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Medical Forum / Diseases and Disorders / Sinusitis / June 2006It's Baaaaaack!
Hello, I am a long-time sinus trouble sufferer. I've had 5 FESS surgeries, which kept me doctor-free for about 5 years. I have had the most trouble in Buffalo, NY and now Seoul, Korea. I recently moved to Seoul to teach English as a Second Language and I have been having intermittent and intense sinus pain. Normally, my treatment for sinus pain has been sudafed and a lot of hope. I quit taking antibiotics for sinus pain (except for really terrible sinus pain) after the 5th FESS surgery. I'm 22 years old and I really don't feel like dealing with this for the rest of my life. Some have even suggested relocating to somewhere with a constant atmosphere, for example Arizona or Nevada. I don't want to take such a drastic measure, though as I now realize, this problem has not gone away, I just had become really good at dealing with it. The air pollution here in Seoul is terrible and I am sure that it is part of the problem with my sinuses. I've been out of the medical-treatment for sinus pain game for several years, as I had decided that doctors were not worth my time with this problem. I am curious if anyone out there has had medical procedures that have actually helped with their sinus problems. If so, what are they? Does anyone have a wonder-drug that they swear by to either relive pain or treat the underlying cause? I teach the kindest kids, and I don't want the sinus crap, which usually turns me into a crabapple, to dictate my attitude towards them. One of the things I have learned about my sinus troubles over the years is that they often dictate my mood. Sometimes I will be in a terrible, negative mood and not know why-- later, I will realize that it is in fact my sinuses hurting me that is putting me into that mood. I am going to go and have an insanely spicy Korean lunch in hopes that it will clear up my head. Here's hoping, -Jake P.S. If you've got any questions pursuant to my situation, please don't hesistate to ask. I'd be glad to answer them if there's a chance it might lead to my finding any sort of a remedy for the way my head feels right now. I'm quite sick of it, and now that I live in Seoul, one of the first things I notice every day is how much my head hurts. Most people on this board probably know that feeling, and how much that feeling just SUCKS! I am once again dependent on sudafed to feel OK or normal, but Korea's sudafed is bound with an antihistimine that makes me feel groggy and I don't think that "pure" sudafed is available here. For sinus pain I take Aleve. Sometimes the pain is so bad I take it 2x aday and will have to take it for a couple of days too. I will not get any drainage that I know of. Then other times I will get some drainage. The pollen has been so high with all the rain that we got, that I am taking Claritin 2x a day now. There is no decongestant in my non-drowsy Claritin. I see now they are selling Claritin +D now though. shirleyann After 5 surgeries and constant antibiotics, I discovered low dose macrolides for chronic sinusitis . I've taken one biaxin 250 mg/day for 4 years and it has reduced my sinusitis dramatically. I also irrigate with a neti pot daily. Here's a URL for an article in "Chest" (American Thoracic Society) about macrolides for sinusitis. At the low dose, they are used for their anti-inflammatory properties. They only work in specific patients: those with low IgE levels, those whose surgeries haven't been helpful, etc. But when they work, they're very helpful. I also use rhinocort AQ and singulair. http://www.chestjournal.org/cgi/content/full/125/2_suppl/52S Judy > For sinus pain I take Aleve. Sometimes the pain is so bad I take it 2x > aday and will have to take it for a couple of days too. [quoted text clipped - 6 lines] > > shirleyann How do you get Biaxin prescription for everyday use.? My MD only gives it to me for a 10 day supply. shirleyann Shirelyann, My ENT reviewed all the articles on low dose macrolide use, and he chooses his patients carefully, and at this point, he has about 10-15 on chronic macrolides. He tracks those cases on a PDA, and he tells me all have benefitted. The key, he feels, is not to just prescribe it to "all comers" but to chose the cases carefully--patients with underlying immunodeficiencies, those who have had no response to surgeries, a low IgE level (which I have, although I clinically have allergies and get allergy shots...). So, I'm lucky to have an ENT who is open minded, and willing to manage patients medically--not just surgically. The articles were all written about erythromycin, biaxin, roxithromycin (not approved in US), but my ENT has had good luck with a zithromax once or twice a week. I looked at the articles and it fits the profile of the type of macrolide. I couldn't find an article studying zithromax, but I haven't searched that hard. Ironically, my daughter's internist was concerned about it, and yet people use chronic erythromycin for acne/rosacea all the time without any concern. For her, it treats her sinusitis and her asthma simultaneously. And she has low IgA levels. So, the article in Chest is a nice summary, and any doctor who reads it should realize that low dose macrolides are an accepted practice for chronic sinusitis, asthma, cystic fibrosis--any disease with thick mucous. Good luck. Judy > How do you get Biaxin prescription for everyday use.? > > My MD only gives it to me for a 10 day supply. > > shirleyann How long before you noticed improvement? The articles say to give it 12 weeks, I think I started feeling better before then, definitely within the first month. My ENT gives people about 8-12 weeks, ant if it's not doing anything for them, he stops it. It helps the sinuses produce less mucous, so many of the changes were subtle. I was really sick when I started it in 2002--I'd had a bone infection from a previous (5th) surgery, and had been on quinolone antibiotics for long stretches of time. It reduced my episodes to one or less a year: one of the effects of macrolides is that you get less colds, because of some inability for the virus to attach to a protein in your nose (there was a study in Japan, on patients taking erythromycin that documented that), so that's been a big help for me, because I work in healthcare, have a mild immunodeficiency and used to catch everything. Judy > How long before you noticed improvement? >Hello, > [quoted text clipped - 20 lines] >that have actually helped with their sinus problems. If so, what are >they? You have to look at a current CT scan before you can say much. If the sinuses are wide open, that is one thing. If they are inflamed, thickened, almost closed off, and full of fluid, that is another...... The symptoms alone do not tell very much..... >Does anyone have a wonder-drug that they swear by to either relive pain >or treat the underlying cause? [quoted text clipped - 23 lines] >normal, but Korea's sudafed is bound with an antihistimine that makes >me feel groggy and I don't think that "pure" sudafed is available here.
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