series of allergy, sinus and headache issues

Started off almost two months ago with light headed and dizzy.  Doc said you have allergies that aren't draining.  Gave me prednisone and flonase, to no avail.  Doc said if prednisone doesn't work must be infection.  Prescribed amoxicillin.  Took amoxicillin for the course and started draining like crazy right at end of medication course.  Drained and blew my nose every 10 minutes and even more in times of sweat and heat.  Just as things seemed to get better, I had a little of my energy back, I now have three days worth of headache between the eyebrows.  Last two days it came as the day went on, but woke up with the headache today and it's been prevalent all day long.  Please advise if you have an answer.  Thanks.

[bsmsl]

Hello,

You probably need to see your doctor again.  It sounds like the infection was probably not cleared and you need the antibiotics longer.  The sooner you can get back with them the better.

You may also want to start sinus rinses after your nose starts draining well.  That will help to wash the gunk out so that you can heal more quickly.

Let us know how you are doing.

God bless.

[Dr Santos]

Hi,
How are you? Sinus headaches, which present with a feeling of deep, throbbing pain and pressure in the face,  and pain that worsens with movement, may occur with sinus infection.  In your case, treatment may involve treating the headache and the underlying sinusitis. Inform your doctor about your symptoms for proper management. It is indeed possible that you need a stronger antibiotic or longer prescription of Amoxicillin. Over-the-counter analgesics, decongestants and nasal irrigation may help provide relief. Check with your doctor for proper evaluation. Take care and do keep us posted.

[terrapin05]

My doc has ordered a CT of my sinuses, so setting up that appointment and will keep updated.

[bsmsl]

Thank you for the update.  
God bless.

[terrapin05]

One small thing I've also noticed is that when these conditions are bothering me, if I drink a beer or two before dinner I can literally feel them go right to my head, like creating swelling/pressure.  Does this mean anything?

[Dr Santos]

Hi,
Beer contains salicylates which are chemicals that may cause allergy symptoms such as trouble breathing and wheezing, headaches, nasal congestion, changes in skin color, itching, skin rash, or hives, stomach pain and even swelling of the hands, feet, and face.  It can also be found in food, medication, cosmetics and beverages such as coffee, wine,  orange juice, apple cider, regular and herbal tea, rum, and sherry. Some people have a low level of tolerance to salicylates and may have reactions if more than a small amount is consumed at one time. Do keep us posted with your CT scan result. Take care and best regards.

[Dr Santos]

Hi,
Beer contains salicylates which are chemicals that may cause allergy symptoms such as trouble breathing and wheezing, headaches, nasal congestion, changes in skin color, itching, skin rash, or hives, stomach pain and even swelling of the hands, feet, and face.  It can also be found in food, medication, cosmetics and beverages such as coffee, wine,  orange juice, apple cider, regular and herbal tea, rum, and sherry. Some people have a low level of tolerance to salicylates and may have reactions if more than a small amount is consumed at one time. Do keep us posted with your CT scan result. Take care and best regards.

[terrapin05]

My CT scan revealed chronic sinus disease on my left side.  Now scheduled to see an ENT doc July 1.

[bsmsl]

Hi,
Ask your doctor to order aspirin sensitivity testing.  AERD (Aspirin Exacerbated Respiratory Disease) is triggered in the mid to late 30's (I see that you are 38 and fit the profile).  Early syptoms (symptoms) of the disease is chronic sinusitis and possibly (but not necessarily) recurring nasal polyps.  If this disease is not caught early and treated it can lead to chronic, severe, prednisone dependent asthma.  I can give you links to the research I did on it if you would like.

This disease is agressive and self perpetuating.  Once it is triggered, the only thing that can help it is aspirin desensitization.  It doesn't help that the chemical that triggers it, salicylate, is also in many fruits and vegetables.  

I would love to help you more if I can.
God bless.

[Dr Santos]

Hi,
Thanks for the updates. How are you? Chronic sinusitis or sinusitis lasting more than eight weeks,may be noninfectious and related to allergy, cystic fibrosis, gastroesophageal reflux, or exposure to environmental pollutants. Discuss the allergy aspect in your consultation as well. CT scan is considered the imaging standard for evaluation of chronic sinusitis but additional diagnostic tests such as nasal endoscopy, biopsy and clinical symptoms may also be done to make a positive diagnosis. Take care and do keep us posted with your ENT consult.

[terrapin05]

Thanks for your input, Dr. Santos.  I will let you know how the ENT visit goes.

[terrapin05]

Well, ENT visit was kind of weird.  Doc says CT clearly shows blockages in my left sinus in the cheekbone location, and he will treat that with nasal spray, Amox/Augmentin and prednisone...what I was prescribed by my reg doc but not in combination and not at this dosage.  And he's doing 10 days instead of 7.  But ENT doc says my lightheadedness may not be related to the sinus issues I have.  That is not a sinus/allergy type issue he says.  Today was first full day of meds so no change with my symptoms yet.
  

[Dr Santos]

Hi,
How are you? You are already in the middle ( 5th day) of your treatment, do you experience improvement in your symptoms? It is good that the CT scan result has showed a possible cause of your symptoms. Antibiotic treatment for sinus infection is usually longer and stronger than the usual 1 week. Continue your medications as prescribed.However, avoid discontinuing the steroid or prednisone abruptly without consulting your attending. Hope to hear from you soon.

[terrapin05]

Prednisone was only for six days, so just finished that up tonight.  Still on antibiotic for 3 more, 10 total.  Nasal spray for 30 days.  My energy seems better, the lightheadedness maybe not as bad but still present.  Things seemed better during the week but today a little tinglig in the forehead like usual.  Tingling seems to increase at night after a long hard day like today.  The prednisone has caused my sleep to be a little erratic, having some goofy dreams and waking up more often.  

[Dr Santos]

Hi,
Thanks for the updates. Good to hear that your symptoms have improved. Continue your medications as prescribed and see your doctor for follow-up. The new symptoms could be due to side effects of prednisone as well. Try to rest and drink plenty of fluids. Take care always and keep me posted.

[terrapin05]

All my meds are finished, just have the nasal spray to finish out the month.  I have to say my symptoms seem better.  I had tingling last Thursday and Friday as mentioned but have woken up feeling better since then and my energy has definitely made a comeback.  Just hope it continues now that the meds have stopped.  Return to ENT in less than 2 weeks for a follow up.  

[Dr Santos]

Hi,
It is so nice to hear that the symptoms are almost gone. This means that the medications were effective. It is important that you go for follow-up to make sure that the infection was controlled. Hope to hear from you in two weeks. Best regards.

[terrapin05]

Well, today was not as good.  I work in the restaurant business and work long hours on weekends.  On Mondays I am generally pretty tired, and the tingling in my forehead and top of head are most prevalent on this day it seems.  I also still have a little lightheadedness when I bend over and down doing things.  One other symptom I've noticed is when I'm working in the restaurant and standing at a prep table and looking down at the table, I get a lightheaded/hot flash feeling, like maybe air is restricted with the way I bend my neck tight looking down or something.  Very weird but happens a lot that way.  This also happens on hot temperature days when I'm outside, if I go outside to do something in 90degree weather I get a hot flash/quick sweat feeling.  

Just worried that maybe as the ENT suggested, the tingling symptoms may not be related to my sinus trouble.  Been reading the forums about the tingling symptoms and a lot of things suggest maybe lyme's disease, which seems very hard to get a good diagnoses on.  Just still worried about things.  

[terrapin05]

so I've completed my meds and been back to the ENT doc.  Thankfully the tingling in my head is largely gone this week.  I am still taking fluticasone (sp) spray once daily and can rescedule with ENT if need be, but the problem I was really worried about is gone.  Thanks for your help.