I like to think I keep up with the current evidence and trends in the “science of pain” (see what I did there) and I am definitely against anything that suggest the old chestnut “it’s all in your head” (subtext for your crazy and imagining your pain). I am also aware even with our best intent sometimes the “pain is a brain construct” also leads patients to think this is still the old “it’s all in your head” suggestion.
For the last month I have been suffering (my personal choice of words) from a severe face pain, which I have experienced in the past, but not this bad. The pain is deep in my face, beneath my left eye and into my front teeth and jaw. I am a frequent allergy and sinus sufferer (still my choice of words). Let me tell you, I understand pain, I know the current construct of nociceptive input being interpreted and the brain deciding, “yep!,here have some pain, you are in danger”.
My pain has taken several personalities over the last month, the dull ache, the sharp twinges in to my teeth (I went to the dentist, as I have in the past, it’s not my teeth), a gnawing sensation like a hamster having a good chew in my sinus, and pressure, lots of uncomfortable pressure. My symptoms have waxed and wained over the four weeks. After a serious session of two days of water boarding (aka salt sinus washes using a sinus was kit) I thought that the worse was over as I could sleep and not wake up all night (did I mention the pain was disturbing my sleep?)
Remember I’m a man, so going to a doctor in the first three weeks was never on my mind, I wasn’t at the about to die stage, so no doctor yet.
I have to confess the things that I tried and the things which gave me the most relief.
1. Water boarding, or the closest I ever wish to come to water boarding, two hourly sinus washing. I am amazed what lives up there.
2. Pressure to my sinus externally. Yes manual therapy, acupressure, what ever you want to call it. It feels great with the pressure on and a bit of deep rubbing, but once you stop the pain comes back in seconds. My wife just gives me knowing looks, as I sit with my index finger poked into my face.
3. Hot pack. I made a rice bag for the microwave. I am loathed to admit, number one best relief, the hotter the better ( I managed to avoid burning myself) the relief lasted up to an hour afterwards, enough time for me to get to sleep.( I think sleeping helped me cope with the daily pain.)
4. I started taking my Claritin (loratadine 10mg) and got some relief from the pressure. Blowing my nose frequently helped, but only temporarily.
5. Hanging my head over the end of the bed or lying on the couch with my head dangled upside down watching TV. (Our brains are amazing, because after 10 minutes you don’t realize the TV is upside down.) I got relief whilst in this position, I figured all the gunk stuck up there flowed somewhere away from what every was irritated up there in my head. Of course half an hour after getting up the pain came back.
6. NSAIDs, I overdosed myself at bed time, which allowed me to sleep, I tried to avoid during the day, as I am not a fan of medication.
Three and a half weeks in I spent a few hours outside walking in the cold, my pain got worse, the pressure increased and I felt back to square one. I also had some increase in life stresses, this seemed to be the straw that broke my tolerance for the pain. My wife was away traveling and I found myself on my own with my pain feeling sorry for myself. ( I truly think my mental state changed and hence my ability to cope changed.)
Yesterday I called an made an appointment to see and MD. I am not a fan of visiting the doctors, but off I went. Let me tell you I had a great experience and I am glad I went. (I know I hear a few voices shouting, you should have gone earlier.) I consulted with a float MD, who I had never met before. He was a 67 year old extremely pleasant MD who immediately asked me what my reason for coming was and how could he assist me. We had the usual chat about my accent (ETHOS) and he looked quickly at my electronic chart, smiling and saying “wow! We better listen to you, you don’t seem to need our help often.” At that point I knew I had met a skilled caring MD who understood that when patients like myself arrive for a consult we do so because we have a problem that is concerning us. He listened to my story and my expectations.
He did a quick exam of my ears throat and nose and listened to my chest. He didn’t press on my sinuses, be trusted that my accurate report of my own palpation.
He explained that he thought I had a severe inflammation of my sinuses, and that some antibiotics and a steroid would be the best initial treatment. I nodded and said that was my main reason for coming.
I have taken two doses of the steroids and one and a half days of antibiotics. The steroids seem to be working as my pain is already 90% improved, I know it will take a few days for the antibiotics to do their job. Today I feel a bit of pressure and sensitivity in my face, but have a positive sense that this is the correct treatment.
As usual the lessons I have learnt from the experience.
1. Maybe I should go to the doctors quicker, but I like to let my body try to work on getting better on it’s own.
2. Pain can be tolerable one day, but the same pain can be intolerable on a different day.
3. Sleep is important when you are in pain and feeling sick.
4. You do strange things to try to get pain relief.
5. Our emotional state affects how we cope with pain.
6. I DO NOT HAVE A HIGH PAIN TOLERANCE. I am totally intolerant to pain, I would prefer not to be in pain. I do have the ability to be tolerant if necessary in the knowledge that this is short duration and has a visible end point. I reached my tipping point at four weeks.
I closing the other driving force or me to go to the doctor was my wife sent me a Viber message saying “isn’t it time you went to the doctors?” I always ask my patients if this is the reason they have come for a consult. “My wife told me to come.”
Thanks for reading.