i'm sick and unhappy about it and still have to work. can i make this any quicker?
January 5, 2012 2:13 PM   Subscribe

i have a sinus infection. i feel confident in that diagnosis because i've had a lot of sinus infections in the past. is there any point to going to the MD?

i have insurance, etc etc, i'm just wondering if there's anything they'll be able to do other than give me an antibiotic i don't even know if i'll need and send me home to recover on my own. day 2 of feeling like ass currently, having to work through it and generally being miserable, looking for some kind of rapid-recovery fix. does an antibiotic help?
posted by radiosilents to Health & Fitness (30 answers total) 7 users marked this as a favorite
Response by poster: please no "if you've had a lot of sinus infections, you should clearly go to the doctor and tell him to look at ____ because _____". it's been years since my last one, i'm just familiar with what they feel like is all i'm saying. I COULD BE WRONG, certainly, but i don't think i am.
posted by radiosilents at 2:14 PM on January 5, 2012 [2 favorites]

Sudafed (Pseudoephedrine) helps. :)

You probably have a viral infection, which antibiotics won't help.. so your best bet is to treat the symtomps. You might also try an anti-inflamatory like Advil or Motrin (ibuprofen) to reduce any swelling you have.

Drink lots of liquids, get as much rest that you can with work.

IANAD. I am a person who's doctor doesn't give out antibiotics until you've been sick a week and it's not going away.
posted by royalsong at 2:20 PM on January 5, 2012

Not all sinus infections are caused by bacteria. Some are viral, in which case antibiotics will be of no help.

But, to your question: how badly is te infection affecting you? If you need medical care, go to the doctor. Especially if you have health insurance.
posted by dfriedman at 2:21 PM on January 5, 2012

Many sinus infections are viral, so antibiotics do little. Here's the Cochrane review:

This review found that antibiotics help some people a bit, but do not make a major difference to most people with acute maxillary sinusitis in primary care settings.

Bottom line, if this were me, I'd do sinus irrigation/neti pot, decongestants (with pseudoephedrine), advil, and lots of liquids for 3-5 days. Then I'd go to the doctor.

(I have no medical credentials, but I get regular sinus infections).
posted by mercredi at 2:23 PM on January 5, 2012 [1 favorite]

I am not a doctor. I am not your doctor. I am a fellow sinus infection sufferer, and I generally get recommended the below:

1) Increase fluid intake/hydration. Related: steamy bath/shower and/or humidifier.
2) Saline nasal rinse or nasal spray, preferably in the bottle-nasal-rinse form (as opposed to the neti pot)
3) Decongestants (Mucinex, pseudoephedrine if you can take it, Affrin, whatever)
4) Removal of any allergens in your environment that could be contributing
5) Spicy foods
6) Accupressure

Like royalsong's, my doctor doesn't give out antibiotics for a sinus infection after two days.
posted by pie ninja at 2:26 PM on January 5, 2012

If you're still hurting after a week, or if you have reason to believe it's bacterial, go to the doctor. Otherwise neti pot, sudafed, and mucinex are your friends.
posted by KathrynT at 2:27 PM on January 5, 2012

I've had tons of sinus infections and most of the time I have not treated them with an antibiotic. Regardless of what I do, they always last for two weeks for me. I have never found an antibiotic to speed that up. So no, I wouldn't go to a doctor unless it's been several weeks with no relief.

All you can really do is promote healing (rest, vitamins, etc) and treat the symptoms. My go-tos:
-Neti pot, if you're not too congested for it
-Lots of hot steamy showers or better yet, spend time time in a steam room
-Heavy-duty 24 hour Sudafed from behind the counter
-hot compresses on the face if you have congestion pain

If you get to a point where you're incredibly miserable from congestion and can't sleep, eat or enjoy life at all, I think it's time to turn to the scary nose spray. I use Afrin in ONE NOSTRIL ONLY at that point. This stuff's majorly addictive and will cause some rebound congestion when you go off it, so using it in one nostril only is key. The idea is that you use it in one nostril (pick a side and stay with it) so you have that side to breathe with, and then as you get better your other nostril will start to open up. Once other nostril is open enough to breath on its own with you can stop using the Afrin, which will cause the previously-drugged nostril to get congested for a little while. But who cares, because you still have the other nostril which is all happy!
posted by joan_holloway at 2:31 PM on January 5, 2012

If you're in a lot of pain, I get good results from "sinus cocktails". I try to avoid steroids but, if you want some quick relief from the sinus pressure they're great.
posted by Carbolic at 2:54 PM on January 5, 2012

Former sinus infection sufferer here. I would be cautious/reluctant with the neti pot -- I gave myself a dandy earache with one when I had some sort of sinus issue going on.
posted by ceiba at 2:55 PM on January 5, 2012

Another reason to be cautious with the neti pot. I am prone to sinus infections myself, and I've switched to Simply Saline.
posted by pinky at 3:04 PM on January 5, 2012 [1 favorite]

I also get frequent sinus infections. I do NOT use the neti pot. I have given myself ear aches as well with those. I threw mine out.

I usually can ride out the sinus infection with just sudafed (behind the counter) and lots of steam. If I am getting a few in a row, I have to go into the doctor and get prednisone.
posted by quodlibet at 3:22 PM on January 5, 2012

Are you calling it a sinus infection, or a sinus "infection"?
I ask because I know so many people who call severe congestion/drainage/crap-up-there "sinus infections" but never seem to ever treat it as an actual infection...i.e. get some antibiotics working on it.

So, if you're thinking it's an actual infection, then, yeah, call the doc.
posted by Thorzdad at 3:22 PM on January 5, 2012

My doctor always tells me wait 2 -3 weeks before coming in with a sinus infection. Like others have stated sinus infections can be viral which antibiotics will not help.
posted by majortom1981 at 3:25 PM on January 5, 2012

I used to have frequent sinus infections. They were excruciating, and nothing helped except antibiotics. One of them also occurred shortly before I had a severe case of pneumonia. (Not sure if they two were related.)

If you're fortunate enough to have insurance, I'd recommend seeing a doctor, if only for the reason radiosilents mentioned.
posted by cyndigo at 3:25 PM on January 5, 2012

I never go in for sinus infections anymore for this exact reason. Tired of the antibiotics, worried about building resistance, etc. Everyone has had good advice...Sudafed (DEFINITELY the real deal stuff, though, with the pseudoephedrine...the other is useless) and Mucinex has a sinus-specific product now that works well.

Neti pots can go either way. I've had good luck with mine.
posted by altopower at 4:37 PM on January 5, 2012

I've had my fair share of sinus infections, and Mucinex D (the one with pseudoephedrine in it) works wonders for me. Mucinex by itself, not really; sudafed by itself, a little; both at once? Magical.
posted by mismatched at 4:41 PM on January 5, 2012

Well. You could be like my husband. Take some Advil Cold and Sinus (also only behind the counter) and do the saline spray. Wake up in pain every night for 5 nights in a row in severe pain and take lots of ibuprofen and hope it goes away. Then go to the clinic and get a prescription for Augumentan. Which is an antibiotic, yes. It's two combined. He took one dose and it started going away.

Our ancestors died from lack of medical care. Yes, you can tough it out, but at some point, a doctor's care is in order.

posted by Marie Mon Dieu at 4:46 PM on January 5, 2012 [1 favorite]

As a chronic sinus infection sufferer, I echo the calls for proper pseudoephedrine and Muxinex. Steam and saline sprays help, too. Up the fluids, and try to keep your head moist and warm. Word of caution about neti pots (or the neti spray bottle) - don't do it if you're completely blocked. It doesn't work and you choke.
posted by kendrak at 4:47 PM on January 5, 2012

Best answer: Thorzdad, what do you think commonly causes "severe congestion/drainage/crap-up-there" other than an infection of some kind? And why do you imply that antibiotics are the obvious treatment for "an actual infection"? Sinus infections can be caused by bacteria, viruses, or even fungi. Antibiotics are only effective against bacteria. Taking antibiotics when you don't have a bacterial infection is generally thought to contribute to the development of antibiotic-resistant strains of bacteria. As others in this thread have already suggested, one of the hallmarks of a bacterial infection is that it tends to linger longer than a viral infection. Otherwise, it can be difficult to discern what the infectious agent is. That's why many doctors won't prescribe antibiotics until you've been sick at least a week, and it may be one reason why the people you know don't get antibiotics to treat their sinus infections—they may not have been sick long enough.

radiosilents, this page has some suggestions for self-care and a "Call your doctor if:" checklist. If you meet any of the criteria on the checklist, such as fever or changes in vision, please do seek medical attention.
posted by Orinda at 4:49 PM on January 5, 2012 [1 favorite]

I've had sinus infections, I'd double up much of the advice above. No antiobiotics, stay hydrated, steamy bath/shower, rest as much as possible, stay warm (layers of clothes, etc.).

Personally, I used to find that taking one of those Theraflu things or equivalent - the flavoured powders you mix with boiling water - and then going to bed and piling on the blankets and trying to sleep - was very helpful. Something about temporarily raising my body temperature as a form of anti-viral response.
posted by carter at 6:00 PM on January 5, 2012

I had a sinus infection about a month ago. After a couple weeks of having basic cold symptoms (congestion, headaches, mucousy cough), I started getting bad headachy pain under my eyes and in my ears. I went to the doctor and he said while he couldn't see anything, I was presenting with all the classic symptoms of a sinus infection. He prescribed antibiotics, and in 24 hours, the pain was gone (although the mucous and congestion was not).

So, to answer your question: yes, antibiotics absolutely can help sometimes. But after only two days, I'd think it's a little early to self-diagnose a sinus infection, myself.

Drink lots of fluids.
posted by leahwrenn at 6:53 PM on January 5, 2012

You don't know whether it is viral or bacterial -- which is why you go to the doctor to have it checked out. Untreated, a bacterial sinus infection can interfere with your ability to smell. I could not smell for a month once after a bad one. Interesting how many answers here assume it must be viral.
posted by mlis at 6:57 PM on January 5, 2012

mlis, it is very difficult if not impossible for a doctor to tell if sinusitis is bacterial or viral. We don't test for that. Read the Cochrane review linked to above. Treatment is not based on knowing which one it is, it's based on how long the symptoms have been going on. That's why the literature tells us not to treat people with antibiotics until it's been going on for a while already. Also, a bacterial sinus infection can cause a lot worse complications than just interfering with your sense of smell, but luckily those complications are rare.

a story like Marie Mon Dieu's is irrelevant. Her husband could have gotten better regardless of whether he took the antibiotics or not, just because time had passed. She just assumes he got better because of the antibiotics because of the temporal relationship between the two. He shoudn't have gotten antibiotics after only a few days of symptoms, based on the evidence. The evidence tells us to wait until symptoms have been going on for 1-2 weeks before antibiotic treatment, because there is no significant benefit gained from doing so, and there are potential side effects to antibiotic use.
posted by treehorn+bunny at 12:00 AM on January 6, 2012 [1 favorite]

Treehorn+bunny, I am sure you know your business, however my current and previous GP do test for that. If it is bacterial (which it often is) then they ask me if I want antibiotics and if I don't, they give me a laundry list of things that would mean "come back for drugs."

That's when I actually go to the doctor....

As a fellow sufferer, my entirely un-trained advice is to skip the doctor if you are not achy and can more or less muddle though with OTC and hot showers and so forth. (OTC and the fear of brain-eating amoebas that Pinky mentioned.)

But, you mention insurance - why not call the nurses line or have a live chat on the insurance company website?
posted by Lesser Shrew at 8:24 AM on January 6, 2012

Sinus infections are why I keep a store of Z-Paks on hand (azithromycin), from a (ahem) distant pharmacist.

Since I do not wish to encourage MSRI, I always complete the course, regardless of apparent effectiveness.
posted by IAmBroom at 10:21 AM on January 6, 2012 [1 favorite]

Just got over a sinus infection. After a month I went to the doctor. Didn't take him long to see what was going on. Prescribed antibiotics. Didn't clear it up after a week so I went back. The good part of going to the doc was that he could see on that second trip that my sinuses looked much better. It was good to get someone to look directly at my sinuses. He said to continue doing what I was doing but to also take Mucinex. When I did that I felt much better.
posted by Taken Outtacontext at 10:22 AM on January 6, 2012 [1 favorite]

Taken Outtacontext, that's the other reason I finish my courses: if I'm attacked by both bacteria & virus, I can at least get half of them, even if it's not clear I'm partially winning. Take last Fall, for instance...
posted by IAmBroom at 10:27 AM on January 6, 2012

If you have asthma or COPD-type issues, I would get it looked at by a doctor. Letting it go away by itself can lead to bronchitis, if you have upper-respiratory issues. Otherwise, I think the home remedy/OTC suggestions above are good, provided it goes away in a week.
posted by dovesandstones at 11:34 AM on January 6, 2012

Advil Cold and Sinus works wonders. (It has pseudoephedrine in it, so if that doesn't work for you, never mind).

I'm actually in the midst of a sinus infection. I ran out of Advil over the weekend, and since the pharmacy was closed, I took a Mucinex D. It zombi-fied me -- not sure why. But yeah, Advil C&S is pretty miraculous stuff.
posted by mingodingo at 3:14 PM on January 6, 2012

Just got over one myself. Not much to do about it besides treat symptoms.

Rest. A lot. Drink a lot of water to keep mucus on the thinner side. Blow your nose as often as needed -- better out than in. Use a neti pot about 2 times per day, with warm distilled water and saline mix. Drink hot tea. Or hot toddies. Take Benadryl as needed...I find they particularly help me at night because of the drowsiness. Sinus infections always make it hard to sleep, and that little bit of help from Benadryl (plus a melatonin or two) will knock me right out.

Also, Afrin for the bad days. Don't use it for more than two days in a row, though.
posted by kaseijin at 7:37 AM on January 7, 2012 [1 favorite]

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