Water you, some kind of comedian?

My appointment was with the Physician's Assistant. Her diagnosis - migraine! Despite telling her I've never had a history of migraines and that the headache was a dull pain, she still prescribed pregnisone and said it was a migraine.

A little bit of a back story that's interesting. My wife was diagnosed a few years ago (by the same PA) as having a sinus infection. She ended up in the hospital later that night, quarantined w/ meningitis and my son in another hospital across town. Thankfully it was viral but I'd say it was a misdiagnosis.

When I was walking out of the office w/ the PA I asked her if the doctor was in today because I'd like to say "hi" to him.

A few minutes later she brings him back into the room for me and I explain the situation. I said that I'm not a doctor and I feel bad asking for a second opinion but I don't think I have a migraine. He tried covering for her a little bit but ended up saying that I should grab 2 bottles of Gatorade on the way home and replenish electrolytes. He said that I easily could have lost a lot of fluid and salt and that if I'm not completely better by Thursday morning he'll run blood work on me.

Thanks for all the responses (incl the clowns) you guys nailed it.

You should page bellatorbaby , as he is an actual physician...

without actually physically examining, you, i can't tell. But from what i know of physiology, i would say this IS NOT dehydration (and also get new doctors... these people are treating you like ****)

The first concern is are you on any form of medication? have you observed your pee? what color are they?

Completely agree with the "get new doctors" part. Not to accuse them of anything, but if I was a doctor or PA and I'd screwed up on a patient so they knew I was an idiot, I'd try to kill them off at the first opportunity. Just saying.

But yeah, if you're worried enough to actually go into the doctors office, they should be concerned enough to run tests that day. Presuming you're not some sort of hypochondriac who's in there every week or anything.

Sorry I have to question how you came to this conclusion that the presentation doesn't fit the symptoms?

while I'd be likely to get the bmp, far more important is the physical exam when considering dehydration so it's not terrible to not get labs right away.. the misdiagnosis is pretty bad, though. Most pas I've worked with have impressed me with their knowledge base in their area of practice

This.

And why should the doctor run a bunch of blood work now when the odds are extremely good this is dehydration and/or electrolyte depletion?

And before someone tells some story about a guy they know who went to the doctors office with the EXACT SAME SYMPTOMS and had blood gushing from his eyeballs 24 hours later, remember that rare illnesses are, well, rare. 99% of the time when someone in their 40s comes in and says they played basketball and afterwards and the next day felt like absolute crap, it's going to be dehydration and/or electrolyte imbalance. The doctors are doing you a favor prescribing Gatorade and bananas for a few days instead of running some expensive tests.

As long as the doctor tells you stuff to watch for that mean you should immediately return to the office (or go to the hospital), OP should be fine.

Don't worry, as one of at least two people with MDs that I think are reading this thread, I don't think OP really needs any different advice than he's already gotten.

Thanks

No, I'm not on any medication aside form the occasional ibuprofen (400-600 mg) a few times a week for aches and pains but that's it. Urine is clear to light yellow.

One of the reasons why the PA didn't think it was dehydration was because my blood pressure was slightly higher than it normally is for me. She said typically with dehydration blood pressure is lower. It's not high mind you, it's just high for me.

I'm still not 100% today just a little off, kind of lightheaded, but the headache is nearly gone. He really seemed to think that blood work wasn't necessary unless I wasn't fully recovered by Thursday.

BTW I'm far from a hypochondriac. I haven't seen my doctor aside from a physical for anything in several years. I wouldn't have gone to see him yesterday if the nurse would have said you should be ok just replenish but she didn't think I should still be feeling this way 2 days later.

It might be less pure dehydration at this point than a depletion of one of the key electrolytes.

Try eating some potassium rich foods and some extra sodium today and see if that helps. Otherwise if you're still light headed or off tomorrow running a blood panel is probably in order, IMO.

I was hospitalized in basic training for water intoxication, and one of the major issues was that I flushed most of the electrolytes out of my system (I was told there was basically no potassium or sodium left in my system). I felt weak and off for days afterwards.

Thanks for the suggestions.

Oh and check out this sweet PM from LOLDONKBETZ


"do you think OOT is your ****ing doctor?

how have you survived 43 years if you go running to the forum everytime you don't feel good? stupid old man, you deserve something worse than dehydration for your stupidity"

Is this dude serious?

You should tell the pa that dehydration is not the same as hypovolemia

Personal experience, a doctor's recommendation and googling hyponatremic leads me to suggest sports drinks over water when you are really getting dehydrated. Probably some water and eating the right things like bananas and salt like SGT RT suggested is good.

OOT is going to give you good advice and bad advice, which is just what happened when you went to the doctor. Pretty ****ing phenomenal that the PA diagnosed you with a migraine and gave you a prescription despite your having no history and running no tests. I mean according to WebMD there are a whole lot of tests that can be used in diagnosing migraines. http://www.webmd.com/migraines-heada...agnosing-tests

regarding the PA though:

"Meningitis is almost always caused by a bacterial or viral infection that began elsewhere in the body, such as in the ears, sinuses, or upper respiratory tract."

So, the sinus infection might not have been wrong.

Very interesting, microbet. Thanks for all of that information, I really appreciate it.

Hypernatremia not hypo. There is no specific tests for migraine. Please stop reading webmd

Well, apparently I'm wrong.

I could be wrong here too, but I meant drinking water as opposed to sports drinks when you are depleted would cause hyponatremia (low sodium concentration in the blood), not hypernatremia which is elevated sodium levels. At least according to wikipedia, which could of course be wrong. But that seems to make sense.

Reading a bit more about migraines I guess most of the tests are used to rule out other causes more than to identify migraines. Still, I definitely wouldn't start taking any medication on any kind of regular basis without a pretty definitive diagnosis and/or very compelling reason.

You're right about sinusitis being a route of entry for bac meningitis.. it is one the three major ways you get that. Explaining electrolytes to someone who doesn't knowthe physio is hard on a cell phone. Look up the fluid composition of sweat and you may be able to pick up why

Yes, Gatorade actually does what it's intended to do.

While I agree that a migraine diagnosis seems out of place here, I don't know how common it is to really run all those tests for migraines. I thought, but am not confident, that it's more of a clinical diagnosis, but I imagine tcc1 would know this. (Oh, I see I took too long to post this)

It's just me googling and trying not to be too dumb. I have a lot of respect for the amount of knowledge most doctors have. A couple of times I've misdiagnosed myself when the real problem was very obvious to the doctor. One time I caused myself at least a year of completely unnecessary persistent moderate pain.

LOLDONKBETZ sent me a scathing PM back in August, too. Guy should be perma'd for all the harassment he dishes out. I just found his PM and was going to post it here but I think that's against the rules and it looks like he's banned anyway?

I came to this conclusion from his history.. he runs a lot, i'm assuming healthy kidney function... after the sports drink he drank and the water ahead of the time

I don't see how normal people with no kidney problems could be dehydrated after what he did... the activity he described doesn't seem to be too strenuous...

This!

also it'd be pretty hard for him to get hyponatremia unless he had a ****ton of ADH, decreased proximal delivery, and something that screws up his diluting portions of his nephrons...

You are dead wrong... hyponatremia isn't a problem with sodium... it's a problem with water...

and just drinking water while you're depleted will NOT cause hyponatremia... just sweating (which is a hyoptonic loss), will NOT cause hyponatremia!!

a whole a lot of stuff has to go wrong for you to get hyponatremia... unless OP is on a thiazide diuretic or has gitelman's syndrome... he's not hyopnatremic....

"OOT isn't your doctor" is one of the first things listed in the sticky, and a thread about having a minor headache is not interesting. Im surprised killa didnt nuke it, must be going soft on us