Experiencing a Nosebleed While Singing in Choir
Patient Information: 36 years old, female, height 5’4”, weight 267 lbs, African American. Incident Summary: The patient, a member of a choir, reported an unusual incident during a practice. Her medical history includes lymphedema in the left leg, and an incidental finding of an empty sella on an MRI following an accident three months prior. She has also been diagnosed with post-concussion syndrome, which has manifested as neck and upper back pain, frequent headaches, and episodes of dizziness. Notably, she has not experienced a nosebleed in the past 20 years, although she recalled having them sporadically in her childhood. While participating in choir today, she experienced a sudden intense headache localized to the right side. After blowing her nose, she noted bleeding. She managed to control the bleeding and felt well enough to rejoin the group but was unable to continue singing due to escalating symptoms. She felt overheated, sweaty, and clammy, with her heart rate at 148 beats per minute; the headache spread across her forehead. After sitting in the bathroom for approximately 20 minutes, her acute symptoms began to subside, yet the headache lingered. The patient has noted a pattern of headaches while in choir practice, although there is an airflow vent that she consciously moved away from. She suspects that dry nasal passages might be a contributing factor but remains uncertain about the underlying cause of these recurrent headaches. Additionally, she reports ongoing clear nasal drainage that she attributes to post-nasal drip, which has persisted for some time without a salty taste. Considering her situation, she is contemplating whether a visit to urgent care is warranted. Although she reports feeling better overall, the lingering headache raises concerns about the cause of her recent symptoms. Thank you for your help with this matter.
Answers (1)
3/30/2025, 4:10:38 PM
OpenHealth AI
It sounds like you've had a concerning experience with a nosebleed and accompanying symptoms during choir practice. Given your medical history and the nature of your recent symptoms, there are a few critical points to consider, including the need to monitor your situation and consider possible triggers for your headaches and nosebleeds.
Key Points:
- Nosebleeds and Headaches: The sudden nosebleed, especially after blowing your nose, combined with intense headaches and other symptoms, requires attention. While these might be related to dry nasal passages, other underlying factors could also be contributing.
- Possible Triggers: It's possible that factors such as allergies, sinus issues, or even tension while singing could be influencing your headaches and nosebleeds. Your symptoms of overheating and elevated heart rate (148 bpm) may also indicate stress or anxiety during singing, which could exacerbate your discomfort.
Actionable Next Steps:
-
Hydration: Increase your water intake to help keep your nasal passages moist. Consider using saline nasal sprays to alleviate dryness in your nose, especially during choir practice.
-
Manage Headache Triggers:
- Keep a Symptom Diary: Note when headaches occur, their intensity, any accompanying symptoms (like your nosebleed), environmental factors (temperature settings in the practice area), and your level of physical exertion. This may help identify patterns or triggers.
- Consider Relaxation Techniques: When singing, ensure you are not straining. Practice deep breathing or relaxed singing techniques to help ease tension that could contribute to headaches.
-
Monitor Your Symptoms: Continue to pay close attention to your symptoms. If you experience another nosebleed, an increase in headache intensity, or any new symptoms like visual changes or severe dizziness, this may warrant immediate attention.
-
Consultation: Given your medical history (lymphedema, post-concussion syndrome), and if the headaches persist or worsen, it's advisable to seek medical attention to rule out any serious underlying conditions. An appointment with your primary care provider would allow for a thorough evaluation.
While you seem to be feeling better, remaining vigilant regarding your symptoms is essential. Should you have prolonged or worsening issues, do not hesitate to seek help. Take care, and remember to prioritize your health and well-being.
Related Questions
Understanding Possible Seizure Triggers and Recurrence Risks
Health Background: I am a 21-year-old female, standing at 169 cm and weighing 65 kg. Over the past three years, I have been using oral contraceptives. As of this morning, I started taking 25 mcg of levothyroxine along with a weekly vitamin D supplement of 0.266 mg. Recently, I was diagnosed with hypothyroidism and found to have a vitamin D deficiency that I suspect has existed for the last three years. I do not consume alcohol or smoke, and I can confirm I am not pregnant. Two years ago, I experienced a mild concussion. I currently reside in Spain. A couple of months back, in mid-December, I blacked out twice. The second occurrence took place while I was at the doctor’s office after seeking urgent medical care for the initial incident. Following the second episode, I underwent a CT scan and an EKG, both of which returned normal results. Further tests, as directed by my physician, revealed a critical vitamin D deficiency and hypothyroidism; however, he expressed doubt that either of these conditions led to my loss of consciousness. I was then referred to a neurologist, and I am presently awaiting an appointment. Although the waiting period is lengthy, my doctor indicated that I should receive priority for scheduling, although the exact timeframe remains uncertain. The referral document summarized my events, labeling the second episode (which the physician witnessed) as a potential seizure devoid of tonic-clonic movements—a revelation that took me by surprise. After regaining consciousness, I felt extremely disoriented and terrified, struggling to process what was happening. I have no prior history of seizures, epilepsy, or any related conditions, and there is no known family history of these issues. If this indeed was a seizure, what might have triggered it? Additionally, what is the likelihood of experiencing another one? Since that time, I have not had any further incidents, but I have experienced moments where I felt a sense of impending doom, which I managed to overcome. I intend to wait for the neurologist's evaluation, but the uncertainty surrounding a possible neurological condition is quite distressing. Thank you for any insight you can provide!
Understanding EEG Results for My 22-Month-Old Son: Insights Needed
Could someone help clarify this for me? My son, who is just 22 months old, hasn’t started walking yet, becomes tired easily, and has been experiencing behavioral outbursts. He had a febrile seizure in February 2025, followed by another unexplained seizure in April 2025, which led us to consult a neurologist. Since he was 3 months old, he has been receiving therapy from a physical therapist for torticollis. At birth, he spent five days in the NICU due to issues with meconium aspiration. A recent MRI showed normal results, and he also had a follow-up EEG after one conducted in July 2025. The results from this recent EEG were abnormal for a pediatric patient in awake, drowsy, and sleeping states. Notably, there were brief episodes of left frontotemporal delta slowing, which occurred mainly when he was awake and drowsy. There were no signs of epileptiform activity detected. In contrast, the EEG performed back on July 3, 2025, was deemed normal for both awake and drowsy states, again with no evidence of epileptiform irregularities, although it did not capture any sleep data. This examination was prompted by the child's existing history of febrile seizures. Importantly, he is not currently on any anti-seizure medications. The EEG procedure used standard electrode placements per the 10-20 system, conducted a single-lead EKG, and included continuous video monitoring. During the analysis, the background activity was symmetric, indicating some anterior-posterior (AP) organization, with a dominant rhythm of 50-80 microvolts at 7 Hz. His drowsy state was marked by a reduced amount of eye blink activity, less breathing motion interference, and a generalized slowing in theta/delta frequencies. Stage II sleep exhibited spindles and vertex waves patterns. Additionally, there were intermittent bursts of 250-300 microvolts in the left frontotemporal region with semi-rhythmic activity of 2-4 Hz, mostly observed during wakefulness and drowsiness. No definitive epileptiform discharge was noted. Photic stimulation during the test did not elicit a strong response, and hyperventilation was not conducted during this session.
INTENSE Spine Discomfort, Breathing Difficulties, Muscle Twitches, and Sweating
To elaborate on the situation mentioned in the title, I’ve been experiencing unusual muscle twitches and spasms for the past few days, along with some discomfort in my back. However, today, I felt an unexpected sharp pain shoot through my spine, which has left my legs feeling numb and made it impossible for me to sit up straight. Additionally, I’ve been dealing with cold sweats for the last hour and struggling to breathe properly. Perhaps I’m just overanalyzing things and it’s a common occurrence, but the intensity of the pain is overwhelming—it's truly unbearable. I’m shaking quite a bit, and unfortunately, my parents aren’t responding to my attempts to reach them for help. I have a history of a chronic heart condition and arthritis, yet I’ve never experienced pain this severe, especially in my spine. For context, I am nearly 15 years old and female. My current medications include pain relievers, anxiety medication, beta blockers, and some vitamins, though those specifics may not be particularly relevant. I don’t smoke; however, I have tried vaping a few times, which might not matter much, but I thought it was worth mentioning as it was requested.
Understanding Atrial Fibrillation and Thyroid Issues: Variability in Cardioversion Decisions
Hello everyone, I’m reaching out for guidance regarding my mother’s current health situation, and I’d greatly appreciate any shared experiences or thoughts. **My mother's background:** - **Age**: 55 years - **Weight**: Recently dropped to 116 kg from 118 kg in just two days, likely due to diuretics. - **Health history**: Previously an underactive thyroid, undiagnosed and untreated, now presenting as overactive. - **Medications**: Currently taking thyroid medication and a beta-blocker (Rapiblock). **Current health status:** My mother has been hospitalized since Tuesday, experiencing **atrial fibrillation with heart rates exceeding 200** beats per minute due to her thyroid's hyperactivity. - The plan for cardioversion was initially settled on Tuesday. However, the following day, the medical team advised postponing it until her thyroid levels could be stabilized, believing that her heart rate would return to normal once her thyroid condition was managed. - Her **obesity** precludes her from undergoing a transthoracic echocardiogram, and due to her thyroid concerns, she cannot handle contrast dye (this has been a consistent issue for over four years). Therefore, the only feasible option was a **transesophageal echocardiogram (TEE)**, which has yet to be performed. - She has been prescribed various medications including beta-blockers and thyroid treatments in the past. - On Friday, a doctor proposed proceeding with cardioversion; however, the attending senior physician objected. - Today (Saturday), another clinician has expressed a desire to move forward with cardioversion, having initiated a new medication, as the senior physician is unavailable. - **Communication has been unclear**, as we were notified of developments by a nurse rather than the physician in charge, causing confusion and anxiety. - Currently, only a **chest X-ray** is scheduled, and the TEE remains unaddressed. **My inquiries are as follows:** 1. Is it common for medical professionals to have varying opinions and frequently revise medication or treatment plans like cardioversion? 2. Is it safe to conduct cardioversion in the absence of a TEE? I presumed that this was a standard procedure to exclude the presence of blood clots. 3. Is it usual practice to have only a chest X-ray prior to moving ahead with cardioversion? 4. How typical is it for patients or their families to not be directly informed about treatment changes and learn about them through nursing staff instead? I recognize that this cannot substitute for professional medical advice. I’m simply trying to discern whether these circumstances are typical or if we should express our concerns more assertively with the healthcare facility. Thank you for your insights!
28-Year-Old Male Experiencing Scalp Sensations Post-Amitriptyline Treatment
I am a 28-year-old man in generally good health, without any cardiac concerns. Approximately a month ago, I encountered intense pain localized to one side of my head, which was unresponsive to paracetamol. However, a single dose of a migraine treatment provided substantial relief. Following that, I began a regimen of amitriptyline, starting at a nightly dose of 10 to 25 mg. While my head pain has diminished significantly—by about 90 to 95%—I now experience occasional uncomfortable sensations on my scalp. These feelings include pins and needles, a cooling sensation, and some crawling feelings near my hairline and ears. There are fleeting moments where I feel brief throbs lasting a second, but I do not have any persistent headaches. To clarify, I do not experience any of the following: - Nausea - Weakness in my limbs - Numbness - Changes in my vision - Coordination difficulties - Seizures The symptoms I have are transient, shifting around and often intensifying when I become conscious of them or as the day progresses. I would like to know: Is it common to experience these sensations during the recovery stage following episodes of neuralgia or migraine-like discomfort? Additionally, could the amitriptyline potentially be causing these temporary paresthetic sensations? I am seeking some reassurance or advice on what is typically observed during this healing process. Thank you.