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My mom-87, says she has a bad headache every day. Have had MRI, X-ray, nothing to indicate the cause. She drinks 2 cups of coffee each day but no more caffeine. Takes 400mg of Tylenol every 4-6 hrs but says it still hurts. Is there anything else we should do?

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Is she on blood pressure meds? My mom too complained of noon headaches. The doctor suggested spreading the blood pressure meds out throughout the day, and that solved the problem.
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Many good ideas posted, here's one that is safe and simple: she may be dehydrated. My husband is a migraine sufferer (not saying that's what your mom has) and when he would go into Urgent Care for bad ones they would often start with just a bag of fluids and his headache would go away. He is 60 and plays hockey 3x per week and thought he was drinking enough. Try to work more plain water into her daily routine and see if that doesn't help. It's a simple experiment that won't interfere with anything else she is taking. She will need to use the bathroom more...

Another thing to consider: I noticed that my MIL who has bad short-term memory loss & mild dementia is that she became less able to accurately describe or pinpoint pain. She was a life-long migraine sufferer, but hasn't had one since being in a facility. Sometimes she will wince with pain as she voids her bladder (a UTI). Then we will ask her about the pain, she will say, "What pain?" Sometimes it's hard to know how to help her. Good luck!
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Good point about medications, many do have unwanted side effects. Some medications also have benefits apart from their prescribed use, something also to consider if something she has previously been on has been changed.
At one point my mom's doctor thought she should try a more modern medication than the propranolol (a beta blocker) that she had been on for 20 years. It soon became apparent that the medication was doing more than regulating her BP, it had also reduced her essential tremor and her chronic headaches.
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My mom was taking prescription meds for Alzheimers, she tried 2 different ones (sorry can't remember which ones), and she was having horrible headaches, which is one of the side effects.  So, if your mom is on medication for ALZ you might rethink giving it to her.  We stopped.  It was not worth her being in pain.
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Lizard61 Aug 2019
Luckily she isn’t on meds except Blood pressure and vitamins. My Dad gave her tea at noon yesterday and no headache! I think it was caffeine withdrawal from her morning coffee.
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She only takes 400 mg at noon and bedtime. Ibuprofen didn’t work. Will try massage. Thanks!
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Did you recently withdraw the caffeine? As that will cause very bad headaches. Do you take her blood pressure at the times that she complains of the headaches? I doubt that these headaches have to do with dementia. What does her doctor think? CWillie is so right that so often headaches come from areas that can be helped by gentle massage. The curvature of the spine with age can cause some awful muscles spasming that will go from shoulders to neck. I SWEAR by physical Therapists for pinpointing where pain is being triggered from. Would your doctor consider a PT consult to see if this is coming from posture, muscles, etc.
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Lizard61 Aug 2019
I will tell my Dad to check again with MD on possible PT consult. She doesn’t drink much caffeine but still has her morning coffee. Headache appears at noon so could be when caffeine wears off!
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Is she able to describe exactly where her headaches are? Sometimes gently massaging the neck and shoulders, temple, jaw, scalp or around the eyes can help. OTC topical analgesics like voltaren can also be helpful if applied to those areas. My mom's doctor also told us to use ibuprofen if the tylenol alone wasn't enough.
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Lizard61 Aug 2019
Thanks for advice . She describes headache as all over her head. Will try massages.
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Have you talked to her doctor about rebound headaches? If she is taking 2400mg of Tylenol a day she is consuming 2.4 times the recommended maximum dose of 1000 mg.

Have you tried Aspirin or Ibuprofen instead of the Tylenol?

There are other options for headaches, but they could well be contraindicated by other medications or health conditions.
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