- Popular streamer Ishowspeed has been struggling
with a devastating medical condition.
Today I wanna watch some of his videos
and messages that he's put out and react to them,
perhaps do some education
on the medical conditions he is describing.
We will not be speculating on what condition
he may or may not have.
I think it's really important for when doctors
talk about celebrities
that they don't act like they're their doctors.
'Cause there's so much information we don't know.
None of the information is really validated.
So right now we're doing some general education
and reaction.
Let's get started.
On July 28th, Ishowspeed posted the following video
to YouTube, presumably from Tokyo, Japan,
where he had been traveling.
- I want to make this video if I die.
Right now, I have one of the worst experiences,
I'm having it right now, guys.
I can't even open up my eyes.
- So not being able to open eyes can be a muscular problem,
but also can be a problem due to light sensitivity.
And this is a common aspect
of several different types of headaches.
- I have this thing called a cluster headache right now.
Deadly headache disease.
- A cluster headache, would not be classified
as one of the most deadly headache diseases.
In fact, the way that we like to think about headaches
is to break them into three categories.
Tension headaches, migraine headaches and cluster headaches.
And while cluster headaches are incredibly debilitating,
meaning that they cause really sharp pain,
very bothersome symptoms that make it difficult
to go on about your day,
they are not diagnosed as a deadly headache condition.
There are some headaches
known as like a thunderclap headache,
which are emergencies and can be deadly.
I would not put cluster headaches in that same category.
- I can't sleep, I can't eat, I can't do anything right now.
- It's very common for cluster headaches
to wake patients up at night.
- Everything I do is like something is pounding in my head
every time, bro.
And I'm so angry.
It just hurts.
Like even now it just hurts.
- I mean this type of agitation
is one of the potential symptoms of cluster headaches.
It's also important to know that
if this is your first time experiencing a cluster headache
it's gonna make you very scared.
It's going make you feel like the world is coming to an end,
that something bad is going on in your brain.
So it's not unusual for patients
going through their first episode with a cluster headache
to feel like something very bad is going on.
That's why emergent care is usually sought
in these situations.
- I want you to know I love y'all if anything happen, bro.
I just love y'all if anything happen.
Bye bye, bro.
- They're usually episodic, short-lived headaches.
And that's one of their more distinguishing factors,
where you have a period of time
where you're getting these 15-minute
to potentially hour-long episodes
of really unremitting, sharp, stabbing pain
usually on one side of your head.
This type of headache usually also comes
with some very unique features.
Watery eyes, swelling of the eyes, skin color changes,
even difficulty with opening the eye.
These symptoms happening in this episodic pattern
can be diagnosed as cluster headaches
with the help of a doctor.
One of the more troublesome factors about cluster headaches
is their period of which they're impacting you.
Meaning that there are times where these
15 to hour-long bouts can be occurring
over a period of months.
And sometimes they can happen multiple times in one day,
sometimes they happen every other day.
Cluster headaches are so debilitating
that we've seen research show that
as many as 40 to 50% of people develop
symptoms of depression related to their cluster headaches.
(upbeat music)
You could see his eye is very swollen,
he's having some orbital edema.
Not sure what the patch on his head is,
perhaps a lidocaine patch.
Very difficult to know in a situation like this,
but you could see his eye is impacted.
There are multiple theories that exist
as to why cluster headaches happen and how they happen.
The main theory really focuses on the trigeminal nerve,
which is the fifth cranial nerve.
It has three distinct branches,
that's why it's called a trigeminal.
Gives sensory sensation to the face.
And then the second part of it is the hypothalamus.
Now that hypothalamus acts as the sensor
for that homeostasis.
And when I say sensor, that means it's merging the worlds
of the neurologic system,
the nerves and how it gets all that information,
and the endocrine system,
which is how it makes impact on the body.
Remember, in order to make changes in the body,
you can do it through nerves,
but you could also do it through hormones.
And hormones essentially act as modulators for the body.
In fact, there is a whole list here
of the hormones that are regulated
by the hypothalamus right here.
Obviously people are wondering about
treatments for a condition like this,
usually 100% oxygen with a non-rebreather mask
is great for acute attacks,
and we do that in the hospital quite frequently.
There are also many medications that we can use
as oral treatments for cluster headaches.
And then if we're having really recurrent attacks,
there are actually preventive medications
we could use as well.
There are some rare instances
where surgery can be an option,
and we'll talk about that when Ishowspeed brings that up.
- Currently still in the hospital, you know,
and I'm hospitalized.
- We're looking at his vitals here on the side.
They look rather normal, which is a a reassuring sign.
- But I don't know how long I'm gonna be here.
You know, I'm like I said, I am hospitalized.
They can keep me here for months, weeks, days, or years.
- I've personally never heard of a condition
where a patient is hospitalized for years.
I mean, I'm sure there's rare outliers.
If this is truly in fact what he's saying,
that it's a cluster headache,
the idea that he would be hospitalized for weeks
let alone months is pretty unheard of
in a situation like this.
- I just did the MRE, MRI, whatever it's called.
- He's saying that he got an MRI
because in order to make the diagnosis based
on the international classification of headache disorders,
you need to rule out any other conditions
that can cause these symptoms.
The way we think about headaches in medicine
is a primary headache or a secondary headache.
Now a primary headache is happening
because the headache itself is the cause, primary.
Secondary is happening as a result of another cause.
So when we're doing an MRI, we're checking for
vascular causes of headaches.
We're checking for neoplasm, causes of headaches,
that's cancer.
So we're checking for structural abnormalities
that could be a secondary cause of headaches.
- This hurt, I'm having like a huge,
it's like a ache right here and back here.
- He's describing ipsilateral pain
that we just talked about
that's necessary for the diagnosis.
It's happening on one side.
We're getting a check mark on these diagnoses
classifications that we need for cluster headaches.
The one thing that he hasn't quite said in all his videos
is whether or not this is episodic.
Is it coming and going?
Is he getting periods of remission?
There are instances where there is no remission
for like chronic cluster headaches.
The cluster episodes just keep coming
for a really long time,
or the periods of remission are just very short.
In those instances,
you have to be much more aggressive in your management.
- Every second I just think I'm gonna die, generally.
Every second.
I'm not like, because it hurts so bad,
I don't know what's going on,
my heart's beating fast.
- If you have a good relationship with a doctor
and they come in and they explain to you,
"Look, I think this is a cluster headache.
This is not lethal.
This is gonna be very debilitating and annoying
until we figure out the correct treatment for you.
But once we do, we can get this under better control
in many instances."
Suddenly that'll calm him down,
allow him to rest, allow him to better manage his symptoms.
But of course if you're worried, and you don't know,
and you have this fear of this terrible he head pain,
without an explanation, it's not unusual
for him to think that his life is coming to an end.
And he even mentions that his heart rate is very fast.
This is a perfect example of how mental health
can be disconnected somewhat to physical health.
When someone says I have a pain in my arm,
and there's nothing anatomically wrong with their arm,
doesn't mean the pain doesn't exist,
it means the source is not coming from the arm,
it's coming from the mind.
And in this situation, you could see on the monitor,
real-time, his pulse is normal,
but he feels like it's fast
because of that mental state he's currently in.
- Hello, guys, quick update.
I don't know what I have right now.
I'm about to go through surgery right now.
- You know, he says in this clip
that he's about to go through surgery.
I don't know if that's necessarily true,
because while there are several promising,
but not really proven ways,
that you can use neurostimulation,
where they put either a deep brain stimulator
or something else to impact the neurological function
of your brain and nerves.
It hasn't been quite proven
over the course of long-term efficacy and safety.
So we don't wanna rush to do that,
especially in a young patient who's experiencing their,
what seems to be the first episode of cluster headaches.
And yet we don't even know
if these are cluster headaches for sure.
So we really need to see how this plays out
before discussing surgery.
Again, this is all if it is a cluster headache,
and we do not have that diagnosis on paper,
only through the words of Ishowspeed.
(upbeat music)
I wanna leave you with some information about headaches
that I think are not well known to the public.
And that is red-flag symptoms with headaches
of when they need to be evaluated by a doctor
or maybe even an emergency room.
Things that I personally look out for
is headaches that get worse with exertion,
a patient waking up with headaches,
starting their headaches at an older age,
headaches that have changed in intensity or characteristics,
meaning that they're different
from the headaches a patient used to have.
We actually have an acronym in medicine
called SNOOP four.
I think it probably should be called SNOOP five,
and the reason that I think it should be Snoop five
is the P has multiple uses as you can see here,
but I think the fifth P should be pregnancy.
Because if you are having headaches during pregnancy
that could be a sign of other secondary conditions
that definitely need to be ruled out before you just say,
"Oh, it must be a migraine, no big deal."
I know this condition is ongoing
and there's gonna be updates
that are gonna be thrown our way.
So if anything drastic changes, or he continues to improve,
I'll make another update video.
For now, click here to check out a video
about a patient that was misdiagnosed,
and this happens all too often in medicine.
And as always, stay happy and healthy,
especially to you, Speed.
(upbeat music)