High on life, no thanks to the walk-in clinic, Part 1

As a presumed side effect of the TMJ that has plagued me for about nine years, I suffer severe headaches from time to time. The first notable one throbbed on one side and was accompanied by nausea and light sensitivity. I had driven the half-hour to work and was struggling to look at my computer screen when I realized, “Holy Sh*t, this is migraine.” I’d never had one before. My doctor’s office happens to be closer to my office than to my home, so it was easy enough to go there and get diagnosed. I can’t remember exactly what she gave me, I think it was a pill, and they left me in the dark exam room while I waited for it to take effect. I was afraid to leave before the headache was gone, so when my doctor came back about 20 minutes later, I told her I wasn’t sure it was better. I thought the migraine was better, but I could still sort of feel it lingering, you know?

The next thing to try would be the Imitrex shot, which as she described it, “feels weird.” You feel a zing and a tingling that goes up through your head and out, and when it leaves, the migraine goes with it. I’m sure people who have had the shot could describe it better. Her description kind of freaked me out. I felt better enough, I decided, drove home and never had another migraine again.

A short time later, though, I had a tension headache that did not ease up for three straight weeks. I had acupuncture, therapeutic massage, heavy drugs, and physical therapy, but I think it just went away on its own. That was four years ago, and since then, I’ve had bad headaches here and there, but nothing like what I’ve already described.

Monday morning, as I was getting ready for an awesome day at work that consisted only of taking pictures of salmon being cooked, eating salmon, and proofreading (which, don’t judge, is something I really love), I started to feel a familiar dull ache around the crown of my head. I popped two Aleve (yes, TWO) and went on my way. When I returned home from my big salmon lunch, I settled into my favorite proofreading chair and fell asleep. I woke up, carried on proofreading, and noticed the headache had returned. By the time I picked Rob up from work, I was slightly dizzy from the headache. After we came home from dinner, I returned to my proofreading chair to make up for the time I missed on account of my nap. At about 9 p.m. I stood up and moved to my computer, and as I sat down, my head started to throb and I thought, “Oh, this must be a migraine.”

Conveniently, I already had an appointment with a craniosacral therapist for the next morning. It was my seventh session, and so far this is the only treatment that has had any lasting benefit for my jaw. He dons a latex glove and massages inside my mouth. Pretty intense. (Probably deserves its own post someday, but let’s move on.)

I thought he might be able to make the throbbing go away. But what if he didn’t? I still had this huge proofreading job to do. I couldn’t just come home and suffer the throbbing. Should I go to the emergency room? Didn’t seem like the most efficient plan. I knew that ERs didn’t consider migraines life-threatening (and once read a “Overheard in the ER” site where ER staffers mocked people for considering migraines “emergencies” when they got them several times a month.) And no way I could drive the half-hour to my doctor’s. I probably shouldn’t even drive myself to craniosacral five minutes away. But Rob was at his second day at a new job and I didn’t want to ask his parents to drive me to my doctor.

I had the genius idea to go to a Walk-In Clinic that takes my insurance and purports to “offer immediate medical services for non-life threatening medical conditions.” (Note: that’s a direct quote from the website and I object to the hyphenation. How do you threaten a “non-life”?)

After my head and gum massage, my head still throbbed. Every time I stood up or changed incline, I felt like my brain was throbbing right behind my eyes. I wasn’t nauseous, though, or light-sensitive. And the pain was dead center, not isolated to one side. So maybe it wasn’t a migraine, but I thought the Walk-In doctor would be able to give me some drugs and make it go away.

I waited more than an hour, alternately reading the subtitles of a Planet Earth special about whales, and closing my eyes and leaning my head against the wall behind me. If I remained perfectly still, the throbbing stopped and I just felt a regular tension headache. I’d had the foresight to bring my Nook with me, but even if I could have read it comfortably, I didn’t want to undermine my claims of a “migraine.”

When I finally saw someone, it wasn’t a doctor, but a physician assistant. She was concerned that my headache did not follow the pattern of my one previous migraine. (Can one migraine have a pattern?) I described it as “A worst headache ever,” and it changed with movement. She didn’t want to treat it as a migraine in case it wasn’t a migraine, because it might be something else. She advised me to go to the emergency room for a CT scan. She’d note in my chart that she’d told me to go there, so insurance wouldn’t think I just decided to do that on my own. I should tell them at the ER that I’d been sent there from the Walk-In Clinic, and they would triage me accordingly.

Instead of saying, “So, do I get my $20 copay back because you have done absolutely nothing for me?”

I asked, “What else do you think it could be, if not a migraine?”

“Oh, you know,” she said (I’m paraphrasing). “Buried aneurysm.”

She left the room to write me a note and I waited another 20 minutes wondering, “Should I call Rob? Do I really want him to leave in the middle of his second day at work? I’ll just go by myself. It will be fine. But what if it is an aneurysm? At what point do I call Rob and tell him, ‘Hey, I’m at the ER. Gonna have some brain surgery.'”

I started to freak out a little. And cry. And feel pissed off that every minute I spent waiting for the Walk-In Clinic to release me was a minute I should be putting toward my ER wait. When the nurse finally came back, she told me that she had been trying to reach my doctor to find out what I took for my last migraine, but no one answered the phone there. I could have told her that you can never get anyone on the phone there.

I went to my car, head throbbing, and called Rob. When he answered, I wailed, “I’m freaking out,” and filled him in. He very calmly came up with a plan to have his mom pick me up where I was and take me to the ER. That’s when I realized he couldn’t come get me himself anyway, because I had driven him to work. He’d have to take the bus home to get his car.

He told me later that when he first heard me crying, he assumed something bad had happened to the dogs. Of course he had. That’s always my first fear, too. Not that he then thought, “Oh, phew. The dogs are fine. Kari’s just having an aneurysm.” No, he thought of Bret Michaels, infamous Lothario and lead singer of the band Poison, who went to the ER a few years ago with the worst headache of his life, which turned out to be a cerebral hemorrhage.

In Part 2 of this thrilling tale:

The Physician Assistant’s note fails to bump me to the front of the triage line, and I start to doubt that I have an aneurysm at all. I realize that my detour to the Walk-In Clinic was a complete waste of time, but it’s not until well into the next day that I start to wonder about that $20 copay. What did I pay for exactly? Do I have recourse to ask for a refund? I mean, she probably spent as much time “examining” me and writing my “note” as she spent with the out-of-town baby with an ear infection who came in after me and left while I was waiting for Rob’s mom to pick me up. But the P.A. didn’t DO anything for me. I was at the Walk-In Clinic for TWO HOURS with a throbbing headache that could have been a brain aneurysm!

Is that my fault for making the wrong choice? I could have gone straight to the ER, but I went to the Walk-In thinking it would be more efficient for me, and not waste the time of those busy ER doctors treating real life-threatening ailments. My visit to the Walk-In Clinic was a gamble where I bet $20 (and two hours of my time) that they could help me, and I lost.