Suggest treatment for middle ear infection
sinusitis and anxiety problem needs independent management.
welcome to HCM
From the given description, the problem of sinusitis gets very apparent. History psychiatric condition needs to be explored.
In my opinion, the sinusitis and anxiety condition appears unrelated to each other and exist independently. Although stress from any medical condition may precipitate and perpetuate anxiety problems, however they both needs to be managed independently.
The symptoms of headache, throat clearing, cough as mentioned by you are highly suggestive if sinusitis. the ear sensations are possibly due to extension inflammation and blocked eustachian tube. The presence of respiratory infection in family further supports it.
Suggestions for sinusitis:
1) A course of antibiotics will be required which can only be obtained on doctors prescription, therefore a consultation to local physican is required.
2) Steam inhalation three times a day will help clearing the congestion.
3) meanwhile, use of over the counter drugs of antihistaminic like cetrizine and NSAIDS like paracetamol can be use to deal with the headache and secretions.
4) A visit to ENT doctor can help to rule out middle ear infection as it can mimic presentation similar to sinusitis.
regarding anxiety problem:
It is important to have a specific diagnosis, know about associated co morbidities. I would need to now
1) do you feel that your heart is racing, all the day or episodic? what are the triggering cases? is it on exposure to specific situation or occurs without reason any time?
2) is it associated with vomiting, dizziness, nausea?
3) how are you keeping your mood lately? low, depressed?
4) any difficulty in sleep? feelings of guilt? persistent worry?
5) kindly provide details of medication prescribed, with duration. Reason for discontinuation?
answer to these will help me to have a clearer clinical picture of your problem.
A psychiatrist consultation can be suggestible considering a need for detailed work up and known history of psychiatric problem. Presence of weight loss is suggestive of co occurring depression.
we shall continue the discussion.
kindly followup with the information.
Dr Pankaj Borade
few suggestion in treatment
thank you for the information.
From your description it appears likely a condition of anxiety disorder.
Possibility of a bipolar or mood disorder can not be discounted as there is a history of lithium.
Considering all the information i have now,
1) A psychiatrist meeting on 3 march is important and very must a thing to look forward to.
2) For your anxiety i would suggest you to discuss with your psychiatrist, an addition of small dose of beta blocker like propranolol to your treatment.
3) For your sleep a long acting benzodiazepine can be considered at bed time.
4) Co occurring mood disorder is very likely, a mood stabilising drug can be considered.
welcome for further suggestions.
few drugs can be discuss for
thank you for the reply.
Yes, there are few options that we can think of putting you on, I would want your doctor at think of considering an addition quetiapine to your prescription.
For anxiety, low dose long acting benzodiazepines can be thought of along with beta blocker. Given in divided doses.
Taking medication is must, and you need to understand that if properly and regularly taken it can improve your functioning to normal.
the above suggestions can be discussed with your treating psychiatrist.
welcome for further suggestion,
Dr Pankaj Borade
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