NWA Mama Doc: Just allergies? Or is it a sinus infection?

Ahhhhh, the smell of fresh cut grass, the gentle breeze blowing through your windows, the chirping birds…spring in Northwest Arkansas is glorious, isn’t it? As I write this, I’m sitting at my desk under the effect of no less than three allergy medications. Yes, I love spring, but I’m ready for less pollen.

This spring has been difficult for many allergy sufferers. Headaches, sinus congestion, sore throats all come with the territory, and unfortunately many people are miserable right now. So how do you know when to go to the doctor? Sometimes it’s difficult for us to figure out as well.

Here’s how it generally works: Saturday morning, you have a million things planned. Groceries, soccer, softball, selling something for your child’s fund raiser. You have even arranged a sitter for the night so that you can have a long awaited date night.

Unfortunately, when you wake up, you notice you can’t breathe. Specifically, you can’t breathe through your nose. You sound a little like Darth Vader. What should you do? Do you need to go to the doctor immediately? What can you take over-the-counter?

As a rule, most people can take some over-the-counter allergy medications without a problem. These would include things like Claritin, Allegra, Zyrtec or any of their generic counterparts. Those medications cause very little, if any, drowsiness and are taken only once a day. Some people prefer older medications like Benadryl or Chlor-Trimeton. These medications may cause more drowsiness but work very well. These are called antihistamines. They tend to dry you up. That will help with a runny nose, itchy eyes, and even sore throat if it’s caused by postnasal drip. That’s a fancy word for snot dripping down the back of your throat. Appetizing, huh?

If your primary concern is congestion, that’s treated better by a decongestant, such as phenylephrine. This works well to open you up but may make it difficult to sleep. It can also cause a fast heart beat and may irritate your high blood pressure. Some decongestants are hard to find because they can be used to make methamphetamine,  so you have to ask the pharmacist. Another option is a decongestant nasal spray like Afrin. These work very well, but if you use it for more than 3-5 days, your nose may be more stuffy when you quit using them, which we call “rebound congestion.”

If you still have pain/pressure after drying out/opening up, then try some ibuprofen or Tylenol. It can work wonders!

All of this being said, sometimes you still feel rotten after taking all these steps. We know now that most sinus infections are caused by viruses. Unfortunately, there’s not a good way to know if your sinus infection is viral or bacterial. We do have some criteria that help us decide if it’s more likely to be a bacterial infection that needs treatment with antibiotics. Here they are:

  • Symptoms last longer than one week
  • You have a fever greater than 101
  • You were initially sick, then got better, then got worse again.

Note:  If you have swelling or redness on one side of your face, it is important for you to see your doctor. 

The antibiotic doesn’t help you feel better if the infection is viral. In fact, it may cause the bacteria that you have in other places (we all have bacteria on our skin, in our mouth, throat, digestive tract, etc, all the time. That’s healthy!) to become resistant to that antibiotic. That’s dangerous.

I know what you’re thinking – but I always feel better after I start an antibiotic. Recent studies have shown us that people who are treated with antibiotics for sinusitis feel better at day 7, but there is no difference at day 10. So that antibiotic that caused a miraculous recovery in 24 hours? It’s probably just a coincidence.

Hang in there, mamas. Spring allergy season won’t last forever. Summer is coming!

To visit with Dr. Vo in person, you can schedule an appointment with her by calling the Mercy Clinic Primary Care Sugar Creek in Bella Vista.  It’s located at 24 Sugar Creek Center and the phone number is 479-876-1414. Same day appointments will be available at the clinic.

If you have a general health question for Dr. Vo, you can email it to mamas@nwaMotherlode.com and she may answer it in a future post.