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Medical Forum / Diseases and Disorders / Sinusitis / March 2006

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eternal post-nasal drip

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mitcheroo - 08 Mar 2006 18:28 GMT
"Eternal" as opposed to "chronic".  "Chronic" just doesn't convey
enough hopelessness.  This feels truly eternal, undefeatable.

PND started over 10 years ago.  Gummy-sticky feeling at back of throat;
constant feeling of drainage at, best I can feel, back of sinus
passages.  Constantly clearing throat, constantly swallowing.

Simultaneous with onset: awful foul taste in back of mouth.  Even the
best chlorate/chloride mouth-washes offer only very temporary relief
(Pro-Fresh, BreathRx).  They say you can't smell your own bad breath,
but, sorry, WRONG -- you can in certain circumstances.  Sometimes it is
as if a small animal has crawled down my throat and died there.

I doubt involvement of any seasonal allergens. Condition persists
regardless of climate or  season.  Persists regardless of geography,
whether I am in the mountains of Vermont, in a desert in New Mexico, or
standing in a swamp in Georgia (and I have spent weeks or months in all
these locations or situations).

I can't seem to find an ENT physician who will take this problem
seriously enough, or seems competent enough in the first place.  First
ENT said I had a "9" deviated septum, on a scale of 1-10.  My current
ENT sees a only a mild DevSep, sees no polyps through simple visual,
and saw nothing on recent CATscan.  (Do polyps show up on CATscans?)
He has not even mentioned a nasal endoscopy.

He tried 2 different -- and very pricey -- prescription sprays: No
change.  Singulair, Rynex: No effect.  Cortisone shot in buttocks:
slight amelioration of discharge for a day or two, then nada.

He seems to have a fixation on allergies.  Wants to set me up for an
allergy-shot program that will likely take several years.  But
expensive tests only showed medium-reactions to ragweed, pine and
timothy, and weaker reactions to a few other pollens.  No reaction to
dustmites.  I don't understand his rationale for this approach.  I have
told them to hold off on putting together any serum "mixes", as his
assistant put it.

[A disturbing note: through all four visits to this physician, he
starts off asking me the exact same questions: "Are you exposed to any
chemicals at work or at your worksites?", and a few others aling that
line.  Each time I respond the same: No, no, no, and no.   If he asks
me those same queries again (if I go there again), I'll ask him to
check my file.  If he says it's not there, I'll say "WELL HOW ABOUT
WRITING SOME OF THIS DOWN, YOU D---A-- QUACK DOOFUS??" ]

I have to find an ENT who knows what this is about, who knows what he's
doing.  Frankly, I am getting fed up with the whole profession.
jmc - 08 Mar 2006 19:32 GMT
Suddenly, without warning, mitcheroo exclaimed (08-Mar-06 6:28 PM):
> "Eternal" as opposed to "chronic".  "Chronic" just doesn't convey
> enough hopelessness.  This feels truly eternal, undefeatable.
[quoted text clipped - 44 lines]
> I have to find an ENT who knows what this is about, who knows what he's
> doing.  Frankly, I am getting fed up with the whole profession.

I very much suspect it's acid reflux.  This can actually cause
post-nasal drip (I know, it is with me!).  The bad taste is pretty
classic, as is the swallowing.  Do you feel like there's a lump in your
throat?  Or like there's a sticky bit of mucus that just won't clear?
All classic, and similar to my symptoms.  Cough?  Worse at night?

I'd suggest you do some googling for GERD, and acid reflux, and see if
you've got other symptoms.  You could try some OTC meds and see if they
help, but you probably should talk to your GP, or mention this
possibility to your ENT.  Maybe he's missing the forest for the trees.

If you think it might be GERD, there's a ng for that too,
alt.support.heartburn.

Good luck!

jmc
Steven L. - 08 Mar 2006 23:22 GMT
> Suddenly, without warning, mitcheroo exclaimed (08-Mar-06 6:28 PM):
>
[quoted text clipped - 52 lines]
> throat?  Or like there's a sticky bit of mucus that just won't clear?
> All classic, and similar to my symptoms.  Cough?  Worse at night?

That's not what my ENT told me.

He said that if you're coughing and spitting up discolored phlegm
(yellow-green), that's not reflux, that's actual PND from sinusitis.
(or from a cold if you just caught one).

While you need lab tests to be sure, the color of the phlegm is a dead
giveaway.

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Don Brady - 08 Mar 2006 20:23 GMT
>He has not even mentioned a nasal endoscopy.

That shows that he is not up-to-date.

Almost every ENT I have seen (at least 5 or 6) uses the endoscope on every
visit.

I would get a second opinion at a major University medical center from their
most experienced sinus surgeon.   You need to get the CTscan films (not just
the report) and bring them along.......
Marsha L. Hillson Gerace • - 08 Mar 2006 22:46 GMT
Welcome to my World!!!

My ENT checked to see if GERD was my cause, but I've had PND forever and
GERD for only a year or so, so it wasn't.  However, I am on Prilosec, but it
has not effect on the PND, only the GERD.  I've also had surgery, which made
it so I can breathe without taking tons of Sudafed, but no effect on the
PND.

The only thing that I have found to work is nasal irrigation, every day and
night, ideally, or at least, every other day.  I hate doing it, it takes a
lot of time, it's messy, but it works!  I use a mixture of salt, baking soda
and Alkalol (http://www.alkalolcompany.com/) which works great.  I also
gargle with the Alkalol, but that really doesn't do very much.  It's washing
all the "drip" out of your sinuses that will do it.  If you wash it all out,
there's nothing left to drip.  I have an old Waterpik with the Grossan tip
and I usually do one tank per side each time.

Good Luck.  FYI, I buy Alkalol by the case online.  It can range in price
from $2 to over $5, so check out all the options for the best deal.  Last
time I ordered from Hocks.com and it was $2.95 per bottle.  Also, I saved an
old half gallon juice bottle and mix up a full bottle at a time, rather than
just a tankful at a time.

> PND started over 10 years ago.  Gummy-sticky feeling at back of throat;
> constant feeling of drainage at, best I can feel, back of sinus
> passages.  Constantly clearing throat, constantly swallowing.
Steven L. - 08 Mar 2006 23:33 GMT
> "Eternal" as opposed to "chronic".  "Chronic" just doesn't convey
> enough hopelessness.  This feels truly eternal, undefeatable.
[quoted text clipped - 8 lines]
> but, sorry, WRONG -- you can in certain circumstances.  Sometimes it is
> as if a small animal has crawled down my throat and died there.

Your best weapon against purulent post nasal drip is nasal irrigation.
 Try one of the better methods like Hydro Pulse or Sinus-Rinse (search
the Internet for them).

And when you irrigate, note carefully the color of whatever material you
flush out of your sinuses.  If it's discolored (yellow, green, brown,
etc.), then you have some kind of sinus problem.  And that's evidence
for your ENT.

Finally, find an ENT who will do a nasal endoscopy on you.  The best
diagnostic tool an ENT has is his own eyes.

Good luck.

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Je Wiz - 09 Mar 2006 02:45 GMT
I had a brown discharge as a blew my nose in the shower (yuk) This was
after I took Bi Yan Pian A few hours earlier. What does Brownish color
meen? The Bi Yan Pian Only opens me up slightly. But it worked this time
to the point that 3 large discharges came out. Very thick. gooey yuk.
Steven L. - 09 Mar 2006 10:27 GMT
> I had a brown discharge as a blew my nose in the shower (yuk) This was
> after I took Bi Yan Pian A few hours earlier. What does Brownish color
> meen?

My ENT would say it's an indication of infection (though only a culture
can prove it for sure).

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timothyswift - 09 Mar 2006 04:09 GMT
Having been a chronic sufferer for 15 years and now 10 years without, I can
relate.  What I discovered,a fter the ENT said "You can use that steriod
spray the rest of your life or have an operation" and I chose neither, was
that my sinusitis was related to my diet.  I eliminated milk and chesse of
all sorts, reduced and at tiem eliminated wheat and corn (and the gluten
thereof) and have not had a sinus infection nor taken an antibotic since!!!!
I, the one who had standing Rx's for pills and sprays, am not free of the
same.  When I don't watch what I eat or ever indulge I have the stuffy
morning after blues.  So my advice, eliminate milke, chesse and all dairy,
stop the wheat and corn (sweeteners and filler) for 30 days and see if you
have any changes in your infections and problems.  If you are like me, you
will be amazed and all your indigestion and stomach issues will disappear as
well.  Good Luck.....Tim in Phoenix

>"Eternal" as opposed to "chronic".  "Chronic" just doesn't convey
>enough hopelessness.  This feels truly eternal, undefeatable.
[quoted text clipped - 44 lines]
>I have to find an ENT who knows what this is about, who knows what he's
>doing.  Frankly, I am getting fed up with the whole profession.
Steven L. - 09 Mar 2006 10:29 GMT
> Having been a chronic sufferer for 15 years and now 10 years without, I can
> relate.  What I discovered,a fter the ENT said "You can use that steriod
[quoted text clipped - 9 lines]
> will be amazed and all your indigestion and stomach issues will disappear as
> well.  

I guess I'm not like you.
I never ate dairy before developing sinusitis or after.
I was tested for all manner of food allergies by a competent allergist
and the results were all negative.

What happened to me, unfortunately, isn't in the medical books.  I
became chronically ill after a severe allergic reaction to a flu shot I
took in 1993.

Signature

Steven D. Litvintchouk
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jmc - 09 Mar 2006 16:45 GMT
Suddenly, without warning, Steven L. exclaimed (09-Mar-06 10:29 AM):

>> Having been a chronic sufferer for 15 years and now 10 years without,
>> I can
[quoted text clipped - 26 lines]
> became chronically ill after a severe allergic reaction to a flu shot I
> took in 1993.

Keep in mind though, that there are food allergies, and food
intolerances.  I'm not allergic to anything, but I've recently developed
 an intolerance to poultry, makes me bloat.  I'm also intolerant of
aspartame, gives me headaches.  So I'd say it still might be worth a
try.  You could try eliminating one at a time, to see if any one thing
is causing problems.  I often read that dairy is implicated in
thickening mucous, which would worsen sinus problems...

jmc
Don Brady - 09 Mar 2006 20:37 GMT
On Thu, 09 Mar 2006 16:45:18 +0000, jmc <NOnewsgroupsSPAM@NOjodiBODY.HOMEus>

> I often read that dairy is implicated in
>thickening mucous, which would worsen sinus problems...

According to studies, there is no evidence for this and it is a myth (except in
a few individuals with a specific allergy to milk protein).

Most adults consume  precious little dairy anyway.....
 
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