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Medical Forum / Diseases and Disorders / Sinusitis / June 2006infection due to packing?
One week after surgery I was having some major med reactions to the Cipro and stopped it; informed the ENT's nurse. Thursday, two weeks after surgery, having trouble keeping that low-grade fever down, with sharp little pains shooting around, suddenly I could blow my nose productively for the first time. Green and shades of brown, strings and clumps and little clots of black. Kept spritzing the saline and blowing, put a call in to the ENT, who is out of the office until Monday. (Since I started seeing him in November, this is the 3rd time when I've called that he's been out for days in a row, but that's my general gripe when having to resort to specialists). Mudballs coming out later in the afternoon when a nurse for the ENT covering for him called me back, said I should start on Levaquin. Friday, lots of long sneezing fits, followed by brown jelly globs. I boiled some RO water, disinfected the Waterpik, and irrigated for the first time. Globs and a few LARGE masses of brown gunk! Some greens and grays. And then a clump of hard solid stuff. I'm wondering if the packing that's supposed to dissolve, didn't, and is causing this. Trying to imagine anything more gross and can't just now......has anyone had experience with it? Rhonda (keeping the Simply Saline company in business) > One week after surgery I was having some major med reactions to the > Cipro and stopped it; informed the ENT's nurse. [quoted text clipped - 23 lines] > Trying to imagine anything more gross and can't just now......has > anyone had experience with it? Because I had the old-style packing that had to be removed by the doctor, I started very gentle irrigation a few days after he removed it, as per his instructions. And sure, I was flushing blood clots out of my nose for many days afterward. The surgery continues to ooze little bits of blood for a week or two and I kept flushing all that out. Now in your case, you hadn't done any irrigation for two weeks. So there's going to be a huge amount of clotted stuff in your sinuses. You may need to make an appointment with your ENT and have him do a thorough cleaning. That dried blood makes an excellent growth medium for bacteria and that is feeding your low-grade infection, I'll bet.  SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. >Now in your case, you hadn't done any irrigation for two weeks. So >there's going to be a huge amount of clotted stuff in your sinuses. You >may need to make an appointment with your ENT and have him do a thorough >cleaning. Thanks-I feel somewhat reassured! I have my second follow-up appointment Monday. He had told me not to irrigate with the Water-pik for two weeks, then our appoinment fell three days later than that. When I did irrigate last night I felt that I shouldn't have started then without his go-ahead, but I was still three days away from seeing him again, and faced with what seemed to be huge amounts of extremely gross, gross., disgusting stuff... .I did it anyway. It was two weeks. I regret doing the surgery at this point. Not that it makes any difference! Rhonda > I have my second follow-up appointment Monday. He had told me not to > irrigate with the Water-pik for two weeks, then our appoinment fell [quoted text clipped - 6 lines] > I regret doing the surgery at this point. Not that it makes any > difference! Please don't feel that way. I had issues with both my surgeries--I ended up with a nasty post-operative sinus infection after my first surgery that lasted for a couple of months. Sinus surgery isn't like having your gall bladder removed. Sinus surgery sets up conditions for slow healing, a process that can take more than six months to get the full effect. In the meantime, you can actually feel worse sometimes; I know I did. Try to be patient. VERY patient. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. >Please don't feel that way. I had issues with both my surgeries--I >ended up with a nasty post-operative sinus infection after my first [quoted text clipped - 4 lines] >more than six months to get the full effect. In the meantime, you can >actually feel worse sometimes; I know I did. Thanks, Steve. That's where I was unprepared and didn't dig around for enough info. Initially the ENT said to take at least a week off and not expect to feel much better again for two. For the first couple of days after surgery I felt okay. When I went back after a week, worried that I felt so bad, he said the symptoms would fluctuate for about SIX weeks. There was no sign of infection then. with the low-grade fever being a normal thing after the surgery. >Try to be patient. VERY patient. I have to remember that I went a full year without being able to get much relief, after years of fighting the infections, before the surgery. Gotta give up the idea that I should feel a little better every day, and just wait. Thank you for the insight and encouragement. I'm sure glad I waited until school was out! And this Levaquin gives me awful nightmares. I had just started to sleep most of the night again. Patience, patience..... Rhonda > And this Levaquin gives me awful nightmares. I had just started to > sleep most of the night again. Patience, patience..... On a small percentage of patients, Levaquin can have a stimulating side effect. (Cipro is even worse in that regard.) I suggest you take it first thing in the morning when you wake up, so that side effect is worn off by the time you get to sleep at night. And it goes without saying that when you take Levaquin, you should avoid taking anything else that is stimulating. No caffeine--no coffee, tea, cola, etc. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. I have the same problem with levaquin, it usually gets better with time. I also try and take it early or mid-day for that reason. The best time to judge the results of your sinus surgery is about 6 months later, when you can take the long view. I've had 5 surgeries, and did have some protracted post-op infections. At this point, life (knock on wood) is fairly stable. I think the surgeons tend to either underestimate the effects of the surgery, or they just don't see it, because they have limited post-op visits with you. Good luck. It will get better, and it's too soon to know if the surgery is a success for you. You're healing, and will be healing for months. Judy > > And this Levaquin gives me awful nightmares. I had just started to > > sleep most of the night again. Patience, patience..... [quoted text clipped - 10 lines] > Email: sdlitvin@earthlinkNOSPAM.net > Remove the NOSPAM before replying to me. >I have the same problem with levaquin, it usually gets better with >time. I also try and take it early or mid-day for that reason. I'm taking it at lunch; will take it a little earlier from now on. Did you ever have zonk-out, anesthesia-like effect with it? I need the sleep, but don't like the heavy grogginess. > I've had 5 surgeries, and did have some protracted post-op >infections. The long post-op has finally sunk in. I went to pre-op with index cards full of questions, trying to be as prepared to cope as possible. Hah. What's making me clutch at this point is that y'all keep talking about your mulltiple surgeries. Don't ever, ever, want to do this again. I fought it off for about 18 years this time! > Good luck. It will get better, and it's too soon to know if the >surgery is a success for you. Thanks for the encouragement--I can get lots more air through my nose since all the crud broke loose and I started irrigating Friday. Years ago when a steroid shot used to work, the effect was similar. "Where is all this air coming from?!" And I'm not stuffing up when I sleep!! Hope this continues..... Having this feedback is a big help in the coping department. Tomorrow, the long, long vacuum again. Didn't know to ask about that before hand! Rhonda >> I have the same problem with levaquin, it usually gets better with >> time. I also try and take it early or mid-day for that reason. > > I'm taking it at lunch; will take it a little earlier from now on. > Did you ever have zonk-out, anesthesia-like effect with it? I need > the sleep, but don't like the heavy grogginess. In clinical trials, the following events were considered likely to be drug-related in patients receiving levofloxacin: nausea 1.5% diarrhea 1.2%, vaginitis 0.5%, insomnia 0.4%, abdominal pain 0.4%, flatulence 0.2%, pruritus 0.2%, dizziness 0.3%, rash 0.3%, dyspepsia 0.3%, genital moniliasis 0.1%, moniliasis 0.2%, taste perversion 0.2%, vomiting 0.3%, injection site pain 0.2%, injection site reaction 0.1%, injection site inflammation 0.1%, constipation 0.1%, fungal infection 0.1%, genital pruritis 0.1%, headache 0.2%, nervousness 0.1%, rash erythematous 0.1%, urticaria 0.1%, anorexia 0.1%, somnolence 0.1%, agitation 0.1%, rash maculo-papular (<0.1%), dry mouth 0.2%, tremor 0.1%, condition aggravated 0.1%, allergic reaction 0.1%. In clinical trials, the following events, of potential medical importance, occurred at a rate of 0.1% to 0.9%, regardless of drug relationship: Psychiatric Disorders: Abnormal dreaming, agitation, anorexia, anxiety, confusion, depression, hallucination, impotence, nervousness, paroniria, sleep disorder, somnolence http://www.rxlist.com/cgi/generic/levoflox_ad.htm SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. >Psychiatric Disorders: Abnormal dreaming, agitation, anorexia, anxiety, >confusion, depression, hallucination, impotence, nervousness, paroniria, >sleep disorder, somnolence I figure if it can play havoc with my brain when I'm asleep, I should have my husband watch me while I'm awake. Rhonda Rhonda, All the quinolone antibiotics can cause nervous system side-effects. (They can also mess with your blood sugar--which is why tequin is not likely to be on the market for long.) My husband tells me he sees ads on TV advertising: "has levaquin hurt your tendons". Yes, they can weaken tendons, but in reality, they rarely cause that side effect. Personally, I can only read the PDR or similar references so much, or all drugs terrify me. (And I prescribe them....) I just have taken levaquin a lot, and talked to many people who have taken it, and lots of us get insomnia or vivid dreams on it. I used to take it at lunch, and the insomnia usually became a non-issue after a few days. If you do look in the PDR and look at the metabolism, it spikes up and then rapidly declines over about 4-6 hours, so I think it's the high blood levels that correspond to the insomnia. Yes, I had multiple surgeries: but my problem was that my first--in 1989--was before endoscopes were widely used (I missed it by a short period of time), my second was endoscopic and I should have stopped there. I was getting very sick, primarily because I was working in a hospital with lots of germs and mold issues, and I let a "super-specialist" do an extensive surgery, that my local ENT was not convinced I needed. I got a bone infection from that surgery, and the expert refused to see me back, so my local ENT had to do two "clean-up" surgeries to deal with infection and scarring. If I had stopped at two, and focused more on medical management, it would have been better for me. But when you feel lousy, and someone tells you they can cure you, it's very hard to say no. I believe the current thinking is "less is more": functional surgery's goal is just to remove the obstructions and leave as much natural anatomy alone. I did take my daughter to a different national expert, and he immediately wanted to book her for the balloon sinus surgery. I spoke to our local ENT, and checked the web site of the ballon manufacturer, and both of us felt it was a case of embracing new technology before knowing if it was a true improvement. My daughter flatly refused the surgery (she's 20, with a mild immune deficiency, and dorm living was rough on her) and is focusing on treating her allergies, irrigating, etc. I think she might ultimately need a minor surgery, based on her CT scan, but she'll go with the conservative surgeon--if she decides to ever do it. Seriously, the actual healing takes a long time. Your cilia are stunned, everything is still healing, you'll be better soon, but it takes months for your mucosa to really recover. (My husband would go to the post-op visits, and he couldn't figure out how all that stuff actually fit up my nose--I understand the long vacuum.) Judy stnick1spaml...@cox.net wrote: > >Psychiatric Disorders: Abnormal dreaming, agitation, anorexia, anxiety, > >confusion, depression, hallucination, impotence, nervousness, paroniria, > >sleep disorder, somnolence > > I figure if it can play havoc with my brain when I'm asleep, I should > have my husband watch me while I'm awake. >Rhonda, > All the quinolone antibiotics can cause nervous system side-effects. >(They can also mess with your blood sugar--which is why tequin is not >likely to be on the market for long.) For the past year, Tequin was the only one that could back my infections off. Figures. Of course, the days of constant resistant infection will be gone now. In the past, I've had disorientation/dizziness reactions to Tetracycline and Ceclor, and severe itching to Lorabid. All after taking them about a week. However, I've taken Cipro a lot in the past, with no problems, so it took me a while to figure this last one out. A week into it, I started having panicy feelings, like I couldn't breathe. I was breathing fine. Had averaged 3 hours of sleep per 24 since the surgery, so thought the deprivation, plus not being able to breathe through my nose, was causing the feeling. Next night, I had a very sudden "anesthesia" attack--my husband had to help me get to the bed. Two hours later I was up again. Figured the drowsiness warning from two different meds had kicked in at the same time. (Had started a new form of hormone the week before with a drowsiness warning-- felt it only the first night). However, the next morning I had "bugs crawling" on one leg for hours. Took Benadryl and the bugs went away within an hour. Duh, maybe I won't take any more of those. I sure hope this round of Levaquin is it for the antibiotics. I'm so dizzy and unsteady, my gross eye-hand coordination is off, and I had a less severe "anesthesia" hit this morning. Then after keeping myself awake all afternoon, hoping to sleep tonight, here I am after midnight wide awake. Guess I should just go with this medicine--sleep when sleepy. > Personally, I can only read the PDR or similar references so much, or >all drugs terrify me. Ditto. > Yes, I had multiple surgeries: I'm wondering how you did it--I actually thought I was tough, never missing work no matter how sick (from sinus and related junk). I sure couldn't function at work now! I drive on my job, but apart from that, I'm zombie-fied in general most of the time, can't focus enough to read much, even. I can't imagine coping with some of the things you guys have described with life going on as usual! (I'm a homebound teacher, off for the summer). . But when you feel lousy, and someone >tells you they can cure you, it's very hard to say no. Yes. And to keep saying no. > (My husband would go to the post-op visits, and he couldn't figure >out how all that stuff actually fit up my nose--I understand the long >vacuum.) My husband is sitting within reach tomorrow, or later today, rather, when the long stuff comes at me. I know I had to hurt the nurse's arm last time. More sheer terror than pain, but I wasn't infected then..... Thanks for the company and comfort! Rhonda Ron I've never had the nurse suction me: only the ENT. I would smack her arm too, if she hurt me. I have felt really awful when they mess with my nose, and I've had to ask them (the ENT's) to give me a break. The last time I took levaquin, I had to stay home from work for a week, I was so dizzy and miserable. So, it's all relative, how much we can tolerate. I've definitely seen patients hallucinate on cipro. I also wouldn't doubt that the two drugs are combining to cause the symptoms you're feeling. It sounds really rough, I hope it starts to improve soon. Judy > >Rhonda, > > All the quinolone antibiotics can cause nervous system side-effects. [quoted text clipped - 65 lines] > > Rhonda >I've never had the nurse suction me: only the ENT. I would smack her >arm too, if she hurt me. I told it wrong--the ENT was doing the suction. But it was the nurse's arm I grabbed. And squeezed real, real hard. Rhonda Rhonda (I don't know why I called you Ron...) Good luck, and squeeze if you need to. I just say: "Could you please stop that now? I think I'm going to faint."--works pretty well. I really know what you're going through, and I'm certain things will only get better. Judy > >I've never had the nurse suction me: only the ENT. I would smack her > >arm too, if she hurt me. [quoted text clipped - 3 lines] > > Rhonda > Good luck, and squeeze if you need to. I just say: "Could you please >stop that now? I think I'm going to faint."--works pretty well. > I really know what you're going through, and I'm certain things will >only get better. It's over! I'm dopey from the one Darvocet I took before going, but MUCH relieved at the report. He said the nose and sinuses look like a month after surgery rather than two weeks. Because I've used so much saline, and irrigated a lot since Friday, he didn't have to poke around much or remove scabs. The vacuum wasn't as intense, either. He stopped and made me breathe in between. He said the infection was already there (forever) and now the sinuses were able to work on it. Everything looks very open and the turbnates are the right size now. I wonder why I didn't get put on another antibiotic right away when I stopped the Cipro, but didn't think to ask. I was just so relieved at the good report, after all the scary stuff last week. Heehee, while we were waiting, my husband was pointing out all these certificates on the wall from Johns Hopkins. Advanced this and that, and instructor. They didn't ease my mind a bit! Time to pass out for a while on the couch-- Rhonda Rhonda, sounds like excellent news. You helped the healing progress with irrigation. You said you use the water pik: do you use the grossan head? And what do you irrigate with? You mentioned RO water. After years of the water pik, my ENT is a neti pot person, so I switched a number of years ago, but have considered the water pik. I just use boiled water and kosher salt. Because I had a pseudomonas infection, I acidify the rinse with some vinegar. I'm so glad you're better. Judy > > Good luck, and squeeze if you need to. I just say: "Could you please > >stop that now? I think I'm going to faint."--works pretty well. [quoted text clipped - 22 lines] > > Rhonda >You said you use the water pik: do you use the grossan head? On my 3rd one. The first specialist all those years ago started me. And what >do you irrigate with? Right now I'm using distilled, non-iodized salt, and white vinegar. Isotonic strength. Regular table salt. Usually I just use RO. The first ENT was real picky--distilled only, precise mixture. This one said RO water was fine when I first started seeing him. He also had me add the vinegar for a natural antibiotic. And introduced me to hypertonic, which helped a lot in the months before the surgery. >You mentioned RO water. My husband gets our water from one of those windmills. You can chew our tap water and get your roughage and minerals. Tastes a litte nasty, too. > I'm so glad you're better. Thank you! I don't feel better yet, but knowing I am so much better makes a huge difference. If anybody asks me about having the surgery, I'll try to tell them everything I wish I'd known, about the recovery time, symptoms, that vacuum.... Rhonda On 6/18/06 5:21 PM, in article 1150676511.967214.155670@c74g2000cwc.googlegroups.com, "judy.n" > I did take my daughter to a different national expert, and he > immediately wanted to book her for the balloon sinus surgery. I spoke [quoted text clipped - 4 lines] > rough on her) and is focusing on treating her allergies, irrigating, > etc. Actually there has been one significant benefit from the balloon PR campaign. It has brought us to realize how simply opening the sinus ostia can reverse even major sinus disease. This has resulted in more doctors using pulsatile irrigation to get the opening patent and thereby reversing sinus pathology. Our concern that by opening the balloon you open the ostea at the expense of underlying ethmoid cells, and the series of patients studied and reported on are few and with short follow up times. What do you think of the balloon--other than its support of ostea patency. Judy > On 6/18/06 5:21 PM, in article > 1150676511.967214.155670@c74g2000cwc.googlegroups.com, "judy.n" [quoted text clipped - 12 lines] > using pulsatile irrigation to get the opening patent and thereby reversing > sinus pathology. On 6/21/06 8:56 AM, in article 1150905389.350899.144590@c74g2000cwc.googlegroups.com, "judy.n" > Our concern that by opening the balloon you open the ostea at the > expense of underlying ethmoid cells, and the series of patients studied > and reported on are few and with short follow up times. What do you > think of the balloon--other than its support of ostea patency. > Judy Next to Somnoplasty, they have the best PR. Faint praise. Other than the relatively few patients studied/followed and the unknown effect of crushing ethmoid air cells to open frontal sinus ostea, the concern I've heard is that it is best suited for frontal sinus disease, which is relatively less common. Judy > On 6/21/06 8:56 AM, in article > 1150905389.350899.144590@c74g2000cwc.googlegroups.com, "judy.n" [quoted text clipped - 6 lines] > > Next to Somnoplasty, they have the best PR. On 6/22/06 5:37 AM, in article 1150979841.862524.135170@m73g2000cwd.googlegroups.com, "judy.n" > Faint praise. > Other than the relatively few patients studied/followed and the [quoted text clipped - 12 lines] >> >> Next to Somnoplasty, they have the best PR. That is correct, we are using it primarily for frontal sinus blockage. Its "nice" to do, sort of like cardiac catheterization. Because the frontal sinus drainage is quite lengthy, having the flouroscopy to guide you is of advantage. We use the Xoran CT scanner for diagnosis and this easily tells us if the sinus blockage at various ostie is amenable to pulsatile irrigation of not. This really saves the patient a great deal of time and medication. Takes away the guess work. On 6/18/06 11:32 AM, in article 44959859.108586995@news.central.cox.net, >> I've had 5 surgeries, and did have some protracted post-op >> infections. After any nasal/sinus surgery the cilia are "zonked". You must avoid iced drinks, and drink HUGE amounts of warm tea/lemon. Mustard ,Wasabi, Horseradish also help. Chicken soup. Until the cilia return, infection can take place. Regrettably some persons still use saline with benzalknium post op and this also slows / impairs the cilia. Either make it fresh yourself or use one without benzalkonium. My product called Breathe.ease XL is designed to speed cilia function and contains no benzalkonium. ( I apologize, not supposed to mention my stuff but...) Isn't Breathe.ease XL slightly alkaline? Both Rhonda and I acidify our rinse to combat pseudomonas. Judy > On 6/18/06 11:32 AM, in article 44959859.108586995@news.central.cox.net, > [quoted text clipped - 10 lines] > speed cilia function and contains no benzalkonium. ( I apologize, not > supposed to mention my stuff but...) You must avoid iced >drinks, and drink HUGE amounts of warm tea/lemon. Mustard ,Wasabi, >Horseradish also help. Chicken soup. Well, I got one of those right! Chicken noodle. Chicken vegetable. Chicken rice. Chicken Whoknoz.. However, I've done bad with the cold stuff. It felt good to alternate it with the hot. The things I keep learning too late! Need to make a list for when others are asking me about all this. Rhonda
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