Confounding Questions Neurologists Ask

There are two things that happen every time I meet a neurologist: a neurological exam and a long list of questions.  And I go to a university hospital, which means that neurologists rarely travel alone and are most often seen in groups (made up of an attending and at least one, but up to five, resident neurologists).  What do you call a group of neurologists, I wonder? But the point is I’ve been asked similar questions easily a dozen times already, because at least two neurologists in every gaggle of neurologists will ask me the exact same questions.  And every time, I find myself confused by the same seemingly simple questions, which leaves me wondering if I’m about to flunk the test and get exposed as a headache fraud. I was reminded of this confundity again last week when I went to my long-awaited appointment at the headache center, which I will write about later.  But I realized while talking to the (rare) lone neurologist at the headache center that I’ve changed my answer to these questions from one neurologist to the next, which I imagine is very frustrating for the neurologists. I wonder if they note how many times my answers have changed. 

Here they are, the questions that always stump me…   

Did you ever have a headache before this all began?

A simple yes/no question, right?  But…who can say no to this question and still claim to know what a headache is?  Hasn’t everyone had a headache? Hasn’t everyone bumped into a wall, or crawled under a table only to forget about a low crossbeam?  Am I naive to think that headaches are part of the human condition? But if everyone has had a headache, then this isn’t a yes/no question, and it’s completely useless to ask.  So I must be wrong that everyone has had a headache, or my definition of headache is too broad. Maybe it doesn’t count as a headache if you hit your head? But then what do we say about concussions?  Concussions are certainly a headache worth noting.  

Have you had a headache before?  Are you sure the headaches you’ve had count as headaches?  

If you’re doubting yourself, now you understand how I feel every time I get asked this question.  I used to answer “No,” because I couldn’t recall any specific headaches I’ve had, but then upon realizing I know what a headache is, I changed my answer briefly to “Yes,” and then I changed it again to “I think so,” but now I’ve settled on, “Well, I’m sure I’ve hit my head on something before, which usually hurts, and my jaw muscles used to ache before I got braces.”  It’s easier to let the neurologists do the interpretive work.  

(Shout out to my friend Austin, who has spent a lot of time pondering the conundrum of subjective realities, such as headaches.)

How would you describe what your headache feels like?

I don’t know, it just…aches?  Is it ok to say that a headache feels like an ache in the head, or do they want something more descriptive?  I know some people have pounding headaches, or throbbing headaches, among many other varieties, but my background headache feels completely unremarkable in every way.  I could say it feels like someone punched me in the head, but I’ve never been punched in the head, so I don’t know if that’s true.  I’m most tempted to say that it feels like a rhino is sitting on my face, except my eyeballs and lips and nose and chin are still in tact and somehow only my skull is affected by the rhino butt.  I wonder if this is the sort of detail they want from me.

For my stabbing headache attacks, I think I’m supposed to say that these feel like getting stabbed in the head.  But again, I have never been stabbed in the head or anywhere else in my body, much like how I’ve never been sat on by a rhino, so I feel dishonest claiming that I know what it feels like to be stabbed.  

So far, no neurologist has been frustrated by me describing my headaches as aches and stabs, so I guess I’ll stick with that.

Do you get ice cream headaches?

No matter how hard I try, I find myself constantly flip-flopping between yes and no on this question.  But it’s not my fault! It’s because whenever a neurologist asks me this question, I ask them what an ice cream headache is, and I get a slightly different answer every single time.  So an ice cream headache is either a headache some people get when eating ice cream, a headache some people get when eating ice cream too quickly, a headache some people get when eating anything cold, or the same exact thing as brain freeze, which I’ve always defined as what happens when you drink a slushie too quickly.  Which of these is it?? I still don’t know. I’ve never gotten a headache from eating ice cream, not even once. But my record indicates I get ice cream headaches because I’ve chugged a slushie before and got brain freeze, and that settled it during my first ever neurology cross-examination.    

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The doctors I see keep extensive internal notes about me, which I usually find handy because they’re all in the same system and able to read up on the latest from Natalie’s great headache saga.  But the internal notes thing can also freak me out. For example, a doctor asked me last month how my dog, Donut, was doing. It was very nice of her to ask, except that this was our first time meeting each other and I hadn’t mentioned my dog, which means some other doctor wrote about my dog and included his name in the internal notes she was reading.  Talk about lack of dog anonymity! If the doctors have written so much about my dog, I wonder what they have on my husband.  And I wonder how many times they’ve written, “Natalie does not seem to know what a headache is or what it feels like. She has clearly lost her marbles.”