A man with a red nose pointing to an old date on a calendar

Adventures in Bacterial Sinusitis

It all started with a cold.

It seemed to last forever. I could not shake it off. The stuffed nose, the constant pressure in the front of my face. Some days my ears would be pressurized. Other days they were fine. I had no other symptoms of a cold. No cough nor bodily aches and pain. I didn't feel sick. Just weeks and weeks of endless nasal congestion and pressure.

When I finally saw my doctor, she was surprised it took me so long to come in. I had… excuses. I’ve been busier than I’ve ever been. I just put up with it and thought it would go away. It didn’t.

“How long has this been going on?” she asked. “About a month” I replied.

I had a cold around Christmas time. Since then, I told her, the cold went away but the constant nasal congestion remained. Some days, it was seemingly unreal. I would blow my nose literally every 10 minutes or less.

Managing sinus problems with RA

The doctor explained to me what I had already read online. You don’t want to treat a cold as if it were a sinus infection (colds are from a virus, sinus infections from bacteria, though they can start from colds). And, you don’t want to treat a sinus infection as if it were only a cold. The latter can become serious and requires attention.

Though my doctor could not confirm with any sort of test that I had an infection, she said there were enough clues from my symptoms to believe I did. We started antibiotics and nasal glucocorticoids, and bam, goodbye congestion. Within three days I felt almost entirely better. Within seven days I felt like a new man.

How does immune supression impact RA medications?

As most people with RA know, many of the medications we take can increase the risk of infection. This is due to immunosuppression. As it stands, I am on three drugs for RA right now. Though my doctor could not confirm that it was immunosuppression from my medication that lead to what was likely bacterial sinusitis, she stated that being on immunosuppressive medication certainly increases the risk.

This was my first sinus infection in my life. It came about four months after going on combination therapy. Correlation is not causation, and I’m a single data point, so no one can really say what caused what. Increased risk means exactly that. The risk is increased. Even if the infection was related to the drugs I am on, I’m not stopping them unless things get far more serious. They have made a major difference.

What surprised me most is how exhausted I felt during the infection. When the infection left, I realized how miserable I had been. Caught in the midst of it, it had become a new normal.

Tips for sinus relief

It was a waste to wait like I did. I could have cleared this up at least a week or more sooner. If you have any doubt about lingering congestion after a cold that just won’t go away, it may be worth getting it checked out. I know going forward I will be quicker to either call and consult with someone on staff or come in to see my doctor.

RA is always hitting me with new challenges. This one came out of nowhere, causing general mayhem at the most inopportune moment. It pays to be vigilant about one’s health, and RA has reminded me again that I am at increased risks of various things and need to be on the lookout. I’ll be quicker next time. It’s just not worth waiting.

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