[49F] Experiencing a range of concerning symptoms

Patient Description

A 49-year-old female has been experiencing a variety of symptoms that have significantly impacted her quality of life. For the past two weeks, she has had sharp pain on the left side of her head, rated 8 out of 10 in severity, located behind her ear where a fixed, warm bump was also found. Additionally, she has been suffering from severe headaches, described as stabbing sensations extending down her neck and into the side of her face, with an intensity also rated as 8 out of 10. These headaches are triggered by bending over, stress, and exposure to fluorescent lights. A movable, hard lump was discovered on the side of her neck four days ago. The patient reports changes in vision, weakness in the face or limbs, fever, neck stiffness, and difficulties in speech. She has been managing her pain with 800mg of Ibuprofen every 6 hours. Her medical history is significant for depression, anxiety, bipolar disorder, hyperthyroidism, vitamin D deficiency, POTS disease, rheumatoid arthritis, cervical disc disease, diverticulosis, and fibromyalgia, diagnosed around 2017. Over the past four years, she has also experienced excessive sweating, numbness in hands and feet, rapid heart rate, irritability, balance issues, visual floaters, occasional hallucinations, episodes of crying, and difficulty staying focused. These symptoms have been causing significant distress and affecting her daily life.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possibilities:

  • Migraines: The severe, stabbing pain you described in your head and behind your ear, along with the sensitivity to light, could be indicative of migraines. Migraines are a type of headache characterized by intense pain, often accompanied by nausea and sensitivity to light and sound.

  • Tension headaches: These are often associated with stress, anxiety, and muscle strain. They can cause a constant ache or pressure around the head, especially at the temples or back of the head and neck.

  • Temporomandibular joint (TMJ) disorders: These conditions affect the joint that connects your jaw to the side of your head. They can cause pain in the ear, face, jaw, and neck.

  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. It can also cause symptoms like the numbness, irritability, and difficulty focusing that you've described.

  • Postural Orthostatic Tachycardia Syndrome (POTS): This condition, which you've been diagnosed with, can cause a rapid increase in heart rate upon standing. It can also cause symptoms like sweating, dizziness, and fainting.

  • Anxiety and depression: These mental health conditions can cause a variety of physical symptoms, including headaches, difficulty focusing, irritability, and rapid heart rate.

Please note that these are just possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Schedule an appointment with your healthcare provider as soon as possible to discuss your symptoms. They may want to conduct further tests or refer you to a specialist for further evaluation.
  2. Keep a symptom diary. Note down when your symptoms occur, their severity, and any potential triggers. This can help your healthcare provider identify patterns and make a diagnosis.
  3. Practice good sleep hygiene. Ensure you're getting enough sleep each night, as lack of sleep can exacerbate many of the symptoms you've described.
  4. Try to manage stress. Techniques such as deep breathing, yoga, and meditation may help reduce your symptoms.
  5. Stay hydrated and maintain a balanced diet. This can help manage symptoms like headaches and dizziness.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • A sudden, severe headache or a headache accompanied by a fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or speaking difficulties
  • A headache after a head injury, especially if the headache worsens
  • A chronic headache that is worse after coughing, exertion, straining, or a sudden movement
  • New headache pain if you're over 50

Remember, I'm an AI and this advice is based on the information you've provided. It's always important to consult with a healthcare provider for an accurate diagnosis and treatment.

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7 mo ago


People Also Ask


What are the common triggers for migraines and how can they be managed?

Common triggers for migraines include stress, certain foods, hormonal changes, bright lights, and lack of sleep. Managing migraines often involves identifying and avoiding triggers, using prescribed medications, and practicing stress-reduction techniques.


How can tension headaches be differentiated from migraines?

Tension headaches typically cause a constant, dull ache or pressure around the head, often described as a tight band. Migraines, on the other hand, are usually more severe, with throbbing pain on one side of the head, and may be accompanied by nausea and sensitivity to light and sound.


What are the symptoms of Temporomandibular Joint (TMJ) disorders?

Symptoms of TMJ disorders include pain or tenderness in the jaw, aching pain around the ear, difficulty chewing, and a clicking sound or grating sensation when opening the mouth or chewing.


How does Postural Orthostatic Tachycardia Syndrome (POTS) affect daily life?

POTS can cause symptoms like rapid heart rate, dizziness, fainting, and fatigue, especially upon standing. It can significantly impact daily activities, making it difficult to perform tasks that require standing or physical exertion.


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1 Comments


Leo#3962

7 mo ago

The warm moveable lump might be a swollen lymph node. Do you have any other signs of a viral infection (your headache might be) like chills, fever, congestion, sore throat, etc?

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