When My ENT Visit Turned Into a Headache Appointment

I have a long history of ear, nose, and throat issues. This started with needing pressure equalizing (PE) tubes, at 5. I had to get this procedure almost yearly til I was in middle school. Then, as an adult, I had to get a permanent T-tube for one ear. I had to have a hole in each eardrum repaired (tympanoplasty) in 6th grade (right), and, in my early 30s (left).

Then there were the issues of nosebleeds that led to getting my adenoids out in elementary school. I had strep throat often as well. I then had my tonsils removed. This was in 6th grade as well. Medically, that was not a good year.

Have I had ear, nose, and throat issues recently?

More recently, I have had lots of sinus issues. The nosebleeds have returned, but, just a bit. My nose has been stuffy a lot. I've had sinus pain and pressure that seemed to last a few days, to, a few weeks accompanied by chills, aches, nausea, dizziness, and lightheadedness.

I had septoplasty with turbinate reduction and a nasal polyp removed. I thought that would help, but things remained as they were before. My immunologist recommended going back to ENT. My ENT specialist had also been following my ethmoid osteoma. That is a bony tumor, benign, on the ethmoid sinuses. I opted not to get it removed with the septoplasty earlier. Now, I was thinking that maybe that was the source.

Is the tumor causing my sinus issues?

Due to my medical history, my ENT specialist, chose to send me to someone who does osteoma removal more frequently. I saw him and he was a very compassionate doctor, but, he did not think the removal would help. Why? First, I have many complex medical issues. Second, he believes that the ethmoid osteoma is not causing the symptoms.

In his opinion, the sinus issues are due to migraine and chronic headache. I am being treating frequently for sinus infections because I have primary immunodeficiency as well. We only treat the sinus infections if they don't resolve with conservative treatment: sinus rinses, antihistamines, Nasacort, guaifenesin, etc. If my fever persists along with chills and aches, we treat it with antibiotics before I end up hospitalized.

This new doctor handed me a “Headache/Migraine,” printout. The printout included information such as that below:

• Treating headaches with things such as: cool cloths, a dark room, massage, and over-the-counter meds.
• Things to do daily: get up and sleep at the same time, de-stress, stay hydrated, make sure you eat, and keep a journal of triggers/symptoms.
• Supplements that may be helpful: Magnesium, Co-Q10, and B2.
• Some common migraine food triggers: processed meats, caffeine (for some), red wine, cheese, chocolate, and some vitamins/herbs (this one was new to me).

Are my migraine and sinus problems under control?

The new ENT specialist believes that if I get my chronic migraine and daily headaches under control, that some of the symptoms will go away, or, be reduced. I always thought I had a good regimen, but, if I am still having dizziness weekly, increased sinus issues, migraines weekly, and increased nausea and/or vomiting, are they really under control?

I personally do not think that my migraines are the root of the sinus issues, but I do believe that when my sinuses flare up, my migraines do increase. It seems that everything impacts my migraines though. I will do my best to get the sinus pain/pressure, with and without infection, under control. The good thing is that I have been put on a compounded sinus rinse by my immunologist. It has some pretty powerful stuff in it: a budesonide ampule, mupirocin capsule, acetylcysteine capsule, sterile water, and a sodium chloride and sodium bicarbonate NeilMed powder. I do have to mix this is the NeilMed bottle to use daily, or every other day.

So…for now, we will use the compounded antibiotic nasal rinse, rescue migraine medications (nasal sumatriptan), and monthly preventative Aimovig. Let’s hope that this year will be better than the rest, for migraines and sinuses.