stuffy head or migraine?

I'm not sure if it's my freshly diagnosed autoimmune issue, my mucositis (yech), or just bad luck, but I've gotten lots more colds in the last couple of years than I ever had before. I don't mind them so much--sometimes I enjoy the scratchy, sultry voice (it allows me sing in lower registers as I belt along with the radio in my car--I'm amazing).

Perhaps it's not the frequency of colds but their duration that has changed in recent years. I used to get a cold for 2-3 days and then have little to no trace of it left. Nowadays it seems my cold develops slowly and takes a long time to leave. This one's been around for at least a week and a half. It started with sneezing and stuffy-headed-ness. Then it moved into my throat, where it settled in and made it hard for me to speak loudly enough for people to understand me well. After my voice started coming back early last week, I figured the cold was on its way out. WRONG. It moved back into my head, focusing mainly on the left side of my sinus cavity.

Here's the rub: I can't always tell the difference between the beginning stages of a migraine and sinus congestion. From what I understand, a lot of migraineurs confuse the two. (Let's not rehash the sinus headache issue here, though.) This past Wednesday, I went to bed early with a congested head; I woke in the middle of the night a couple of times because my head was so heavy and it was hard to breathe. After awaking Thursday and walking around the house a bit, I realized I was not suffering from just sinus congestion: I had a migraine that was rapidly progressing. I kicked myself for not having taken a triptan in the middle of the night.

But it had been so hard to tell the difference between sinus pressure & the early stages of migraine!

This morning I awoke with so much sinus congestion on the left that I immediately opened my bedside table drawer to get a Maxalt tab. There was no such tab in the drawer, so, favoring another hour in bed over getting up to look for my triptan pill, I took a nasal decongestent (I have an emergency drug arsenal next to my bed, of course). Upon waking in earnest, I dared to try my neti pot again. (Months ago I had a strange experience wherein using my neti pot led to an immediate and severe migraine--not sure how I screwed up, but I did and it HURT. I've been scared to try the pot again ever since despite its having worked wonders pre-pain-incident.) I can't claim that any one thing cured today's head issues, but the decongestent + neti pot flush rid me of the migrainey feeling I had. Interesting.

Do any migraineurs (or folks with sinus problems like me) have any tips as to how to know when to use a triptan and when to focus on the sinuses? How do you tell the difference between the beginning of a migraine and a side effect of sinus problems?

Dinah won't you blow, Dinah won't you blow...

WARNING: THIS POST MIGHT HAVE TOO MUCH INFORMATION FOR THE NON-MUCUS-FRIENDLY OR FEINT OF HEART.

I have had this bout of sinusitis for at least (at least!) a week now. Despite a Z-pack, lots of rest, and some doctor-recommended over-the-counter meds, the cough and mucus are not going away as quickly as I'd expect. Ugh.

On Tuesday night, the night before my doctor's appointment, I was doing the routine nose-blow-before-bed move when, all of a sudden, liquid started coming out of my right nostril. A lot of it. For a few minutes, I continuously blew my nose and clear, very warm water (water?) came out of my right nostril. At first I couldn't help but be relieved: it seemed that as soon as this strange liquid was brought forth, the pain in my cheek and ear immediately became MUCH better. So much better. But then I got a little nervous. I've never seen anything like that happen before and even thought about calling J. to see if it'd ever happened to him. "Oh, you're worrying for nothing," thought I. After the few minutes of the clear stuff (which was nothing like mucus, mind you) coming out, it seemed the coast was clear. I sat on my bed cross-legged and--suddenly--plop! It was dripping from my nose and onto my pant leg. GROSS. A couple more tissues and everything was fine. As if it'd never happened.

I told the doctor about this episode because it seemed so strange to me. Okay, my cyberchondriac self knew the chances were slim, but couldn't there be a chance I was leaking cerebrospinal fluid? (I didn't voice this concern to the doctor, but I had voiced it to myself the night of the weirdness after a twenty minute internet search.) As I told her about the episode, she frowned and looked at me: "Well, since you edit medical documents, I'm guessing you might be a bit concerned about a cerebrospinal fluid leak?" "Yes!" (I didn't mention that I don't edit anything dealing with CSF leak ever and that it was a late-night Googling session that made me aware of the problem in the first place. Let her think I have professional interest.) She told me that she really doubted there was a CSF leak, but that if it happened again like that I should call her and make a trip to the ER. She said it was quite possible that the severity of my sinus problem could have meant that for days my mucus has been building up in my sinuses. I was staying well hydrated, and the water I was drinking wasn't able to mix well with the older, thicker, nastier mucus so the watery stuff was sort of building up behind the old, gross mucus. Once I cleared that old, super-green mucus out for the moment, the watery stuff was released in a gush. Maybe. (Yuck, right?) She then said, "And it's not as if you've had any head injury lately, right?" "Actually, I was in a car wreck in mid-November and had a minor head injury." Oh. Then let's keep an eye out just in case something else is up, kids!

The waterfall phenomenon has not happened again, but that doesn't mean I'm not keeping an eye (a nose?) out just in case.

And then tonight something strange happened. I have been feeling a bit better today--just a few coughs and much less need to blow my nose (though I certainly am obviously sick, both audibly and visibly). Had a migraine this morning (period-related) but Imitrex wiped it out immediately. I blew my nose before settling into bed when suddenly I realized I couldn't stop. Couldn't stop blowing my nose, that is. I spent five minutes blowing my nose, people--and everything was coming from the right nostril. It seemed each tissue must be my last, but within 2-3 seconds I could feel more coming immediately. Then the clear feeling for a second, then the need to blow my nose. (Here's when I go into even more detail, for those of you who are as gross as I and have continued reading this far!) The mucus was green but not as thick as it's been for the last few days. It was green and really thin and liquidy. And it kept coming. For 5-7 minutes. TWELVE tissues' worth.

Does anyone have any insight? I'm hoping this all can be easily explained. I have never had such a sinus problem last so long, so perhaps this is just par for the course when sinusitis has progressed as far as mine has.

Still--let me know your thoughts, even if you are as gross and crazy as I have sounded in this post!

Goodnight!

doctor's diagnosis: sinusitis

I was nervous to go to the doctor today. I called around to a few clinics and urgent care centers yesterday afternoon to see what places could take me soonest and at what price. Despite reading a couple lackluster reviews for the health center closest to me, I booked an appointment anyway. Were I needing to see someone about Migraine, perhaps I would have been a bit more cautious. But since I was going in to get some antibiotics for a seemingly routine sinus infection, I figured it wouldn't hurt to see a family doctor and hope for the best. The initial appointment is only $50 (over $110 cheaper than my second option, and 4 miles closer to my house!); after that, you pay on a sliding scale based on income information you provide to the clerk. The maximum payment for a doctor's visit is $50, however. Awesome.

It's been over two years since I had a good, old-fashioned, regular (read: non-neurologist, non-ER) doctor's appointment and I was pretty nervous. I prepare myself for a meeting with someone who might not be a good listener, who might not be warm and caring. Despite his being warm and kind, my former neurologist was not the best listener--his NPs were atrocious, but that's a whole other story.

This feels silly, to be basking in the glow of a great doctor's appointment. Who does this? Someone who has been treated as if she were just another routine appointment to check off the list during a very long, very typical day? I'm not sure. Someone who's used to people trying to play her (contractors for home improvements, car repair folks, insurance companies)? Maybe. In any case, I was really happy with almost every aspect of my time spent at the place.

First off, I must give props (ew--I've never said that before and hope never to again; I'll keep it in to remind myself of that solemn oath) to the receptionist I spoke with yesterday afternoon when making the appointment. She heard how stuffed up I was and was really warm and very helpful: "Oh, honey, you don't sound good! Let me see if I can squeeze you in tomorrow morning. And I'll call you if something opens up this afternoon!"

Despite my better intentions, I drove to the center instead of walking. Hey, it was raining and I felt sick and the .9 mile drive probably didn't kill the environment all that much. By the time I left, the rain was POURING down and I was grateful to have a car. I walked in to a room half-full of families of various races. Seemed most people had colds or the flu--it is a rainy December, after all. The guy at the desk was really friendly, even when I walked up to the window after an hour to ask when I would be seen. Yeah, that was the frustrating part--my ten o'clock appointment ended up being at 11:05. Alas. Luckily I didn't have anything better to do than sit and read.

Oh, oh! The WAITING ROOM! I'd brought my red-tinted shady glasses to protect my little eyeballs and brain from the inevitable fluorescent lights, and guess what? The waiting room was softly lit with low-wattage incandescent bulbs. Oh, what a relief, especially when the wait was a bit long! Even my highly revered neurologist, a headache specialist, has glaring fluorescents in the waiting room. (I really don't mean to rag on him and his staff so much--apparently I have some pent-up bitterness!)

I got weighed and was a bit disappointed--turns out the post-Zonegran weight I successfully gained has, for the most part, dropped off again. Still technically underweight by a couple pounds, but I don't look creepy-skinny or anything. Not at all. I waited in the exam room for a while between nurse and doctor visits, but I passed the time by reading an outdated People--I hadn't realized just how bad the writing and stories and fluff had gotten! Not my style. The doctor walked in and I immediately felt a sense of relief--she was young, smiling, and genuinely apologetic about the supposedly atypical wait. She seemed knowledgeable about Migraine disease, patiently listened to my whole story of the cold-turned-sinus-trouble, and made some OTC drug recommendations as she prescribed an antibiotic. I mentioned something else troublesome to her and she was really comforting and helpful on that front, too--more on that later. For now I'm freaking myself out a bit over a symptom that could very well be nothing, so I'll just wait it out 'til I forget about it again.

All in all, I was really pleased--can you tell? What a sense of relief! How great to have a ten- or fifteen-minute appointment with a doctor who listens, who's friendly, and who didn't act like I was crazy when I mentioned weird symptoms I was concerned about. Three cheers for new doctor! I have a checkup next week. If I'm still this infatuated, maybe she will become my regular family doctor! Yippee.

Very sleepy and very sinusy and very drugged up.

No significant migraine pain for eight days, kids. EIGHT DAYS! True I have this sinusitis frustration, but it sure does beat a migraine episode!

congested congestion never ends

I have felt congested for, I don't know, a few MONTHS now? I chalked it up at first to Georgia weather, but this has gotten out of control. Quite often my entire head, from the skin on the back of it to my nose to the sinus cavities under my cheekbones (uh, there are sinus cavities there, right?) has been stuffy. Yes, experts, I realize that the diagnosis of "sinus headache" is not accurate and that it's usually Migraine at work (this is touched upon here). Yes, I realize that sinus congestion can be a precursor or side effect of a Migraine attack. But all the time? Really? Even when I'm not in the midst of a Migraine episode?

Perhaps this is tied to the incessant tiredness I've been dealing with. In the last couple weeks, I've gotten so tired I've succumbed to the desire to take a nap for 30-120 minutes. When I awake, I feel groggy at first but then have energy again. Imagine that--energy!

Here's what I'm thinking. I need to make more money. I need to make more money so I can see a doctor who actually practices in my town. I need to talk to a doctor whose staff doesn't feel like I'm bothering them. I need to figure out what's going on with my body as a whole, but I have to get over my hesitation when it comes to holistic healing. Okay, let's clarify: holistic treatment is one of the only methods that makes sense. Of course you have to look at the entire body in order to figure out what's happening to make you function under par. But so many holistic healers I've come across--mainly on the web or in accidental late night conversations at music shows--are a bit kooky. The daughter of two die-hard skeptics (not to mention I'm a skeptical little squirrel myself), it's difficult for me to swallow the talk they deliver, the talk that smacks of New Age (e.g., millenia-old) wisdom. What to do?

For now I can't do anything anyway. Ain't no dispensible income to speak of, so I'll just sit tight. Bright news at the moment? My stuffiness is only 15% present at the moment. And yes, that's an official calculation.

a pain a day

I have had a headache every day for the last week or so. This achey, sinusy feeling throbbing on the left side of my head feels like a grade 2 Migraine headache. It's only progressed to a full-fledged Migraine twice in 8 days, and I've only taken a triptan twice. I am wary of taking pain medication for it because I don't want my chronic daily headache to rear its ugly head again in the same way it used to. This is how it used to feel, minus the sinusy aspects.

Had I not learned that the vast majority "sinus headaches" are really undiagnosed Migraine headaches, I'd think I were suffering from a sinus headache in part. I also feel the way I do the night before I get my period, that particular brand of Migraine I endure right before the onset.

It has been around 100 degrees out every day for the last several days here, and maybe that has something to do with this. I don't know. I just feel tired and helpless since I feel I can't take my medication due to fear of rebound headache.

springing into action?

The weather has been gorgeous lately--ridiculously high temperatures for early and mid-March, puffy clouds, temperatures in the 70s, and sunshine, sunshine, sunshine. This, of course, also means flowers and pollen and runny noses and sneezing.


For me it also means a stuffy head, tight neck, and increase in Migraine frequency. I've grown used to the fact that my Migraines are triggered by shifts in barometric pressure: when it's going to rain, my temples and neck seem to know it before I even step outside or check the weather online. Perhaps it's because I've only really started studying my Migraine patterns in the last couple of years; perhaps it's because seasons don't change all that frequently--in any case, from spring to spring I forget how frustratingly stuffy and painful my head and body get while the weather patterns shift and winter disappears.

It's not at all uncommon for Migraineurs to be affected by changes in weather. It's true that sinus medication might ease symptoms, but there's always the risk that taking over-the-counter medication will (a) lessen the effectiveness of prescription medication, (b) lead to an increase in the number of rebound headaches, and/or (c) lead to more intense Migraines.

Yet another conundrum.

I don't mean to simply use this as a forum for my own venting. What I found today was that spending the day outside was slightly painful but really enjoyable. I "paid for it" by having to lie low in the evening time, having a quiet dinner and then canceling my tentative plans to spend time with friends because my headache's just bad enough not to socialize, but not bad enough for me to want to take prescription meds for the second day in a row.

So for me, it's bedtime.

For you, I wish you a pleasant day or evening, depending on when you're reading. Take care.