2.11.2015

[miss_lucy21]

The more I think about it, the more I think there's multiple problems here. There is most definitely a sinus drainage problem (more like, a sinus non-drainage problem). I do legitimately get sinusitis about 4-5 times a year and lately that's also included ear infections. So even though there's not an obvious structural problem on the CT scan, there's obviously something going wrong up in there.

The headache, however, is probably actually not sinus related, judging by the reading I've been doing. I've seen multiple studies that say that roughly 90% of sinus headaches are actually migraines. Apparently, migraines can cause runny noses and puffy eyes, which I've been attributing to my allergies/sinus issues. And since the pain is mostly localised on one side and I am photosensitive (although, I'm always photosensitive, not just when my head hurts), that would tend to suggest migraine. I did used to have more traditional migraines with the nausea and the one sided throbbing and auras when I was younger, too. The nausea and the aura/visual disturbances aren't happening now, but apparently, those aren't entirely necessary to the diagnosis.

And then there's the possible immune system dysfunction, which would play a larger role in the legitimate sinus issues. I don't know what exactly we do about that- I'm reading a lot of conflicting things about whether it's worth treating if it's just one set of immunoglobulins or if it's on the milder end, which it would seem to be what I'm looking at here, at a guess. I won't have bloodwork back until early March, because I can't even go get it done until the 26th. I'm guessing it's not a primary disorder or a severe issue because those are usually identified in children. And while I was frequently sick as a kid, a lot of it diminished when my asthma was brought under control and after the initial sinus surgery. So, I'm backburnering this issue until I have more info- I can't do anything with this one for a couple weeks.

And then there's the depression/anxiety issue, which is probably feeding on one or more of the other issues, but still needs attention. I've been suspecting the Prozac has been losing effectiveness for awhile now, but I was managing. I am not managing at this point. Not well. So, exploring that angle would probably be useful. I see my GP on Monday, I can see if she's willing to prescribe something else (some GPs like to stick to a limited number of SSRIs). If not, then I'll go shopping for a psych. That's probably not a horrible idea, anyway, given the mix of brain stuff going on (I don't necessarily need to be medicated for the ADHD- I'm clearly functional without meds, since I haven't been on them for several years and I'm employed, housed, current on bills and more or less well fed on my own- but I'm sure that's a complicating factor, somehow).

But at the moment, I need to try to go sleep.

Comments

[sailorsol]

I got put on wellbutrin when I brought up that the Prozac wasn't cutting it anymore. I am back on the ProzacProzac after six weeks because the wellbutrin fueled my anxiety. And a lot of people end up with memory/concentration problems with it. So take care if that is what your doc suggests.

Good luck.

[miss_lucy21]

Thanks for the heads up. Wellbutrin is actually supposed to work well and increase concentration for people with ADHD, so I'd been considering it (isn't neuro-divergence bizarre like that?), but it's good to hear other people's experiences.

[sailorsol]

Definitely not my experience with ADHD + Wellbutrin. I mean, my ADHD is fairly mild, but.... yeah. One of the listed side effects is anxiety, and even with some Prozac still balancing things.... You can see my DW entries talking about my anxiety explosion if you're interested. And hey, yeah, everyone's different, so. Hopefully they can find you something that helps more than just the Prozac, because it totally sucks when you realize your meds aren't working well enough and wonder if there's anything else to try.

[hagar_972]

...Cipralex is also indicated against anxiety. It's another SSRI, but sometimes switching within a drug family works. (They do all have subtly different actions.) Switching to another SSRI would also be a more conservative option than switching to the one SNRI in existence (Cymbalta) or to the nicotinic ones (Wellbutrin, Effexor). The nicotinic ones can and often are combined with the SSRIs, but that's where you'd need a psych.

(The one thing with the Cipralex is that for the first two weeks or so, it makes the anxiety that much worse. However, that's the one side effect guaranteed to go away.)

And ADHD is a resource leech which, yeah, would make everything else harder.

I don't remember if you tolerate coffee? Because strong coffee (preferably with sugar) at migraine onset is an ages-old treatment. Alt., try keeping your shoulder/neck/head better covered than they currently are. Taking a look at how you're doing with salt may not be a bad idea either. (You more likely need to add than reduce.)

[miss_lucy21]

Coffee is a no-go. My caffeine tolerance tops out at chai latte, which has about a third as much caffeine as a regular cup of coffee. Plus milk, to mitigate it even further. I'll check the salt out, though.

[ernads]

One thing in addition to Hagar‘s comment: in cases of multiple neurological issue you might need a neurologist as well. I was given Chiperlex by a GP and a psychiatrist. And even the psychiatrist didn't take into Account it will mess my epilepsy. So there was a big mess there. In the end and with lots of help (Hagar did better homework here than the doctor. It was bad) we settled on Cymbalta. But it was a huge mess.

Now I am a special mess with ADHD,epilepsy,Fibromyalgia,DPD and depression. But better be safe than sorry?

[miss_lucy21]

Yeah, I'm anticipating a neurologist for the head if the ENT decides that migraine is the most likely cause. I do, however, have a pretty good track record with the psych drugs. A couple I've tried just plain didn't work, but for the most part I haven't had significant side effect issues. The one exception was the stimulant meds for the ADHD- they worked beautifully, but screwed with my blood pressure. So I'm pretty okay with going the experimental route with the GP if it works out that way. My GP is pretty on the ball and she's in communication with my asthma doc and I know the ENT dropped her a note, too, so everyone's talking to each other.