So, as you know, we are in the midst of a pandemic.  The coronavirus, specifically known as COVID-19, is a global problem that affects us all in some way.  One recurring complaint I get from my patients is that they are experiencing a symptom that may be associated with COVID.  And being springtime, with a lot of pollen in the air, it complicates matters even further.

My patients are able to contact me via an internal email application that is built into the Kaiser website.  I am often contacted this way by my patients initially to run something by me.  Here's an example of a communication I received recently from Alan Jenkins, who is 49 years old.

Hello Dr. Tanaka.  I am experiencing sinus headaches almost every day.  I have some coughing too, and some tightness in my chest.  I am not sure what it is.  Could it be the coronavirus?

Well sure, it is possible that it is COVID.  Often in this case, I'll ask my patient to get a COVID test.  Then, depending on the result, I'll recommend a course of action.  In this particular case, my patient's COVID test result came back negative.  Because he had already received the COVID vaccination, I asked him to come into my office so I can see what is really going on.  He had not had a regular checkup in some time, so I can use this as a reason to give him a thorough examination. 

The reception desk took him to an examination room upon his arrival.  A nurse took his temperature, pulse, blood pressure and weight, and noted them in the system. I enter the room, and we start discussing his symptoms.

Dr. Tanaka: Hello, Alan.  How are you doing?

Mr. Jenkins: Hello doctor.  Well, about the same as I said in my email.  I have a sinus headache right now, and I have to blow my nose a lot.  I cough now and then, but not that much.  I feel a little heaviness in my chest when I cough.

I checked his vitals in the system, and his blood pressure was slightly high.  I used my stethoscope to listen to his heart and lung function.

Dr. Tanaka: Can you breathe deeply through your nose for me?  Let the air out through your mouth.

I listened carefully, and notice that there is indeed some lung congestion, but it is minor.  I feel the glands on both sides of his neck for tenderness and swelling.  None.  I grab a tongue depressor from the dispenser.

Dr. Tanaka: Ok, I hear a little congestion.  Open your mouth and say "ah".

I checked inside, and his tongue and throat look normal.  No swelling near the tonsils.  Upper and lower palates feel normal.  

Dr. Tanaka: Ok, lay down on the table for me.  I want to check you out a bit more, as I saw in your record that you have not been in for a checkup for a long time.

Mr. Jenkins: Sure doctor, go right ahead.  I know I am overdue.

I did a few more checks of the abdomen.  Finally, I have to check his prostate.  My male patients are never thrilled about this exam!

Dr. Tanaka: Ok, one final thing.  I need to check your prostate.  Please stand up, drop your drawers and bend over the table a bit.

Mr. Jenkins raised his eyebrows, frowned, and took a deep breath.  

Dr. Tanaka: Ok, all done.  No problems there.  Do you have any other things that have been bothering you?  I see from your medical record that you are in pretty good shape, taking no medications, getting regular exercise.  That is all great.  

Mr. Jenkins:  No, other than this, I am fine.

Dr. Tanaka:  Good.  Ok, I will order some lab tests for you. You can go to the lab now if you want, or anytime when its convenient.  About your symptoms, it appears to me that what you are feeling are the effects of an allergy.  It does not look like you have a cold or the flu.  You can try an over the counter allergy relief medicine to see if it helps.  Give it a week and if things don't change for the better then let me know.

Mr. Jenkins:  Thanks doctor.  Will do.