I am thrilled to find this board and so grateful for the information I have found already.  5 days ago I had what I believe to have been a Cluster Headache - I can only describe it as the worst headache of my life and I've been reading everything I can since then trying to make sense of what happened.  For the purposes of introduction, here's a thumbnail history.

I'm a 41 year old woman living in North Carolina, I have 3 teenagers (more than enough for a headache right?)  If I'm completely honest, I have struggled with migraine-type headaches since I was about 17 years old - I have learned to manage them as "sinus pressure headaches" and my preferred cocktail has always been 2 liquid advil caplets and 1 sudafed (or sudafed PE)  The combination of anti inflammatory / decongestant has always worked well for me.  My headaches aren't frequent - maybe 4-8 in a year but if I catch them quickly they probably don't get remembered - I do notice I am much more prone to problems during shifts of barometric pressure (tropical storms, hurricanes and the like can set me off)  I was diagnosed with sleep apnea / hypopnea about a year ago and got on CPAP and I've noticed that my sinus issues are greatly improved since starting that therapy.  I hadn't had any kind of migraine/sinus headache in months until about 10 days ago when a tropical storm moved through and I woke up the next morning feeling a headache coming - I was out of town for work and had nothing with me - a co worker gave me some Goody's Powder which I'd never tried and much to my surprise, it worked.

The real problem happened about 5 days after that - June 5 -the day of the "Monster Headache"  This headache was NOTHING like anything I had previously experienced.  If I think back, I began to feel 'off' about 11 a.m., work was stressful, there was domestic drama and the yard got sprayed with pesticides.  The day was so chaotic that I was in denial that I even had a headache, but by 4 p.m. I realized I was in serious trouble - and that was when the party really got started.

At 4 p.m. I was finishing up work in my office and realized my pain threshold was moving off the charts.  My right eye was watering, my right nostril was intermittently pouring out liquid and the roof of my mouth throbbed - it felt like every tooth needed a root canal.  I managed to drive myself home, realizing that the vision in my right eye was getting blurry.  When I got home I immediately took 2 Goody's extra strength headache powders (thinking back to my experience the week before and hoping the caffeine combo might come through for me.)  I also took 1 liquid advil and 1 sudafed PE.  The logic was that I was hitting this with the 3 main pain relievers, caffeine and a decongestant - no headache could survive this. 

I retreated to my room for quiet, hoping to pass out and "sleep it off" but sleep would not come.  I writhed on the bed in agony for 2 hours in the worst pain of my life, I watched the clock telling myself I just had to make it 15 more minutes and the meds would kick in.  My daughter brought me cold wash cloths - none of my usual tricks were of any use.  I was unable to reach my husband - I called my boss (who is a nurse) to get her advice and make sure it wasn't an aneurysm or a stroke.  She told me she suspected a migraine and to go to the ER - at that point I was just in too bad of shape to go anywhere.  The pain in my sinus cavity felt severe and it felt like I had been shot behind my right eye. 

About 2 hours had passed and I decided I absolutely had to have some kind of help.  I didn't want to go to the ER with a 10 year old by myself and I was still unable to reach other family for help.  I called an urgent care I'd used for my kids in the past and asked if they could treat migraines - what I really wanted to know was could they give the shot they give people in the ER (Imitrex) but I was in too much pain to ask good questions.  They told me to come in and somehow I drove myself there (mostly back roads). 

Urgent Care wasn't much help, but I was in too much pain to be able to give them very much information.  I kept repeating it was the worst headache I've had in my whole life, yes I've had migraines, but none of them touched this level of pain.  I told them my eye hurt, but mostly I was just in agony and afraid I was scaring my daughter.  The doctor couldn't/didn't do much to examine me.  He made a passing comment about 'cluster migraine' and prescribed me Esgric Plus, a steroid pack and some Augmentin (I think he assumed I may have a sinus infection)   

I drove to the pharmacy and waited 2 hours for them to fill the meds, I was still in pain but the level was dropping by then. I started researching cluster migraines.  I took the Esgric Plus and the steroids but haven't taken the antibiotic since I truly don't believe I have a sinus infection.  I went home and crashed. 

I felt better most of the next day but could still feel a "shadow" of where the pain had been.  At 5:00 my right temple started to pound and I got worried so I took another Esgric Plus and attempted to lay down.  I found it made me very jittery, but very stoned and I really don't care for that combination.  I never reached a level of pain but I was annoyed by the medication side effects the rest of the evening.  The next 2 days were much better but yesterday I began to have that 'shadow' sensation again.  It's not pain, but my head didn't feel right and the location of the sensation was entirely too familiar.  I took advil + sudafed to see if that would help - it really didn't seem to make much difference.  There have been no further headaches but the 'shadow' scares the bajeezers out of me.

The entire event has me so spooked that I've booked an appointment with my doctor - this is significant because I don't go to the doctor, "my doctor" has never even met me.  I called and explained what happened and that Urgent Care had recommended a follow up - so next Wed I'm going to the doctor for the first time since almost forever.  My primary goal is to make sure I never have another headache like that again in my life - but if I do - I want to have a better understanding of what to do about it - how to treat it - etc...  I'd love to understand more about how it is similar/different to the other migraine/sinus headaches I've dealt with for so long. From what I've read, there may or may not be a connection.  All I know is that the pain I felt this week was NOTHING like I've ever experienced.

I'd love more information about "shadows" and is there anything I can do about this sensation?  Does it mean another headache is coming?  Is there anything that can be done to treat myself on this preliminary level?  I already know Esgric Plus is not a drug that agrees with me - what should I be talking to the doctor about?  Should I agree to a bunch of tests and scans or stick to my gut that this is probably my body being pissed off at me?  I really really hope this was a one time event, but in the event that it was not - I would LOVE some helpful advice.

Thanks

We all know full well that the pain can drive us nuts in our efforts to find relief. BUT it can also blind our judgment!

Self-diagnosis and self-treatment is a blind alley. Really quite important that you find a doc who has knowledge about headache disorders--a far more complex area of medicine than many people appreciate.

OTC pain meds will work to make headaches worse!

====
LOCATING HEADACHE SPECIALIST

1. Search the OUCH site (button on left) for a list of recommended M.D.s.


2. Yellow Pages phone book: look for "Headache Clinics" in the M.D. section and look under "neurologist" where some docs will list speciality areas of practice.

3.  Call your hospital/medical center. They often have an office to assist in finding a physician. You may have to ask for the social worker/patient advocate.

4. Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or On-line screen to find a physician.

5. Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or Look for "Physician Finder" search box. They will send a list of M.D.s for your state.I suggest using this source for several reasons: first, we have read several messages from people who, even seeing neurologists, are unhappy with the quality of care and ATTITUDES they have encountered; second, the clinical director of the Jefferson (Philadelphia) Headache Clinic said, in late 1999, that upwards of 40%+ of U.S. doctors have poor training in treating headache and/or hold attitudes about headache ("hysterical female disorder") which block them from sympathetic and effective work with the patient; third, it's necessary to find a doctor who has experience, skill, and a set of attitudes which give hope of success. This is the best method I know of to find such a physician.

6. Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or NEW certification program for "Headache Medicine" by the United Council for Neurologic Subspecialties, an independent, non-profit, professional medical organization.
        Since this is a new program, the initial listing is limited and so it should be checked each time you have an interest in locating a headache doctor.
=====

Thanks for all the helpful replies and info.  I certainly don't want to diagnose myself, and no offense, but I really really hope this isn't CH.  I do want to go to my doctor armed and educated in hopes of getting the best answers as fast as possible.

The thing that bothers me the most right now is this "shadow" sensation.  Is this something I need to be concerned about?  Should I be looking to treat this? Could it be related to the steriods?  I know every question comes with 100 more so thank you for your patience and your extremely helpful information.

Hi, I do hope you will go ahead and at least get an MRI if they suggest it. Just to be on the safe side. Its very possible that the shadows you are experiencing would have been full blown clusters without the prednisone. In other words, the steroids are cooling things off a bit, but not 100%. Still, hopefully for you it will not get worse & you will get on a good prevent when you see your doctor. Ask for a prescription for Imitrex injections (get the vials and try to use only half a vial since most cluster headaches respond well to half) and fill your prescription every month for a while until you see what is going on with the headaches. Its better to be prepared and not have to use the medicine than to be caught off guard with nothing to . Good luck to you.