Brain MRI for headache while on Ipi

› Forums › General Melanoma Community › Brain MRI for headache while on Ipi

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    • April 24, 2017 at 12:22 am
    MovingOn
    Participant

      I've completed 3 Ipi infusions (10mg/kg). Most recent infusion on 4/18. Headache started very mildly on 4/13. 4/18 Lab results still show that pituitary function is in the normal range (but lower than past labs). Thyroid output is below the expected range for the first time.

      Headache got worse on Thurs/Fri/Sat/Sun. Consulted with Oncologist and went to Urgent Care today (Sunday). Urgent Care consulted with my Oncologist and did a brain CT scan (without contrast). CT result was "normal" but they said it showed buildup in my sinus resulting in a sinus headache. I've never had a sinus headache before in my life, so I hope they are right (rather than this being hypophisitis). Previously in the approval process for a Brain MRI and still planning to get it as soon as my insurance approves it (approval by Tuesday and MRI will then be scheduled for Thurs/Fri or Mon).

      Prescribed Hydrocodone and over-the-counter Flonase. Hoping that Flonase results in some output from my nasal passages because I sure don't feel like anything is in them. Maybe this is an allergic reaction headache to the wild flowers in CA this time of year but I haven't experienced this before.

       

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        • April 24, 2017 at 12:27 am
        jennunicorn
        Participant

          Could be sinusitis, I've heard of that being one of the not very common side effects. I barely had allergy problems prior to treatment, when I started Ipi 10mg my allergies got way worse and were always terrible for a few days after an infusion. Now I take Claritin every morning which helps most days and I have a steroid prescription nasal spray that I use as well.

          • April 24, 2017 at 11:35 am
          ed williams
          Participant

            I have a similiar story to Jenn's. It had been a small problem ( hard to breath through nose at night) until I took an airplane on a family trip. I thought my sinuses were going to explode. My Oncologist gave me a prescription for Mometason Furoate nasal spray and this has controlled things ever since. Best Wishes!!!Ed

            • April 24, 2017 at 10:20 pm
            MovingOn
            Participant

              Thank you!

              The headache got worse (stayed in bed for 36 hours) so I'm about to start a steroid burst.

              Looking forward to being a functioning human being once again.

              • April 25, 2017 at 4:58 am
              UBContributor
              Participant

                Hi! Hope things have sorted out for you. Pls update us on your situation. What has helped with your headache?

                • April 25, 2017 at 2:59 pm
                Mat
                Participant

                  I've had immunotherapy-induced sinusitis.  Thoughts:

                  1.  You should see a ear, nose and throat specialist.

                  2.  MRI is not that helpful in diagnosis for sinusitis (as opposed to other issues).  The ENT has a specialized CT scanner for the sinuses.  Not sure if needed since you had a regular CT.

                  3.  Oral steroids are probably not sufficient to resolve.  Likely need an antibiotic (due to infection caused by inflammation) plus oral steroids.  I was on 20mg of prednisone to supplement the antibiotic.

                  4.  Nasal rinse of combined saline and topical steroid everyday helps tremendously.  I still do this even though I don't currently have sinusitis.  The bottle and saline (salt) are available at the drugstore.  The brand is Neilmed.  Need a prescription for the steriod, which I think is called bactroban.

                    • April 25, 2017 at 3:00 pm
                    Mat
                    Participant

                      Bactroban is a topical antibiotic, not a steroid.

                    • April 25, 2017 at 4:20 pm
                    MovingOn
                    Participant

                      Thank you!

                      I'm 17 hours into the steroid burst (prednisolone for 6 days) and my headache is 90% resolved. I only feel pains now when I bend down to pick something up or make quick movements. 

                      I'm not sure if I will still be having the MRI. My insurance takes 48 hours to approve imaging so I was waiting for approval when we made the decision to start steroids. Glad that option was available and that we took it. I wasn't sure if the headache was going to get better, stay the same, or get worse. Retrospectively, I don't think it had finished getting worse when I started the steroids (after my second infusion the headache only appeared around day 11, and this was day 6 following third infusion).

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