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Medical Forum / Diseases and Disorders / Sinusitis / December 2005Recurring Severe Sore Throat and Earache
Hi, Everyone... I have been having recurring sore throat and earache for the past couple of months that is very severe. I have never had this type before. Usually, I will get a cold/sore throat, then after a couple of days, the sore throat will be gone. This time that's what's lingering. I was on Zithromax first, which did clear it completely. 4 days after being off it, the sore throat started returning, within a few days, it was severe again and the "ice-pick" earache came back too. Went on Ketek after that, which also stopped it. 4 days after being off that, back it started coming again. Yesterday, hour by hour, it increased in intensity so rapidly that I had to call my doctor yet again and we're trying Augmentin 875 mg. this time for 10 days. I do have sinus symptoms associated with this as well - congestion, excess mucus, pressure, etc. The first time I had the green mucus, since then it's stayed clear/white. Very thick. I've also been taking Duratuss (Guaifenisin and Pseudoephedrine) though I can't take the pseudo- at night due to restless legs and agitation. Have been trying to drink lots of water, but when the pain gets so bad I can hardly swallow this is hard. Actually, the pain gets so severe I can hardly talk - moving my mouth open and shut HURTS! I go back tomorrow for her to recheck and see if we can figure out why this keeps recurring. I read on here something about being on antibiotics for 3 weeks? Should I ask her about this? Is Augmentin a good one to use or is there something better? I also have a Grossan irrigator adapter but my Waterpik seems to not be working - won't pump hardly at all - so I've been using saling spray for now. My doctor is recommending xylitol spray or mints - have any of you tried that and does it help? Is there a brand that's better than others? Where do I get this?! Any other suggestions would sure be appreciated. This has already gotten OLD, and I sure don't want to go through Christmas season like this! Thanks so much, Jacki Xylitol might be a good idea for you to try. I like the mints (and the fruit ones) from Zellies.com. > Xylitol might be a good idea for you to try. I like the mints (and the > fruit ones) from Zellies.com. Thanks a bunch - I did find some Xlear spray today locally so I got that to get started on it. Will have to mail order the mints, though, so I appreciate the info! Jacki > Hi, Everyone... > [quoted text clipped - 19 lines] > keeps recurring. I read on here something about being on antibiotics for 3 > weeks? Should I ask her about this? Undertreatment of a sinus infection is one of the main reasons why it not only recurs, but can become chronic. That's how I got stuck with chronic sinusitis. Besides that, when the infection recurs after an insufficient dose of antibiotic, the surviving bugs are more resistant to that antibiotic than before. That's happened to me too. The next time you try Ketek, Zithromax or Augmentin, you may find they won't work at all because your bugs have become resistant to them. Sinus infections are stubborn. It can take up to 3 weeks worth of an antibiotic to clear it, because oral antibiotics depend on the bloodstream to carry them to the site of the infection, and the blood supply to the sinuses is relatively poor. In particular, Zithromax is a real crock because the typical Z-Pak only has 5 days' worth. The manufacturer claims that because of its longer half life that's all you need, which is nonsense where sinus infections are concerned. So far, the antibiotics you've tried aren't the "big guns" where sinusitis is concerned. Ask your physician for 3 weeks' worth of Levaquin or Avelox. If even that fails, then it's time to see an ENT. Recurring sinus infections can be due to a physical blockage in the sinuses, which antibiotics won't fix.  SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. On 12/7/05 7:43 AM, in article ZqDlf.317$QQ1.47@newsread3.news.pas.earthlink.net, "Steven L." <sdlitvin@earthlinkNOSPAM.net> wrote: >> Hi, Everyone... >> [quoted text clipped - 43 lines] > infections can be due to a physical blockage in the sinuses, which > antibiotics won't fix. Actually its not YOU taking an inadequate supply that makes the bugs resistant, its you neighbors that take a pill or two whenever they feel an infection or a cold. Resistant bugs are found in Areas, not in single persons i.e. Resistant staph is southern detroit. > Actually its not YOU taking an inadequate supply that makes the bugs > resistant, its you neighbors that take a pill or two whenever they feel an > infection or a cold. Resistant bugs are found in Areas, not in single > persons i.e. Resistant staph is southern detroit. Actually, it's much more a matter of the livestock and produce manufactured by agribusiness are dumping 80% of all antibiotics manufactured in the U.S. into livestock and onto produce. I think if we disallow such practices, we'll have taken the most important precaution. There's no excuse for spraying produce with streptomycin, or raising cattle in such an unhealthy manner that they constantly need abx. Susan > Actually, it's much more a matter of the livestock and produce > manufactured by agribusiness are dumping 80% of all antibiotics > manufactured in the U.S. into livestock and onto produce. Uh, let me rephrase that. The livestock and produce aren't doing it, it's being dumped into/onto them. Sheesh. > Susan > x-no-archive: yes > [quoted text clipped - 11 lines] > There's no excuse for spraying produce with streptomycin, or raising > cattle in such an unhealthy manner that they constantly need abx. Livestock aren't "raised in an unhealthy manner." But all livestock are prone to infectious diseases, just like your pet poodle is or you are. And every time livestock gets sick, that reduces the yield of meat, eggs and milk and raises prices. The price differential between so-called "organically grown" produce or free-range chickens vs. the standard foodstuffs is exactly how much the antibiotics are saving agribusiness. And I've seen "organically grown" produce that is infested with bugs, worms and rot, all of which are prevented by agribusiness practices. I'm certainly not prepared to deliberately pay more $$$ for food just to prevent this practice. I can't afford it. Having said that, it's worthwhile for agribusiness to not use the same broad-spectrum antibiotics on their food products that we humans do. I'm not that worried about streptomycin, because we don't use that much anymore except for bubonic plague and that hasn't been a problem in a very long time. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > Livestock aren't "raised in an unhealthy manner." But all livestock are > prone to infectious diseases, just like your pet poodle is or you are. > And every time livestock gets sick, that reduces the yield of meat, eggs > and milk and raises prices. Steven, feedlot livestock are raised in terrible conditions on foods they're not meant to eat. This makes them ill and causes them to require a lot of antibiotics. Some livestock are given routine abx whether they need it or not. Perhaps this is your idea of healthy livestock, but it isn't mine. Some livestock are not raised this way, and those are the only ones I eat; grassfed cattle that are antibiotic and hormone free. > The price differential between so-called "organically grown" produce or > free-range chickens vs. the standard foodstuffs is exactly how much the > antibiotics are saving agribusiness. And I've seen "organically grown" > produce that is infested with bugs, worms and rot, all of which are > prevented by agribusiness practices. The places I shop would never put such crappy product on the shelves. If you're happy to eat the cheapest crap out there, go for it. Your point has absolutely nothing to do with the fact that 80% of abx manufactured in the U.S. ends up dumped in feedlots or on produce, promoting resistant bacteria. > I'm certainly not prepared to deliberately pay more $$$ for food just to > prevent this practice. I can't afford it. I don't care what you pay or what you eat. That doesn't change the fact that antibiotic resistant bugs are being developed by agribusiness practices. > Having said that, it's worthwhile for agribusiness to not use the same > broad-spectrum antibiotics on their food products that we humans do. I'm > not that worried about streptomycin, because we don't use that much > anymore except for bubonic plague and that hasn't been a problem in a > very long time. They're using tons of a variety of abx. Streptomycin is used on produce. Susan >x-no-archive: yes >> Livestock aren't "raised in an unhealthy manner." But all livestock are >> prone to infectious diseases, just like your pet poodle is or you are. >> And every time livestock gets sick, that reduces the yield of meat, eggs >> and milk and raises prices. >Steven, feedlot livestock are raised in terrible conditions on foods >they're not meant to eat. This makes them ill and causes them to >require a lot of antibiotics. Yup. And spending most of one's life knee-deep in fecal material is neither good nor natural for man or beast. > So far, the antibiotics you've tried aren't the "big guns" where > sinusitis is concerned. Ask your physician for 3 weeks' worth of [quoted text clipped - 3 lines] > infections can be due to a physical blockage in the sinuses, which > antibiotics won't fix. Thanks so very much for the response... So since I just started on Augmentin 2 days ago, should I go ahead and finish this out to see what happens - she gave me 10 days worth...? How long does it usually take with Augmentin to know if it's going to work? My sore throat is definitely improving (it hasn't even been 48 hours yet) but it's still pretty painful. It also feels like it's raw and painful at the very back right side of my tongue... I will definitely keep your note about the "big guns" and I'm sure she would agree to let me try those, especially if this Augmentin doesn't cut it. I guess my main question at this point is should I finish out the Augmentin or drop that and switch to one of the others? I did take Levaquin years ago and don't remember what it did or didn't do for me, but it was at least 5 years ago. I did get some xylitol spray today from the health food store (Xlear brand) - how often do you use this stuff?! I'm also wondering if I should add the nasal steroid (Rhinocort AQ seems to be best according to the FAQ) - or wait and see if the Xlear will do the trick? Thanks again... Jacki >>So far, the antibiotics you've tried aren't the "big guns" where >>sinusitis is concerned. Ask your physician for 3 weeks' worth of [quoted text clipped - 11 lines] > It also feels like it's raw and painful at the very back right side of my > tongue... Generally if the antibiotic is working, the symptoms should start to improve within 4-5 days. But like I said, it's probable that the infection won't be completely eradicated with the 10 day course. 10 days is just not enough for many stubborn sinus infections. > I will definitely keep your note about the "big guns" and I'm sure she would > agree to let me try those, especially if this Augmentin doesn't cut it. I > guess my main question at this point is should I finish out the Augmentin or > drop that and switch to one of the others? I think it's more important to eradicate the infection thoroughly, which means you need to find a doctor who's willing to give you more than 10 days worth of whatever antibiotic s/he prescribes. It seems like this is the third short course you've had. I sure don't want your doctor to give you just 10 days worth of the "big guns" and ruin those for you too. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > I think it's more important to eradicate the infection thoroughly, which > means you need to find a doctor who's willing to give you more than 10 > days worth of whatever antibiotic s/he prescribes. It seems like this > is the third short course you've had. I sure don't want your doctor to > give you just 10 days worth of the "big guns" and ruin those for you too. She will probably go along with whatever I ask for - so I've shared the Mayo clinic article that says 4 weeks minimum! I'm just wondering now if I should go ahead and SWITCH to one of those other antibiotics for 3-4 weeks immediately or stay on the Augmentin for 3-4 weeks instead of just 10 days... Thanks again! Jacki On 12/7/05 8:01 PM, in article BFBD1A46.15FE0%gbarineauii100845@comcast.net, >> I think it's more important to eradicate the infection thoroughly, which >> means you need to find a doctor who's willing to give you more than 10 [quoted text clipped - 11 lines] > > Jacki The Mayo article DOES NOT SAY FOUR WEEKS MINIMUM. THE PDR and the FDA does say that Augmentin is indicated for Sinus Infection. What the Mayo web site is is a general discussion. All patients vary and it says MAY require four weeks of Rx. Everyone is different and each patient needs to be treated individually. It would be very poor practice to arbitrarily give someone more antibiotic than is necessary. Did you know that antibiotics have side effects? If you read the info here you would know that other factors help healing so that less antibiotic may be needed. > The Mayo article DOES NOT SAY FOUR WEEKS MINIMUM. Here's the exact quote: "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." > THE PDR and the FDA does say that Augmentin is indicated for Sinus > Infection. > What the Mayo web site is is a general discussion. All patients vary and it > says MAY require four weeks of Rx. > Everyone is different and each patient needs to be treated individually. It says MAY require 4-12 weeks. I think the range makes it clear that treatment must be individualized. In my case, I think even if I took abx for 6 mos, the day I stopped, the PND would resume and the infection crop right back up, so I'm avoiding oral abx for now. > It would be very poor practice to arbitrarily give someone more antibiotic > than is necessary. Did you know that antibiotics have side effects? Isn't the choice of drug and length of treatment what the art of clinical medicine is all about? I don't think anyone is recommending an arbitrary choice without clinical consultation. I think most folks reading here are trying a variety of the alternative/adjunct methods discussed here (as am I) and are still suffering from unremitting chronic sinusitis (as am I). Susan > On 12/7/05 8:01 PM, in article BFBD1A46.15FE0%gbarineauii100845@comcast.net, > [quoted text clipped - 23 lines] > It would be very poor practice to arbitrarily give someone more antibiotic > than is necessary. The problem is that with sinusitis, it is virtually IMPOSSIBLE for a primary-care physician, a family doctor, to know what is "necessary." They just don't have the needed diagnostic tools--CT scans, endoscopes, sinus cultures--that ENTs have. Thus they are unable to determine just what antibiotic to take and how long to take it, till all sinus disease is eliminated. For primary-care physicians it is guesswork, and with sinusitis it's better to err on the side of wiping out the infection thoroughly rather than undertreating it and allowing it to flare right up again. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. On 12/8/05 8:22 AM, in article o5Zlf.756$n1.455@newsread2.news.pas.earthlink.net, "Steven L." <sdlitvin@earthlinkNOSPAM.net> wrote: >> On 12/7/05 8:01 PM, in article BFBD1A46.15FE0%gbarineauii100845@comcast.net, >> [quoted text clipped - 34 lines] > better to err on the side of wiping out the infection thoroughly rather > than undertreating it and allowing it to flare right up again. What generally happens, what we see in our clinic is that the antibiotic did kill all the invading bacteria. But unless the cilia return to normal function, then the infection can start afresh. > It would be very poor practice to arbitrarily give someone more antibiotic > than is necessary. Did you know that antibiotics have side effects? > > If you read the info here you would know that other factors help healing so > that less antibiotic may be needed. Thanks, Dr. Grossan... I definitely know the antibiotics have side effects and wouldn't even be using them if it hadn't gotten excruciatingly painful (throat and ears) - I didn't see any option since the other things I was doing wasn't stopping it this time. Short history - I had suffered from chronic sinusitis for about 3 years straight approximately 7 years ago - leading up to sinus surgery (septoplasty and a 2nd surgery for making a "window" and turbinate reduction) - which still didn't seem to help. I was doing the irrigation using your adapter with a Water Pik for quite some time and got the papaya enzymes locally (don't think you were selling them at that time) and did everything I read about here! Finally, it seems what kicked it for me was using Claritin D 24 hour, Nasacort AQ, and Vit. C with quercetin on a daily basis for about a year. I then went with no problems at all for about the past 2-3 years. If a cold occurred or what I thought was anything at all kicking up the sinus symptoms, I'd start the Claritin D 24 hour back, and that had kept it at bay. For some reason when this particular "cold" hit back in late October, the Claritin D didn't stop it from progressing to the infection - and that's where I'm at now... So I'm wondering whether to add back Allegra D 24 hour (cheaper for me since insurance won't cover the Claritin any more) and Rhinocort AQ (which I read on here is best as far as the preservatives) - or what exactly to do at this point to get back over this! The Augmentin does seem to have helped the sore throat finally (as of today - my 3rd day on it), so I'm pretty sure that making sure I take it long enough to kick this is a good idea, unless you have other opinions on that! I'm also doing other things: increasing my water intake, using xylitol spray, and am trying to either get a new Water Pik or might just use a bulb for now if I can't get one soon. Do you think all this is a good idea for me at this point? Or are there other alternatives that you would recommend either in addition to, or instead of, what I'm doing? Thanks so much for your opinion on this... Jacki On 12/8/05 2:03 PM, in article BFBE17E5.1606D%gbarineauii100845@comcast.net, >> It would be very poor practice to arbitrarily give someone more antibiotic >> than is necessary. Did you know that antibiotics have side effects? [quoted text clipped - 36 lines] > > Jacki Allegra D and Claritin D have similar actions and individuals react differently - some say one works better than the other. Whichever works for you. You might want to wait to see if the medicaiton you are currently taking does the job for you. If you need a new irrigator, ask your insurance if they cover the Hydro Pulse. Increasingly more carriers do. Although Hydro Pulse doesn't require a prescription, you will need to send one in for the insurance to cover. Best wishes, . Hello jack....I found a site with an irrigator which will reach way up into nose if you have passage from prior surgery ...I have been using it along with dr grossans to get a through cleaning ...I was set for surgery 2 weeks ago would have been my 7th one but ent said nose looked good and put off the operation...I have been mixing a solution of 3oz white vinegar 1/2 teaspoon salt 1/2 oz graprfruit seed extract in 2 quarts clean water ....I use the grossan tip for the 1st rinse then switch to the #5 dsi tip for the long reach I have both tips that use a water pic unit......http://www.ethicare.com/prodinfo.html ........seems to finally be working for me so thought I'd share...good luck....Mahalo michael >> It would be very poor practice to arbitrarily give someone more >> antibiotic [quoted text clipped - 48 lines] > > Jacki On 12/24/05 10:44 PM, in article 6drrf.7875$hI1.4465@tornado.socal.rr.com, > Hello jack....I found a site with an irrigator which will reach way up into > nose if you have passage from prior surgery ...I have been using it along [quoted text clipped - 59 lines] >> >> Jacki Ask your doctor about using antibiotic in the pulsatile irrigation solution, that can be a help. Also, ask your insurance carrier if they reimburse for the Hydro Pulse Nasal/Sinus Irrigator. Insurance carriers are covering these days, but not all. Note: Hydro Pulse is my device sold by my company, Hydro Med. >>I think it's more important to eradicate the infection thoroughly, which >>means you need to find a doctor who's willing to give you more than 10 [quoted text clipped - 7 lines] > immediately or stay on the Augmentin for 3-4 weeks instead of just 10 > days... If you can get her to give you a refill of Augmentin so that you take it continuously for 4 weeks (no intervening gaps), it might be worth a try because Augmentin is a good first-line antibiotic for sinusitis. My ENT would use it on me if I weren't allergic to it. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > If you can get her to give you a refill of Augmentin so that you take it > continuously for 4 weeks (no intervening gaps), it might be worth a try > because Augmentin is a good first-line antibiotic for sinusitis. My ENT > would use it on me if I weren't allergic to it. That's actually what she has said she'd prefer to do at this point, so I will go with that to make sure it doesn't just come right back. What allergic symptoms do you experience with Augmentin? Just curious. So far it's mainly just causing me some diarrhea (not bad, just aggravating) - and yes, I'm taking probiotics in between doses - maybe not enough, though... Thanks again, Jacki >>If you can get her to give you a refill of Augmentin so that you take it >>continuously for 4 weeks (no intervening gaps), it might be worth a try [quoted text clipped - 4 lines] > will go with that to make sure it doesn't just come right back. What > allergic symptoms do you experience with Augmentin? Hives and rash. > Just curious. So far > it's mainly just causing me some diarrhea (not bad, just aggravating) That's not really an allergic reaction. Antibiotics also kill off the "good" bacteria in the gut that help control water balance in there. Keep taking the probiotics, you're doing the right thing. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me.
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