"What a weird feeling headache," she thought

MJ is a 38-year-old woman presenting to the emergency room with sudden onset blurred vision. One week earlier, she was having a headache. It was right around her eyes and nose, and it would radiate to her forehead. [music] This continuous bilateral pain would somewhat alleviate with ibuprofen. It never really went away, [music] and once

the medicine wore off, the pain returned. She'd feel a fullness happening [music] between her eyes. And then she noticed that her ears would pop when she yawned or when she pinched her nose and breathed against it. That part was like having a cold, but this felt like something different. MJ was a doctor herself, and the only reason that

she was in this emergency room was because these were her colleagues. This was her hospital. It wasn't that busy at the moment. This issue was bothering her, and she can't be her own patient. She just wanted another set of eyes to take a quick look. She described her problems, and the emergency doctor knew

where to look. Physical exam found bilateral middle ears. This is fluid accumulation in the ear on both sides. Nasal mucosa revealed athemma and edema inside her nose on the inner lining was red and swollen. These check out with her symptoms. Fluid swelling in her ears and nose will cause headache. If it keeps expanding, it can feel like the

eyes are getting pushed out of her skull and it can result in the ears popping when one yawns or breathes against a plugged nose to push out pressure in the sinuses. The doctor checks one final thing. The sinuses are right next to the brain. We have multiple cranial nerves that connect the brain to sensory organs