Migraine, Anemia-bleeding related

[ForeverHeadache]

Sorry for the long post but there is a story leading to the question:

2 weeks ago I had a d&c for heavy and clotted menstrual cycles.  A week later I ended up in the ER due to dramatically large clots and bleeding.  The OBGYN on call was a doc that clashed with the ER doc.  Despite me being symptomatic of hemorrhage and the ER doctor feeling I needed immediate surgery, the OBGYN decided to send me home because my hemoglobin was at the low end of normal.  So I went home and continued to get worse.  I got to the point of blacking out several times, my bp dropped, I was laboring to breath and my coloring was that of a person in a casket.  The following day the bleeding and clots slowed and my color slowly was regaining.  Though it was a horrifying event, I made it through.  Since I lost so much blood I immediately put myself on Iron and vitamin C supplements.  A week later, this past Thursday, I went in for my follow up.  The nurse practitioner immediately did a finger ***** hemoglobin in me and found that I was very low at a 7.  So despite my efforts with supplements, I was quite anemic.

Here is my question:  I did not share with her that I had a migraine because I figured it was just one of my cluster headaches that usually turns into a migraine.  I figured I would just go home and take something and be fine.  Well here it is, day number 4 and I have yet to find relief.  The pain is different.  It is staying in one place.  It is on the top right front side of my head.  My right eye is very photo sensitive at this point.  And I am finding the need to constantly put pressure on the painful area.  When I am laying down I can constantly hear my blood flow in my ears.  The pain is making it difficult to sleep.  Is it possible that this is related somehow?  I really don't want to go back to that ER after how things went last time.  Any suggestions?

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Headaches can be divided into primary and secondary causes. Primary headache disorders are headaches without a direct cause, such as migraine. These are diagnosed after secondary causes have been excluded. Secondary headache disorders are due to an underlying problem. You may have a combination of both. You have a history of migraines, but with the anemia, you may have a secondary headache.

I would suggest that if you cannot find relief from your migraine with your typical medications, you may need to visit a headache specialist. Additionally, you should have your hemoglobin checked. If it is still low, you may need a transfusion and/or intravenous fluids.

Lastly, if your headache is different now than previous headaches you have had, you should be evaluated sooner than later, such as going to the emergency room.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[ForeverHeadache]

Thank you for your response.  The info was very useful and mostly an "I told you so" to myself.  I am an LPN who always always second guesses herself when it comes to her own personal health.


Since my post I received the results of my blood test and my iron stores have been depleted.  So they are trying to prevent my approaching menstrual cycle from being the usual heavy drawn out problem with meds and they have also placed me on an iron script.  The OBGYN said to call if the period seemed heavy and that they don't need me back for a year.  A week later, today, I am still weak and still presenting with anemia symptoms.  So I decided to go to my regular doc for some ideas of what to do and to talk about the head pain.  He doubled my iron script and sent me for more blood work.  If the blood work comes back low, I have to go for a transfusion.  If it comes back improved then I will continue on the double load of iron and then go back in two weeks after my cycle for the same scenario all over again.  I think the blood work will be improved because I can tell that I am slowly slowly gaining and the head pain has eased somewhat.  The doc is going on the basis that the head pain has improved some to determine that it is secondary.  He has given me a script to help the cramping I still have and to help with the head pain until I am back to see him in two weeks.  But I am to call immediately if it intensifies or changes in any way.  I am pleased that we now have a plan of action and that I don't have to sit and hope that things are improving.

Thank you for all of your help.  It is greatly appreciated.  God Bless.