clinical

When The Doctor Is Sick: Just a Sinus Infection…

Yeah, it’s just a sinus infection, but man, it’s a sinus infection.

Here at our house, it’s been one illness after another for a month, and ten days since I got a nasty cold virus from the kids. I was just getting better, when things got worse. Friday morning, I woke up with pressure in my head, completely blocked nasal passages, gross postnasal drip, and green pus coming out of my eyeballs. Seriously, oozing out of my tear ducts.

It was five a.m. and a workday. I looked at myself in the mirror: Sclerae injected red, eyelids swollen, green goo, purple under-circles… scary.

My thought process: Hubby’s been away all week, and my poor mother is coming to take care of the kids. Maybe I should stay home… But, my clinic starts at seven-forty a.m. I would have to call every patient on the schedule myself, right now… No way. It’s easier to go in. 

I went to work. Not without complaining to a colleague, though.

“Pus from your eyeballs, awesome!” She commented. “It’s the path of least resistance. Ethmoid sinusitis.”

I’ve never had a sinus infection. We briefly discussed treatment. Call myself in antibiotics? Probably. Which one? Debatable. I decided to think it over.

With liberal use of phenylephrine, oxymetazoline, dextromethorphan, naproxen, and my trusty albuterol MDI, I made it through clinic. With thick mental fogginess, too. Not only could I not decide what antibiotic to prescribe for myself, I struggled with every other medical decision of the day.

What should I take? I read about it on UpToDate; I posted the question on Facebook’s Physician Mother’s Group; I discussed with colleagues.

Here’s the crux of the matter: Staph aureus is a known and not uncommon cause of sinusitis. As a healthcare provider who sees scads of MRSA (methcillin resistant staph aureus), including two juicy abscesses in the prior week alone, should I be on an antibiotic that covers MRSA? Because the all the guidelines call for Augmentin as first-line against acute sinusitis, and Augmentin, while awesome for many things, does diddly-squat for MRSA.

Of course, pretty much every patient I saw Friday morning had some infectious issue: pharyngitis, sinusitis, pneumonia, possible osteomyelitis… I must have pursued the antibiotic susceptibilities tables on our institution’s clinical resource website about a million times, both for them, and for me.

Decisions were made for everyone, prescriptions called in for all, except me. I went home, muddling over the issue, and decided to give it one more day of supportive care: Neti pot, tea, soup, and the cocktail of over-the-counter drugs listed above, plus Nyquil.

Yesterday, Saturday. Hubby wasn’t due back until late afternoon. I felt worse. The kids had their swimming lesson at the YMCA. The idea of bustling them into their winter clothes, driving to the crazy crowded YMCA with its ridiculous parking lot, and maybe even having to get into the water (with Babyboy’s class, parents are encouraged to get in the water) and freeze to death on the way to the locker room… The sheer enormity of the undertaking almost made me sick to my stomach. (Actually, with all the OTC meds on board, and very little solid food, I really did feel sick to my stomach.)

But, as moms do the world over, I sucked it up, and we made it through swimming. I declined to get in the water, though, citing my gross eyes. After all, pus in the eyes technically is Pink Eye, the dreaded scourge that keeps all kinds of people home on Occupational Health’s orders (except doctors, of course). The instructors took one look at me and were more than happy to keep me far, far away from the pool.

We survived swimming, and then friends of ours took Babygirl for an afternoon play date (thank you, thank you, thank you). Babyboy, who is still on his albuterol inhaler, was pretty wiped out after class, and I was done, just DONE. Chills, body aches, upper tooth pain, throat pain, and white stuff growing on the back of my throat, to boot. I felt like a human Petri dish. So Babyboy and I lounged around with books and cartoons until Hubby came home.

I finally called a real doctor (my brother) and hashed out the antibiotic issue. There had been so many differing opinions, in print and on consultation. He called me in Doxycycline, which covers just about all the possibilities, including MRSA.

It’s Sunday, and I’m a little better, I think. Thankfully, I finagled Monday off, and so I have one more day to recover…

And when I’m back in clinic and a patient tells me they’re miserable with a sinus infection, I will really and truly know what they’re talking about. Best medical education, ever.

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