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Medical Forum / Diseases and Disorders / Sinusitis / August 2006Substantial PND
Hello - I have been suffering from severe PND and am curious for the latest information on trying to resolve this problem. Background - I have been allergy tested several times but nothing shows up - CT scans and catscans are clear - I have been blood tested but again tests were clear - I have seen a food allergiest and attempted special diets but no help (although I lost some lbs) - I have tried numerous antibiotics, allergy RXs, nose spray RXs and saline nasal sprays but no consistent help - Also been thru detox programs to restore my immune system - but again no luck The drainage is often very thick and hard to clear. Often when talking I have the need to clear my throat before speaking and before completing a sentence. The drainage seems to get worse after exercise (jogging) or in a stressful situation (ie leading a conference call at work). Sometimes at night I wake up coughing to clear my throat. If I blow my nose its clear and rarely have sinus headaches. I dont have the itchy eyes or sneezing symptoms that most allergy sufferers do. Obviously this is very frustrating - Interested in hearing your thoughts on what to do at this point > Hello - I have been suffering from severe PND and am curious for the > latest information on trying to resolve this problem. [quoted text clipped - 25 lines] > Obviously this is very frustrating - Interested in hearing your > thoughts on what to do at this point It sure sounds as if you have allergies, perhaps to dust mites that live in your pillow and bedding? Skin tests aren't foolproof, nor are RAST serum tests, they missed every single one of my severe inhalant allergies, but picked up food allergies in the order of severity I listed them. Do you drink a lot of water? It thins mucus and might help, if you're at all dehydrated now. Do you irrigate with saline solution? Susan > It sure sounds as if you have allergies, perhaps to dust mites that live > in your pillow and bedding? I am not so sure. We did buy the recommending pillows and bedding some time back but that did not seem to help > Do you drink a lot of water? It thins mucus and might help, if you're > at all dehydrated now. I try to - and Dr's continue to recommend it. However it does not seem to make a noticeable difference > Do you irrigate with saline solution? Yes- but again not noticeable difference in the PND Thanks for post > I am not so sure. We did buy the recommending pillows and bedding some > time back but that did not seem to help That doesn't help unless you clean the room, including the ceilings, walls, backs of furnitures, remove rugs and curtains, etc. >>Do you drink a lot of water? It thins mucus and might help, if you're >>at all dehydrated now. > > I try to - and Dr's continue to recommend it. However it does not seem > to make a noticeable difference Really, no lessening of the thickness? >>Do you irrigate with saline solution? > > Yes- but again not noticeable difference in the PND I'm sorry you're stumped. Susan On 8/14/06 1:54 PM, in article 4kc68bFbjmuuU1@individual.net, "Susan" <nevermind@nomail.com> wrote: > x-no-archive: yes > [quoted text clipped - 41 lines] > > Susan Anyone with thick heavy mucus should switch to green/black tea in HUGE amounts, and add lemon /lime to drinking water. Sometimes that is the cure. > Anyone with thick heavy mucus should switch to green/black tea in HUGE > amounts, and add lemon /lime to drinking water. Sometimes that is the cure. Thanks for your post. I am definitely willing to try this and its not something I normally do. I assume you mean hot tea? > Anyone with thick heavy mucus should switch to green/black tea in HUGE > amounts, and add lemon /lime to drinking water. Sometimes that is the cure. Do you mean decaffeinated, or huge amounts of caffeine? Is there objective literature confirming the benefits? Susan On 8/15/06 1:02 PM, in article 4kenjbFbojeuU3@individual.net, "Susan" <nevermind@nomail.com> wrote: > x-no-archive: yes > [quoted text clipped - 6 lines] > > Susan It can be decaffinated, but should be green or black. From How to be free of Sinusitis Permanently: The Chemicals In Tea A compound called EGCG was reported in the Journal of Agricultural and Food Chemistry (Oct 9, 2003 ) to block the receptor involved in allergic response. The compounds found in tea helps with allergy to pollen, dust, pets, etc., by blocking the production of histamine and IgE. The Harvard Medical School Family Health Guide July 2002 reported that drinking tea can help prevent death after a heart attack. In addition to other benefits it can increase bone mineral density which helps prevent fractures and osteoporosis. Tea can boost the body¹s defense fivefold against disease. Dr Jack Bukowski of Harvard reported that five cups of tea a day increased the body¹s defenses against disease. The tea chemical is L-theanine. In the liver it becomes ethylamine, a molecule that primes the response of an immune blood cell, one of the T cells. They even have anti-tumor factor. These T cells called gamma delta T cells prompt the secretion of interferon, a key defense against infection. Tea is high in antioxidants and chemically stimulates cilia action > Tea can boost the body¹s defense fivefold against disease. Dr Jack > Bukowski of Harvard reported that five cups of tea a day increased the [quoted text clipped - 3 lines] > These T cells called gamma delta T cells prompt the secretion of interferon, > a key defense against infection. >>>Tea is high in antioxidants and chemically > stimulates cilia action<<< Is this part also contained in the Harvard report? Are there any objective studies of this effect? Susan <coffee lover> I've had very similar symptoms for over 6 years now. I've been all over trying to figure it out and still I suffer with the PND everday. I even flew out to Mayo clinic in March (Cold). All ENT's have said, Vasomotor Rhinitis; meaning-We don't know why your nose produces so much mucus. It sucks for sure but you aren't the only one. David Sacramento, CA Me too. My PND has been worse since I had sinus surgery (the last one was four years ago), and seems to keep getting worse. It really irritates my throat too, I lose my voice, etc. > I've had very similar symptoms for over 6 years now. I've been all over > trying to figure it out and still I suffer with the PND everday. I even [quoted text clipped - 4 lines] > David > Sacramento, CA MS and David Do you feel bad with the PND (other sinusitis symptoms such as pain, pressure, malaise, fatigue) or is it more of just a nuisance? Are you still able to function? Kathyw > MS and David > [quoted text clipped - 3 lines] > > Kathyw No, PND is not my only symptom. It is just one that has got worse in recent years. And it is much worse than a mere nuisance! I wasn't trying to indicate that it was just a nuisance; but for some people that seems to be their only symptom. I'm completely with you. I've had the terrible PND to the point that I've thrown up, and then alternating with severe headaches when it won't drain, all the while being told I didn't have sinusitis even with 4 gram - bacteria and a pathogenic mold cultured out in the last 2 years. I had surgery a month ago to open up my frontals and sphenoids which were almost closed and now I have another gram- infection (which I later found out I had before the surgery) and not even able to function most of the time at this point. So, I'm saying you need to get someone to take this seriously if it means continuous doctor shopping or whatever it takes. Could you find an ENT to to do an endoscopic culture? It would be best to know which antibiotics work for whatever you have? I didn't get this done until 2 years ago and because I've been on so many antibiotics without knowing what was actually there, I've ended up with all of these hard to treat microbes. Also, have you considered the eosinophilic fungal sinusitis. As to your other post about taking research to doctors, it has been my experience that most do not like it. They may act like it at first, but then get tired of it. I don't know if it's not wanting the patient to perhaps know more than they do, if they are too busy or what. At least my current ENT admits that nobody knows what causes this so perhaps that is the problem too. Then if they treat you for what you've brought in and it doesn't work or makes you worse, then what? Then you've lost that doctor. I've been there too. I know I've been so desperate that I've taken things in that have ended up not being the cuprit at all. So, I now find it best to do the research and then just have some questions written down and let them think they come up with the answers. Again, I COMPLETELY understand where you are "coming from." I"ve had the PND so bad, I've been up all night trying to clear it out. Then by the time I get to the ENT, it is all out, so they say I don't even have it. > > MS and David > > [quoted text clipped - 6 lines] > No, PND is not my only symptom. It is just one that has got worse in recent > years. And it is much worse than a mere nuisance! > Me too. My PND has been worse since I had sinus surgery (the last one was > four years ago), and seems to keep getting worse. It really irritates my > throat too, I lose my vo Do you all ever get pain/discomfort in the area of your eustachion (sp?) tubes? This happens to me on the right side of my head. It typically occurs during periods of significant pnd so I guess things are backing up. Sometimes when I wiggle my jaw my ear will pop and feel squishy inside. My ENT paid close attention to this area during the scans but found nothing. Thanks Yes!! I have had fluid behind ears and ear aches a lot, but not actual ear infections? Dr. Sherris saw a grayish fluid going from my eustachian tubes into my middle ears during his exam and said there was really nothing to do but treat the sinus drainage. Don't know if it was infection or inflammatin. BTW, sometimes chronic sinusitis can be mainly inflammation and not infection. Treatment in that case is with nasal steroids and if that doesn't work oral steroids. Sometimes a prednisone dose pak can help with inflammation. > > Me too. My PND has been worse since I had sinus surgery (the last one was > > four years ago), and seems to keep getting worse. It really irritates my [quoted text clipped - 8 lines] > > Thanks For myself the PND is mostly a nuisance. Occasionally I have pressure in my cheek and forehead and fatuige but not daily. The PND is in huge amounts of clear - white thin and think mucus everyday. I'm sure that I have a combination of problems going on but I can find anyone that can help. I did have the best luck a few months ago when starting a GERD medication (Aciphex) It cleared me up for about 2 weeks and then return slowly. David Sacramento, CA > For myself the PND is mostly a nuisance. Occasionally I have pressure > in my cheek and forehead and fatuige but not daily. The PND is in huge [quoted text clipped - 6 lines] > David > Sacramento, CA Davnid, Did anyone suggest you try Astelin or Atrovent? If you truly have vasomotor rhinitis, these are the most current options for it. Astelin is a nasal antihistimine, but supposed to help with the "runny" kind. They didn't do anything for me. My final diagnosis was "mild" vasomotor rhinitis on both of my earlier trips to Mayo even with major fatigue, purulent post nasal drainage, mild to moderate pressure/pain behind my nose (it got severe after not getting adequately diagnosed), body aches, etc. Kathyw On 8/15/06 1:02 PM, in article 4kenjbFbojeuU3@individual.net, "Susan" <nevermind@nomail.com> wrote: > x-no-archive: yes > [quoted text clipped - 6 lines] > > Susan It can be with or without caffeine. The Chemicals In Tea A compound called EGCG was reported in the Journal of Agricultural and Food Chemistry (Oct 9, 2003 ) to block the receptor involved in allergic response. The compounds found in tea helps with allergy to pollen, dust, pets, etc., by blocking the production of histamine and IgE. The Harvard Medical School Family Health Guide July 2002 reported that drinking tea can help prevent death after a heart attack. In addition to other benefits it can increase bone mineral density which helps prevent fractures and osteoporosis. Tea can boost the body¹s defense fivefold against disease. Dr Jack Bukowski of Harvard reported that five cups of tea a day increased the body¹s defenses against disease. The tea chemical is L-theanine. In the liver it becomes ethylamine, a molecule that primes the response of an immune blood cell, one of the T cells. They even have anti-tumor factor. These T cells called gamma delta T cells prompt the secretion of interferon, a key defense against infection. Tea is high in antioxidants and chemically stimulates cilia action > On 8/14/06 1:54 PM, in article 4kc68bFbjmuuU1@individual.net, "Susan" > <nevermind@nomail.com> wrote: [quoted text clipped - 46 lines] > Anyone with thick heavy mucus should switch to green/black tea in HUGE > amounts, and add lemon /lime to drinking water. Sometimes that is the cure. Anybody who gets chronic sinusitis from frequent flying should stay on the ground if possible. Flight attendants have lots of sinus problems.  SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. Have you considered eosinophilic fungal sinusitis (previously called allergic fungal sinusitis, but now they are proving you don't have to be allergic)? Do you live or work in a moldy enviroment? That's not essential to developing it because we are all exposed to mold all the time, but could definitely make it worse. It's caused by an abnormal immune response to the mold; that's why everyone isn't affected. Kathyw > Hello - I have been suffering from severe PND and am curious for the > latest information on trying to resolve this problem. > Have you considered eosinophilic fungal sinusitis (previously called > allergic fungal sinusitis, but now they are proving you don't have to > be allergic)? Thanks for your post How can one go about to determine if they have eosinophilic fungal sinusitis? I havent been tested for this that I know of Thanks > Sometimes at night I wake up coughing to clear my throat. > [quoted text clipped - 4 lines] > Obviously this is very frustrating - Interested in hearing your > thoughts on what to do at this point There are many irritants and pollutants in the air that aren't true allergies, so allergy tests won't pick them up. A complete patient history is the first place to start, so let me ask you some basic questions: 1. When did your bad PND start for the first time? Did it start with any lifestyle changes (new job, new home, etc.), or illnesses (bad cold, flu, etc.)? Or did you have it all your life? 2. What color is your PND? (Clear or discolored?) 3. Any sources of air pollution in your community? The website www.scorecard.org will give you the air pollution data for your neighborhood from the EPA's own monitoring stations. Just enter your Zip Code in the box where it asks you. 4. Do you use decongestant nasal sprays (e.g. Afrin or the equivalent) on a regular basis? 5. Do you smoke anything or snort anything? [feel free to email me privately if you use illegal substances] 6. Do you drink alcohol? SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > 1. When did your bad PND start for the first time? Did it start with > any lifestyle changes (new job, new home, etc.), or illnesses (bad cold, > flu, etc.)? Or did you have it all your life? It seemed to come on gradually after starting a new job where I had to travel quite a bit deliver presentations. It has definitely gotten worse over time. > 2. What color is your PND? (Clear or discolored?) Ranging from clear to brown colored. At times it gets very thick though. So thick any attempts to clear it are worthless. > 3. Any sources of air pollution in your community? The website > www.scorecard.org will give you the air pollution data for your > neighborhood from the EPA's own monitoring stations. Just enter your > Zip Code in the box where it asks you. Interesting. Our county ranks in the 10% worst for toxic chem, smog and soot, and air pollutants. > 4. Do you use decongestant nasal sprays (e.g. Afrin or the equivalent) > on a regular basis? I tried numerous RX allergy/decongenstant sprays Flonase, Nasonex, etc. The dr.s rotated me thru all the brands to try to find one that works. My nasal cavities felt very clear but no real impact on throat drainage. > 5. Do you smoke anything or snort anything? [feel free to email me > privately if you use illegal substances] Nope > 6. Do you drink alcohol? Yes typically beer every other weekend or so Let me know Brown mucus is typical of fungal sinusitis. It has the consistency of peanut butter. Mayo Clinic is the pioneer of the eosinophilic fungal sinusitis theory, but most up to date ENTs are familiar with it. The main treatment they are using is an antifungal wash usually amphotericn B, but it has to be refrigerated. Some companies are making an itraconazole (sporanox) rinse that doesn't have to be refigerated and has a longer shelf life. Getting to the bottom of this with a negative CT scan is going to be difficult. Most ENTS will just dismiss you as not having any sinus problems if your CT scan is clear. But many of us have had significant sinusitis with "clear" scans. Some ENTs are testing for MBP (major basic protein) as a marker in the mucus because supposedly everyone has fungus in their nose. There are so many possibilities that this is just a guess on my part. You have to do a lot of research on your symptoms, etc. In my experience there about as many theories as there are ENTs. Do you feel bad with this? Run any fever? > > 2. What color is your PND? (Clear or discolored?) > Ranging from clear to brown colored. At times it gets very thick > though. So thick any attempts to clear it are worthless. >> 1. When did your bad PND start for the first time? Did it start with >> any lifestyle changes (new job, new home, etc.), or illnesses (bad cold, [quoted text clipped - 13 lines] > Interesting. Our county ranks in the 10% worst for toxic chem, smog > and soot, and air pollutants. OK. Based on my own experience, here is where I think you stand: Frequent air travel is murder on sinuses because of the low air pressure and poor quality air in airliner cabins. (The Boeing 757 is the worst offender, with the fewest air changes per hour.) And living in a highly polluted area doesn't help either. As part of your treatment program, you have to think seriously about changing your lifestyle, even if it means relocating or getting another job. In the end, I was forced to. Brown colored PND is a sure sign of sinusitis, no matter what the CT scan shows. You won't be the first person on this newsgroup to have sinusitis despite a negative CT scan. I did. So did many others. CT scans have maybe a 5% rate of false negatives. No test is perfect. And the really good physicians know that. However, I disagree with Karen about brown PND meaning fungal infection. I had brown PND with my worst bacterial sinus infections. But what it means is that, just as I did, you need to find an ENT who will take a DETAILED patient history (just like I just tried to do with you); and trust your symptoms and history and diagnose you with sinusitis despite the negative test results. Those ENTs are hard to come by. But they are out there; I found one. You might start your search here: http://www.usnews.com/usnews/health/best-hospitals/rankings/specihqotol.htm I don't know what antibiotics you have tried or for how long. For sinusitis, the big gun is either Avelox or Levaquin. And given you've suffered for so long, you might need to be on it for a couple of *months* to completely clear the infection. Sinus infections are stubborn, and the usual 10 day course of antibiotic is often nowhere near enough to do the whole job. If even that fails, then surgery might be required. In my case, the two things that helped me the most were surgery and lifestyle changes. In the end, I had to sell my home and leave the polluted area. I doubt I would ever have treated my sinusitis effectively if I had continued to stay in an unhealthy environment. You need to think seriously about that. Good luck. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. As part of your treatment program, > you have to think seriously about changing your lifestyle, even if it > means relocating or getting another job. In the end, I was forced to. Why on earth would he have to start there? I mean, there's nothing *wrong* with moving to a cleaner environment, but the biggest life disruptor wouldn't be my first choice of treatment, though desert air sounds like a real sinusitis healer from all reports. > Brown colored PND is a sure sign of sinusitis, no matter what the CT > scan shows. You won't be the first person on this newsgroup to have > sinusitis despite a negative CT scan. I did. So did many others. CT > scans have maybe a 5% rate of false negatives. No test is perfect. And > the really good physicians know that. Steven, do I recall correctly that that rate goes up to 25% in the case of ethmoid sinusitis? > However, I disagree with Karen about brown PND meaning fungal infection. > I had brown PND with my worst bacterial sinus infections. But what it [quoted text clipped - 5 lines] > > http://www.usnews.com/usnews/health/best-hospitals/rankings/specihqotol.htm > I don't know what antibiotics you have tried or for how long. For > sinusitis, the big gun is either Avelox or Levaquin. And given you've [quoted text clipped - 3 lines] > near enough to do the whole job. If even that fails, then surgery might > be required. Mayo clinic, on their web site, recommends 4-12 weeks of antibiotics. 10 days is when my antibiotic starts making a difference, far from clearing up the infection. > In my case, the two things that helped me the most were surgery and > lifestyle changes. In the end, I had to sell my home and leave the > polluted area. I doubt I would ever have treated my sinusitis > effectively if I had continued to stay in an unhealthy environment. You > need to think seriously about that. Steven, I don't know your history; did you do allergic desensitization and major home hygiene improvements first? Susan > However, I disagree with Karen about brown PND meaning fungal infection. > I had brown PND with my worst bacterial sinus infections. But what it > means is that, just as I did, > http://www.usnews.com/usnews/health/best-hospitals/rankings/specihqotol.htm Steven, I didn't say that the brown PND always means that it is a fungal infection. I was just saying that it does occur frequently in fungal sinusitis, and giving some other options to consider. > I don't know what antibiotics you have tried or for how long. For > sinusitis, the big gun is either Avelox or Levaquin. And given you've [quoted text clipped - 3 lines] > near enough to do the whole job. If even that fails, then surgery might > be required. You can get into trouble with the over use of antibiotics too. I know I've been there; am now getting resistant gram - bacteria that I never had before; am having to constantly stay on antibiotics; when one goes away, another comes. I'm not saying not to use them. I know they have saved my life on many occasions, but I would suggest trying to get a culture to see what is there and what it is sensitive too if indeed it turns out to be bacterial. And if one does end up having surgery, then I think cultures and sensitivities should be taken then also. Our experiences are all different, and what has worked for one may not work for another. I do agree that an aggressive approach needs to be taken to finding out what is wrong. KATHY Hello John I'd just like to let you know that I have very similar symptoms to yours. I have very thick PND discharge - it's amazing how one small part of the body can have such an large impact on your life. I also have to clear my throat regularly, which can be very embarrasing. It keeps me awake at night, and is very often on my mind. I've been trying hard to find a cure (I'm on all sorts of nasal sprays, and last month I had endoscopic sinus surgery). Once I do I'll post it here. But in the mean time, I thinks it's helpful to let you know that your not alone in suffering with this condition. The best of luck in your search for a solution. Ollie > Hello - I have been suffering from severe PND and am curious for the > latest information on trying to resolve this problem. [quoted text clipped - 25 lines] > Obviously this is very frustrating - Interested in hearing your > thoughts on what to do at this point >Hello John > [quoted text clipped - 13 lines] > >The best of luck in your search for a solution. Your sinuses must still be partly blocked and full of fluid. It should improve gradually over the coming months if the sinus surgery got the blockages etc. The other possibility us that you are exposed to irritants or allergens where you live or work....just an hour or two of exposure is enough to cause ongoing inflammation and blockage.....if so, you will have to remedy that to solve the problem, or you will be stuck with it unfortunately..... |
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