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Medical Forum / Diseases and Disorders / Sinusitis / June 2005

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Gentamicin Irrigation

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1Potato - 09 May 2005 11:32 GMT
All:

I really get irritated when promising new treatments don't get to the
actual sufferers.  

Problem #1:  Most doctors don't, at least in my area, know much about
pulsile irrigation.  Freaking Middle Ages in my neck of the woods.

Problem #2:  Very few use gentamicin irrigation (for whatever reason),
even though the results are published and the concept itslef is as logical
as you can get, namely let's put the antibiotic where the infection is.

Problem #3:  When you do find a doctor, he/she sends you go a company like
Sinucare (perhaps the pharmacuetical salesperson gave him discounts on a
cruise or whatever), which "pre-mixes" the solution (dilutes it), and
makes it so confusing you don't really know what dose you are taking.

Another weird thing I found out is that the company actually mixes a range
of potentcies, but doesn't tell the doctors.  They said my doctor requested
the minimun potency, but when I called my doctor and asked why they said
the form just has one box to check, that says gentamicin, and they were
unaware of different potentcies.  How convenient for the company to use
the "default" dosage with the least medicine in it.  It also suggests that
my doctor didn't even know how much actual medicine I was getting.

Stay away from companies that premix the gentamicin, whatever their name
is.  (primarily for the dosage reasons, but also because they charge a lot
extra to "mix" the stuff and ALSO because when it is pre-mixed you have to
refridgerate the whole solution to keep it active, and you don't want to
irrigate with
such a cold liquid).

Just do it Dr. Grossan's way, and get the vials and just put the medicine
into your irriagator yourself.  I am having my doctor do it this way when
I talk to him today.

So I don't know if this treatment will work yet, but if it doesn't at
least I tried the real deal.

Joe
Steven L. - 09 May 2005 21:05 GMT
> All:
>
[quoted text clipped - 7 lines]
> even though the results are published and the concept itslef is as logical
> as you can get, namely let's put the antibiotic where the infection is.

The Cleveland Clinic abandoned gentamicin irrigation due to severe
systemic side effects in their more sensitive patients.

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Steven D. Litvintchouk
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1Potato - 10 May 2005 06:27 GMT
Thanks, I had read your mention of this in other posts and took note of it.
However, many other hospitals and doctors do still prescribe it.  My local
pharmacist assures me it is safe.  

It's clearly not a high risk medicine in this form.  My pharmacist says it
is actually in some over the counter medicines.  From what I understand,
the problems with gentamicin are more from IV use.

It may well be that Cleveland Clinic had a few reactions, and that's too
bad.  Perhaps they feel Bactroban is a little safer, so why take the risk
even if small.  But it appears very small from all I hear and read.
Cleveland Clinic may be very conservative and/or had some bad luck.

OR... maybe you are right and I am about to go deaf!  I hope not.

Joe
uuperiwinkle@yahoo.com - 11 May 2005 22:37 GMT
In regard to the Sinucare formulation and irrigating- I get my
irrigation solution from Sinucare, but it's not Gentamycin, it's
Sporanox.  I do my usual Hydropulse irrigation with saline, and then
when the solution is gone I pour about 40 cc of the Sporanox solution
(Sporanox plus saline, premixed by Sinucare) in the Hydropulse and
irrigate with that.  It's just about enough for a brief lavage in each
nostril.  That gives me the benefit of the more lengthy irrigation to
remove mucous, following up with the medicine to leave it in there.
Good luck.
> Thanks, I had read your mention of this in other posts and took note of it.
>  However, many other hospitals and doctors do still prescribe it.  My local
[quoted text clipped - 12 lines]
>
> Joe
1Potato - 21 May 2005 11:50 GMT
OK, it seems like I was a bit harsh on Sinucare.  Their pre-made mix is
working.  I used it the way they said, with a syringe shooting it into the
nose (I then hold both nostrils, but my head down, and tilt it, etc. to let
the medicine get where it needs to), and it is working great.  

First I use the hydorpulse irrigator to clean things out.  Then I use the
syringe.  The serum is refidgerated so I put the amount in a cup and
micowave it litterally for a few seconds, maybe 6 or 7, just to take the
cold edge off, not to make it hot or even warm by any means!

Also, I think it is important to know the anatomy of your nose.  The
sinucare treatment calls for 2 injections (these are just syringes without
the needle, naturally) in each nostril, twice a day.  I start with one
nostril, and shoot it strait in.  But the second one I sort of push in
more and angle it to get into the maxillary sinus.  I don't think I would
get much in that sinus, which is the most problem for me, if I did not aim
it that way.

I think gentamicin irrigation is incredible.  I feel like I knocked out
the infection, or sent it into remission, for the first time in a year and
a half.  I need less irrigations, can handle more stress without that
feeling that the infection is building up, and simply feel much better.
I'd say I feel normal, which is miraculous.

This is an incredible treatment, but please remember, your health is
always in your hands, the buck stops with you.  For example, Dr. Grossan
and some other physicians prescribe a different way of irrigating with
gentamicin.  He has you put the gentamicin in the irrigator for delivery
via pulsile irrigation.  He also uses a significantly higher concentration
of gentamicn then in Sinucare's premixed solution.  So, if one way doesn't
work, try another.  Don't give up.  

If infection is your problem this is a very logic treatment.  I will also
point out that I have taken allergy shots for the last year and a half and
this has helped open my turnbinate passages.

If your doctor waives the idea off, get another doctor.  BTW, D.O.s are
often more open minded, that's where I got my prescription.  

Joe
Murray Grossan - 22 May 2005 02:27 GMT
On 5/21/05 3:50 AM, in article
3a5ef5ade6a112567d7591a0da2de10b@localhost.talkaboutsupport.com, "1Potato"
<jcheffo@aol.com> wrote:

> He has you put the gentamicin in the irrigator for delivery
> via pulsile irrigation.  He also uses a significantly higher concentration
> of gentamicn then in Sinucare's premixed solution.  So, if one way doesn't
> work, try another.  Don't give up.

Actually the concentration if much more dilute: Its 40 mg diluted to 200 cc.
But your method is good because the Hydro Pulse irrigation first, removes
the thick phlegm to allow for contact with the nasal mucosa.
Lateralus - 18 Jun 2005 02:32 GMT
I just saw Dr, Grossan, i'm a little worried now i'm about to start
gentimicyn treatment, worried about systemic effects?????
Steven L. - 18 Jun 2005 14:01 GMT
> I just saw Dr, Grossan, i'm a little worried now i'm about to start
> gentimicyn treatment, worried about systemic effects?????

Did you discuss your worries with Dr. Grossan?

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Steven D. Litvintchouk
Email:  sdlitvin@earthlinkNOSPAM.net

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