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Medical Forum / Diseases and Disorders / Sinusitis / August 2005Question for Dr. Grossan on Mayo "snot" theory
Dr. Grossan wrote in a recent post: "Latest miracle cure from Mayo shows that the mucus is the culprit that holds the toxins and makes you sick in chronic sinusitis, so removal of same explains why many improve with pulsatile irrigation and other means." Dr. Grossan, How do you feel about all of the Mayo theories? Do you think any of them have merit? It does seem like at least they are trying. I wasn't too happy with them when I went there (Jacksonville) several years ago, but maybe they are better at listening to symptoms now. When you mention the toxins what kind are you talking about. My symptoms always improve when I can get the mucus out. Also, how can one have huge amounts of mucus draining from sinuses and it not show up on CT scans? Thanks in advance!! Kathyw On 8/7/05 4:10 PM, in article 1123456249.844033.242160@f14g2000cwb.googlegroups.com, > Dr. Grossan wrote in a recent post: > [quoted text clipped - 18 lines] > Thanks in advance!! > Kathyw I like the Mayo finding about MBP - major basic protein being the toxin that give the sinus sympotoms because it explains why some persons get excellent results with pulsatile irrigation. Mayo says that the eosinophiles go into the mucus and make MBP , which is toxic to the bacteria. But this toxin also affects the nasal cells and slows cilia. This toxin also causes the sinus symptoms of fatigue, swelling, pain, etc. So if you remove this mucus, you remove the toxin and allow the sinus membranes to heal. Many of the references he quotes have written advocating pulsatile irrigation - Meltzer, Kaliner, etc. So how does this "fit in" with the fungal hypothesis? Have they abandoned that now? On 8/7/05 6:47 PM, in article 1123465629.656965.138370@g14g2000cwa.googlegroups.com, > So how does this "fit in" with the fungal hypothesis? Have they > abandoned that now? Again, eosinophiles are specifically designed to combat fungus and worms so the system is in place to produce toxins that kills fungus and worms and incidentally bacteria too. Unfortunately the same toxin also harms nasal membranes and impairs cilia function. Whether its fungus or bacteria, using pulsatile irrigation to remove the stuff is validated by these findings. Plus tea, adequate hydration, humming "ooooommmm" and other suggestions. What is nice is that now you can measure MBP - the toxin and guage the progress of your treatment, rather than relying on x rays or patient's symptoms. In other words, you rely on Blood pressure re the readings and not what the patient's symptoms are to guage the progress of the treatment. > So how does this "fit in" with the fungal hypothesis? Have they > abandoned that now? Mayo is a large organization, and it is quite possible you would get offered a different treatment depending who you saw there. The guy who discovered the fungal cause is Jens Ponikau. His findings have been proven with double blind studies and replicated at Univ. Buffalo NY, as well as Univ. Graz Austria. Ponikau found the the eosinophils were degranulating in response to the fungus, but he could not explain why patients and not controls had this aberrent reaction to the fungus. More recently Univ of Michigan discovered why, and it boils down to antibiotics and their effect on the gut flora causing a fungal infection. Actually a number of physicians were treating sinusitis with antifungal agents even before Mayo. Such as Robert Ivker who wrote the book "Sinus Survival" and William Crook who was also a prodigous writer. The problem is these guys overstated the efficacy of their treatments, and so nobody believed them. Like trying to cure a fungal infection with a low carbohydrate diet is practically a joke for anyone who has tried it. The reality is fungal infections of any severity are damn near impossible to cure. The mortality rate for aspergillosis sepsis is over 95% even with the best IV antifungal drugs timely adminstered. By comparison, a severe bacterial sepsis like staph aureus has a mortality rate of under 5%, assuming the patient receives the right antibiotics timely. And even an infection as minor as toenail fungus can be impossible to cure in a large % of people. So the Mayo Clinic along with Univ Michigan have discovered how to prevent chronic sinusitis (just don't take antibiotics) but not how to cure it. On 8/8/05 4:03 PM, in article 1123542205.856352.43500@g14g2000cwa.googlegroups.com, "Woody Long" <woodylong30@hotmail.com> wrote: > Actually a number of physicians were treating sinusitis with antifungal > agents even before Mayo. Such as Robert Ivker who wrote the book [quoted text clipped - 11 lines] > along with Univ Michigan have discovered how to prevent chronic > sinusitis (just don't take antibiotics) but not how to cure it. Again, the problem is in semantics. All the authors use the same term to define three totally different conditions 1. the severe fungus that occupies the entire sinus and nasal system that is very very serious. This is uncommon. The Aspergillosisis sepsis would be one. 2. the fungus infection that causes an excess of eosinophile reaction. Its not the fungus, its the eosinophiles in the mucus that makes you sick. 3. the fungus that is opportunistic and grows from overuse of antibiotics 4. there is a fourth one that just happpens to be in the nose. Remember you can culture a fungus from your room air. And from the forest air. But authors refer freely from all three types. And confuse the hell out of readers. > On 8/8/05 4:03 PM, in article > 1123542205.856352.43500@g14g2000cwa.googlegroups.com, "Woody Long" [quoted text clipped - 31 lines] > But authors refer freely from all three types. And confuse the hell out of > readers. There is no question that the more severe the infection, the more difficult to cure. I was trying to make an apples & apples comparison. Lets say a wounded soldier arrives in hospital sick with a Staph Aureus Sepsis (infection of the blood). The odds are overwhelming that with the right treatment he will survive, assuming he has nothing else going on. On the other hand if a wounded soldier arrives in hospital with aspergillosis sepsis, the odds are overwhelming he will die, regardless of treatment. This is what the statistics show, no? So what's my point? That fungal infections are very very difficult to treat as compared to bacterial infections. Therefore the fact that antifungal medicine has minimal effect (or no discernable effect) on a case of chronic sinusitis does NOT imply that fungus is not involved. Woody >>So how does this "fit in" with the fungal hypothesis? Have they >>abandoned that now? [quoted text clipped - 9 lines] > antibiotics and their effect on the gut flora causing a fungal > infection. This is great. I believed this for a long time and I also believe I improved myself very much by taking acidophilus. I can't begin to tell you the difference it made. I went to UM several years ago. I brought up the fungal theory. The ENT I saw got irritated with me. She was mad that I was diagnosing myself. She said it was all quackery and she "will not test me for or treat me for it." HAHAHA! Here's a post I made a while back. I may be wrong but right now I think there is some truth to it... Although it's an unpopular theory here I'll give it to you. You start out by getting a sinus infection, maybe a bad one. You take antibiotics. Maybe this happens several times over. During this all you kill off helpful bacteria in the gut. Yeast overgrowth occurs. This yeast can penetrate the gut wall with it's spike like growths. Not a massive invasive yeast infection but it's there nonetheless. The body recognizes the yeast on the outside of the gut wall as an invader. It creates antibodies to combat the yeast. This yeast is being fueled from the inside out so the antibodies have a hard time controlling it. In the meantime the antibodies travel throughout your body attacking yeast wherever it is. Maybe it attacks yeast in the sinuses where the soft mucus membranes are damaged by the attack and polyps form. There happens to be yeast in beer. When you drink you get the yeast in small quantities in your sinuses through the fizz, burping etc. Your body overreacts (remember, allergies are an overreaction of the immune system to normal substances) and you nose runs like water falls and you sneeze like thunderstorms. I used to be like this all the time whenever I drank beer. Especially Anchor Liberty Ale which is bottle conditioned (meaning lots of live yeast). I have been taking acidophilus 3 to 4 times a day for several months and now I can drink that same beer without a reaction. My guts feels 100% better too. I had what I would describe as IBS (irritable bowel syndrome). My sinuses are still congested and I think I still have a bacterial infection. I actually have the opinion that mycoplasma/ureaplasma may be causing it. My ENT has agreed to PCR test me for it. Mycoplasma can take a year on antibiotics to get rid of. If I do that I will certainly stay on the acidophilus. This would explain why many, many different attempts of antibiotics for a week or two failed to cure me. Although some people here consider him to be a quack, Dr. Mirkin claims mycoplasma can cause sinusitis and he has CURED sinusitis w/nasal polyps with long term antibiotics. On 8/11/05 6:41 PM, in article r7TKe.4564$WD.750@newsread1.news.pas.earthlink.net, "afdr9lk" <9ekdu@dikmd.com> wrote: >>> So how does this "fit in" with the fungal hypothesis? Have they >>> abandoned that now? [quoted text clipped - 57 lines] > sinusitis and he has CURED sinusitis w/nasal polyps with > long term antibiotics. You use the term long term antibiotics and let it fall lightly from your tongue. We consult and agonize any time we need to use long term antibiotics. We feel less hesitation is giving radiation or surgery because we better understand most of the HARMFUL effects these entail. Long term antibiotics have significant effects and should be clearly understood before undertaking these ESPECIALLY when the indication may not be there and when much simpler alternatives that we KNOW about are available. <snip> >>him to be a quack, Dr. Mirkin claims mycoplasma can cause >>sinusitis and he has CURED sinusitis w/nasal polyps with [quoted text clipped - 9 lines] > be there and when much simpler alternatives that we KNOW about are > available. I don't think pulsatile irrigation will cure a chronic infection. It may make you somewhat more comfortable but that's all. I've been irrigating (Neilmed) for years and years and always there is thick yellow discharge and I can't smell. I start antibiotics and after several months I can smell and the discharge is all but gone, the little that is still present is clear. In the 18 or so years I've suffered I've never had antibiotics for more than 2 weeks and I've never got better. Now things are changing. "Antibiotics. Chronic sinusitis may require a long period of antibiotic treatment. You may need to take antibiotics for a minimum of four weeks, and for as long as 12 weeks." http://www.mayoclinic.com/invoke.cfm?objectid=A2BE5F0B-0600-4C43-BE1191EFF704F5F 4&dsection=6 "Taking antibiotics for one week almost never cures a sinus infection. Many previous studies show that you have to take antibiotics for a long time to cure sinusitis. What is encouraging about this paper is that the authors treated their patients, each day, for more than a year with 250 mg of Biaxin, a potent erythromycin antibiotic, and 12 out of 17 patients improved dramatically." http://www.drmirkin.com/morehealth/g144.htm > I don't think pulsatile irrigation will cure a chronic infection. It may > make you somewhat more comfortable but that's all. I've been irrigating [quoted text clipped - 3 lines] > is clear. In the 18 or so years I've suffered I've never had antibiotics > for more than 2 weeks and I've never got better. Now things are changing. I've had both experiences, sort of. For years, I needed a minimum of 4 weeks of oral abx to clear a sinus infection flareup; the first 10 days just began to make a dent. This year, it didn't matter how long I stayed on, the inflammation and infection rebounded quickly the day I stopped abx, and some abx stopped working as well. I used a NeilMed bottle and didn't get much help from it. I began pulsatile irrigation and it was a bit more effective (and the BreathEase is more comfortable), but even with mucus thinners, decongestants, nasal sprays, antihistamines, it wasn't enough. Two things made an enormous change for the better; I resumed aggressive allergic desensitization. I can't overestimate the impact this has. I tried a capful of hydrogen peroxide with the saline in the irrigator. This is where I turned the corner and found I was able to clear out the remaining infection without further oral abx. Frankly, oral abx take forever to get into the sinus cavities, with their poor blood supply. My allergist says his father rx'ed sprays with abx going back decades for sinus infections, to get the medicine to where the problem is. My regimen just passed a minor test recently; the dizziness, headaches and body aches returned as I came down with a minor summer cold. I began irrigating with saline/peroxide, then just saline, daily, and the infection didn't progress. Winter colds will be the final test, of course. Susan On 8/12/05 7:24 PM, in article gRcLe.5186$WD.335@newsread1.news.pas.earthlink.net, "afdr9lk" <9ekdu@dikmd.com> wrote: > I don't think pulsatile irrigation will cure a chronic infection. It may > make you somewhat more comfortable but that's all. I've been irrigating > (Neilmed) for years and years and always there is thick yellow discharge > and I can't smell. Ask your doctor if using pulsatile irrigation in order to restore the cilia function would be of benefit. Simple irrigatio nmay not be adequate for removing biofilm or MBP as discussed by Panikau in Jour of Allergy and Immunology August 05. What measures have you taken to improve your nasal cilia acton? > On 8/12/05 7:24 PM, in article > gRcLe.5186$WD.335@newsread1.news.pas.earthlink.net, "afdr9lk" [quoted text clipped - 10 lines] > discussed by Panikau in Jour of Allergy and Immunology August 05. > What measures have you taken to improve your nasal cilia acton? Has there ever been a study that would indicate that pulsating irrigation actually motivates cilia? Not just that a patient is "better" after pulsating irrigation but that the cilia is truly working/moving better? On 8/15/05 6:56 PM, in article bJbMe.6723$WD.810@newsread1.news.pas.earthlink.net, "afdr9lk" <9ekdu@dikmd.com> wrote: > Has there ever been a study that would indicate that pulsating irrigation > actually motivates cilia? Not just that a patient is "better" after > pulsating irrigation but that the cilia is truly working/moving better? Of course, I did the study and have exhibited it, that's how pulstile irrigation came about. > On 8/15/05 6:56 PM, in article > bJbMe.6723$WD.810@newsread1.news.pas.earthlink.net, "afdr9lk" [quoted text clipped - 6 lines] > Of course, I did the study and have exhibited it, that's how pulstile > irrigation came about. How did you determine that the cilia was inactive then active? Could you tell what percentage of the cilia in your test cases was immobile? Is the pulsatile irrigator able to activate inactive cilia in all recesses of the sinuses? Can I read the study? > >>So how does this "fit in" with the fungal hypothesis? Have they > >>abandoned that now? [quoted text clipped - 48 lines] > (irritable bowel syndrome). My sinuses are still congested > and I think I still have a bacterial infection. It is certainly reasonable that once the mucuous membrane becomes inflamed and damaged (from the fungus) it is susceptible to constant bacterial infections, and the bacterial infection actually makes you feel worse than even the fungal infection. This could explain why antibiotics may appear to help chronic sinusitis in the short term by treating the bacterial infection sequelae while worsening the underlying cause. I actually > have the opinion that mycoplasma/ureaplasma may be causing > it. My ENT has agreed to PCR test me for it. Mycoplasma [quoted text clipped - 5 lines] > sinusitis and he has CURED sinusitis w/nasal polyps with > long term antibiotics. You could ask to speak to some of his patients who have taken his "cure" and are off all meds for some time to see if they honestly feel they are better than before the "cure". If a patient does not come back for follow up many doctors will consider him "cured" (and even write in in his chart) even though he may just as sick and have lost confidence with the doctor's methods. <snip> > You could ask to speak to some of his patients who have taken his > "cure" and are off all meds for some time to see if they honestly feel > they are better than before the "cure". If a patient does not come > back for follow up many doctors will consider him "cured" (and even > write in in his chart) even though he may just as sick and have lost > confidence with the doctor's methods. Very unlikely in this day and age esp with the privacy act that you can talk to other patients. >Very unlikely in this day and age esp with the privacy act that you can >talk to other patients. I think that he should be be able to give patient references who have volunteered and signed waivers. I let Dr. Kennedy video an examiantion of me and give it to a TV station.... >>Very unlikely in this day and age esp with the privacy act that you can >>talk to other patients. [quoted text clipped - 3 lines] > > I let Dr. Kennedy video an examiantion of me and give it to a TV station.... Docs aren't going to give out references for unhappy patients either. >Docs aren't going to give out references for unhappy patients either. True enough..... > So how does this "fit in" with the fungal hypothesis? Have they > abandoned that now? Mayo is a large organization, and it is quite possible you would get offered a different treatment depending who you saw there. The guy who discovered the fungal cause is Jens Ponikau. His findings have been proven with double blind studies and replicated at Univ. Buffalo NY, as well as Univ. Graz Austria. Ponikau found the the eosinophils were degranulating in response to the fungus, but he could not explain why patients and not controls had this aberrent reaction to the fungus. More recently Univ of Michigan discovered why, and it boils down to antibiotics and their effect on the gut flora causing a fungal infection. Actually a number of physicians were treating sinusitis with antifungal agents even before Mayo. Such as Robert Ivker who wrote the book "Sinus Survival" and William Crook who was also a prodigous writer. The problem is these guys overstated the efficacy of their treatments, and so nobody believed them. Like trying to cure a fungal infection with a low carbohydrate diet is practically a joke for anyone who has tried it. The reality is fungal infections of any severity are damn near impossible to cure. The mortality rate for aspergillosis sepsis is over 95% even with the best IV antifungal drugs timely adminstered. By comparison, a severe bacterial sepsis like staph aureus has a mortality rate of under 5%, assuming the patient receives the right antibiotics timely. And even an infection as minor as toenail fungus can be impossible to cure in a large % of people. So the Mayo Clinic along with Univ Michigan have discovered how to prevent chronic sinusitis (just don't take antibiotics) but not how to cure it. > On 8/7/05 4:10 PM, in article > 1123456249.844033.242160@f14g2000cwb.googlegroups.com, [quoted text clipped - 30 lines] > etc. So if you remove this mucus, you remove the toxin and allow the sinus > membranes to heal. Have you given any thought to creating a Breathe-ease mucus solvent product to be used in the pulsatile irrigation to speed removal of the mucus and any biofilm? Alkalol works but is too irritating for me. Also, have you ever considered developing a travel case for the HydroPulse? When on travel, it's a pain to have to put that wet HydroPulse in my suitcase.  SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. I think I may still have this "biofilm." Even after all the antibitoics, etc., I still wash out this tremendous amount of clear jelly like stuff. They have all helped somewhat, but when I quit, it comes right back, then the brown junk again. I've read that if the bacteria is in the biofilm, the antibiotic can't get to it to kill it. And I irrigate several times a day. Sometimes it washes it out and sometimes it doesn't. BTW, Dr. Grossan, How does one measure the MBP? Does the ENT take a sample of the "snot", the tissue or what? Is it done endoscopically? Kathyw On 8/8/05 1:20 PM, in article 1123532423.068373.197610@g47g2000cwa.googlegroups.com, > BTW, Dr. Grossan, How does one measure the MBP? Does the ENT take a > sample of the "snot", the tissue or what? Is it done endoscopically? This is all brand new stuff.I hope the technique will be available in labs soon. On 8/9/05 7:33 AM, in article BF1E0CE1.3F6B%hydromed@adelphia.net, "Murray Grossan" <hydromed@adelphia.net> wrote: > On 8/8/05 1:20 PM, in article > 1123532423.068373.197610@g47g2000cwa.googlegroups.com, > >>On 8/8/05 1:10 PM, in article 2%OJe.3140$WD.1826@newsread1.news.pas.earthlink.net, "Steven L." <sdlitvin@earthlinkNOSPAM.net> wrote: > Have you given any thought to creating a Breathe-ease mucus solvent > product to be used in the pulsatile irrigation to speed removal of the > mucus and any biofilm? There are lots of products that could be used, but to get them certified by FDA is a 20 million dollar proposition and I happen to be 10 dollars short. Besides the best mucus thinner is till lots of tea. Also, Clear.ease was developed for this purpose and usually works. Also, since doctors are adding antibiotics to the Hydro Pulse, that seems to do the required healing. > Alkalol works but is too irritating for me. Alkalol is a good product, trick is to find a dilution that doesn't irritate. > Also, have you ever considered developing a travel case for the > HydroPulse? When on travel, it's a pain to have to put that wet > HydroPulse in my suitcase. Now that's a million dollar idea and remind me to give you that when this is launched. I will look into it. -- Murray Grossan, M.D. Www.ent-consult.com Www.grossan.com http://www.hydromedonline.com/presentingthehydropulse/ On 8/8/05 1:20 PM, in article 1123532423.068373.197610@g47g2000cwa.googlegroups.com, > BTW, Dr. Grossan, How does one measure the MBP? Does the ENT take a > sample of the "snot", the tissue or what? Is it done endoscopically? The method of measuring is fairly complex - to me - and is a laboratory measurement that Poinikau describes in his article. Don"t know when this will be readily available, hopefully soon. Instead of ordering an expensive CT in order to make a diagnosis, you will be able to order this lab test. > On 8/8/05 1:20 PM, in article > 1123532423.068373.197610@g47g2000cwa.googlegroups.com, [quoted text clipped - 6 lines] > will be readily available, hopefully soon. Instead of ordering an expensive > CT in order to make a diagnosis, you will be able to order this lab test. Has anyone else validated it by independent replication yet? I'd hate to see them cash in on the marketplace before that happens. Susan |
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