Hi XXXXXXX and thank you so much for this query. I am Dr. Ditah and feel honored having this opportunity to address your health questions today. I am so sorry about this severe headache you are having now.

Your symptoms raise the suspicion of temporal arteritis. This often causes severe unilateral headaches in the temple area associated with blur vision, pains on opening the mouth and chewing, pains combing the hair on this side, double vision and in extreme cases immediate spontaneous loss of vision. At times, a swollen and tender artery(temporal) may be palpable in the temple area on the affected side. Your age is a little out of place because it occurs typically in the elderly though not exclusively.

In order to confirm this diagnosis, you will need to be consulted by a physician who will interview you, examine this area and ask a few tests including erythrocyte sedimentation rate, blood count and others depending on the initial findings. He will also ask questions to investigate and rule out the other common cause of severe unilateral headache like migraines and cluster headaches.

The most feared complications of this headaches are blindness(permanent), stroke and aortic aneurysm. This is why it is very important to get consulted as soon as possible(without any delays) so that if this is for real the final diagnosis, prompt treatment should be started to prevent these possible complications.

I hope this answers your query and provides ample information for you to act on and make informed choices. If you should however need more information or have follow up question related to this query, please I am ready to help you with them. I wish you all the best as you continue to figure out what this problem is.
Dr. Ditah, MD.

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Hi XXXXXXX

I am so sorry to hear that you still have this terrible headache and the recent diagnosis of high blood pressure. In this period when you are so stressed, I have a high suspicion that this high blood pressure is as a result of stress and should disappear when you have your pains controlled. Please, do not forget to get this blood pressure controlled when the headaches are gone. This is just to make sure it is really the case with you.

The best specialist to see now is a neurologist or rheumatologist, which ever you get first. Though I may prefer a neurologist because he can look into many other causes of headaches if it turns out not to be temporal arteritis.I am so sorry about this persistence of symptoms and hope you will soon get to find relief and a long lasting solution to this. I wish you all the best.
Please, feel free to ask more questions related to this query if need be.
Dr. Ditah, MD.

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Hi XXXXXXX and thank you so much for continuous follow up questions and more information.

I feel like there is some information i never got from you. If you are having sinusitis symptoms, then you should probably have runny nose, increase mucus production that either drains through your nostrils or the back of your throat associated with this headache. It often gets worse when you lean forward and rarely associated with blur vision except in very serious cases.

If you have most of these symptoms, then it could be that for real you have sinusitis. The treatment of sinusitis depends on the cause. Most cases are caused by viruses and treatment is often limited to simple management of symptoms. For example, pain killers for pains/headaches and fevers, nasal irrigation for obstructed nostrils, nasal decongestant sprays etc.

If the cause is a bacteria, antibiotics are only required in persistent cases(like yours) or very severe symptoms. The most commonly prescribed drug is amoxicillin at appropriate doses for about 10-14days even if symptoms have resolved. Also, symptoms are addressed accordingly.

If the symptoms should not resolve and you feeling better in a week's time, you may need to do some tests to find out if there are any other reasons which may explain why. They may include blood test, xray of the head etc

So for now: Get some pain killers(Ibuprofene and paracetamol),antibiotics like amoxicillin, mucolytics like carbocysteine and solutions for nasal irrigation. You would want to double check what doses are appropriate for you with the pharmacist or your physician.
For now, there are no dos and don'ts. If this problem should continue and specific reasons found to make such suggestions, we would in future.

I hope this really helps. I feel like I never got all the symptoms because looking back i still find it difficult to settle on this diagnosis but for the fact that you have suggested so. This treatment should be of help to you if for real it is sinusitis. I wish you get relieved as soon as possible. If there are any more ways I can help you, please, do not hesitate. Also, you may want to summarize exactly how you feel now and send to me if you think much has changed.

Dr. Ditah, MD

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Hi and thank you so much for this follow up.

With little mucus, it could still be a case of sinusitis though not typical.
Please, with very confusing signs and symptoms that don't really get the clear diagnosis merits that you get an in person doctor's attention. You will need to be examined and maybe do a few tests to settle on the exact cause of this problem. Besides, reporting early morning stiffness is not typical in sinusitis and for me to stop and conclude on this is very difficult and disturbing as a doctor who wants the best for his patients.

Pain killers are meant to control the symptoms while we treat the cause. Without a clearly identified cause, pain killers will only mask the bigger picture and may prevent us from addressing potentially concerning problems. You cannot continue the indefinitely unless we really think that's the best way forward and that decision cannot be made now.

I had really wished I resolved this problem without asking you to see a doctor physically but your symptoms are not typical of any clear cause of unilateral headaches. An ENT is going to be the best option for now. This is in your best interest.

I hope you understand why I am asking you to be seen by a doctor.
I wish you well. I hope you get the cause figured out and you treated accordingly. I wish you a speedy recovery fro this and good health in future.
Dr. Ditah, MD.

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You are welcome.
I wish you well.
Dr. Ditah, MD.

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