[63F] Experiencing headache, dry cough, and ear pressure

Patient Description

A 63-year-old female presents with a severe headache localized to the forehead and above the eyebrows, rated 7/10 in intensity, which started abruptly and has persisted for about a week. The headache is accompanied by a moderate dry cough with minimal phlegm and ear pressure. The patient also reports feeling weak and drained but has continued with daily activities. She experienced chills one night but has no fever. The patient works at a wholesale warehouse and has frequent contact with the public. She has a history of Myelodysplastic Syndromes (MDS) diagnosed during a hospitalization for pneumonia. Her current medications include Losartan 100 mg for high blood pressure, a Trellegy inhaler once a day, and Montelukast for COPD. She has no known medication allergies and takes over-the-counter allergy medicine annually for undiagnosed allergies. No recent injuries, accidents, changes in vision, sensitivity to light, neck stiffness, pain, or mental status changes were reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Sinusitis: This is an inflammation or swelling of the tissue lining the sinuses. It can cause headaches, particularly in the area you described (between the eyebrows and forehead), as well as a cough and a feeling of pressure in the ears.

    • Treatment typically involves the use of over-the-counter remedies to relieve symptoms, such as pain relievers for the headache, and decongestants to help clear the sinuses. If the sinusitis is caused by a bacterial infection, antibiotics may be prescribed.
  • Tension Headache: This is a common type of headache characterized by a constant pressure or ache around the head, particularly in the forehead or back of the head and neck. They can be caused by stress, lack of sleep, poor posture, or depression.

    • Treatment typically involves over-the-counter pain relievers, such as ibuprofen or aspirin. Lifestyle changes, such as regular physical activity, relaxation techniques, and adequate sleep, can also help.
  • Migraine: This is a type of headache characterized by severe pain, usually on one side of the head. It can be accompanied by other symptoms such as nausea, vomiting, and sensitivity to light and sound. However, you didn't mention these other symptoms, so this may be less likely.

    • Treatment typically involves medications to relieve the headache pain and prevent future attacks.

Your cough and feelings of weakness could be due to a common cold or other viral infection, especially given your exposure to many people at your workplace. However, these symptoms could also be related to your COPD, particularly if you've been exposed to triggers such as dust or cold air.

What you can do

  1. Over-the-counter pain relievers, such as ibuprofen, can help to relieve your headache. However, you've mentioned that this hasn't been effective for you. It may be worth trying a different type of over-the-counter pain reliever, such as aspirin or acetaminophen.

  2. Over-the-counter decongestants can help to relieve sinus pressure and congestion, which may help to alleviate your headache and ear pressure.

  3. Rest and hydration are important, particularly if you have a viral infection.

  4. If your symptoms are related to your COPD, using your prescribed inhaler as directed can help. Avoiding triggers, such as dust and cold air, can also be beneficial.

  5. If your symptoms persist or worsen, seek medical attention. Your doctor can provide a formal assessment and order relevant tests if necessary.

What you should look out for

Reasons to seek medical attention more urgently:

  • If your headache becomes severe or is the worst headache you've ever had
  • If you develop a high fever (temperature over 100.4°F)
  • If you have difficulty breathing or your COPD symptoms worsen
  • If your symptoms persist or worsen despite home treatment

Please remember that while I strive to provide accurate and helpful information, I am an AI and not a doctor. Always consult with a healthcare professional for a formal diagnosis and treatment.

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10 mo ago

People Also Ask


What are the common symptoms of sinusitis and how is it treated?

Common symptoms of sinusitis include headache, facial pain or pressure, nasal congestion, cough, and ear pressure. Treatment often involves over-the-counter pain relievers, decongestants, and sometimes antibiotics if a bacterial infection is suspected.


How can tension headaches be managed or prevented?

Tension headaches can be managed with over-the-counter pain relievers like ibuprofen or aspirin. Preventive measures include regular physical activity, stress management techniques, maintaining good posture, and ensuring adequate sleep.


What are the potential triggers for COPD symptoms and how can they be avoided?

Potential triggers for COPD symptoms include exposure to dust, cold air, smoke, and other environmental pollutants. Avoiding these triggers, using prescribed inhalers, and maintaining a clean living environment can help manage symptoms.


When should someone with a headache seek medical attention?

Medical attention should be sought if a headache is severe or the worst one ever experienced, if accompanied by a high fever, if there is difficulty breathing, or if symptoms persist or worsen despite home treatment.


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