[42F] Experiencing severe migraines, muscle pain, and persistent cough

Patient Description

A 42-year-old female presents with a history of severe migraines occurring a few times a week, with pain localized behind the eyes and across the skull, accompanied by nausea, sensitivity to light and sound, and intensity ranging from 7 to 10 out of 10. She also reports chronic muscle pain, particularly in the left hand which stays numb and is exacerbated by certain stances, and has been ongoing for over a year. Additionally, she has a severe cough that has lasted about a year, with difficulty breathing and wheezing, and no expectoration. The patient mentions constant feelings of fatigue and difficulty staying awake, as well as experiencing fever and chills regularly. She has a history of Crohn's disease, which she reports is under control. The abdominal pain she experiences is described as a sour stomach feeling, different from her Crohn's symptoms, and has been present since around the age of 22. The patient's stool is brown with slight mucus and is between hard and soft. She also experiences pain behind and in front of the lungs, which affects her back and ribs, and has been present for approximately a year. No recent injuries or accidents were reported that could explain the muscle pain. The patient has not provided any specific triggers for her migraines, and there are no warning signs or aura preceding the episodes.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Chronic Obstructive Pulmonary Disease (COPD): This is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing.

    • Treatment typically involves medications to manage symptoms, pulmonary rehabilitation, and in severe cases, oxygen therapy or surgery.
  • Migraines: You've described having frequent migraines, which are a type of headache characterized by intense, throbbing pain, often accompanied by nausea and sensitivity to light and sound.

    • Treatment options include over-the-counter pain relievers, prescription medications, and lifestyle modifications to manage triggers.
  • Depression: You've mentioned feelings of giving up, which could be a sign of depression. Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest and can cause physical symptoms.

    • Treatment typically involves a combination of medication, psychotherapy, and lifestyle changes.
  • Crohn's Disease: You've mentioned that you have Crohn's disease, which is a type of inflammatory bowel disease. It causes inflammation of your digestive tract, which can lead to abdominal pain, severe diarrhea, fatigue, weight loss and malnutrition.

    • Treatment usually involves medication to reduce inflammation and manage symptoms, and in some cases, surgery.
  • Numbness in left hand: This could be due to a variety of conditions, such as nerve compression, carpal tunnel syndrome, or a neurological condition.

    • Treatment depends on the underlying cause and may involve physical therapy, medication, or surgery.

Please note that these are possible explanations based on the symptoms you've described, but they are not definitive. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Seek immediate medical attention for your breathing difficulties. This could be a sign of a serious condition that needs urgent treatment.
  2. Consult with a healthcare provider about your migraines. They can provide you with a treatment plan to manage your symptoms.
  3. Speak with a mental health professional about your feelings of giving up. They can provide you with resources and strategies to manage these feelings.
  4. Continue to manage your Crohn's disease as directed by your healthcare provider.
  5. Consult with a healthcare provider about the numbness in your left hand. They can provide you with a treatment plan based on the underlying cause.

What you should look out for

  • If your breathing difficulties worsen or you experience chest pain, seek immediate medical attention.
  • If your migraines become more frequent or severe, consult with a healthcare provider.
  • If your feelings of giving up worsen or you have thoughts of harming yourself, seek help immediately. You can reach the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or use the Crisis Text Line by texting HOME to 741741.
  • If your Crohn's disease symptoms worsen, consult with your healthcare provider.
  • If the numbness in your left hand worsens or spreads to other parts of your body, seek medical attention.

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for accurate information.

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9 mo ago


People Also Ask


What are common treatments for managing chronic migraines?

Common treatments for managing chronic migraines include over-the-counter pain relievers like ibuprofen or acetaminophen, prescription medications such as triptans, preventive medications like beta-blockers or anticonvulsants, and lifestyle modifications to avoid known triggers. It's important to consult with a healthcare provider to tailor a treatment plan specific to your needs.


How can I differentiate between symptoms of COPD and other respiratory conditions?

COPD symptoms include chronic cough, difficulty breathing, wheezing, and mucus production. These symptoms can overlap with other respiratory conditions like asthma or bronchitis. A healthcare provider can perform tests such as spirometry to measure lung function and help differentiate between these conditions.


What are some potential causes of numbness in the hand?

Numbness in the hand can be caused by nerve compression (such as carpal tunnel syndrome), nerve damage, poor circulation, or neurological conditions. It's important to consult with a healthcare provider to determine the underlying cause and appropriate treatment.


How can Crohn's disease affect overall health and what are the management strategies?

Crohn's disease can lead to symptoms like abdominal pain, diarrhea, fatigue, and weight loss. Management strategies include medication to reduce inflammation, dietary changes, and sometimes surgery. Regular follow-ups with a healthcare provider are essential to monitor the condition and adjust treatment as needed.


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