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Medical Forum / Diseases and Disorders / Sinusitis / November 2005nebulized medication
hello: does anyone take any type of medication via a nebulizer? i was prescribed some itraconazole (anti-fungal) to be used in a nebulizer without a definite culture showing that i had yeast in my sinuses. it will be an investment both financially and time (two 30 minute sessions daily). i am just wondering if i wouldnt be better off with other options. I will discuss with the doctor but my appts are so brief that i want to research as much as possible beforehand. also the company that provides the nebulizer and the prescription seems to me like they are running out of some garage somewhere. do doctors ever get a kick-back from companies for recommending their treatment plans? greg I tried nebulized antibiotic last year it did not work well for me, your sinuses have to be very open in order for it to treat everywhere. My insurance paid for part of if but it was not easy. > hello: > [quoted text clipped - 3 lines] > investment both financially and time (two 30 minute sessions daily). i am > just wondering if i wouldnt be better off with other options. What was the *exact* diagnosis? If your physician thinks this is the way to treat Allergic Fungal Sinusitis (AFS), he doesn't know what he's talking about.  SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. he said that some of his patients have benefitted from this. the prescription has changed from the nebulizer to a sinus spray containing itraconazole from sinuspray--sinuscare. he did not mention afs but did say that i might be allergic to the fungus (incl. candida - or yeast) that is in my sinuses. what is the way to treat AFS? thanks, > he said that some of his patients have benefitted from this. the > prescription has changed from the nebulizer to a sinus spray containing [quoted text clipped - 3 lines] > > thanks, It depends upon whether you are actually allergic to the fungus and have IgE antibodies to it in your blood and it is showing up on CT scan or MRI, then you need steroids and maybe surgery to remove it. If, on the other hand it is just colonizing as suggested by the current Mayo theory, then antifungals are appropiate. However, using a amphotericin B nasal wash is supposed to be effective and if you have a local compounding pharmacy, they can make it up pretty cheap. I paid $5.00 for my last supply that lasts about a month. That was copay with insurance. I've had some limited luck with it, at least enough to keep continuing to use it. I put 20 ml. in the water pik for each side. Just takes a few seconds and burns a little, not bad. It might be worth talking to your doctor about. Kathyw > he said that some of his patients have benefitted from this. the > prescription has changed from the nebulizer to a sinus spray containing [quoted text clipped - 3 lines] > > thanks, It depends upon whether you are actually allergic to the fungus and have IgE antibodies to it in your blood and it is showing up on CT scan or MRI, then you need steroids and maybe surgery to remove it. If, on the other hand it is just colonizing as suggested by the current Mayo theory, then antifungals are appropiate. However, using a amphotericin B nasal wash is supposed to be effective and if you have a local compounding pharmacy, they can make it up pretty cheap. I paid $5.00 for my last supply that lasts about a month. That was copay with insurance. I've had some limited luck with it, at least enough to keep continuing to use it. I put 20 ml. in the water pik for each side. Just takes a few seconds and burns a little, not bad. It might be worth talking to your doctor about. Kathyw > he said that some of his patients have benefitted from this. the > prescription has changed from the nebulizer to a sinus spray containing > itraconazole from sinuspray--sinuscare. he did not mention afs but did > say that i might be allergic to the fungus (incl. candida - or yeast) that > is in my sinuses. what is the way to treat AFS? I am concerned about your physician mentioning "candida" in your sinuses in the absence of a positive result from a sinus culture. According to the American Academy of Allergy Asthma and Immunology (AAAI), this theory is unproven. And could prove dangerous; why take a risk on dosing yourself with antifungals if you don't need them? Evaluating fungal sinusitis of any type is a job for a skilled ENT who is familiar with those types of diseases. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > hello: > > does anyone take any type of medication via a nebulizer? i was prescribed > some itraconazole (anti-fungal) to be used in a nebulizer Have you tried just taking the pills instead? More convenient, and perhaps more likely to be beneficial. Woody i was originally given a prescription for diflucon from my General Practioner but the pharmacy shot it down because my insurance company refused to allow more than 1 pill being prescribed. i called the dr and asked him to call the ins co and tell them i needed it but he said to wait and talk to the ENT - appt was a week away -- and see what he said. On 11/4/05 7:47 PM, in article 43f9f1080a0305d1f4d0ab2b5274c4a2@localhost.talkaboutsupport.com, "loxaluck" > i was originally given a prescription for diflucon from my General > Practioner but the pharmacy shot it down because my insurance company > refused to allow more than 1 pill being prescribed. i called the dr and > asked him to call the ins co and tell them i needed it but he said to wait > and talk to the ENT - appt was a week away -- and see what he said. Try to explain to your insurance carrier that paying for the pills is a lot cheaper than paying for a surgery. With these companies, it is usually a high school graduate that makes the decisions and being persistant can be helpful. Tragically that high school graduate doesn't know zip about treatment. i have tried. it ended up that the dr prescribed me a compound med adminsiterd via a nose spray ONLY available from sinucare -- the ins company told me it was "out of network" and they would only pay if my pharmacy TEL-DRUG verified that they didnt have the meds. TEL-DRUG insisted that they could prepare the meds and that the dr just need provide the ingredients and parts per mil. The dr said how the hell am i supposed to know. back and forth and back and forth. i told my ins co what if i do end up with the TEL-DRUG prepared meds and they are not effective? wont the dr then ask me to go on the other? wont this cost more? they (CIGNA) are lame. > On 11/4/05 7:47 PM, in article > 43f9f1080a0305d1f4d0ab2b5274c4a2@localhost.talkaboutsupport.com, "loxaluck" [quoted text clipped - 10 lines] > helpful. Tragically that high school graduate doesn't know zip about > treatment. A few years ago here in Massachusetts, Tufts HMO announced that they would no longer pay for the minimally sedating antihistamines like Allegra. Period. They told their customers to just use steroid nasal sprays or buy Benadryl OTC. They conveniently forgot that asthmatics with allergies also depend on minimally sedating antihistamines. The asthma specialists got together and raised such a collective hue and cry that Tufts retracted their decision. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. >> On 11/4/05 7:47 PM, in article >> 43f9f1080a0305d1f4d0ab2b5274c4a2@localhost.talkaboutsupport.com, [quoted text clipped - 22 lines] > asthma specialists got together and raised such a collective hue and cry > that Tufts retracted their decision. Okaaaayyy, but do you or Murray truly believe that decision was made by a high school grad? I'm sure it was made by someone with a medical degree and a willingness to prostitute it for a buck; otherwise known as HMO medical director, policy signer off-er. Susan > i was originally given a prescription for diflucon from my General > Practioner but the pharmacy shot it down because my insurance company > refused to allow more than 1 pill being prescribed. i called the dr and > asked him to call the ins co and tell them i needed it but he said to wait > and talk to the ENT - appt was a week away -- and see what he said. You can find quality generics at a very affordable cost (perhaps the whole for less than your co-pay) online. Seek and you shall find. Woody |
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