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Part 8...Headaches SUCK!

It was the morning of Saturday May 6th, I had stayed home from my weekend warrior commitment with the Air Force to attend to some family obligations. As the morning continued a dull generalized headache started to gain some traction. By noon the headache was real and even 800mg of Ibuprofen wasn't touching the pain. Luckily it came with no other symptoms other then the typical fuzzy vision which had been a daily occurance.  I am fortunate enough to have never experienced a migraine and to those who suffer from them I now have a new appreciation as to how debilitating a headache truly can be.  For some reason I had the idea to take my blood pressure. Yes, I was cheating and had my own blood pressure machine at home. Yes I already can see your eyes rolling as you explain how inaccurate that garbage is. Needless to say I took it anyway and was greeted with a reading of 180/110. I honestly believed this reading, I could feel that my blood pressure was elevated and I didn't feel good. I waited about a half an hour and rechecked it, having had no real relief of symptoms. Not to my surprise I was just as high with my subsequent attempts that followed. 

It is good to know people in places and yet again I was thrown out of my comfort zone and entered the realm of emergency care. "Lucky" for me I had spent years working on and off for a local Emergency Department so I was fortunate enough to know the system and providers who would be taking care of me. At the time I was triaged my blood pressure still had not budged and I was expeditiously brought back to a bed where the real fun began. All along I had mentioned my possible medical concern lurking and the medical team focused in on that being the cause of my symptoms. I had the typical care rendered with an EKG, IV placement and blood work. I was offered something stronger for my headache but I declined as I already was uncomfortable with the lack of control I was experiencing. I did however accept a dose of zofran for some new nausea that was starting to present. 

Most medical providers will attempt to explain the lovely world of insurance in relation to obtaining the proper authorization for certain diagnostic testing. My current medical visit was no exception. I was ordered to have a CT Scan of the head which had a high percentage of not showing this type of tumor unless is was of significant size. The CT had to be completed before the authorization would be granted for an MRI. Secondly, anyone who has ever tried to get an "emergent" MRI knows that it can be rather frustrating and nearly impossible. 

I am all in favor of technology and for those who have a need for control, especially with their healthcare. I truly appreciate having results at our fingertips with the online patient portals. The unfortunate part of having immediate results is that it allows you to glance at them before being told by a medical professional. Not that it is any better to hear the results versus reading them however, having someone there with you to ask questions and state concerns truly goes a long way. Unfortunately we are still recovering from the COVID pandemic and most hospital Emergency Departments still have a limited or a no visitor policy in effect. The no visitor policy is what this hospital was abiding by and I was left to read my results by myself without the comfort of my family...

FINDINGS: 
The ventricles, sulci, and subarachnoid spaces are appropriate in size and configuration. There is no evidence of acute intracranial hemorrhage or CT evidence of acute territorial infarct. There is no significant midline shift. There is asymmetric enlargement of the left aspect of the pituitary gland (for example 601-47 and 2-16). No acute osseous findings. The visualized paranasal sinuses and mastoid air cells are clear.

IMPRESSION:
1. No acute intracranial hemorrhage, hydrocephalus, or CT evidence of acute territorial infarct.
2. Asymmetric enlargement of the left aspect of the pituitary gland raises concern for underlying lesion. Recommend further evaluation with pituitary protocol MRI.

Brian was finally found and so the journey continued...

"I wish my name was Brian because maybe sometimes people would misspell my name and call me Brain. That's like a free compliment and you don't even gotta be smart to notice it". ~ Mitch Hedberg


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