rapid onsent and dissipation of vomiting and headache (no nausea)

by Amelia
(Salt Lake City, UT)

My main problem is the startlingly rapid onset of eye pain followed quickly by a headache so bad I can barely make my body move, and I feel like I have to vomit all the time.

It's happened twice, and each time it has come like a hurricane and passed within twelve hours. Here are the circumstances of the first bout:

I have a back problem where I landed on my butt and have such pain that I can't sit. I've been to various doctors and finally my mother persuaded me to see an acupuncturist (despite my fear of needles, yikes!) The doctor said it was mostly in my mind - it should've healed by now but my brain's still activating its circuit for "pain! pain!" erroneously. In case it was real, she handed me a lot of pills, including a Chinese one I couldn't spell or pronounce, B6, a few more B's - I was taking 20 pills a day, most of them the same kind and spread throughout the day.

Three days later after feeling increasingly off-color, I woke up to an odd eye pain over my right eye, like a localized headache. It got worse with every minute, but was still tolerable. Then in 20 minutes, it was no longer tolerable. The headache had increased so much that moving, even speaking, was an effort. My behaviour also wasn't normal: I was emotional and irritable when I could bring myself to move at all. I also vomited - a lot - mostly in the next 30 minutes, when I had the most energy. I was vomiting so hard I couldn't breathe for a minute at a time. I got back in bed, resigned to skipping my daily routine, but was up again in a minute to vomit. Back to bed, back to toilet. Rinse, repeat. A full hour and a half after I had woken up, I was finally able to get back in bed and stay there. I discovered that at this point, when I was horizontal I could hold in the vomit. I was so exhausted that I rested for ten minutes before getting up again. After another hour the vomiting had mostly stopped, and I slept for a couple hours. I woke up, cranky, and though I felt like I had to vomit, I didn't. I slept again. I woke up in a couple more hours, drank some water, and held it down. I had a piece of toast and rested some more. I was really bored and tried to read, but my eyes still hurt too much to focus. Another hour and I ate two more pieces of toast and a bowl of applesauce. By the end of the day I felt a whole lot better - almost the way I had before taking the acupuncturist's pills, but for being weak and shaky - probably from exhaustion and vomiting. I hadn't taken the pills all day, and decided to stop for good.

About three weeks later I got some gummy-bear vitamins for my sister. I felt a little silly but I liked them too, and started eating two or three a day instead of the adult ones (the instructions on the bottle say to take three.) A few days later I noticed I wasn't feeling that well - just a little off-color, no real symptoms to point at. Three days after that I woke up with a pain behind my right eye, exactly as before, although not as intense. I was, understandably, already dreading the day ahead of me, and went to get a bucket. But although I really felt like throwing up, my body only did it a few times. I lay down, but my eye kept hurting, so I got a washcloth damp and laid it over my eye. It felt so good, and I went straight to sleep. I woke up two hours later. Indirect sunlight came through my window, garishly bright when I lifted the makeshift eye patch. I frowned at it, recovered my eye (my left eye was buried in the pillow) and slept some more. The next time I woke up I felt almost normal again - and it was only noon! It was nowhere near as bad as the first attack, lasting barely half a day instead of the whole day, with little vomiting and a headache that felt like a gentle tap in comparison to the first wallop.

Because I started taking vitamins before each incident, I think it may be related to a vitamin excess. I tried looking it up online, but a lot of them have the same symptoms, so I was wondering if you could distinguish which one so I could avoid foods that contain it in abundance.

I know I mentioned a back problem before, and though I have pain from it, I have been improving and have not taken a pain pill for it in months. When I did, I took ibuprofen or naproxen, and then only about once every two months, as needed to manage pain. I have no relevant family history. I also don't smoke, drink, or do drugs, and I try to eat a balanced diet. I am a vegetarian, but again, I eat a balanced diet, with lots of fruits, veggies, some nuts, mushrooms, some soymilk or almond milk, oatmeal, multigrain or whole wheat breads, beans, and some cheese - I make sure to have more than three food groups in every meal, and I'm careful to control how much protein I eat and drink enough water. (I know I'm coming across as a bit defensive, sorry! But I really am receptive to constructive criticism, so fire away if you think something about my diet could be improved.)

Oh yes - I have not attempted to treat these weird episodes, since I wasn't in any condition to drive anywhere and get medication, and I wouldn't have known what to get if I did. I also haven't seen a doctor about them.

One more thing I should mention - about a week after the second episode, my eyes started feeling dry and itchy whenever I wake up, which has never happened. I also see blurry greyish lines in front of my eyes when I look at a blank piece of white paper, the sky, or anything monochromatic with a slight glare to it - the same lines every time, blurry like something too close to my eyes.

I do tend to have dry skin, but mostly on my hands - which may either make sense, because I wash the dishes in the family (and we have A LOT of dishes), or may be masking a symptom. One week the skin on my left hand actually did start to peel off, and I began wearing gloves when cleaning, which - along with some Neutrogena - took care of the problem. I don't think it's relevant, but just in case I thought I'd let you know.

Thanks for reading!

Headaches and Vitamins

Amelia, the history of intermittent, sharp pain around the eye with associated visual disturbance is characteristic of migraine headache which I suspect is causing your symptoms. There are other causes of this type of pain, particularly glaucoma due to raised intraocular pressure. This should be checked by an optometrist as it is a condition that could caused vision problems and can be easily treated. Other causes of unilateral, sharp pain around the eye include aneurysms, tumours and cavernous sinus thromboses but these are much rarer than migraine.

It is curious that there appears to be an association with the vitamins you take. Interesting, it is thought that vitamins, particularly B vitamins can actually help prevent migraine headache. Vitamin A in high doses can actually cause headache, although you don’t mention this particular vitamin. I wonder whether the issue is not the vitamin itself, but maybe any artificial additives within the gummy bear vitamins (sorry I’m not au fait with the actual constituents of this vitamin preparation). It could be a coincidence that you have been getting your headaches when taking these. Your diet certainly appears to be good and I can’t criticise this.

Migraine can be very disabling, but there are lots of medical treatment options for this. No one really knows the underlying cause of migraine, but it has got something to do with the dilatation of cerebral blood vessels. The common drugs that are used to treat migraine include simple analgesics such as Paracetamol and codeine and NSAIDs such as Ibuprofen or more complex drugs. 5-HT agonists such as Naratriptan and Sumatriptan can be very effective. They are so called serotonin agonists that actually narrow the cerebral blood vessels. There are other drug options too including tricyclic antidepressants, betablockers, Pizotifen, antiemetics and many more that are really too numerous to discuss here.

I would strongly advise that you see a doctor to be examined and also an optometrist to check your eyes. Treatment can then be honed to your particular complaint. Good luck!

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