[40F] Experiencing headache, muscle aches, post nasal drip, and vomiting

Patient Description

A 40-year-old female presents with a constellation of symptoms including a persistent headache located behind the eyes, described as a squeezing sensation, and a history of migraines. She also reports thick, yellow post nasal drip without an associated runny nose. The patient has been experiencing vomiting multiple times, particularly when attempting to eat solid foods, though she can tolerate liquids. She notes stiffness in her neck. The patient's medical history includes bipolar disorder and anxiety, for which she is on lithium, trazadone, and estrogen as part of hormone replacement therapy. She is also a bariatric patient. No known drug allergies are reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've provided, here are some possible conditions:

  • Sinusitis: This is an inflammation or swelling of the tissue lining the sinuses. It can cause a headache, post nasal drip, and sometimes vomiting due to the mucus irritating the stomach. The mucus from post nasal drip can be thick and yellow.

    • Treatment typically involves rest, hydration, over-the-counter remedies, and sometimes antibiotics if a bacterial infection is suspected.
  • Migraines: You mentioned a history of migraines, and the headache you described could be a migraine. Migraines can sometimes be triggered by sinusitis.

    • Treatment typically involves pain relief medication and rest in a dark, quiet room.
  • Muscle strain or tension: This could explain the muscle aches and neck stiffness you're experiencing. This can occur due to stress, poor posture, or overuse.

    • Treatment usually involves rest, heat or cold therapy, and over-the-counter pain relievers.

Please note that these are possibilities based on the symptoms you've provided and not a definitive diagnosis.

What you can do

Here are some steps you can take to manage your symptoms:

  1. Rest and hydrate: This can help your body recover from any potential infections and can also help manage your migraine symptoms.

  2. Over-the-counter remedies: Decongestants or saline nasal spray can help with post nasal drip. Pain relievers can help with your headache and muscle aches.

  3. Avoid triggers: If you notice certain foods or activities worsen your symptoms, try to avoid them.

  4. Seek medical attention: If your symptoms persist or worsen, please seek medical attention. Your healthcare provider can provide a more accurate diagnosis and appropriate treatment.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe headache or a headache that is worsening
  • High fever
  • Stiff neck and sensitivity to light
  • Any changes in vision or consciousness
  • Difficulty breathing

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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10 mo ago

People Also Ask


What are the common symptoms of sinusitis?

Common symptoms of sinusitis include facial pain or pressure, nasal congestion, thick nasal discharge, reduced sense of smell, and sometimes fever. Headaches and post nasal drip are also common.


How can migraines be managed effectively?

Migraines can be managed with a combination of lifestyle changes, such as avoiding known triggers, maintaining a regular sleep schedule, and staying hydrated. Medications like triptans, NSAIDs, or anti-nausea drugs can also be used to relieve symptoms.


What might cause neck stiffness and how can it be relieved?

Neck stiffness can be caused by muscle strain, tension, or poor posture. It can be relieved by applying heat or cold packs, gentle stretching exercises, maintaining good posture, and using over-the-counter pain relievers if necessary.


Are there any interactions between lithium, trazadone, and hormone replacement therapy?

Lithium, trazadone, and hormone replacement therapy can interact in ways that affect mood stability and electrolyte balance. It's important to have regular monitoring by a healthcare provider to manage any potential interactions and side effects.


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