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Medical Forum / Diseases and Disorders / Sinusitis / December 2006sinus & doctor advice
I've just read through all the active posts on this group and I'm really glad to find this place. I think I have chronic sinusitis but my doctor seems reluctant to believe there's anything wrong with me. I've had a history of colds/sinus problems every winter. Five years ago I started on Nasonex every day, and the 2-3 colds every year disappeared completely. I'd actually forgotten I ever had sinus problems. Then last May, 3 months after moving to a new house, I bgot sick My throat hurt occasionally but never for more than a day, my ears hurt momentarily, I was feeling dizzy and fatigued and had serious energy drain. One night I woke up feeling so sick, like I was going to throw up and pass out. It scared the hell out of me. From that moment on I felt "carsick" all the time, with the occasional dizzy spell that made me think I would faint. We tested for mold in the new house but it came up negative. In July I went to the ER because the dizziness got so bad. They did a CT scan, blood work, and found nothing. Went to a new GP a few days later, did more test and blood work, again nothing. No one suggested sinuses nor did I even think about sinuses as the cause. Finally in August I had pressure in my maxillary sinuses, and even my teeth were hurting. The dizziness would return when my sinuses hurt the worst. I switched from Nasonex to Flonase but it just got worse. Went to the GP again, who insisted the dizziness I had in May-August wasn't related to the sinus problem. He made me wait a week for antibiotics to prove it wasn't viral. After 10 days of amoxicillin and 4 days of augmentin I felt *great*. I felt normal for the first time in months. To help prevent more sinus problems I started doing nasal rinses with a bulb irrigator. It hasn't helped, because about 6 weeks ago I started getting the momentary dizziness again. This time my GP told me I was making it all up in my head because of my "inactive lifestyle" and was worrying too much, tests proved there was nothing wrong with me. Two weeks later, just before Halloween, I got congestion, dizziness, etc again. I tried to wait it out but even after a little improvement it returned. This time my sinuses hurt like hell, I'm so tired and fatigued and weak that I can barely do anything. Friday my GP was closed but the on-call doctor called in Zithromax for me. Today's my 3rd day and it's helped the pain somewhat, and the mucous is definitely moving around in my head, but otherwise I still feel sick. I guess I was wondering a few things. What should I ask my GP to do, specifically? Just refer me to an ENT or are there more tests? Should I have them go back and look a the CT scan from July or get a new one? Also, what can I do at home? The nasal irrigation didn't do any good, but was I doing it wrong? Would you stay on the Flonase or go back to Nasonex, is there any difference between the two? Any advice would be appreciated. Stacia > I've just read through all the active posts on this group and I'm > really glad to find this place. I think I have chronic sinusitis but my [quoted text clipped - 41 lines] > Nasonex, is there any difference between the two? > Any advice would be appreciated. The thing that leaps out at me is that your condition worsened (as did mine) upon moving to a new house. In my case, mold sensitivity is the issue. A combination of aggressive allergic desensitization and mold (and dust) remediation, along with irrigation and antihistamine Zyrtec and Astelin nasal spray is extremely helpful to me. You don't want to use a steroid spray or any kind of steroid for more than 3 weeks without taking a break, and I suggest you gradually wean yourself off it it; they cause adrenal suppression, and my endocrinologist says this is absolute within two weeks of using them. My advice, then, is to get yourself allergy tested and treated by an aggressive allergist who will give you shots that desensitize within 3 months (not a year or more), use Astelin nasal spray instead of a steroid spray, take an antihistimine, irrigate, and look up ways of minimizing exposure to molds, dust and other household allergens online. In my case, that means allergen barriers on all bedding, no carpeting (just area rugs I can vacuum beneath) scrupulous attention to removing dust even where hidden, HEPA filtration vacuum, HEPA filter bedroom air cleaner, bleaching of my master bath top to bottom at least weekly, etc. Susan >The thing that leaps out at me is that your condition worsened (as did >mine) upon moving to a new house. In my case, mold sensitivity is the >issue. I bought a home test kit which said there wasn't mold, but I wonder. Black mold does grow in the bathroom, but I lived in an apartment years ago where black mold grew on a window and had no ill effects there. For the most part the mold has been easy to control, unless there's hidden mold where the previous owners let leaks go for months without fixing them. Thanks for the advice about the steroid sprays. I'll ask my GP tomorrow about allergy tests, too. What kind of irrigation do you do? I've been thinking about some irrigators I saw on Amazon but don't know much about them. Stacia > I bought a home test kit which said there wasn't mold, but I wonder. > Black mold does grow in the bathroom, but I lived in an apartment years > ago where black mold grew on a window and had no ill effects there. For > the most part the mold has been easy to control, unless there's hidden > mold where the previous owners let leaks go for months without fixing > them. I used to get sinus induced migraine episodes with vomiting til I discovred invisible mold in my bathroom. I *never* let any mold progress to the point that there's visible black mold. This is a very fine, white powder on til that looks sparkling clean and shiny til I rub my fingers over it and get the white powdery stuff off. As long as I bleach the apparently clean walls and ceiling in my bathroom, I never have the congestion and headaches any more, completely gone. > Thanks for the advice about the steroid sprays. I'll ask my GP > tomorrow about allergy tests, too. > What kind of irrigation do you do? I've been thinking about some > irrigators I saw on Amazon but don't know much about them. I use a pulsatile irrigator but there's no research to indicate that it's superior to any other method. The NeilMed bottle was worthless to me, but a lot of folks get good results with neti pots and saline solution. There's also an irrigator you can attach to a WaterPik, and this site, ethicare.com that someone posted about not too long ago; their machines look sturdier than what I have, and when mine dies, that's something I might try. Susan >> The thing that leaps out at me is that your condition worsened (as did >> mine) upon moving to a new house. In my case, mold sensitivity is the [quoted text clipped - 6 lines] > mold where the previous owners let leaks go for months without fixing > them. I have a different suggestion from Susan's: Allergists can't possibly test you for more than a tiny fraction of all the things you could be allergic to. There are at least 200 different strains of mold in any vegetated area of the U.S., of which your allergist typically tests for about 6. And there are a lot of things that can be wrong with a new home, such as outgassing resins, chemicals, solvents, and nearly sources of air pollution, that allergy testing won't pick up at all. Given that your history suggests that your new home (or its location) may be the problem, my advice would be to pay an industrial hygienist to come into the home and assess it, as well as a professional home inspector with proven expertise in allergen and pollutant remediation (most aren't). I would also point you to a website like www.scorecard.org, to identify sources of air pollution near where you may be living. That was my problem. There wasn't anything structurally wrong with my new home. But it turned out to be downwind of a factory that I found out later is the worst polluter of sulfur dioxide air pollution in my area.  SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. >>> The thing that leaps out at me is that your condition worsened (as >>> did mine) upon moving to a new house. In my case, mold sensitivity [quoted text clipped - 28 lines] > it turned out to be downwind of a factory that I found out later is the > worst polluter of sulfur dioxide air pollution in my area. I also recommend this book: "My House Is Killing Me!" http://www.amazon.com/My-House-Killing-Me-Allergies/dp/0801867304 SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > I have a different suggestion from Susan's: > [quoted text clipped - 17 lines] > it turned out to be downwind of a factory that I found out later is the > worst polluter of sulfur dioxide air pollution in my area. Steven, that sounds like a GREAT plan to follow if the cheap, easy to accomplish stuff doesn't yield results. To leap to the most costly option first is usually unnecessary and always a bad idea, IMO. The OP has visible mold; you don't think that maybe a cleanup and attempt to vent the humidity is a better first line of attack, perhaps? Further, though my immunologist only tested me for about 8 molds, treating me for those has improved my sinusitis enormously and completely rid me of asthma. My own detection of the culprit I sleep next to will, once I send it out for ID, be added to my desensitization; this is a moderate cost option available to anyone, too. Susan >> allergist typically tests for about 6. And there are a lot of things >> that can be wrong with a new home, such as outgassing resins, chemicals, >> solvents, and nearly sources of air pollution, that allergy testing >> won't pick up at all. You're right, of course. Once I read Susan's post I did some research online and found 3-4 things in the home that may cause allergies. This was our first home and we did our purchasing and research entirely on our own. Being stupid newbies, we ended up with a home that the previous owners had not cleaned nor kept clean at all. That meant cockroaches, dirty carpets, and some hidden water damage the inspector didn't find when he went through the house. But we got the house cheap, so that was great, right? Sigh. >> Given that your history suggests that your new home (or its location) >> may be the problem, my advice would be to pay an industrial hygienist to >> come into the home and assess it, as well as a professional home >> inspector with proven expertise in allergen and pollutant remediation >> (most aren't). I live in Kansas so that's going to be a problem. Hopefully there's someone affiliated with Kansas State who can do such an inspection, but I haven't found them online yet. Also, there was nothing listed on scorecard.org, thankfully. Both are great suggestions, thanks. >The OP has visible mold; you don't think that maybe a cleanup and >attempt to vent the humidity is a better first line of attack, perhaps? We use Lysol on almost everything in the bathroom, and purchased an expensive dehumidifier which helped. However, the toilet and a sink drain have black mold that never completely goes away, even with bleaching. For some reason my husband has had no problem whatsoever. This is not the first place we lived with mold, either, and I didn't have a problem at the other places, so I didn't think mold was the issue, but if there's hundreds of kinds of mold then this may be completely different. >Further, though my immunologist only tested me for about 8 molds, >treating me for those has improved my sinusitis enormously and >completely rid me of asthma. Thanks for your advice. I read what you said elsewhere about the irrigator. I have another question: what kind of air filters do you use? HEPA filters, or the class II medical devices, or both? Stacia > You're right, of course. Once I read Susan's post I did some research > online and found 3-4 things in the home that may cause allergies. This [quoted text clipped - 4 lines] > didn't find when he went through the house. But we got the house cheap, > so that was great, right? Sigh. Well, you've certainly got your work cut out for you. Best way to make sure you get rid of roaches for good without overdosing on chemicals is to have holes drilled in the walls all over the place, and boric acid blown in. You'll never see another bug. If my house ever gets roaches (I have a Major Roach Phobia), I'll burn it down and rebuild with boric acid everywhere. You can buy DYI kits to do the boric acid, too. Carpeting has to go, it's just a haven for dust, dust mites, and molds, too. Anything that can't be moved and cleaned under is out of the question. The water damage must be repaired, and then any moldy lumber or other materials replaced or cleaned of all mold. If there's sheetrock involved, replace it; just look up stachybotros mold and your symptoms. :-/ I also tested wildly high to cockroach antigen, which may be a biological basis for my phobia, but there are none here, thankfully. Getting the house cheap means you have work to do, to bring it to market value and to improve your health. > I live in Kansas so that's going to be a problem. Hopefully there's > someone affiliated with Kansas State who can do such an inspection, but > I haven't found them online yet. Also, there was nothing listed on > scorecard.org, thankfully. Both are great suggestions, thanks. I agree, but for after you've done all the self help and remediation that's easy to do on your own, if you still have a lasting problem. > We use Lysol on almost everything in the bathroom, and purchased an > expensive dehumidifier which helped. However, the toilet and a sink [quoted text clipped - 4 lines] > at the other places, so I didn't think mold was the issue, but if > there's hundreds of kinds of mold then this may be completely different. You may have a different kind of mold than before, or the total load may be higher in your current home. Or it could be the highly toxic stachybotros. > Thanks for your advice. I read what you said elsewhere about the > irrigator. I have another question: what kind of air filters do you > use? HEPA filters, or the class II medical devices, or both? If I were fortunate enough to have forced air heat, I'd use Filtrete in teh ducts; they're cheap and easy. I use on air cleaner, a larg, powerful HEPA filter that is electrostatic (but emits no ozone into the air) too in my bedroom only. I also use a bleach/water solution to sponge down every inch of the bathroom, including walls, ceiling, etc. I spray the walls of the shower and the shower curtain with a diluted bleach solution every time I shower. World of difference in my symptoms. Susan On 11/26/06 10:45 AM, in article ekcnd5$pja$1@news.xmission.com, "Stacia" <stacia@xmission.com> wrote: >>> allergist typically tests for about 6. And there are a lot of things >>> that can be wrong with a new home, such as outgassing resins, chemicals, [quoted text clipped - 42 lines] > > Stacia Please don't go overboard on Mold Fear. People survive nicely in tropical climates where mold destroys the closets, live in Forests where there is mold evreywhere and if we culture the next 10 healthy people walking down the street we can culture mold from their noses. It is only the RARE person that is having symptoms from mold infection. For example my lovely lady has been on immunocomprimise medication and she had mold sinus disease. But it had nothing to do with her home or bathroom, it was the drug. > Please don't go overboard on Mold Fear. People survive nicely in tropical > climates where mold destroys the closets, live in Forests where there is [quoted text clipped - 4 lines] > mold sinus disease. But it had nothing to do with her home or bathroom, it > was the drug. Did you read Stacia's original post, Murray? She got sicker upon moving into her new home, with a water leak, visible black mold and other highly antigenic substances. Are you seriously suggesting that she shouldn't try self help by cleaning it up to see if her sinusitis improves? Unbelievable. If she had no bad symptoms already, we wouldn't be having this discussion. Susan On 11/26/06 9:41 AM, in article Tkkah.3454$sf5.1039@newsread4.news.pas.earthlink.net, "Steven L." <sdlitvin@earthlinkNOSPAM.net> wrote: >>> The thing that leaps out at me is that your condition worsened (as did >>> mine) upon moving to a new house. In my case, mold sensitivity is the [quoted text clipped - 28 lines] > But it turned out to be downwind of a factory that I found out later is > the worst polluter of sulfur dioxide air pollution in my area. In a new home one must be aware of formaldehyde that can come from manfuctured wood and brand new carpeting. With winter and the new homes sealed tight, the level can be high enough to give symptoms. If you are in such a new home, try to get it aired out whenever possible. There are some serious disadvantages to the sealed tight new homes and trailers. Murray Grossan, M.D. http://hydromedonline.com/HydroPulseWEB_Sm.mov > On 11/26/06 9:41 AM, in article > Tkkah.3454$sf5.1039@newsread4.news.pas.earthlink.net, "Steven L." [quoted text clipped - 37 lines] > There are some serious disadvantages to the sealed tight new homes and > trailers. The solution to that is simple--keep a window slightly ajar at all times. Your heating bill may be slightly higher, but think of the money you'll save on sinus surgery. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. Get another ENT, one who knows what he's doing.. -- Bruce > I guess I was wondering a few things. What should I ask my GP to do, >specifically? Just refer me to an ENT or are there more tests? Stacia, You need a specialist, and that would be an ENT. Have you been tested for allergies? That might be the cause. In that case, you need an immunologist. You could certainly ask your GP for a referral to both, as he or she seems to not be helping you, and wants to be done with you. Outside of a CT scan, I'm not familiar with any other tests. Should >I have them go back and look a the CT scan from July or get a new one? Make sure you keep every *old* CT scan you have, and bring them with you to every appointment with an ENT. > Also, what can I do at home? The nasal irrigation didn't do any good, >but was I doing it wrong? The ENT you see may take a culture and send it off to evaluate it for fungus. If so, you might be prescribed Ampho-B, a liquid anti-fungal medication. It didn't work for me, however. But you should get an irrigator, either by WaterPik or a Grossnan-type. Would you stay on the Flonase or go back to >Nasonex, is there any difference between the two? I take Nasonex. I can't really say it helps. I can't really say it doesn't. > Any advice would be appreciated. I hope that helps, and am sure others have some advice of their own to share. Good luck. >Stacia I went to my GP today and I think the guy is crazy. I'll tell you what he said and maybe you guys can help sort it out. First, his intern did the examination without my doctor in the room. It reminded me that my GP hasn't even examined me, not even looked at my throat or ears, for 3 months or so. Then Dr. F came in and suggested nasal irrigation. I told him I already did it, using salt and distilled water. He gave me a box of powdered stuff to mix with water and said this would be better because it had sodium bicarbonate in it. Baking soda! I do put a little pinch of baking soda in the solution I use already, but hadn't mentioned it. Still, baking soda isn't the reason rinses work, is it? Dr. F then wrote me a prescription for these packets of powdered stuff. I'm not a doctor, but does one need a script for NeilMed Sinus Rinse? The only other suggestion he had was guaifenesin, i.e. Robitussin. The thing is, I'm having tons of drainage right now, down the back of my throat. There is no lung congestion. How would guaifenesin help me? When I asked about a referral he said it wasn't time to go to a specialist yet. He said if the zithromax and Tussin didn't work then he'd try 3 weeks of amoxicillin, then he'd "think of something else". This all sounded completely insane to me. Isn't fatigue, dizziness, sinus pain, etc. for 8 straight months enough to call an ENT? I'm on my 3rd antibiotic already, if this hasn't cleared it up will another round of the same antibiotic really help? I'm second-guessing myself because I just don't go to doctors enough to know if they're always this slow. Maybe I'm being impatient. Stacia > I went to my GP today and I think the guy is crazy. I'll tell you > what he said and maybe you guys can help sort it out. > First, his intern did the examination without my doctor in the room. > It reminded me that my GP hasn't even examined me, not even looked at my > throat or ears, for 3 months or so. Perhaps you should directly ask him to? > Then Dr. F came in and suggested nasal irrigation. I told him I > already did it, using salt and distilled water. He gave me a box of > powdered stuff to mix with water and said this would be better because > it had sodium bicarbonate in it. Baking soda! I do put a little pinch > of baking soda in the solution I use already, but hadn't mentioned it. > Still, baking soda isn't the reason rinses work, is it? No, it just makes it more gentle. > Dr. F then wrote me a prescription for these packets of powdered > stuff. I'm not a doctor, but does one need a script for NeilMed Sinus > Rinse? Nope. > The only other suggestion he had was guaifenesin, i.e. Robitussin. > The thing is, I'm having tons of drainage right now, down the back of my > throat. There is no lung congestion. How would guaifenesin help me? It probably won't. Drinking tons of water will thin the secretions. Gauifenesis makes you awfully thirsty, but I don't think it helps at all without the water, and with it, you don't need the guai. > When I asked about a referral he said it wasn't time to go to a > specialist yet. He said if the zithromax and Tussin didn't work then [quoted text clipped - 3 lines] > 3rd antibiotic already, if this hasn't cleared it up will another round > of the same antibiotic really help? Possibly, but only if you clean up your house really well at the same time, keep it that way daily, get allergy tests and treatment, and stay on the antibiotic for up to a few months (all the while irrigating), a more effective one than amoxicillin; Augmentin XR perhaps. Truly, though, if you still haven't taken care of the irritants in your house, the day you come off any treatment is going to be the day the infection comes roaring back, IME. I don't see how an ENT will help more at this point; surgery isn't going to make your house any less infectious to you. Susan > I'm second-guessing myself because I just don't go to doctors enough > to know if they're always this slow. Maybe I'm being impatient. > > Stacia >> Still, baking soda isn't the reason rinses work, is it? > >No, it just makes it more gentle. That's what I thought. I've been checking online and couldn't find anything that said baking soda was the active ingredient or even necessary. Why he wrote me a script for saline solution is beyond me. >more effective one than amoxicillin; Augmentin XR perhaps. Truly, >though, if you still haven't taken care of the irritants in your house, >the day you come off any treatment is going to be the day the infection >comes roaring back, IME. While I'm willing to entertain the idea that I'm allergic to something in my house, I'm not going to just diagnose myself. I'd like a referral to an ENT or allergist (the ones in town apparently require a referral) and go from there. I think all this futzing around with Tussin and my GP saying that there's no need for a specialist is just postponing the inevitable. Stacia >>> Still, baking soda isn't the reason rinses work, is it? >> [quoted text clipped - 3 lines] >anything that said baking soda was the active ingredient or even >necessary. Why he wrote me a script for saline solution is beyond me. The pH of blood is very slightly alkaline (pH around 7.4) while that of salt solution is neutral pH of 7.0). Adding a pinch of sodium bicarbonate raises the pH to make it closer to that of blood/plasma, so as to be less irritating to nasal membranes. > While I'm willing to entertain the idea that I'm allergic to something > in my house, I'm not going to just diagnose myself. I don't think taking steps to make your house less toxic is every contraindicated. And, frankly, if Mayo clinic is correct, then 95% of chronic sinusitis is allergic fungal sinusitis, where the body starts churning out an inflammatory protein that keeps the sinuses swollen and inflamed and prone to secondary bacterial buildup. You could *bet* on being in the other 5%, but the smart thing to do is to clean house and get allergy tests and treatment. I'd like a referral > to an ENT or allergist (the ones in town apparently require a referral) > and go from there. I think all this futzing around with Tussin and my > GP saying that there's no need for a specialist is just postponing the > inevitable. I agree that an allergist is key, but it won't help you until you clean up the mold, dust, etc. in your home. Susan >>> Still, baking soda isn't the reason rinses work, is it? >> No, it just makes it more gentle. [quoted text clipped - 14 lines] > GP saying that there's no need for a specialist is just postponing the > inevitable. I agree that you need to get better medical care. But that's not a substitute for identifying the cause. Many folks (myself included) take allergy tests and end up disappointed because there's no way an allergist can test you for everything. Theoretically your allergist should continue to help you do the detective work to find the offending cause, even if it doesn't show up in the allergy tests. But in practice, most don't, and then fall back on symptomatic treatment--antihistamines and steroids. And they can't fix your neighborhood where you live--if there's a lot of air pollution in your neighborhood, you're just SOL. Finally, if you do have chronic sinusitis (which is unclear at this point), then you will continue to have it even if you have allergies that get treated. It's a vicious cycle that only an ENT can break. So an ENT can find out just what is going on inside your sinuses. Then that can give clues as to what might be causing it. A good ENT can see visual evidence of allergy (e.g., pale, boggy turbinates) and refer you to an allergist if needed. But if it's an inflammation, then either it's an infection or a non-allergic irritant that an allergist can't do much with. An ENT can prescribe antihistamines and steroids just like an allergist can. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. >So an ENT can find out just what is going on inside your sinuses. Then >that can give clues as to what might be causing it. A good ENT can see [quoted text clipped - 3 lines] >much with. An ENT can prescribe antihistamines and steroids just like >an allergist can. Thank you. This was extremely helpful. I've decided to go ahead and wait until this round of antibiotics is finished and I'll contact an ENT. We're already removing the mold sources we've found, of course. Stacia > Thank you. This was extremely helpful. I've decided to go ahead and > wait until this round of antibiotics is finished and I'll contact an > ENT. We're already removing the mold sources we've found, of course. That's a great idea; you'll want to remove dust sources, too, quite likely, particulary any wall to wall carpeting, which harbors tons of mold, dust mites and their antigenic excrement. Roach excrement is extraordinarily antigenic, too. Susan > x-no-archive: yes > [quoted text clipped - 6 lines] > mold, dust mites and their antigenic excrement. Roach excrement is > extraordinarily antigenic, too. If you want to see a real chamber of horrors for mold growth, take a look inside heating ducts or an old room air conditioner. All climate-control systems should be professionally cleaned yearly. Otherwise, when you turn on the system (either for heating in the winter or cooling in the summer), you are going to get mold spores blasted all thru your house from every vent. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > If you want to see a real chamber of horrors for mold growth, take a > look inside heating ducts or an old room air conditioner. All > climate-control systems should be professionally cleaned yearly. > Otherwise, when you turn on the system (either for heating in the winter > or cooling in the summer), you are going to get mold spores blasted all > thru your house from every vent. I'm well aware of that, and my husband's company does duct cleaning constantly (it's an ISP) to protect their investment in servers and the data center, if not the employees. Forget yearly, I think they clean the ducts very frequently. OTOH, I'd love to have forced air/ductwork so I could clean it *and* use cheap, cleanable or replaceable duct filters. Susan >> So an ENT can find out just what is going on inside your sinuses. Then >> that can give clues as to what might be causing it. A good ENT can see [quoted text clipped - 7 lines] > wait until this round of antibiotics is finished and I'll contact an > ENT. We're already removing the mold sources we've found, of course. Mold experts have stated, and I have found in my own experience, that if you have *visible* mold, you are very likely to also have *invisible* mold as well, because it usually starts invisibly and only becomes visible when it's severe. If the black mold you found is growing on the wallboard (sheetrock), it may have penetrated past the latex paint and is now growing into the sheetrock itself. In that case, the sheetrock may need to be completely removed and replaced. But for now, I think it's jumping the gun. You don't even know if you have mold allergies. And a little bit of mildew isn't fatal. I still think the right order of business is: ENT first. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > I don't see how an ENT will help more at this point; surgery isn't going > to make your house any less infectious to you. No, but if he's already developed chronic sinusitis, then even relocation elsewhere won't fix the problem. Chronic sinusitis is not self-limiting even if the original insult irritant is removed. He'll still need to see an ENT. But I absolutely agree that if the offending cause is not discovered, the ENT won't help either. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. >> I don't see how an ENT will help more at this point; surgery isn't going >> to make your house any less infectious to you. >No, but if he's already developed chronic sinusitis, then even >relocation elsewhere won't fix the problem. Chronic sinusitis is not >self-limiting even if the original insult irritant is removed. He'll >still need to see an ENT. >But I absolutely agree that if the offending cause is not discovered, >the ENT won't help either. I'm a she. Anyhow, I'm very aware that the offending cause needs to be discovered. But right now, can't that be almost anything? I'd need to see an ENT to make sure it's not a deviated septum or polyps or something similar, and see an allergist to discover what in the house I'm allergic to (if anything). I'm not saying it's not an allergy to something in the house, but I don't want to diagnose myself. And shouldn't I make sure first before spending hundreds of dollars? My real concern was that my doctor didn't seem to think I should even consider a specialist right now, and didn't think a chronic sinus infection was anything serious. I wanted to make sure I wasn't being unreasonable in wanting to see an ENT and allergist now. Stacia > I'm a she. > Anyhow, I'm very aware that the offending cause needs to be > discovered. But right now, can't that be almost anything? It could be, but you've listed number ONE, mold as being present in the home you got worse upon moving into. Roaches and dusty/moldy carpeting rank right up there. I don't think you have to think hard about whether to be aggressive about removing them and seeing what your result is. I'd need to > see an ENT to make sure it's not a deviated septum or polyps or > something similar, and see an allergist to discover what in the house > I'm allergic to (if anything). Those are great ideaa, but they won't accomplish JACK if you don't clean your toxic house of molds, dust and roaches. In fact, by doing so, you may discover the cause of your worst symptoms, the way I did by discovering the invisible powdery mold in my master bath. > I'm not saying it's not an allergy to > something in the house, but I don't want to diagnose myself. Uh, why not? If you could get relief right now by cleaning up the mold, roaches and dust in your home, why wouldn't you? It would be very informative for the doctors, too, and you have to do it because you're living in extremely toxic conditions. And > shouldn't I make sure first before spending hundreds of dollars? Don't you have to spend the money anyway? What you describe is a toxic, moldy, roach excrement and dust filled home. You have to do those things just for the sake of home hygiene, and nothing that any doc does for you will overcome the effect of those conditions, believe me. My house is spotless and well maintained, and it still flares my sinuses and disables me if I don't stay after dust and mold scrupulously every day and weekly. > My real concern was that my doctor didn't seem to think I should even > consider a specialist right now, and didn't think a chronic sinus > infection was anything serious. I wanted to make sure I wasn't being > unreasonable in wanting to see an ENT and allergist now. Your doctor is probably right. No specialist will help until you remediate the conditions that have triggered your sinusitis. Susan >>> I don't see how an ENT will help more at this point; surgery isn't going >>> to make your house any less infectious to you. [quoted text clipped - 13 lines] > something similar, and see an allergist to discover what in the house > I'm allergic to (if anything). I think we're all in "violent agreement" here on your need to see an ENT. > I'm not saying it's not an allergy to > something in the house, but I don't want to diagnose myself. And > shouldn't I make sure first before spending hundreds of dollars? > My real concern was that my doctor didn't seem to think I should even > consider a specialist right now, and didn't think a chronic sinus > infection was anything serious. I've heard this before and here's what I think the problem is: There are some 37 million Americans who suffer from chronic sinusitis. With such huge numbers, our health care system will try to treat them at the "first line of defense"--the primary care physician, rather then referring them all to ENTs. That's what penny-pinching health insurance companies prefer. The problem is that primary care physicians have not been given the modern tools needed to treat sinusitis properly. They haven't been trained in the use of the nasal endoscope. They don't know about the modern advances in allergic fungal sinusitis. Thus their only option is antibiotics and steroid sprays. The result is that underlying causes of sinusitis go undetected and untreated all too often. In fact, most of the tremendous advances in high-tech medicine have not filtered down to the primary care physician's office. His examination doesn't differ much from what my mom would have gotten 50 years ago--stethoscope to listen to chest, vital signs, patient history. A primary care physician's office doesn't look much more advanced today than it did 50 years ago. And yet "managed care" puts the onus on the primary care physician to be the gatekeeper for the patient's well being. That's the disconnect. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > No, but if he's already developed chronic sinusitis, then even > relocation elsewhere won't fix the problem. Chronic sinusitis is not > self-limiting even if the original insult irritant is removed. He'll > still need to see an ENT. I agree, the secondary infection, the blockage causing it will still exist. > But I absolutely agree that if the offending cause is not discovered, > the ENT won't help either. Discovered and removed, yes. Susan I have wanted to respond to this sooner, but have had a really bad week. I do want you to know that I agree with the other posters here, except for Dr. Grossan, who doesn't seeem to think mold causes much of a problem except in rare cases. Since most of us that post here are the "rare" cases that don't get better no matter what we do, then there is that possiblitly that you might be one of the rare ones that could be affected by mold. I hope that you have had the mold removed and I meant to tell you to leave the house while it was being done and then make sure that you use air purifiers to get rid of any spores that might be floating around afterwards. After a remediation or cleanup the mold can actually be worse because it stirs up the spores. If you havne't had it done yet, you need to have it walled off from the rest of the house while it is being done and leave the house until it is completley cleaned up. You also need to thoroughly clean any thing in the bedroom that can be washed in borax solution and I would discard anything that can't be washed just as a precaution in case this is Stachybotrys or one of the other molds that can produce toxins. The other main ones that can do so are Fusarium, Acremonium, Aspergillus, and Penicillium. I agree with Dr. Grossan that most people aren't going to be affected by mold, but I am one of those RARE persons whose life has literally been destroyed by my exposure which was long term. The fact that you have gotten sicker since being in it, would make me believe that it is very likely that it is what is making you sick. Also, the mold growing in the tropical rainforest is in its natural habitat and not as likely to produce toxins as that which grows behind walls or other places where it doesn't naturally belong. Your problem could be totally allergic, but according to the newest Mayo theory, it is not an actual allergy in many cases, but an abnormal immune response that only predisposed people (genetic) produce to its presence. This sets up an inflammatory reaction that then creates the condtions for bacteria to grow in your sinuses. This can be just to everyday exposure to common molds. So, it is very unlikely that you actually have a fungal infection unless you are immunocompromised, but it can cause you to be more susceptible to the bacterial infections. Then also as mentioned there is the possibility of a reaction to toxins. The good news is that even if this is your problem, if you haven't been exposed too long, then if you get away from it immediately, you are not as likely to have long term effects from it unless you have true allergies, then you will probably need to be treated for that. I don't mean to scare you and there probably isn't any need to panic, but I would take this seriously. I do think a lot of people overreact to just a patch of mold being found in a closet, etc., but that is much different than Stachybotrys or another toxic mold growing in your wall. Good luck!! Let us know what you find out. kathyw On 12/3/06 11:24 PM, in article 1165217089.687337.265510@80g2000cwy.googlegroups.com, > I have wanted to respond to this sooner, but have had a really bad > week. I do want you to know that I agree with the other posters here, [quoted text clipped - 48 lines] > > kathyw Kathryn there is a serious problem in terminology. A mold condition can be A mild allergic response B a severe allergic response C a serius infection of mold that fills the sinus cavities D. an infection with a toxic mold The problem is that everyone including doctors use the same term for one of the types and of course the average person can be totally confused, and frightened. Whether the sinus problem is Major Basic Protein from the eosinophiles or biofilm from the bacteria or a stobborn bacteria resistant to drugs, restoring the clia function by pulsatile irrigation is of value, which at the same time effectively removed these products. If you do suspect a mold allergic reaction you can be tested and desensitized. Even though there are thousands of individual molds, most fall into a common group that can be tested for. On the other hand unless its the serious widespread mold infection that we see im immunocomprimised patients, you are going to grow a mold out of your nose even if you are Mr Perfect Health. > Kathryn there is a serious problem in terminology. A mold condition can be > A mild allergic response > B a severe allergic response > C a serius infection of mold that fills the sinus cavities > D. an infection with a toxic mold Dr. Grossan, First: my name is KATHY; the W is the first initial of my last name that I use in case there might be other posters named Kathy. If you want to use the full name, it is Katherine, not Kathryn. Second, you have left out part E. the eosinophilic reaction to mold which IS NOT ALLERGIC, according to the Mayo theory, but does include the reaction to MBP as you do go on to mention. I am not trying to be facitious and pretend that I know more than you or any other doctor, but my life has been literally destroyed by my mold exposure and I have been doing reserach for over 3 years and have been dealing with one of the top Mayo Clinic physicians who was one of the original proponents of this theory. I still don't know if this is all of my problem for sure because I was on predisone when I had my last surgery, so it would have affected the tests. Since I have had Blastomyces cultured out twice, I still could possibily have a TRUE infection. Third: it seems that C and D would be the same category with effects of toxic mold being a separate category although if one had an infection with a toxic mold such as Fusarium, then I suppose they would be affected by both the infection and the toxins. From my research and DOCTORs' input, the toxins can do far more than cause an infection; as mentioned earlier, neurological effects are just one example. But they can also make one more susceptible to bacterial infections (I've had 5 gram - bacteria culture out of my sinuses over the last 2 years and I was exposed to Fusarium and T-2 toxin). > The problem is that everyone including doctors use the same term for one of > the types and of course the average person can be totally confused, and > frightened. > Whether the sinus problem is Major Basic Protein from the eosinophiles or > biofilm from the bacteria or a stobborn bacteria resistant to drugs, > restoring the clia function by pulsatile irrigation is of value, which at > the same time effectively removed these products. Well, they should be frightened if they have been affected by toxic mold. I do agree that would be a MINORITY of the posters here. I'm sure that most have simple bacterial infections, but since the subject was brought up, and these peoples' lives could possibly be affected by more than just allergy to mold, I felt it was important to mention these possibilities. I think I said that one SHOULD NOT PANIC if they find a little mold. I know there is a lot of unfounded HYPE associated with mold. And quite frankly, I'm tired of hearing about restoring the cilia with pulsatile irrigation as being the ONLY factor in getting well. Again, this may work for the MAJORITY of first time posters whose porblem hasn't become chronic, but just telling them that is going to solve all of their porblems seems a little irresponsible to me. I've been using it for years and it does have great benefit in removing the mucus, but if the cilia aren't restored by now, then they aren't ever going to be. I am very grateful that you invented this device and don't know what I would have done without it, but it is NOT the CURE ALL. And I don't see how you can say that it doesn't matter what is causing it, that restoring the cilia will solve it all. Then why are so many of us still sick after years of using it? And what if someone reads this post and has one of the serious bacterial infections and isn't treated for it and it spreads to their brain, which can be a complication of untreated bacterial or fungal sinusitis? > If you do suspect a mold allergic reaction you can be tested and > desensitized. Even though there are thousands of individual molds, most fall > into a common group that can be tested for. > On the other hand unless its the serious widespread mold infection that we > see im immunocomprimised patients, you are going to grow a mold out of your > nose even if you are Mr Perfect Health. Again, I think you have missed the point here. A lot of the posters are saying that they have been tested for mold allergies and they test negative, so what are they going to get desensitized to? I agree that allergy testing should be one of the first approaches that one tries and I also agree with others who have mentioned that there are many molds that they don't test for, so even a trial of desensitization might be appropriate. As always, I appreciate your input; but some of us who have been dealing with this for years have found equally good information. I have NEVER said that anyone should follow my advice. I realize that there are as many theories of what causes chronic sinusitis as there are ENTS. But the mold is one of them and people at least need to be aware of it. Respectfully, Kathyw > I have wanted to respond to this sooner, but have had a really bad > week. I do want you to know that I agree with the other posters here, [quoted text clipped - 48 lines] > > kathyw After looking over this and another thread, I realized that I should have made some of these comments elsewhere. I thought you were the one that had the bedroom with the mold, so if my answer sounds confunsing, that is why. I still think you need to check out your bathroom more thorougly to find the source of the mold, keep these other comments in mind., and do the other things suggested on this thrread. |
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