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Medical Forum / Diseases and Disorders / Sinusitis / March 2005Severe sinus headaches..any tips?
I am a chronic sinusitis sufferer (since 1996), I've had over 5 surgeries, and I'm only 15. I also have Cystic Fibrosis, which is the main reason I have the sinus problems. Anyway, it's been so bad that I've been on antibiotics pretty much since 2000. Problem is now, I'm resistant to every one of them, and the surgeries aren't doing a THING anymore...lately I've been having VERY bad headaches...now I've had the occasional (well, every day for me) sinus headache, but lately they've started under/above my eyes, all over my nose, my teeth, and then into my head and back of my head. I think it's triggering migraines also. My ENT doctor says there's nothing else he can do and to just manage the symptoms (coughing, headaches, fever, etc). I can manage the coughing with OTC stuff, but the headaches just won't respond to anything except stuff like Tylenol 3, Vicodin, etc..and he WON'T give these at all. He says there's 'not any indication from the CT scans that my pain should be bad enough for narcotics'. Now I don't want to be a pill popper, but seriously, that CT scan doesn't show just how much I hurt every day. It's gotten to the point I can't go to school because of them. He still doesn't see a reason to prescribe them. My PCP thinks otherwise, and gave me a week supply of hydrocodone (Vicodin) and that helped a lot. Have any of you guys dealt with an ENT doctor this stubborn before? What should I do? Get a second opinion and an ENT who will be more helping? He's the only doctor who will see me around here for that. Is this common to deny pain killers (especially to teens, I can understand why), but I'm really tired of the pain and would like to be back in school. Do pain management clinics deal with this stuff? Thanks >Do pain management clinics deal with this stuff? Yes they do and that is exactly what I was about to suggest. They take a more sympathetic view and know when they can prescribe strong drugs if needed... So I would suggest going to one and letting them deal with the pain aspects. Ok, thanks. We'll look into going to one then, maybe they will do more than my ENT. Nick > I am a chronic sinusitis sufferer (since 1996), I've had over 5 > surgeries, and I'm only 15. I also have Cystic Fibrosis, which is the [quoted text clipped - 5 lines] > started under/above my eyes, all over my nose, my teeth, and then into > my head and back of my head. I think it's triggering migraines also. I can only imagine the sinus infections and headaches a person with cystic fibrosis might encounter. I'm curious as to whether you have tried daily saline nasal irrigation such as with the Grossan Hydropulse? If not, and you are able, I'd certainly recommend trying daily irrigation for 3-6 months and see if you have any improvement. Irrigation certainly helped with my sinus headaches but it took a couple months of irrigation before the real benefits became clear to me. (snip) > Do pain management clinics deal with this stuff? > Thanks Yes, all the time, and I'd certainly suggest you try to find a good pain clinic. Some pain clinics might not want to deal with a 15 yr old patient, and you'd probably need your parents ok, but keep looking and I'm sure you can find someone willing to help as long as you were also trying all options besides drugs to manage your situation. You might also look into getting a new ENT Dr or at least start getting second opinions. No one deserves to have 5 nasal surgeries and unremitting pain at age 15. best, AW Yeah, my mom thinks I should go to a clinic like that too. I've tried everything for the pain, including 1200mg of Motrin, 1500mg of Tylenol, and 500mg of Naproxen, sinus irrigations, surgeries, ice packs, etc. I don't know what else is left to try..none of those helped, and I still kept the awful headache about 5 hours. (They usually tend to last between 3-5 hours, go away, and then come back again by the time I go to bed, which keeps me awake all night.) I can't even use decongestants anymore, they bother with my heart and BP. We have an appointment with a different ENT doctor at Vanderbilt, but it isn't until May. I'll also check on the saline irrigation, thanks. Nick On 3/8/05 9:21 PM, in article 1110345719.913429.15220@l41g2000cwc.googlegroups.com, "nick9742@gmail.com" > I am a chronic sinusitis sufferer (since 1996), I've had over 5 > surgeries, and I'm only 15. I also have Cystic Fibrosis, which is the [quoted text clipped - 26 lines] > > Thanks Yes, pain management clinics do deal with this. However, ask your doctor to review the article by Terrance Davidson at UC San Diego re using Tobramycin via pulsatile irrigation for CF. Does Aleve help the headache? Make sure the headache isn't from the neck or some other cause . Ask your doctor if taking proteolytic enxyames like Papase ar Bromelain as in Clear.ease would be of help. Management of Chronic Sinusitis in Cystic Fibrosis, Davidson, T., Laryngoscope 105:354 April 1995. Pulsatile irrigator Irrigation with [Nasal] Adaptor is used for CF, Cystic Fibrosis Currents Volume 11, No 4 Aleve used to help, but only to prevent. They never really helped AFTER I got it. Now it doesn't prevent or do anything when I have it. I'll ask about that too, thanks. From what I can tell, I don't think it's from the neck, but I'll ask the doctor about it. It starts around the bridge of my nose and goes outward. Nick When I get those bad sinus headaches I take 2 Aleve in the morning and 2 in the late afternoon. Sometimes I have to take them for a couple of days before I am without pain or can function. shirley I went on an Aleve regimen for about a month actually, 500mg (Naprosyn) twice a day, for about 4 weeks. It worked for about a week, then I started to get them every night again. After those 4 weeks, I went back to just regular old Aleve and never got results from it again. Same goes with Motrin, it used to help better than anything. Tylenol never worked, period. Last time I was in the hospital, they were so bad even morphine wouldn't clear them up much. Dilaudid worked well though, but I didn't want to take that very much so after a few doses (just to get a break from the pain for awhile), I told them to just give me the morphine occasionaly and Vicodin for the breakthrough pain. Well, just had another sinus xray. Won't have the results from the doctor until tomorrow. Even though I know that sinus xrays are mostly useless for sinusitis, whatever he wants. He does give me short prescriptions for pain meds when he sees how bad they look, so if I can get a 2 or 3 day worth of pain medicine I'd be glad. Last night was almost the limit for me, I was SO close to going to the hospital. It felt like all of my top teeth were being pulled, my eyes exploding, and my head throbbing. This is coming from a guy who has had 4 kidney stones since age 11, and I would take one of those over these headaches any day. My mom is going to ask him to refer me to a pain management clinic, so hopefully soon I will get some relief from some one. Thanks to everyone here who has suggested and helped. Nick >Well, just had another sinus xray. Won't have the results from the >doctor until tomorrow. Even though I know that sinus xrays are mostly [quoted text clipped - 9 lines] >management clinic, so hopefully soon I will get some relief from some >one. Thanks to everyone here who has suggested and helped. You need to pursue short term and long-term strategies to deal with this. Short-term, as you say, there is pain management. Long term, you need to find the underlying cause. It could be any of dental (I almost suspect this one), infection, vascular, benign tumor, TMJ in jaw, etc. You certainly need to get the pain under control and I think that the pain management clnic will help with that. Something else must be going on with your sinuses though. The eye pain would be your ethmoid sinuses and the tooth pain is the maxillary sinuses. Sometimes one can refer pain to the other. A Waters view xray shows only a good part of the maxillary sinuses. If you can you choose your own doctors and specialists in your health plan, why don't you go to an ENT specialist at a major university medical center. They are usually the best all-around bet. They are also not so cowed by insurance companies' cost controls. Yeah, that's what we're doing. Managing the pain now, and we're going to a specialist at Vanderbilt (in Nashville), the only problem is the earliest appointment they could give me was in May. I guess until then, I'll just have to deal with the symptoms. >Yeah, that's what we're doing. Managing the pain now, and we're going >to a specialist at Vanderbilt (in Nashville), the only problem is the >earliest appointment they could give me was in May. > >I guess until then, I'll just have to deal with the symptoms. Gee I hate to think you should have to wait that long. I have found that quite often you can phone in say twice a week, whiel waiting, to ask if there have been any cancellations. After you explain a few times why you are calling so often, they tend to be symapthetic and fit you in. Also they may need to order a CT scan and/or MRI b before thet can do much. You might want to inquire about that..... I use Sudafed (decongestant) and Afrin (nasal spray - don't use for more that 3 day running, read the instructions) to open my sinuses up, Benedryl to dry them out, and nasal washes to clean them out. This usually improves my sinuses for a while. Note: if the acute pain is ever centered right above your eyebrow, about one inch from the center of your face go directly to the hospital and tell them to check you for "acute frontal sinusitis". As I understand it, this can fairly quickly push the infection into your brain. steve > Well, just had another sinus xray. Won't have the results from the > doctor until tomorrow. Even though I know that sinus xrays are mostly [quoted text clipped - 11 lines] > > Nick It might be helpful to see a doctor who is knowledgeable in Natural Hormone Replacement Therapy (HRT). These are not synthetic hormones such as Premarin or Prevara, but are hormones tailored to your personal needs based on your labwork results and other tests that the doctor would use, such as saliva testing. The prescription would be filled at a pharmacy experienced in "compounding" specific hormone formulas. If you are unfamiliar with this type of therapy, your local library may have some books on this subject. Sometimes, those who are experiencing what they believe are re-occuring, severe sinus headaches can find relief or elimination from such headaches by using HRT. That was my personal experience. For years, what I thought were severe sinus headaches that occured quite frequently, were eliminated through the use of HRT. The books I've read on the subject since then, have explained in detail why such headaches can be hormone imbalance related and go undiagnosed for years and years. Even though you are quite young, this is still a viable possibility. > I am a chronic sinusitis sufferer (since 1996), I've had over 5 > surgeries, and I'm only 15. I also have Cystic Fibrosis, which is the [quoted text clipped - 26 lines] > > Thanks
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