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Hello! I Have Sudden Swelling Of The Left Side Of

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Posted on Wed, 1 May 2019
Question: Hello! I have sudden swelling of the left side of my forehead, above the brow. It’s lasting for 3.5 hours now and no signs of letting up. I have some head and temple pain and pressure, along with some left inner ear aching and neck pain. I haven’t been bitten and no traumas. I have iced it, taken two arnica 200c and two apis 200c.
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Follow up: Dr. Dariush Saghafi (0 minute later)
Hello! I have sudden swelling of the left side of my forehead, above the brow. It’s lasting for 3.5 hours now and no signs of letting up. I have some head and temple pain and pressure, along with some left inner ear aching and neck pain. I haven’t been bitten and no traumas. I have iced it, taken two arnica 200c and two apis 200c.
doctor
Answered by Dr. Dariush Saghafi (1 hour later)
Brief Answer:
Appears to be a small blood vessel that may have broken

Detailed Answer:
Good morning.

So sorry this is bothering you late at night. The photograph and description appear to be that of a spontaneous rupture of either a small subcutaneous blood vessel since it appears to be at the end of a small venule seen in the forehead.

Another possibility is that of a small pustule/abscess under the skin that has been developing and finally gotten to a noticeable point but if that were the case I would’ve expected more aggressive symptoms consistent with an infectious process such as a red, warm, painfully sore to the touch and firm mass (hard) with maybe a fever, possibly some chills, etc. The swelling actually appears benign.

So long as it doesn’t convert into any of the other things I mentioned as parameters of a bacterial process then, I would just do twice daily cold ice packs (frozen vegetable packs work great) and not worry about seeing anybody just yet unless it continues to grow or become converted the way I mentioned. Though not an entirely satisfactory explanation, the earache and neck pain are products of the mass swelling compressing the underlying nerves and structures in the forehead resulting in pain by referral to the ear and neck on the same side.

Reasonable lab tests to get would be a CBC with differential and perhaps an ESR or a C-reactive protein in the bloodstream. An X-ray of that area might show blood if it were a burst blood vessel...... or you could simply follow it for now and save having to be exposed to a lot of radiation.

If I’ve adequately answered your questions could you be so helpful by CLOSING THE QUERY and providing some positive words of encouragement for the answers, maybe even a 5 Star rating if you feel it was worth the credits.....

Cheers young lady...... !
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Dariush Saghafi (0 minute later)
Brief Answer:
Appears to be a small blood vessel that may have broken

Detailed Answer:
Good morning.

So sorry this is bothering you late at night. The photograph and description appear to be that of a spontaneous rupture of either a small subcutaneous blood vessel since it appears to be at the end of a small venule seen in the forehead.

Another possibility is that of a small pustule/abscess under the skin that has been developing and finally gotten to a noticeable point but if that were the case I would’ve expected more aggressive symptoms consistent with an infectious process such as a red, warm, painfully sore to the touch and firm mass (hard) with maybe a fever, possibly some chills, etc. The swelling actually appears benign.

So long as it doesn’t convert into any of the other things I mentioned as parameters of a bacterial process then, I would just do twice daily cold ice packs (frozen vegetable packs work great) and not worry about seeing anybody just yet unless it continues to grow or become converted the way I mentioned. Though not an entirely satisfactory explanation, the earache and neck pain are products of the mass swelling compressing the underlying nerves and structures in the forehead resulting in pain by referral to the ear and neck on the same side.

Reasonable lab tests to get would be a CBC with differential and perhaps an ESR or a C-reactive protein in the bloodstream. An X-ray of that area might show blood if it were a burst blood vessel...... or you could simply follow it for now and save having to be exposed to a lot of radiation.

If I’ve adequately answered your questions could you be so helpful by CLOSING THE QUERY and providing some positive words of encouragement for the answers, maybe even a 5 Star rating if you feel it was worth the credits.....

Cheers young lady...... !
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Dariush Saghafi (15 minutes later)
Actually, yes, it is hard and warm. A much smaller one has now appeared on the right side. I will update a photo.
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Follow up: Dr. Dariush Saghafi (0 minute later)
Actually, yes, it is hard and warm. A much smaller one has now appeared on the right side. I will update a photo.
doctor
Answered by Dr. Dariush Saghafi (6 hours later)
Brief Answer:
Good morning from XXXXXXX Miss XXXXXXX from Oklahoma

Detailed Answer:
Ahhh.....I see that other little bump on the other side and now you say the first one has become "hard" (indurated) and warm to the touch? The area is also looking slightly erythematous (reddened) and so now over the last several hours it seems to be evolving into something more of what an inflammatory or infectious process might look like.

Since this is involving the structures below the level of the skin (subcutaneous region) and the skin itself appears to be relatively intact without punctures or infection itself we could refer to this as a CELLULITIC INFLAMMATION or CELLULITIS. Sometimes these things will just pop up. I don't know if you had any acne looking spots or lesions that you have may have been trying to recently treat....or if there were any whiteheads or blackheads that you were trying to clean, scrub, or pop in the last week or so over the forehead....but those could be some things that could've been present before this all began that then, resulted in the start of this infection.

At this point, I believe it would be a very good idea for you to seek an appointment this morning with your doctor or if they're not open on Saturdays to get to an outpatient URGENT CARE FACILITY or even one of these MINUTE CLINICS at CVS or Rite Aid so that someone can take a look at that area directly and also run some bloodwork. My guess is that you may have an elevated WHITE CELL COUNT with some inflammatory markers to suggest the presence of some kind of infectious process.

I would also switch from cold compresses to warm compresses because now the idea is to get this thing to open up the circulation so as much immune fighting power as you have can get to the areas that need it the most. So I'd try gaining warm compresses and putting them on the forehead for about 15-20 min. at a time a couple times per day. If an infection can be verified or substantiated then, a broad spectrum antibiotic would be justified and I'm sure whoever you see will give you something appropriate for your condition depending upon your allergies, etc.

You should also mention of course, that you ear and neck have been hurting as well to make sure they check out the ear canal and eardrum on the left and the adenoids and tonsils to see if they're also showing any signs of swelling as you may have a more generalized process involving the ear and oropharyngeal area.

You should also drink lots of FLUIDS, water mostly and cut back or stop any alcohol and tobacco consumption while this is being taken care of (if any of that is relevant). Also, you don't want to be physically manipulating trying to SQUEEZE, MASSAGE, or otherwise force or expel any fluid out from your pores. I would not recommend that you or anyone else try and XXXXXXX the lesions at this time before being sure that they are not going to simply spread the infectious entity. I don't think you need to be that aggressive right now before giving your body and some antibiotics a chance to heal this thing up which could take anywhere from 5-10 days once you start the antibiotics. In some more unusual cases of cellulitis the swelling may APPEAR to be infectious when it is actually a response to an AUTOIMMUNE process such as psoriasis, Lupus, etc. So long as you don't have any of these types of diagnoses I think the bet is more on the bacterial form of cellulitis but that's just so cover all the bases since I don't know you except for the photos.

BTW, I did look carefully at the areas of swelling and do not see any spread into the orbital areas on the right or left so I think you're good to go on that count (eyes, eyebrow, tear glands, conjunctiva, etc.). You are at the front of this whole process so as long as you go out this morning and get someone to look at this and check your bloodwork out and get a prescription I think you should be good.

The risk is that any infectious process in this area could spread into neighboring structures such as the sinuses and allow bacteria to set up and start causing problems there....right now the swelling that's going on is the body's way of trying to limit the spread of everything until the immune system can mount a good response to whatever's causing this to begin with.....make sense?

Here is a nice little summary article that sort of highlights a lot of the things I said if you wanna take a look:

https://www.medicinenet.com/cellulitis/article.htm#cellulitis_facts

If I've provided useful or helpful information to your questions could you do me the utmost of favors in CLOSING THE QUERY along with a few positive words of feedback and maybe even a 5-star rating if you feel it is deserving? I am definitely interested in getting updated information if you'd care to drop me a line at www.bit.ly/drdariushsaghafi and send some photographs of the area so we can see how it's progressing.

You can always reach me at the above address for this and other questions. I wish you the best with everything and hope this discussion has aided in your understanding of a few concepts related to your problems and given you some direction as to which way to go for an evaluation.

This query required 103 minutes of professional time to research, assimilate, and file a response.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Dariush Saghafi (0 minute later)
Brief Answer:
Good morning from XXXXXXX Miss XXXXXXX from Oklahoma

Detailed Answer:
Ahhh.....I see that other little bump on the other side and now you say the first one has become "hard" (indurated) and warm to the touch? The area is also looking slightly erythematous (reddened) and so now over the last several hours it seems to be evolving into something more of what an inflammatory or infectious process might look like.

Since this is involving the structures below the level of the skin (subcutaneous region) and the skin itself appears to be relatively intact without punctures or infection itself we could refer to this as a CELLULITIC INFLAMMATION or CELLULITIS. Sometimes these things will just pop up. I don't know if you had any acne looking spots or lesions that you have may have been trying to recently treat....or if there were any whiteheads or blackheads that you were trying to clean, scrub, or pop in the last week or so over the forehead....but those could be some things that could've been present before this all began that then, resulted in the start of this infection.

At this point, I believe it would be a very good idea for you to seek an appointment this morning with your doctor or if they're not open on Saturdays to get to an outpatient URGENT CARE FACILITY or even one of these MINUTE CLINICS at CVS or Rite Aid so that someone can take a look at that area directly and also run some bloodwork. My guess is that you may have an elevated WHITE CELL COUNT with some inflammatory markers to suggest the presence of some kind of infectious process.

I would also switch from cold compresses to warm compresses because now the idea is to get this thing to open up the circulation so as much immune fighting power as you have can get to the areas that need it the most. So I'd try gaining warm compresses and putting them on the forehead for about 15-20 min. at a time a couple times per day. If an infection can be verified or substantiated then, a broad spectrum antibiotic would be justified and I'm sure whoever you see will give you something appropriate for your condition depending upon your allergies, etc.

You should also mention of course, that you ear and neck have been hurting as well to make sure they check out the ear canal and eardrum on the left and the adenoids and tonsils to see if they're also showing any signs of swelling as you may have a more generalized process involving the ear and oropharyngeal area.

You should also drink lots of FLUIDS, water mostly and cut back or stop any alcohol and tobacco consumption while this is being taken care of (if any of that is relevant). Also, you don't want to be physically manipulating trying to SQUEEZE, MASSAGE, or otherwise force or expel any fluid out from your pores. I would not recommend that you or anyone else try and XXXXXXX the lesions at this time before being sure that they are not going to simply spread the infectious entity. I don't think you need to be that aggressive right now before giving your body and some antibiotics a chance to heal this thing up which could take anywhere from 5-10 days once you start the antibiotics. In some more unusual cases of cellulitis the swelling may APPEAR to be infectious when it is actually a response to an AUTOIMMUNE process such as psoriasis, Lupus, etc. So long as you don't have any of these types of diagnoses I think the bet is more on the bacterial form of cellulitis but that's just so cover all the bases since I don't know you except for the photos.

BTW, I did look carefully at the areas of swelling and do not see any spread into the orbital areas on the right or left so I think you're good to go on that count (eyes, eyebrow, tear glands, conjunctiva, etc.). You are at the front of this whole process so as long as you go out this morning and get someone to look at this and check your bloodwork out and get a prescription I think you should be good.

The risk is that any infectious process in this area could spread into neighboring structures such as the sinuses and allow bacteria to set up and start causing problems there....right now the swelling that's going on is the body's way of trying to limit the spread of everything until the immune system can mount a good response to whatever's causing this to begin with.....make sense?

Here is a nice little summary article that sort of highlights a lot of the things I said if you wanna take a look:

https://www.medicinenet.com/cellulitis/article.htm#cellulitis_facts

If I've provided useful or helpful information to your questions could you do me the utmost of favors in CLOSING THE QUERY along with a few positive words of feedback and maybe even a 5-star rating if you feel it is deserving? I am definitely interested in getting updated information if you'd care to drop me a line at www.bit.ly/drdariushsaghafi and send some photographs of the area so we can see how it's progressing.

You can always reach me at the above address for this and other questions. I wish you the best with everything and hope this discussion has aided in your understanding of a few concepts related to your problems and given you some direction as to which way to go for an evaluation.

This query required 103 minutes of professional time to research, assimilate, and file a response.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dariush Saghafi (1 hour later)
Good morning! I finally fell asleep and just woke up. My sisters midwifes husband works at the convenient care and has been contacted. He’s expecting me. Thank you so much for such detailed responses!

I did recently switch (a month or so ago) skincare lines to aconpletely edible/natural one. It has really brightened and cleared up my pores, acne isn’t much of a problem for me.

I do have functional hypothyroidism, Lyme’s disease, Candida, parasites, EBV, and have been working with a functional medicine to address these issues. We are still in the beginning (3 months in) with addressing the Candida and parasites. Once those are taken care of, then we will proceed with the Lyme, which he found when no one else would even check me, so at this point I have had it for well over 10-15 years.

I will get my butt into the convenient care today and get those labs you’ve suggested. I think I only get two responses to you, so I don’t think I will be able to update you on the outcome. But, know that I am going this morning and will be in it to take care of it. :)

Thank you, again! You were excellent!!! I actually looked you up online and you have an “excellent” review from your patients as well! Take care!!
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Follow up: Dr. Dariush Saghafi (0 minute later)
Good morning! I finally fell asleep and just woke up. My sisters midwifes husband works at the convenient care and has been contacted. He’s expecting me. Thank you so much for such detailed responses!

I did recently switch (a month or so ago) skincare lines to aconpletely edible/natural one. It has really brightened and cleared up my pores, acne isn’t much of a problem for me.

I do have functional hypothyroidism, Lyme’s disease, Candida, parasites, EBV, and have been working with a functional medicine to address these issues. We are still in the beginning (3 months in) with addressing the Candida and parasites. Once those are taken care of, then we will proceed with the Lyme, which he found when no one else would even check me, so at this point I have had it for well over 10-15 years.

I will get my butt into the convenient care today and get those labs you’ve suggested. I think I only get two responses to you, so I don’t think I will be able to update you on the outcome. But, know that I am going this morning and will be in it to take care of it. :)

Thank you, again! You were excellent!!! I actually looked you up online and you have an “excellent” review from your patients as well! Take care!!
doctor
Answered by Dr. Dariush Saghafi (3 hours later)
Brief Answer:
Very glad you can make it to local center for a checkup

Detailed Answer:
My Dear Miss XXXXXXX ... your kind words are much appreciated! As it turns out I’m sitting in an Urgent Care facility myself right now in XXXXXXX KY accompanying a teammate to get stitches in a deep head wound that I wasn’t able to fix on the field! Isn’t that too much?! Haha! We’re down from XXXXXXX today to play rugby and he ended up getting a huge hit to the head. I was able to clean him up pretty well but they didn’t stock the STITCHES in the med kit so I drove him to the nearest Urgent Care and here I sit waiting for him reading your note! LOL! And get this....just as our team arrived on the field this morning, a girl from a women’s rugby team had collapsed on the field with a heart condition.... and the guys told me about it so I ran over there and started working on her..... didn’t even bring my stethoscope.... imagine that???? Didn’t think I’d need it! She recovered without needing an ambulance or CPR.....Oh man, has it been busy today! And then, there is my Miss XXXXXXX in OK! ROFLMAO! So, reading that you are getting yourself checked out was perfect! Now, I know everybody’s tucked in and fine! Ha! Do I dare go out with guys tonight or stay in? I may be bad luck or something! Anyhow, you are most welcome for everything and if you do get a chance please let me know what they find and what the plan is.... I suspect you will be just fine. Sounds like you’ve got good folks looking out for you over there. So my dear.... Carry on! My URL if you ever have the need in the future is www.bit.ly/drdariushsaghafi And again even though your comments are undeserving I greatly appreciate letting me know that the information was helpful Hope you get everything worked out in short order! Perhaps, you’ll see the XXXXXXX Rovers take a trip to your part of the world. We are in the hunt for the Midwest Championship so.......Cheers!
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Dariush Saghafi (0 minute later)
Brief Answer:
Very glad you can make it to local center for a checkup

Detailed Answer:
My Dear Miss XXXXXXX ... your kind words are much appreciated! As it turns out I’m sitting in an Urgent Care facility myself right now in XXXXXXX KY accompanying a teammate to get stitches in a deep head wound that I wasn’t able to fix on the field! Isn’t that too much?! Haha! We’re down from XXXXXXX today to play rugby and he ended up getting a huge hit to the head. I was able to clean him up pretty well but they didn’t stock the STITCHES in the med kit so I drove him to the nearest Urgent Care and here I sit waiting for him reading your note! LOL! And get this....just as our team arrived on the field this morning, a girl from a women’s rugby team had collapsed on the field with a heart condition.... and the guys told me about it so I ran over there and started working on her..... didn’t even bring my stethoscope.... imagine that???? Didn’t think I’d need it! She recovered without needing an ambulance or CPR.....Oh man, has it been busy today! And then, there is my Miss XXXXXXX in OK! ROFLMAO! So, reading that you are getting yourself checked out was perfect! Now, I know everybody’s tucked in and fine! Ha! Do I dare go out with guys tonight or stay in? I may be bad luck or something! Anyhow, you are most welcome for everything and if you do get a chance please let me know what they find and what the plan is.... I suspect you will be just fine. Sounds like you’ve got good folks looking out for you over there. So my dear.... Carry on! My URL if you ever have the need in the future is www.bit.ly/drdariushsaghafi And again even though your comments are undeserving I greatly appreciate letting me know that the information was helpful Hope you get everything worked out in short order! Perhaps, you’ll see the XXXXXXX Rovers take a trip to your part of the world. We are in the hunt for the Midwest Championship so.......Cheers!
Above answer was peer-reviewed by : Dr. Raju A.T
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Dr. Dariush Saghafi

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Practicing since :1988

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Hello! I Have Sudden Swelling Of The Left Side Of

Hello! I have sudden swelling of the left side of my forehead, above the brow. It’s lasting for 3.5 hours now and no signs of letting up. I have some head and temple pain and pressure, along with some left inner ear aching and neck pain. I haven’t been bitten and no traumas. I have iced it, taken two arnica 200c and two apis 200c.