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Dr. Andrew Rynne

Family Physician

Exp 50 years

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How can serious headaches and intermittent nose pain and pressure be treated while on Prednisolone, Mucinex and Fluticasone OTC nasal spray?

Answered by
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Dr. Uday Nath Sahoo

General & Family Physician

Practicing since :1969

Answered : 2452 Questions

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Posted on Tue, 20 Nov 2018 in Ear, Nose and Throat Problems
Question: Hello,

My wife has some serious headache and nose pain issue that looks like a chronic sinusitis to me. Which is why, I went for a CT Scan of Paranasal Sinuses. I have uploaded 3 CT Scans films: ct_scan_1, ct_scan_2, ct_scan_3 for you to understand and the radiologists final observation: ct_scan_observation.

I have also uploaded 3 images pointing how the pain moves. The pain starts from the point shown in image paint_starts and ends to the point according to the image pain_ends. Pain sustains within the area pointed in image pain_around_this_finger_points

My wife had nasal polyps surgery 10 years ago. She uses spectacle and she also feels a pressure appears from the spectacles to the nose.

Currently, she is taking prednisolone. For first 4 days, she used 40mg prednisolone, next 4 days she used 20 mg, and it is her 9th day and she is on 10mg prednisolone right now. She uses Fluticasone OTC nasal spray every evening. She is currently feeling better, but the pain suddenly comes and go. She also feels pain if you put pressure on her nose.

She is also taking Mucinex 1200mg extended release tablet for 5 days now.

Please advise if you think the issue is sinusitis or something else or any other diagnostic that you think required to understand the problem with the nose. Should I try Xray for nose to find if she has any problem with nasal ortho or anything else? Thanks.
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Answered by Dr. Uday Nath Sahoo 2 hours later
Brief Answer:
This seems to be chronic sinusitis

Detailed Answer:

Hello,

As far as your clinical history is concerned, please follow like this:-

1) Do a clinical examination by your doctor [ENT]. To reconfirm do a few investigations like [CBC with differential, Nasal endoscopy, and tissue culture of maxillary sinus] to know the exact cause of inflammation.

2) Do take all prescribed medications as per your treating doctor's advice.

3) Discuss with your doctor about endoscopic sinus surgery as per nasal endoscopy and culture report only.

Follow lifestyle modification like this:-

1) Try to avoid upper respiratory infections. Minimize contact with people who have cold. Wash your hands frequently with soap and water, especially before meals.

2) Try to manage your allergies. Work with your doctor to keep symptoms under control and check your blood differential count every month.

3) Try to avoid cigarette smoke and polluted air.

4) Always use a humidifier. If the air in your bedroom is dry. Be sure the humidifier stays clean and free of mold with regular, thorough cleaning.

Hope that helps.

Regards,
Dr. Uday Nath Sahoo,
General & Family Physician
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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