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Medical Forum / Diseases and Disorders / Sinusitis / May 2007Neil update
Had the CT a week ago. Can't get a f/u until 5/22, and can't seem to get any early read on the results from the doc. Meanwhile, the Amoxi doesn't seem to be working. Left side, maxillary seems the worst. Twice-daily (kosher salt solution only) Irrigation is ... um ... quite productive--primarily yellow and blood. ENT said he'd have an Augmentin Rx called in for me, to take for 10d atop the Amoxi, then to return to just the Amoxi after that. Again: in Feb-Mar, I was on Amoxi, Doxy, AND Zithro, but it didn't resolve. Been doing the tagamet/chewable C thing, steaming at the gym, getting the little exercise I can (local bike rides, about 30min, a few times a week), avoiding all the stuff I can avoid, etc. No travel. Humidity's good, etc. One question: after irrigation, I (gently) do the upside down "whale blow" thing, do pronounced head tilts, etc., etc., to promote drainage, and gently blow for a minute or two to clear out residual fluid, BUT ... almost invariably ... 5-20 minutes later, I'll sniffle or bend or something and there'll be significant flow of thin irrigation fluid from one nostril or both. I've had 3x surgery (2x old school, last: fess in '04, IIRC, WITH finding of polyps). Is polyps the only hitch in the plumbing that likely explains this delayed drainage, or can anybody think of something else that might cause it?? I know I've read here that others experience this, too. There's a guy doing a bit of work on our home right now ... who just had the pleasure of watching Old Faithful erupt and soak my shirt. A little tough to explain--primarily with MY crap Spanish--just what happened ... and that I'm (more or less) okay ;-) TIA, Neil > One question: after irrigation, I (gently) do the upside down "whale > blow" thing, do pronounced head tilts, etc., etc., to promote [quoted text clipped - 16 lines] > TIA, > Neil (With deepest apologies to Dr Grossan) I call this phenomena "grossan out strangers." A while back I was in a computer store talking with strangers about hard drives and when I leaned over to pick up a box my nose cut loose with a big stream of saline that was at least an hour old. All I could do was smile and keep on talking as I'm sure they didn't need to hear about my sinusitis and irrigation issues. I've learned that if I wait about 5-10 minutes after irrigating that if I go lean over the toilet and tilt my head slightly to each side the remaining saline will trickle out and this greatly reduces the chances of my grossing out strangers. My left maxillary sinus loves to store copious amounts of saline so now this emptying routine has become a regular part of the irrigating process for me. AW > (With deepest apologies to Dr Grossan) I call this phenomena "grossan out > strangers." A while back I was in a computer store talking with strangers [quoted text clipped - 9 lines] > saline so now this emptying routine has become a regular part of the > irrigating process for me. AW Thanks much, August. I'll do the whole wash, rinse, and repeat thing. By the way ... why did I only just now catch what AW stood for?? Over 150 shows on my side .... and WR may be my favorite of all of 'em (though it IS sooo tough to say). Neil "Stumblin' around, all drunk on burgundy wine" [which, in reality, would probably not help my sinuses at all] On 5/2/07 6:52 AM, in article 1178113940.297696.32030@h2g2000hsg.googlegroups.com, "neil0502@yahoo.com" >> (With deepest apologies to Dr Grossan) I call this phenomena "grossan out >> strangers." A while back I was in a computer store talking with strangers [quoted text clipped - 13 lines] > >The fact that the solution is actually in the sinus is desireable. The saline is therapeutic, dilutes toxins, etc. So many other "therapies" have been shown not to enter the sinuses. This is why more doctors are turning to pulsatile irrigaiton to deliver medications. >One question: after irrigation, I (gently) do the > upside down "whale blow" thing, do [quoted text clipped - 5 lines] > flow of thin irrigation fluid from one nostril or > both. Don't blow-- period. ...Just breath out by lying chest down on a bed, with your head sticking over the edge, and pointing it to one side first. ..Then to the other. To help remove the excess liquid, try this: While in the position above, pinch the nose to prevent any movement of air through it. ...Then swallow, and hold for 10 seconds. ...You'll find it creates a vacuum within your sinuses, which not only permits the irrigation fluid to run out, but also helps pull out the infected material. ...Jon On May 2, 12:58 pm, Johnny1...@webtv.net wrote: > Don't blow-- period. ...Just breath out by lying chest down on a bed, > with your head sticking over the edge, and pointing it to one side [quoted text clipped - 5 lines] > within your sinuses, which not only permits the irrigation fluid to run > out, but also helps pull out the infected material. ...Jon Very interesting. Seems like going back to bed can fix most anything :-) I'll try this. Thanks much. Follow up and review of CT today. CT is crystal clear. He scoped me. Looked "like a million bucks" that way, too. So some combination of the Doxy, Zithro, long-term Amoxi, Augmentin, Bromelain, Chewable C w/antacid, bid irrigation, food-grade hydrogen peroxide, grapefruit seed extract, time, and/or dumb luck seems to have wiped out the most tenacious and refractory sinus infection I've had in my life. But ... I'm left exhausted and showing signs of fungal overgrowth again. I stopped the antibiotics a few days ago ... when I was feeling my worst. Though I've BEEN hitting it pretty hard (daily) with kefir, Dannon's DanActive, and dietary restrictions, I'll look to add such things as pycnogenol, clove oil, and oil of oregano. PubMed seems to show strong clinical antifungal efficacy with these things. Hope everybody's (at least reasonably) well. Neil On 5/22/07 5:25 PM, in article 1179879954.857914.271640@x18g2000prd.googlegroups.com, "neil0502@yahoo.com" > Follow up and review of CT today. > [quoted text clipped - 19 lines] > > Neil One aspect of exhaustion that can be helped is taking Vitamin B12 sublingual 500 mcg twice a day. > On 5/22/07 5:25 PM, in article > 1179879954.857914.271...@x18g2000prd.googlegroups.com, "neil0...@yahoo.com" [quoted text clipped - 26 lines] > One aspect of exhaustion that can be helped is taking Vitamin B12 sublingual > 500 mcg twice a day. Thanks much. I'll pick that up today. On May 22, 8:25 pm, neil0...@yahoo.com wrote: > Follow up and review of CT today. > [quoted text clipped - 19 lines] > > Neil glad that you're heading in the right direction. it sounds like you stopped the anitbiotics based on the ct scan results since you indicate that you were feeling your worst. but does that mean that your current state is caused by fungal complications? i guess i don't even know what signs of fungal overgrowth are besides the obvious (thrush, vaginal infections, etc) having just come out of the worst acute sinusitis that i've ever head & hence, the longest period on antibiotics (i think over 40 days on 3 different types), i'm still inexperienced about the longterm effects. just started 250 mg of azithromycin/day to see if the chronic problems are responsive to it. been taking my daily probiotic but my guts are not exactly happy (have had ibs for many years, generally mild & well managed). so i'm wondering if you or the other folks have other advice for keeping the body as balanced as possible while dealing with ongoing antibiotic use? i'm used to employing a variety of treatments to fight this stuff, but i'm conscious right now of not wanting to introduce too many variables into the treatment course. let me know how it works out for you. ellen > glad that you're heading in the right direction. Thanks, Ellen. > it sounds like you > stopped the anitbiotics based on the ct scan results since you I actually stopped the antibiotics a few days /before/ getting the CT results. It had been a few weeks since I'd gotten any major (disgusting) discharge with irrigation and my sinuses /felt/ much better. On the other hand, I was feeling the ... fungal ... symptoms rather strongly. > indicate that you were feeling your worst. but does that mean that > your current state is caused by fungal complications? My guess--and that's really all it is--is: yes, my sinus issues have a fungal etiology. I'm 43 now. In something like 15 years, I've never felt better than when I'm on systemic antifungals. My ENT--a pretty well-known guy--subscribes to the notion that a whopping dose/ protracted course of these ABX's CAN cause fungal overgrowth. His recommendation was that I let the body recover. I'm still thinking that the "natural" remedies can't hurt. Still, as to whether or not it "IS" a fungal etiology? I'm rational/ skeptical/wise enough to say I just don't know for sure.... > i guess i don't > even know what signs of fungal overgrowth are besides the obvious > (thrush, vaginal infections, etc) It's sort of "the usual" for Candida/fungal problems. Here's a random site, from Google, that lists "the usual:" http://www.candida-society.org/ncs/symptoms.htm > having just come out of the worst acute sinusitis that i've ever head > & hence, the longest period on antibiotics (i think over 40 days on 3 > different types), i'm still inexperienced about the longterm effects. Ouch. I feel your pain ... and all the other symptoms. I'm sorry for you. > just started 250 mg of azithromycin/day to see if the chronic problems > are responsive to it. been taking my daily probiotic but my guts are > not exactly happy (have had ibs for many years, generally mild & well > managed). so i'm wondering if you or the other folks have other advice > for keeping the body as balanced as possible while dealing with > ongoing antibiotic use? I can tell you what I discovered when I made a casual pass at researching the issue: - PubMed studies seem to support that it's a very good thing to take probiotics while (and after) taking antibiotics. Obviously--or not so obviously--don't take them together (the theory is that the antibiotic will simply wipe out the probiotic). Wait a few hours in between. - As I mentioned, I'm drinking a DanActive yogurt or two every day, drinking kefir (unsweetened), eating plain yogurt, AND taking the "shelf-stable" (no refrigeration required) acidophillus beads every day. - Today, in addition to sublingual vitamin B12, I picked up Inulin--a PREbiotic (I think it's fructooligosaccharides) that's supposed to be a precursor, helping to foster the environment for healthy bacteria to grow [1]. Who knows? ;-) As you likely know, there seems to be good evidence that IBS responds well to treatment with probiotics, so ... no harm (that I know of!). I think it was Consumer Reports that found that--for the most part-- your average plain yogurt contained just as much live probiotic bacteria as did your average nutritional probiotic supplement. I'm simply hedging my bets. > i'm used to employing a variety of treatments > to fight this stuff, but i'm conscious right now of not wanting to > introduce too many variables into the treatment course. I understand only too well. > let me know how it works out for you. Ditto. I wish you a speedy, definitive, and permanent recovery :-) [1] http://jn.nutrition.org/cgi/content/full/129/7/1402S I also have had good results with Sporanox. I know that there is the theory that antibotic use causes fungal overgrowth, but can send you photos of the fungi growing happily with the bacteria. Streptomycetes produce antifungals ----other bacteria such as e coli especially premot fungal attachment. I when I got my present infection I had not had antibotics for the 4 previous years, so I think that weather or not you get a fungial infection is more determined by what had the oppertunity to latch on during your last viral respiratory infection. A cold or flu kills off the cillia and when the defenses are down the baddies can attach if you breath them in. A person in a small village might only be exposed to a new cold virus every couple of years, now thanks to higher population density, larger schools, clubs, rock concerty, world travel etc, we can be exposed to new viral varients every day. I have a theory that sinus infections should be rarer in isolated communities, but opservationally people in dry dusty communities seem to get pretty bad sinus infections, regardless of community size, so maybe some virus is adsorbed on the dust particals. MASK anyone?. I am limited in the samples that I have to examine, but I have never seen fungi attached directly to epithieal cells, the fungi has cellulose in the cell walls so you can use dyes that preferentially stain cellulose. What one sees using congo red and CW is a layer of bacteria on the cell surface, with the fungi anchoring to the bacterial goo, or curli if you will, in fact I think that gentimycian works because it kills the e-coli that pretty much allows everything else, fungi and all, to attach. I also think that your response to antibotics depends on the degree of endotoxin release from the bacteria being killed. Some of the bugs are little vipers and the when the cell wall is ruptured the toxin inside is released. To keep your gut bacteria populated with good bacteria while taking the antibotic. Try Culturell by ConAgria, in the vitiman section at CVS, peppermint tea, and celery. > I also have had good results with Sporanox. > [quoted text clipped - 35 lines] > Try Culturell by ConAgria, in the vitiman section at CVS, peppermint > tea, and celery. good suggestions, links, info, & other points. oh, if only this were a little easier, but then we all wouldn't be conversing with each other. never had a conventional medical practitioner give any credence to the candida theory, but then i've been told many things in the past by doctors (such as irrigation & probiotics are useless) that become more mainstream as time passes. & i've been told plenty of strange things by holistic practioners that have turned out to be potentially harmful. i'm not familiar with the celery reference, but i do use peppermint as a digestive aid. here's hoping that we all feel well enough on the holiday weekend to do something fun & give pause for remembrance. & i hope at some point to amass enough knowledge of all this to be as helpful to others as all of you have been for me. peace, ellen > never had a conventional medical practitioner give any credence to the > candida theory, ellen: The fact that it is not the mere presence or absense of fungus, but what happened immediately procedeing that allowed it to grow seems to cause unending confusion in the medical community. Jens Ponikau at the Mayo clinic thought he had it solved when he found that the sticky clear mucus (snot) was full of all kinds of fungus. http://www.sciencedaily.com/releases/1999/09/990910080344.htm Then later they found that healthy controls have as many kinds of fungus present, at least as spores, as people with chronic sinusitis do, so they went back to think again. ENTs do not usually run tests for fungi and actinomycetes, and when they do the hopitial labs are usually pretty bad at it. An exception is the facility at which you are being treated, but I can guarentee that if you went through the whole nine yards to make your own growth medium and boil and strielize and inocculate some slants with material from your sinuses and incubate some uninocculated samples as controls etc, that you would within 3 to 7 days you would see several different types of fungus grow out, and then if you were being treated by a standard ENT you would be subjected to a discussion about weather the presence of fungus was revelent or not. Back in the early 80s Couch, a microbiologist at the CDC, postulated and showed that the difference was a previous respiratory virus. Most everyone has fungus and bacteria around, they can't do anything unless a virus damages the epithieal lining and allows them to attach. Lactobacillus, does fight fungus, garlic mustard fights fungus, asprin was the willow tree's defense against fungus, and the kind of fungus that you run into while your nose is vulnerable does matter. It does not help that most of the fungi have not been discribed. A couple of my samples have come back as "unknown fungus." then I found that just about everything fungus is unknown outside a very narrow window. If you want to name something there are millions of fungus just waiting to be classified, discribed and named. For the most part they are not invasive pathogens, but they won't overlook the chance to grow in a moist nutrient rich goo environment and lend their strength and long range structural integreity to the goo. Most don't form filiments at temperatures above about 85 F, which is why they are confined to the cooler parts of your face and nose, The bugs in biofilm may be highly resistant to antibotics, but they DO have to respect physics. Certain proteins in the fungal filiments denature at lower temperatures than mammalian proteins. and that is why wearing a mask for a few hours each day which allows the air in your nose and cheekbones to become warmer and hot tea and hot chicken soup, and warm irrigation solution makes the goo become a lot less viscos and easier to get rid of. On 5/25/07 8:14 PM, in article 1180149249.791754.179760@o5g2000hsb.googlegroups.com, "truehawk" > hot tea and hot chicken soup, and warm > irrigation solution makes the goo become a lot less viscos and easier > to get rid of. The tea and chicken soup stimulate cilia movement which can then cleanse the nasal passages. As you point out, the fungus patient and the normal guy down the street grow the same fungus culture. The difference is the eosinophile reaction producing major basic protein. This is a poison to the fungus, but also to the patient. Getting the cilia moving and irrigationg may be of significant help. Again it is very important to differentiate the various kinds of fungal sinus canditions as they are often clumped together. Good place to read is www.sinuses.com > On 5/25/07 8:14 PM, in article > 1180149249.791754.179...@o5g2000hsb.googlegroups.com, "truehawk" [quoted text clipped - 14 lines] > Again it is very important to differentiate the various kinds of fungal > sinus canditions as they are often clumped together. Good place to read iswww.sinuses.com With respect, The studies that have looked at have have all had glareing gaps, and tend to state conclusions far in excess of their supporting evidence. The healthy control and the sinusitis patient have not been proved to grow the SAME fungus with the difference being the eosinphilic reaction. Both groups had fungus, but not the same species. Like I said, most fungus are apparently unknown, and in what little work has been done mycologists will tell you that what hospital tests pick up on is FAR from the complete picture. The fact is that the culture protocol is more concerned with quashing the tramp fungal contaminate than growing out the unknown. ( try running the cultures without that dose of chlorenphenicol, last time I noticed humans did not spontaniously produce complex cloronated hydrocarbons in their sinuses, so how did that become standard in fungal culture medium? ) Not one has sequenced the metagenome in the snot and shown the same fungal protein profile exists for both healthy controls and chronic sinusitis patients. In fact, who cares about the species, what fungal toxins, which are both powerful and diverse, what pumps, and what vulnerability so we can get rid of it. A few studies that I have seen actually showed something it said was an eosinophile that had machinery that did not look quite right to be one, which makes me wonder if they were looking at a yeast instead, cause I have had eosinophile looking things pick up caldoflour white and resist sodium hydroxide. ( and NO in this sense a yeast is not Candidia, any fungus in a single cell roundish form is in it's yeast phase.) Consider this, plants have been fighting for a lot longer than we have. The fossile record is littered with the evidence of the chemical warfare between plant and beetle, plant mammal, plant and fungus. But of these, other than US the most deadly is fungus. Once there were European Tea Roses. Now all grown on wild American root stock bacause fungus destroyed the rest. Once there were European Grapes, now all grown on wild American root stock because of fungus. Once there were skyscraping chesnut trees 6 feet in girth and 200 feet high, now there are the little round huts of my childhood with chinkypenns growning from the old roots because of the chesnut blight. There is a good reason that the food we eat depends on the use of about a half a billion pounds of triazoles that you never heard of, otherwise the rice rust and wheat rust and soybean rust, blights, cankers, and wilts, in other words fungus, would literally eat our lunch. They are a billion years in the making, out there and wildly diverse, hyland (clear), difficult to identify without genomic testing because most fungus are identified by their fruiting bodies which they may not feel like producing for identification for some time, and when they finally do spore, they may not look like anything anyone has ever seen before, and which ones you get DO matter. Thanks for a scientific, rather than anectodal reason for why warm tea/ compresses help with sinus problems. When you do sinus surgery, you often remove the structures that help to create circular, warming, filtering air flow in the nose--the ultimate being the "empty nose syndrome". My sister had a protracted sinusitits, was treated with antibiotics for months, and finally her fungal cultures grew rhizopus--a nasty fungus. Her primary told her to ignore the culture. She argued with Kaiser, and finally got amphotericin washes. The candida syndrome doesn't get a lot of credance in medical circles. But, the concept of an infammatory diet, high in carbohydrates, is felt to be an issue. Perhaps systemic candida is not truly a recognizable entity, but a high gycemic diet is not healthy-- and I think the solution to the "candida syndrome" was to avoid carbohydrates, and consider nystatin. Judy > > never had a conventional medical practitioner give any credence to the > > candida theory, [quoted text clipped - 48 lines] > irrigation solution makes the goo become a lot less viscos and easier > to get rid of. > Thanks for a scientific, rather than anectodal reason for why warm tea/ > compresses help with sinus problems. [quoted text clipped - 66 lines] > > irrigation solution makes the goo become a lot less viscos and easier > > to get rid of. wow, that's alot of post holiday information to absorb. & i'm having flashbacks again to the film footage of the fungi popping through the bodies of their insect hosts. but aside from that, this is all good information. i'm familiar with the link to the site with the descriptions of the different fungal conditions. i do everything to keep the cilia as healthy as possible & try to follow an anti-inflammatory diet. & i've always known that my reaction to mold is like waving kryptonite in front of me. there was no change in that after 3 years of allergy shots. the aspect of temperature's effect on fungi is interesting. i had always noted feeling far worse in humid & high temperature environments, but perhaps the humidity variable is the key because of the release in the environment of the mold spores? at any rate, for the record i'm on the 2nd week of the azithromycin & i've had some moments that i have felt the best that i have in i don't know how long. i was absolutely overjoyed. i'm a little inflammed right now due to some exposure last night (mold? fire debis allergens?) that got me even though i had a mask & limited the time exposed. but i'm encouraged by the general response thus far & will consult with the ent at the end of week three, at which point we will discuss further treatment direction ( which at the evaluation included the possibility of the amphotericin nasal wash). the doctor who treated me for this last acute sinusitis episode would not even have a discussion with me about the role of fungi in sinusitis. he pronounced that i don't have fungal sinusitis - end of issue. i suspect that he was making that dx based on certain models & really all i wanted to do was explore the more recent theories & possible treatment considerations. thank goodness for this group & the u of m sinus clinic. > > Thanks for a scientific, rather than anectodal reason for why warm tea/ > > compresses help with sinus problems. [quoted text clipped - 98 lines] > > - Show quoted text - I am glad we are helping. The doctor that was giving you a hard time is just in denial. They would like for it to be simple. And it is just not. One size does not fit all. When you look at the potential living causes of sinusitis, it would take from now till doomsday to count all the possible permutations and combinations. Bacteria in the same family vary tremendously in their toxin production. Fungi in the same family vary tremendously in their temperature tolerence and need for oxygen and toxin production. When they were trying to upscale penecillian production they went through 2000 samples before they found one (on a cantalope from a fruit market) that would grow in the deep culture vats. Take a look at this paper. They conclude that immunocompromise is a prerequsite for invasive fungal infection. However 59% of their sample with invasive mycosis showed no reported immune compromise. 85% of the people with a fungus ball had no immune compromise, and 0% of the 4 people with allergic sinusitis showed immune compromise. The broad conclusion is not supported by the data, and yet you will have doctors that will uncritically rule out fungus on the basis of a patient not being immune compromised because they did not read anything other than the conclusion. Allergic fungal sinusitis, fungus ball and invasive sinonasal mycosis - three fungal-related diseases.][Article in German] Driemel O, Wagner C, Hurrass S, Muller-Richter U, Kuhnel T, Reichert TE, Kosmehl H. Klinik und Poliklinik fur Mund-, Kiefer- und Gesichtschirurgie, Klinikum der Universitat Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany, oliver.driemel@klinik.uni-regensburg.de. BACKGROUND: Three different fungal-related clinical pictures have to be differentiated in the paranasal sinuses: allergic fungal sinusitis, fungus ball and invasive sinonasal mycosis. PURPOSE: A morphological reevaluation of fungal-related diseases of the paranasal sinuses as well as a retrospective analysis of their clinical parameters was performed. PATIENTS AND METHODS: 86 patients with patho-histological proven fungal-related disease of the nasal sinuses were enclosed in this study. Reevaluation and correlation of clinical and histological parameters were conducted on routine material (HE, PAS and Grocott) according to the modern morphological definitions. RESULTS: Invasive sinonasal mycosis was seen in 22 cases, eleven male and eleven female, mean age 57 years (22 to 84 years). It was significantly related (nine out of 22 patients, 41%) to immunocompromising conditions: three patients had diabetes mellitus type II, five had have a radiation therapy due to carcinoma and one patient suffered from bacterial endocarditis. A fungus ball was diagnosed in 60 patients, 26 male, 34 female, mean age 54 years (22-88 years). An immunocompromising condition was seen in nine out of 60 patients (15%). Causes for immune impairment were diabetes mellitus (two patients), radiation therapy due to carcinoma (four patients), myocarditis (one patient) and chronic hepatitis (two patients). Allergic fungal sinusitis was recorded in four patients, three male, one female, mean age 43 years (17-63 years). No immunosuppression was diagnosed. CONCLUSIONS: Despite the fact that allergic fungal sinusitis is the most common fungal disease of the paranasal sinuses, it is not well known among physicians and pathologists and therefore underrepresented within the diagnoses of paranasal infections. The term "aspergilloma" is imprecise and does not represent a clear diagnosis. A further differentiation in "fungus ball" (without invasion) and "invasive sinonasal mycosis" is required. The three groups of fungal-related sinusitis occur at different ages. Allergic fungal sinusitis is common among young adults. An immunocompromising condition is a prerequisite for an invasive sinonasal mycosis. > glad that you're heading in the right direction. Thanks, Ellen. > it sounds like you > stopped the anitbiotics based on the ct scan results since you I actually stopped the antibiotics a few days /before/ getting the CT results. It had been a few weeks since I'd gotten any major (disgusting) discharge with irrigation and my sinuses /felt/ much better. On the other hand, I was feeling the ... fungal ... symptoms rather strongly. > indicate that you were feeling your worst. but does that mean that > your current state is caused by fungal complications? My guess--and that's really all it is--is: yes, my sinus issues have a fungal etiology. I'm 43 now. In something like 15 years, I've never felt better than when I'm on systemic antifungals. My ENT--a pretty well-known guy--subscribes to the notion that a whopping dose/ protracted course of these ABX's CAN cause fungal overgrowth. His recommendation was that I let the body recover. I'm still thinking that the "natural" remedies can't hurt. Still, as to whether or not it "IS" a fungal etiology? I'm rational/ skeptical/wise enough to say I just don't know for sure.... > i guess i don't > even know what signs of fungal overgrowth are besides the obvious > (thrush, vaginal infections, etc) It's sort of "the usual" for Candida/fungal problems. Here's a random site, from Google, that lists "the usual:" http://www.candida-society.org/ncs/symptoms.htm > having just come out of the worst acute sinusitis that i've ever head > & hence, the longest period on antibiotics (i think over 40 days on 3 > different types), i'm still inexperienced about the longterm effects. Ouch. I feel your pain ... and all the other symptoms. I'm sorry for you. > just started 250 mg of azithromycin/day to see if the chronic problems > are responsive to it. been taking my daily probiotic but my guts are > not exactly happy (have had ibs for many years, generally mild & well > managed). so i'm wondering if you or the other folks have other advice > for keeping the body as balanced as possible while dealing with > ongoing antibiotic use? I can tell you what I discovered when I made a casual pass at researching the issue: - PubMed studies seem to support that it's a very good thing to take probiotics while (and after) taking antibiotics. Obviously--or not so obviously--don't take them together (the theory is that the antibiotic will simply wipe out the probiotic). Wait a few hours in between. - As I mentioned, I'm drinking a DanActive yogurt or two every day, drinking kefir (unsweetened), eating plain yogurt, AND taking the "shelf-stable" (no refrigeration required) acidophillus beads every day. - Today, in addition to sublingual vitamin B12, I picked up Inulin--a PREbiotic (I think it's fructooligosaccharides) that's supposed to be a precursor, helping to foster the environment for healthy bacteria to grow [1]. Who knows? ;-) As you likely know, there seems to be good evidence that IBS responds well to treatment with probiotics, so ... no harm (that I know of!). I think it was Consumer Reports that found that--for the most part-- your average plain yogurt contained just as much live probiotic bacteria as did your average nutritional probiotic supplement. I'm simply hedging my bets. > i'm used to employing a variety of treatments > to fight this stuff, but i'm conscious right now of not wanting to > introduce too many variables into the treatment course. I understand only too well. > let me know how it works out for you. Ditto. I wish you a speedy, definitive, and permanent recovery :-) [1] http://jn.nutrition.org/cgi/content/full/129/7/1402S > glad that you're heading in the right direction. Thanks, Ellen. > it sounds like you > stopped the anitbiotics based on the ct scan results since you I actually stopped the antibiotics a few days /before/ getting the CT results. It had been a few weeks since I'd gotten any major (disgusting) discharge with irrigation and my sinuses /felt/ much better. On the other hand, I was feeling the ... fungal ... symptoms rather strongly. > indicate that you were feeling your worst. but does that mean that > your current state is caused by fungal complications? My guess--and that's really all it is--is: yes, my sinus issues have a fungal etiology. I'm 43 now. In something like 15 years, I've never felt better than when I'm on systemic antifungals. My ENT--a pretty well-known guy--subscribes to the notion that a whopping dose/ protracted course of these ABX's CAN cause fungal overgrowth. His recommendation was that I let the body recover. I'm still thinking that the "natural" remedies can't hurt. Still, as to whether or not it "IS" a fungal etiology? I'm rational/ skeptical/wise enough to say I just don't know for sure.... > i guess i don't > even know what signs of fungal overgrowth are besides the obvious > (thrush, vaginal infections, etc) It's sort of "the usual" for Candida/fungal problems. Here's a random site, from Google, that lists "the usual:" http://www.candida-society.org/ncs/symptoms.htm > having just come out of the worst acute sinusitis that i've ever head > & hence, the longest period on antibiotics (i think over 40 days on 3 > different types), i'm still inexperienced about the longterm effects. Ouch. I feel your pain ... and all the other symptoms. I'm sorry for you. > just started 250 mg of azithromycin/day to see if the chronic problems > are responsive to it. been taking my daily probiotic but my guts are > not exactly happy (have had ibs for many years, generally mild & well > managed). so i'm wondering if you or the other folks have other advice > for keeping the body as balanced as possible while dealing with > ongoing antibiotic use? I can tell you what I discovered when I made a casual pass at researching the issue: - PubMed studies seem to support that it's a very good thing to take probiotics while (and after) taking antibiotics. Obviously--or not so obviously--don't take them together (the theory is that the antibiotic will simply wipe out the probiotic). Wait a few hours in between. - As I mentioned, I'm drinking a DanActive yogurt or two every day, drinking kefir (unsweetened), eating plain yogurt, AND taking the "shelf-stable" (no refrigeration required) acidophillus beads every day. - Today, in addition to sublingual vitamin B12, I picked up Inulin--a PREbiotic (I think it's fructooligosaccharides) that's supposed to be a precursor, helping to foster the environment for healthy bacteria to grow [1]. Who knows? ;-) As you likely know, there seems to be good evidence that IBS responds well to treatment with probiotics, so ... no harm (that I know of!). I think it was Consumer Reports that found that--for the most part-- your average plain yogurt contained just as much live probiotic bacteria as did your average nutritional probiotic supplement. I'm simply hedging my bets. > i'm used to employing a variety of treatments > to fight this stuff, but i'm conscious right now of not wanting to > introduce too many variables into the treatment course. I understand only too well. > let me know how it works out for you. Ditto. I wish you a speedy, definitive, and permanent recovery :-) [1] http://jn.nutrition.org/cgi/content/full/129/7/1402S > glad that you're heading in the right direction. Thanks, Ellen. > it sounds like you > stopped the anitbiotics based on the ct scan results since you I actually stopped the antibiotics a few days /before/ getting the CT results. It had been a few weeks since I'd gotten any major (disgusting) discharge with irrigation and my sinuses /felt/ much better. On the other hand, I was feeling the ... fungal ... symptoms rather strongly. > indicate that you were feeling your worst. but does that mean that > your current state is caused by fungal complications? My guess--and that's really all it is--is: yes, my sinus issues have a fungal etiology. I'm 43 now. In something like 15 years, I've never felt better than when I'm on systemic antifungals. My ENT--a pretty well-known guy--subscribes to the notion that a whopping dose/ protracted course of these ABX's CAN cause fungal overgrowth. His recommendation was that I let the body recover. I'm still thinking that the "natural" remedies can't hurt. Still, as to whether or not it "IS" a fungal etiology? I'm rational/ skeptical/wise enough to say I just don't know for sure.... > i guess i don't > even know what signs of fungal overgrowth are besides the obvious > (thrush, vaginal infections, etc) It's sort of "the usual" for Candida/fungal problems. Here's a random site, from Google, that lists "the usual:" http://www.candida-society.org/ncs/symptoms.htm > having just come out of the worst acute sinusitis that i've ever head > & hence, the longest period on antibiotics (i think over 40 days on 3 > different types), i'm still inexperienced about the longterm effects. Ouch. I feel your pain ... and all the other symptoms. I'm sorry for you. > just started 250 mg of azithromycin/day to see if the chronic problems > are responsive to it. been taking my daily probiotic but my guts are > not exactly happy (have had ibs for many years, generally mild & well > managed). so i'm wondering if you or the other folks have other advice > for keeping the body as balanced as possible while dealing with > ongoing antibiotic use? I can tell you what I discovered when I made a casual pass at researching the issue: - PubMed studies seem to support that it's a very good thing to take probiotics while (and after) taking antibiotics. Obviously--or not so obviously--don't take them together (the theory is that the antibiotic will simply wipe out the probiotic). Wait a few hours in between. - As I mentioned, I'm drinking a DanActive yogurt or two every day, drinking kefir (unsweetened), eating plain yogurt, AND taking the "shelf-stable" (no refrigeration required) acidophillus beads every day. - Today, in addition to sublingual vitamin B12, I picked up Inulin--a PREbiotic (I think it's fructooligosaccharides) that's supposed to be a precursor, helping to foster the environment for healthy bacteria to grow [1]. Who knows? ;-) As you likely know, there seems to be good evidence that IBS responds well to treatment with probiotics, so ... no harm (that I know of!). I think it was Consumer Reports that found that--for the most part-- your average plain yogurt contained just as much live probiotic bacteria as did your average nutritional probiotic supplement. I'm simply hedging my bets. > i'm used to employing a variety of treatments > to fight this stuff, but i'm conscious right now of not wanting to > introduce too many variables into the treatment course. I understand only too well. > let me know how it works out for you. Ditto. I wish you a speedy, definitive, and permanent recovery :-) [1] http://jn.nutrition.org/cgi/content/full/129/7/1402S > glad that you're heading in the right direction. Thanks, Ellen. > it sounds like you > stopped the anitbiotics based on the ct scan results since you I actually stopped the antibiotics a few days /before/ getting the CT results. It had been a few weeks since I'd gotten any major (disgusting) discharge with irrigation and my sinuses /felt/ much better. On the other hand, I was feeling the ... fungal ... symptoms rather strongly. > indicate that you were feeling your worst. but does that mean that > your current state is caused by fungal complications? My guess--and that's really all it is--is: yes, my sinus issues have a fungal etiology. I'm 43 now. In something like 15 years, I've never felt better than when I'm on systemic antifungals. My ENT--a pretty well-known guy--subscribes to the notion that a whopping dose/ protracted course of these ABX's CAN cause fungal overgrowth. His recommendation was that I let the body recover. I'm still thinking that the "natural" remedies can't hurt. Still, as to whether or not it "IS" a fungal etiology? I'm rational/ skeptical/wise enough to say I just don't know for sure.... > i guess i don't > even know what signs of fungal overgrowth are besides the obvious > (thrush, vaginal infections, etc) It's sort of "the usual" for Candida/fungal problems. Here's a random site, from Google, that lists "the usual:" http://www.candida-society.org/ncs/symptoms.htm > having just come out of the worst acute sinusitis that i've ever head > & hence, the longest period on antibiotics (i think over 40 days on 3 > different types), i'm still inexperienced about the longterm effects. Ouch. I feel your pain ... and all the other symptoms. I'm sorry for you. > just started 250 mg of azithromycin/day to see if the chronic problems > are responsive to it. been taking my daily probiotic but my guts are > not exactly happy (have had ibs for many years, generally mild & well > managed). so i'm wondering if you or the other folks have other advice > for keeping the body as balanced as possible while dealing with > ongoing antibiotic use? I can tell you what I discovered when I made a casual pass at researching the issue: - PubMed studies seem to support that it's a very good thing to take probiotics while (and after) taking antibiotics. Obviously--or not so obviously--don't take them together (the theory is that the antibiotic will simply wipe out the probiotic). Wait a few hours in between. - As I mentioned, I'm drinking a DanActive yogurt or two every day, drinking kefir (unsweetened), eating plain yogurt, AND taking the "shelf-stable" (no refrigeration required) acidophillus beads every day. - Today, in addition to sublingual vitamin B12, I picked up Inulin--a PREbiotic (I think it's fructooligosaccharides) that's supposed to be a precursor, helping to foster the environment for healthy bacteria to grow [1]. Who knows? ;-) As you likely know, there seems to be good evidence that IBS responds well to treatment with probiotics, so ... no harm (that I know of!). I think it was Consumer Reports that found that--for the most part-- your average plain yogurt contained just as much live probiotic bacteria as did your average nutritional probiotic supplement. I'm simply hedging my bets. > i'm used to employing a variety of treatments > to fight this stuff, but i'm conscious right now of not wanting to > introduce too many variables into the treatment course. I understand only too well. > let me know how it works out for you. Ditto. I wish you a speedy, definitive, and permanent recovery :-) [1] http://jn.nutrition.org/cgi/content/full/129/7/1402S Follow up and review of CT today. CT is crystal clear. He scoped me. Looked "like a million bucks" that way, too. So some combination of the Doxy, Zithro, long-term Amoxi, Augmentin, Bromelain, Chewable C w/antacid, bid irrigation, food-grade hydrogen peroxide, grapefruit seed extract, time, and/or dumb luck seems to have wiped out the most tenacious and refractory sinus infection I've had in my life. But ... I'm left exhausted and showing signs of fungal overgrowth again. I stopped the antibiotics a few days ago ... when I was feeling my worst. Though I've BEEN hitting it pretty hard (daily) with kefir, Dannon's DanActive, and dietary restrictions, I'll look to add such things as pycnogenol, clove oil, and oil of oregano. PubMed seems to show strong clinical antifungal efficacy with these things. Hope everybody's (at least reasonably) well. Neil Follow up and review of CT today. CT is crystal clear. He scoped me. Looked "like a million bucks" that way, too. So some combination of the Doxy, Zithro, long-term Amoxi, Augmentin, Bromelain, Chewable C w/antacid, bid irrigation, food-grade hydrogen peroxide, grapefruit seed extract, time, and/or dumb luck seems to have wiped out the most tenacious and refractory sinus infection I've had in my life. But ... I'm left exhausted and showing signs of fungal overgrowth again. I stopped the antibiotics a few days ago ... when I was feeling my worst. Though I've BEEN hitting it pretty hard (daily) with kefir, Dannon's DanActive, and dietary restrictions, I'll look to add such things as pycnogenol, clove oil, and oil of oregano. PubMed seems to show strong clinical antifungal efficacy with these things. Hope everybody's (at least reasonably) well. Neil
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