Krain. (Took 1000mg of Walgreen brand of Extra-strength Tylenol instead b/c of caffeine in Excedrin Migraine-did not help headache).

Tuesday June 12th
Same issues with balance and dizziness, headache on right side above right eyebrow, as well as vision tracking issues. Loss of appetite. Itching all over, no rash. Very tired. Tried taking Vanquish (same Excedrin Migraine with less caffeine)-help was not significant.




Wednesday June 13th, 2007
Same issues with balance and dizziness, headache on right side above right eyebrow, as well as vision tracking issues. Loss of appetite. Itching all over, no rash. Very tired.

Thursday June 14th, 2007
Same issues with balance and dizziness, headache on right side above right eyebrow, as well as vision tracking issues. Loss of appetite. Itching all over, no rash. Very tired. Concentration issues as well. Appointment with neurologist, Dr. Laurence Krain. Thinks headache is more than tension headache but would not classify as migraine as I don’t have the major symptoms. Prescribes Nortriptyline HCL 25mg-1 caplet at bedtime, increase to 2 caplets if helps headache. Orders MRA of head as well as additional blood work (?ESR, ?ANA, Lyme).

Friday June 15th, 2007
Unable to function b/c of extreme tiredness, slept most of the day and night. Medication knocks headache back. Still have some pain 2 to 3 times on each side of head-lasts for less than 5 minutes on right side less than 2 minutes on left side. Still having problems with dizziness and itching all over. Had MRA at Mercy

Saturday June 16th, 2007
Able to do approximately 1 hour of light yard work. Felt overheated and very unstable on my feet. Went inside and stayed there. Very tired. Slept for several hours. Some pain 2 to 3 times on each side of head which lasts for less than 5 minutes on right side less than 2 minutes on left side. At bedtime have a headache on right side that lasts for 20-30 minutes took Nortriptyline and went to bed with headache, gone in the morning.

Sunday June 17, 2007
Light issues with dizziness. Slight pain in my head on both sides about 1 to 2 on a 1-10 scale-easily tolerable. Having some thought and speech issues.
Evening – Pulse has been between 100-112 today. I can feel my pulse in my head. Headache across the entire top of my forehead with a pain level of about 4.


Monday June 18, 2007
Morning – Dizzy, same all across fore head headache but pain lot less 1 or 2 maybe. Going to work. Headache most of the day left side, mostly right by the afternoon. Feels like pressure across my upper forehead. Tingling in my right and left cheeks and scalp.
Spoke with Jamie McDonald, MS, Licensed Genetic Counselor University of Utah Medical Center – Co-Director of the HHT Clinic today. Pager 801-339-8138 Phone 866-292-4448. She requested I have an Echocardiogram with contrast to determine the presence of a Pulmonary AVM. Called and talked with Karen(Dr Yacoub’s nurse) and she was going to relay all of the information and call me back tomorrow. Kelly dropped off the an HHT article, family history and symptom history to date to Karen .

Tuesday June 19, 2007
Morning – felt good just pressure in my head across the forehead. Still balance and dizziness issues. I am either getting used to the way I feel or I am getting better.
Afternoon – Unfortunately I am just getting used to it. Have had a headache since about 11am on the right side mostly and across the top of my forehead to go along with the pressure. I have been having trouble speaking all day not affecting my job but getting close. I also forgot to mention in the morning that I have been having some memory problems. Forgot to rinse conditioner out of my hair etc. I am just getting to where I am worn out by the time I get home. Want to have a beer but can’t because of the medicine that doesn’t work that great but is better than nothing. Talked with Karen and Dr P who is filling in for Dr. Yacoub is ok with getting the ecocardigram done but wants confirmation from Dr. Yacoub who is still on his honeymoon. Left Karen another message but did not hear back.

Wednesday June 20, 2007
Woke up with a terrible headache about 7 on the scale in the top of my head on the left side. Hurts the most when I bend over.
Afternoon – Just got home from the hospital had a shot of deloded, anti-nausea meds, and liquid benadryl. Had a chest CT that showed no large AVM’s. Have a echocardiogram scheduled for Friday at 2pm.

Thursday June 21, 2007
Woke pretty groggy but after that I have felt better today than I did May 29th. I have had 2 times today when I have had a headache. In both cases it lasted less than 2 minutes. I have had tons of energy. No issues with dizziness or balance issues. Still itching all over. Things did feel a little surreal at times like I was just moving way to fast.

Friday June 22, 2007
I had a good day. No headaches. Had the Contrast “Bubble” Echocardiography today and it showed the “bubbles” passing from one side of the heart to the other.

Saturday June 23, 2007
Most of the day went well. I did end up having a headache late in the evening. I took Hydrocodone in addition to the Nortryptelene I take every night.
Sunday June 24, 2007
I worked outside most of the day and felt really good. I ended the day again with having another headache. I took the Nortryptelene at my regular time. I have since gotten another headache and I have take the Hydrocodone again.

Monday June 25, 2007
I woke up with a headache in the front right hand side above my right eyebrow. It feels more like a sinus headache. I went through most of the day with the headache disappearing and reappearing. Did not take hydrocodone.

Tuesday June 26, 2007
I woke up with a headache. I have felt strange most of the day. Just not feeling like I am 100%. Still have a slight headache. My hands feel like the skin is tight, like they are swelling but there is none, especially around my fingers. Headache is on the right side just above my right eyebrow. On the scale of 1-10 it is only about a 3. Talked with Jamie McDonald at the HHT clinic in Utah today and we will be making an appointment this week. Met with Dr Yacoub and he is having me try Cymbalta rather than the Nortryptelene. I will start that in the morning. I did get a second headache in the evening that I went to bed with it got to a 5 a one point.

Wednesday June 27, 2007
I woke up and was very tired. I did not take the Nortryptelene in advance of switching to the Cymbalta which I took this morning. I have had a headache since I sat up this morning. This morning I feel very frustrated. Nobody but Jamie wants to see that the possibility of a PAVM is my issue. Everyone else seems to just think that it is a migraine based issue and so far the treatment sucks. I really hope the new meds work. The only side effect that I need to worry about is nightmares. I did feel weird this morning same as yesterday. Something that I have not noted but for the last 8 days I have had tingling in my neck and radiating out from my shoulders from time to time it is my whole head too. This may just be a result of the cervical fusion but felt I should note it.

Thursday June 28th
I had a headache when I woke up but not until I stood up. The Cymbalta seems to have a different effect. It speeds me up rather than making me tired. I had the headache all day through the evening and until I went to bed. The pain level was about 3 at it’s highest point which was later in the evening.

Friday June 29, 2007
Went all day without a headache. Odd thing was I cleaned the garage today and I still did not have any issues with allergies. I haven’t had any allergy symptoms since the headache started. We went to the races tonight and for some reason my heart rate went up to 120. We left early. About 30 minutes after my heartrate went up I started getting a headache. It got worse all the way home. The pain is about 5. I took hydrocodone.




Saturday June 30, 2007
I woke up with a headache across the middle of the top of my head. I now have it in my temples and in the same spot in the right above my eyebrow. Took my Cymbalta late about 9:45am.

Sunday July 1, 2007
Took my Cymbalata late again. I had an all around good day. No headaches of note some off and on pain but nothing lasting more than a few minutes. Went to bed with out a headache

Monday July 2, 2007
Took my Cymbalta late again. I have had a couple of headaches today. Have had a lot of stress with Dad’s medical needs coming up. None of the headaches lasted very long no more than 10 minutes at a time and did not go above a 3. Got great news about Dad at about 2:30. He does not have to have brain surgery until September. No emergency and the surgeon has removed all restrictions. Weird experience tonight though. I had some nausea for the first time with a headache. My body temperature also spiked. I was burning up but my feet were ice cold. My head was pounding at about a 7. My wife put a cold rag on my head and with that I could at least get to sleep.

Tuesday July 3rd, 2007
I woke up with a headache. Pain was only about 2 went away for a little while only lasted about 2 hours. Came back in the afternoon still on the right side above the eyebrow and seeming to have it there and on occasion above the left eyebrow would kick in for about 5 minutes at a time. It stayed at about a 3 to 5 most of the afternoon. We did some work when I got home outside in the heat. I started to notice today and have reflected back that if I focus very intently on a task I can either make it to where I don’t feel the pain until I am done. My headache came back. We watched a movie and by the end of it my pain was about a 5 and I could feel my pulse in my head. I also had the body temperature thing happen again. Not as bad as the night before. I used a cold rag again and was able to go to sleep. Since the Cymbalta I have been able to sleep through the night except for getting up to go to the bathroom once a night.

Wednesday July 4, 2007
I woke up with a headache at about a 3 it is down now to a 2. Felt some dizziness throughout the day. Took a nap felt pretty groggy for a longtime. Had a headache from about 7pm until bed and also had the body temperature go up and felt clammy.

Thursday July 5, 2007
I had a headache most of the day. I had problems in the afternoon with focusing on things with my eyes. The pain stayed about a 3 and would throb at a 4. I had the problem with my body temperature again in the evening. It started about 8pm which was earlier in the evening than the past 2 nights. I have been taking 2 of the Cymbalta since Wednesday morning.

Friday July, 6th 2007
I was very groggy this morning. I had a 1 level headache most of the day. I took a nap when I got home about 2pm I slept until about 5:30pm I was very sweaty when I woke up. I have continued to have overheating issues at night especially. I lay down again after dinner. When I woke up I watered the lawn and some flowers. Once I sat down after the activity I had a level 3 headache. I went to bed shortly afterwards

Saturday July 7, 2007
I felt pretty good when I woke up. Lately the headaches seem to be a throbbing and it only seems to hurt when it does throb. After my heart rate increases I get a headache. We went to the races this evening and after each event that our nephews ran my headache would get worse. My heart rate always goes up when they race.

Sunday July 8, 2007
I slept in very late and took my Cymbalta at 11am. I have had a headache since I got up. I was working at the computer this afternoon and all of the sudden the hearing in my right ear was gone for about 5 seconds ending in a ringing in my ear. My headache immediately went from about a 1 to a 3 hurting above my right eyebrow and for the first time in my right cheek. I went in to tell Kelly and it did it again for about 5 seconds again ending with increased pain and ringing. I decided it was a good time to document it. This happened right about 3pm today.

Monday July 9, 2007
I had a pretty good day. Small headaches through out the day. By the late afternoon it was worse to where I could fell throbbing. I only could feel it though at the pulse or peak of the throb. It has gotten worse as the night goes on. I have had two instances were words were blurry to me that I could read normally and earlier in the day. I am going to take a hydrocodone and go to bed.

Tuesday July 10, 2007
This morning my headache is not there it is more like a pressure inside the front of my skull. Unless I state it is in a different area it is above my right eyebrow. I am having to force my eyes to focus. I had a headache most of the day. It never got above a 3 but was there all day.

Wednesday July 11, 2007
I had a headache when I woke up that got worse as the day went on. I ended coming home from work with it being about a 5 on the scale. I took a hydrocodone. I slept the rest of the day ate dinner and went back to bed.

Thursday July 12, 2007
I again woke with a headache it ended up about a 4. I was able to make it through the whole day at work but it wiped me out and I was in bed early. I took another Hydrocodone.



Friday July 13, 2007
I had a better day. I only worked a half day which was scheduled. I did end up with a headache before bed about a 2.

Saturday July 14, 2007
Had a headache all day about a 2 it went up to a 3 before bed. I did not take anything and was able to make it through most of the day without an issue. I did have some dizziness at times throughout the day but was able to tolerate it ok. I had some shortness of breath and some pains in my chest as well.

Sunday July 15, 2007
I worked outside all day and was able to function all day. I did have some dizziness and was light headed a few times. I was exhausted by bedtime but had trouble getting to sleep. I have continued to have issues with my body temperature going way up at night.

Monday July 16, 2007
I had a pretty good day. My headache was about a 1 all day and I was on getting a lot of stuff done at work.

Tuesday July 17, 2007
I woke up with a headache that was about a 3. By the afternoon it was on both sides at about a 4. We went out to eat and I drank a margarita and by the time we were heading home I was having vision problems. I went to bed when I got home.

Wednesday July 18, 2007
I woke at 4:50am with a throbbing headache. I had been force feeding myself water through out the night to get the alcohol out of my system. It was about a 6 on the scale it continued to be that way through the whole day. It was on the right and left sides and was not good. I tolerated it through the whole day. I took a hyrdrocodone about 8pm and went to bed soon after.

Thursday July 19, 2007
I woke up with the same headache most on the left. Left side is about a 3 right side is about a 1. It got worse in the morning. I started having problems with my vision and balance again. The pain got up to a 6 and I made the decision to go home from work. I took hydrocodone and went to bed. I got up at around 5pm and ate dinner. The headache on the left side was gone but the right side was still there and about a 5. I took another hydrocodone. I stayed up for a little bit. Around 7pm I got very nauseated. I went to bed. I was freezing cold and sweating at the same time. I went most of the night with seating and then getting cold. It was like I was breaking a fever only to have another one.





Friday July 20, 2007
Had a headache, about a 3, when I woke up this morning. It is gone now but I am very groggy. I had a couple of headaches in the regular right side area. I did not have anything above a 2 until about 10:30pm. I had talked with Dr Yacoub’s office and he has added Lyrica add bedtime. I took that about 10pm and by 10:45 I was getting dizzy and having blurry vision which are side effects of the medication. I went to bed.


Saturday July 21, 2007
Woke up this morning with no headache and just a little bit of pressure. This is the first time in a long while that I woke up without a headache. I slept through the night for the first time in months without the use of the hydrocodone. Most of the day I had either a little pressure or nothing at all. I took my Lyrica at 11pm and I had a headache at 10:45pm and then I could feel my pulse again in my head.

Sunday July 22, 2007
I did not have a headache when I woke up this morning. I took my Cymbalta at about 9am. I had a good day without a headache. After vacuuming the basement I had some vision problems with words shaking and being blurry trying to read the newspaper. I was fine watching a movie though. I took my Lyrica at a little at 10:15pm. I had the same affect as yesterday. With a headache in my right front and the rear base of my skull.

Monday July 23, 2007
No headache again this morning but I need to take my Lyrica medicine earlier because I have some issues this morning. I had problems with my vision being blurry and big problems tracking. I was about falling down when I was walking.

Tuesday July 24, 2007
I had a pretty good day. I had three headaches today all below a 2. I took my Cymbalta on time and my Lyrica on time. I had a headache about a 3 at around 10:30pm at a 3 or 4.

Wednesday July 25, 2007
I had 2 headaches today they were both about a 3. I took my Cymbalta on time and the Lyrica on time. I again had a headache late at a 4 this time about 11:00 when trying to get to sleep. Since starting the Lyrica I am still having issues with being really hot about an hour after I take it.

Thursday July 26, 2007
I had a headache from 2;00pm until I went to bed at 3. I took the Cymbalta on time and the Lyrica on time as well. I was again really hot at night.

Friday July 27, 2007
I had a headache at about 2:30 after doing a lot of house cleaning at a 4. I slept for an hour and was a lot better. I took my Cymbalta on time. I took my Lyrica an hour late in the evening and had a headache at 10:30 at a 3 and went to bed.

Saturday July 28, 2007
I took my Cymbalata late in the morning 3 hours late to be exact. I did not eat all day other than a breakfast bar. I ended up with a headache starting at 1pm. At 1:24pm I lost hearing in my right ear for 5-7 minutes. By 4pm my headache was at a 6. I laid down for an hour and when I woke up it was at an 8. I took Hydrocodone and went back to bed until 6pm. I ate and went back to bed around 7pm. I took another Hydrocodone with my Lyrica at 9pm as my headache was only down to a 6. I slept through the night.

Sunday July 29, 2007
I woke up and 5:45am with pain in my right eye. I got up and took my Cymbalta at my normal time at 6:30 am and went back to bed. I had a little bit of a headache when I woke up at a 2. I have had a instances where I don’t have a headache and I will get a spike of pain in the spot above my right eyebrow. It will be about a 4 but only lasts 2-3 seconds and it is gone.

Monday July 30, 2007
I woke up with a headache across my whole forehead at a 4. (Cymbalta 6:15) It is gone now. I had headache off and on throughout the day never more than a 2. I did get a good one that stayed at about a 4 from 9:00pm (took Lyrica) until bedtime at around 10:30

Tuesday July 31, 2007
I woke up with pain across the top of my forehead again at about a 4. It only lasted about 20 minutes. I took my morning medication (Cymbalta 6:10). I have had a headache at about a 3 and I have had some light dizziness since I got up. It got a little better after I really woke and had some caffeine. I got a pretty good headache at 2pm it was a 5. It stayed there until I got home. I tried some caffeine and it helped a little and it went down to about a 3. At around 7pm I started having some vision problems. I was having trouble focusing and vision seemed to be “shaking”. I lay down for about 90 minutes. When I got up the “shaking” was gone but I still had problems getting my eyes to focus. I took my medication (Lyrica 8:57pm) and went to bed. I did wake up twice in the night. Also of note I had a pain in the right upper side of my chest. It started in the morning after I coughed in the shower and stayed until the afternoon.






Wednesday August 1, 2007
I woke up with a headache at a 2 and I took my medication (Cymbalta 6:18am). I do feel a little better right now but still have the headache. The headache stayed all day at a 2 until about 4pm and it went to a 3-4. If it stays at a 4 or below I can usually tolerate it. By about 7pm it was pretty uncomfortable. I started having the itching again all over (hands, back, head, legs, ankles, arms). I took a Benadryl in addition to my other medication (Lyrica 8:58pm). I was having issues with balance as well from 8:30pm on. I went to bed at about 10:30 and from 9pm until them I had to have Kelly help me around the house as a precaution.

Thursday August 2, 2007
I woke up with the same headache at a 3 no better. I also had pain and pressure at a 2 across the top of my head. I have had a headache the normal spot at a 4 all day since about 10am is when the pain got worse. It is now at a 6. It is above my right eyebrow about the size of a golf ball and goes back to the middle of my head and wraps around to the right above my right ear. I have intermittent pulse pain on the left side above my right eyebrow. I am going to take a single dose of the Hydorcodone at 7:30pm. I took my evening med on time (Cymbalta 9:00pm) and I still had about a 3 headache at that time.

Friday August 3, 2007
I feel a little groggy this morning but my headache is back down to a 2. I took my morning medication on time (Cymbalta 6:05am) this morning. I had a 4 headache all day into the evening. I had 4 instances today where I had issues with memory. I would go into a different room and forget what I went in there for. I also had three instances today already. I forgot to wash my face in the shower, I have forgot to get an extra pack of cigarettes for Kelly and something else. I laid down for about 30 minutes and it helped it go down to a 3 for most of the evening. It got worse later in the evening. I took my medication (Cymbalta 8:55pm) on time. I went to bed late about 11:00pm. At that time it was about a 5.5 and I took a Hydrocodone. The headache was on my right side above my right eye and was pulsing up to the right up past my hairline. I also had pressure pain in my temple area. Starting yesterday I started to have pain behind my eye and it seemed to be aggravated when looking up and towards my nose it was a pressure type pain with some sharpness depending on where I was looking

Saturday August 4, 2007
I set my alarm for 6am to take my medication (Cymbalta 6:10am) on time. I woke up with pressure pain on both sides of my forehead specifically above both eyes. When I sat up the pain on the right started pulsing and it extended to the middle of the top of my head. I went back to bed. I got back up at 8:30am and felt better with the pain being at a 4 and only on the right side. It has been there ever since at the same pain level sometimes pulsing to a 5. I went back to bed this morning at around 9:30 and did not wake up until 2:30pm. My head feels better. I can still feel my headache on the right side but it is back down to a 2. This headache has been going since Monday night July 31st. It is not the longest one. I also have some pressure that I can notice at the back of my head, base of my skull on the right side.

Sunday August 5, 2007
I feel ok today. I am pretty groggy and have some pain but it is no higher than a 2. I am just tired of headaches. I really can’t wait until it gets better or we at least find some answers. This morning I have more pain on my left side than my right. I woke up twice in the night with pain at a 5. I slept well I believe.