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Medical Forum / Diseases and Disorders / Sinusitis / July 2007Newcomer
Hello. I just joined this group, because I have had a sinus infection for about five-and-a-half weeks, and I was looking for someplace where people discuss the topic. I'm forty-two years old, and this is the first time I've been aware of having a sinus infection that doesn't seem to be able to clear up on its own. I have a lot of the standard symptoms I've seen scanning through some of the posts here (headache on the left forehead, pressure around the eyes and nose, some drainage down the back of my throat). After I had had the condition for three weeks, I went to see this nurse practitioner that I visit, and she put me on Augmentin. After taking ten days of the fourteen-day course of the antibiotic, I called her to tell her that it was doing no good. She was out of the office, and in her absence a doctor switched me to Levaquin. The Levaquin seemed to be helping; the headaches I was getting in the evening started to come on later, and became less severe. However, I was only on the prescription for a week, and now (two days after I stopped taking it), I think I'm losing ground and the nighttime headaches are getting worse again. I've already read in this group that you need to take Levaquin for three weeks for it to be effective. That's good to know; I guess the doctor who prescribed it was unaware of this. There's an Asthma, Sinus and Allergy Program at Vanderbilt University, which is near me, that I made an appointment to visit yesterday. The do some kind of four-hour initial intake visit, but I couldn't get an appointment until July 27th, so I have to wait until then. I suspect many of you know all about this sort of thing, but I'm new to this topic. I'm wondering if I should bother to go back to the nurse practitioner that I see in the meantime. I've made an appointment to see her again this coming Thursday, because I don't really know what else to do with myself while I wait, but I'm not confident that she really knows the nitty-gritty of sinusitis. Also, the fact that her associate doctor only put me on Levaquin for a week isn't making me feel particularly confident either. Any thoughts? Anyway, I'm really glad this forum exists. Frankly, I was starting to feel a bit depressed by the fact that I really didn't have anywhere to discuss my situation comfortably. Thanks! Mason > Hello. I just joined this group, because I have had a sinus infection > for about five-and-a-half weeks, and I was looking for someplace where [quoted text clipped - 12 lines] > seemed to be helping; the headaches I was getting in the evening > started to come on later, and became less severe. If the infection were really sensitive to the Levaquin, the symptoms should have improved dramatically within 5 days, not just somewhat. Did I read you correctly in that there was just some improvement but you still felt symptomatic even after a whole week of the Levaquin? If so, then your infection could be resistant, or there could be another factor. In that case, asking for two more weeks of Levaquin is worth a try, but don't be too surprised if it's not a complete cure either. You may need to see an ENT. In the meantime, you might ask the associate doctor for a prescription for a tapered dose of Medrol (oral steroid), which will knock down that inflammation enough to stop the headaches while you wait to see the ENT. And do nasal irrigation regularly. The irrigation and Medrol may also help open up the sinuses enough to let them drain and facilitate healing--if you get lucky.  SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > > Hello. I just joined this group, because I have had a sinus infection > > for about five-and-a-half weeks, and I was looking for someplace where [quoted text clipped - 38 lines] > > - Show quoted text - I'm really new to most of this, including the terminology. Is an "ENT" an ear, nose and throat person? Also, no one has talked to me about irrigation. I don't even really know what it is. Thanks, Mason > > > Hello. I just joined this group, because I have had a sinus infection > > > for about five-and-a-half weeks, and I was looking for someplace where [quoted text clipped - 46 lines] > > Mason Mason: welcome to the group. You might want to go over to PubMed.gov and do a search on "Biofilm Sinusitis." Single species cultures were a useful investigative simplification devised 100 years ago to make the problem of investigation tractable with the technology available then. Real bacteria live in complex communities that are much more resistant to antibotics (like three orders of magnitude) than free floating bacteria and some academic disciplines that deal with bacteria including some labs in the Centers for Disease Control know that, but a whole segment of the medical community that includes the Ortolarengalogists, Eye Ear and Throat Docs is largely unaware of biofilms. How your sinusitis is affected by Levaquin would depend on the mix of bacteria that you have, however Levaquin is almost a specific for gram negative germs that latch onto and penetrate human cell walls. Levaquin and quinine inhibit the formation of pilia and curli which are necessary for attachment to new cells human cells as the old ones slough off. If it is not killing, but just holding the bug in check until your body can slough it off, you not see a dramatic improvement but would gradually get better as the colony looses it's attachment. Please tell us how it goes at Vanderbilt. I have been curious as to weather they recognize biofilms as one of the root causes of chronic sinusitis or not. > > > > Hello. I just joined this group, because I have had a sinus infection > > > > for about five-and-a-half weeks, and I was looking for someplace where [quoted text clipped - 78 lines] > > - Show quoted text - That was really interesting. Thanks. So you are saying essentially that I could continue to see improvement as a result of having taken the Levaquin, even if it didn't clear up the situation completely. That's good to know. Actually, I was suprised last night that my typical headache was definitely less than usual. Maybe I am still seeing some improvement. I'll look into Biofilm Sinusitis and let you know how it goes at Vanderbilt. Thanks again, Mason >>>>> Hello. I just joined this group, because I have had a sinus infection >>>>> for about five-and-a-half weeks, and I was looking for someplace where [quoted text clipped - 70 lines] > that I could continue to see improvement as a result of having taken > the Levaquin, even if it didn't clear up the situation completely. I'm sorry, but I do not agree with this. The reason I don't agree with this is that unless drainage has improved sufficiently, the infection cannot continue to clear on its own after the antibiotic is stopped. And the fact that you still have headaches suggests that drainage has not been sufficiently restored. That's why I mentioned Medrol, and someone else mentioned pseudoephedrine. Improved drainage is at least as important as killing bacteria, probably more so. SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > >>>>> Hello. I just joined this group, because I have had a sinus infection > >>>>> for about five-and-a-half weeks, and I was looking for someplace where [quoted text clipped - 88 lines] > > - Show quoted text - Thanks, Steven. No matter how you slice it, the infection definitely hasn't cleared up. I'm seeing the nurse practitioner again Thursday, and I'm going to mention the Medrol and pseudoephedrine to her. I'm also going to bring up irrigation with her. I suspect she might refer me to an ENT. Mason > > >>>>> Hello. I just joined this group, because I have had a sinus infection > > >>>>> for about five-and-a-half weeks, and I was looking for someplace where [quoted text clipped - 96 lines] > > Mason Stephen: "The infection could continue to clear up on it's own." With "imporved drainage." If drainage is the issue to begin with. Certainly drainage is an issue but at this point, before any diagnostic work has been done, it would be difficult to know if it is THE cause or the effect. Was the infection was engendered by a lack of drainage, or the other way around. When someone gets to forty five before getting chronic sinusitis it seems unlikely that serious structural drainage issues existed. If drainage issues suddenly have emerged, there are a couple of possibilities that come to mind. One is that a biofilm infection subsequent to a respiratory virus has finally reached the narrow spot called the nasal valve and blocked the ostemeatal complex. The other is that you may have contracted a virus that has created a nasal wart that is blocking drainage. And then there are another 50 possibilities etc, etc, etc. So far there are many ways to wind up with sinusitis and no complete cure that I know of. Steven has had several surgeries and subsequent courses of antibiotics and still has a much diminished form of his disease. Where as I have had zero surgeries, antibotics and anti fungals and have a much diminished form of my disease. Remember that 42% of people with CT scans which apparently show deviated septums and the like, report NO sinus disease. While only 62% of people with Chronic sinusitis show abnormalities on their CT scans. http://www.aafp.org/afp/20041101/1685.html Conversely we know that flu kill cilia and some varients of the staph bacteria carry all the verilence factors and toxins necessary to muck with epithelial secretory machinery so that the mucus becomes much more thick, obstructive and gooey. I need much more data to test the model but I think that the likelyhood that you will or will not get sinusitis is a kind of probability density function where the factors are how many times you are exposed to respiratory viruses, and what organisms that you inhale while your defenses are down, and the size of your air passages to begin with. Anyway, you may want to ask for Biaxin or Zithromax. These antibotics belong to a class of antibotics called macrolides which are built around lactones. Even at sublethal doses they seem to ramp biofilm goo production down. The bugs communicate via lactones, so maybe the message of the macrolides is "less goo". Anyway, I hope Vanderbilt helps. > > > >>>>> Hello. I just joined this group, because I have had a sinus infection > > > >>>>> for about five-and-a-half weeks, and I was looking for someplace where [quoted text clipped - 150 lines] > > - Show quoted text - Thanks again for all this information. I'll write down the names of the antibiotic so I can mention them at Vanderbilt. You know, I don't mean to pry, but is it alright if I ask how long some of you guys have been living with sinusitis? > > > > >>>>> Hello. I just joined this group, because I have had a sinus infection > > > > >>>>> for about five-and-a-half weeks, and I was looking for someplace where [quoted text clipped - 155 lines] > mean to pry, but is it alright if I ask how long some of you guys have > been living with sinusitis? Fifty years of episodes and tests and allergy shots. The last started September of 2001 when I had the flu while I mulched the yard in Michigan, and I still have the tail end of it. My mucus went from watery to clear rubber cement, with sometimes little yellow green. My blood pressure went from 120/80 to 100/145. Unless I was taking Advil, in which case it would be down again. > > > > > >>>>> Hello. I just joined this group, because I have had a sinus infection > > > > > >>>>> for about five-and-a-half weeks, and I was looking for someplace where [quoted text clipped - 166 lines] > > - Show quoted text - Fifty years? Wow. That really gives me a sense of perspective. > > > > > >>>>> Hello. I just joined this group, because I have had a sinus infection > > > > > >>>>> for about five-and-a-half weeks, and I was looking for someplace where [quoted text clipped - 166 lines] > > - Show quoted text - Fifty years? Wow. That really gives me a sense of perspective. > > > > > >>>>> Hello. I just joined this group, because I have had a sinus infection > > > > > >>>>> for about five-and-a-half weeks, and I was looking for someplace where [quoted text clipped - 166 lines] > > - Show quoted text - For some reason the text of my reply has not gone through two times now. It keeps coming up blank. What I wrote was : "Fifty years? Wow. That really gives me a sense of perspective." Hopefully it is coming through this time. That really does sound like quite a journey. Mason > I'm really new to most of this, including the terminology. Is an > "ENT" an ear, nose and throat person? Yes. Technical term is otolaryngologist. > Also, no one has talked to me > about irrigation. I don't even really know what it is. Go here: http://groups.google.com/group/alt.support.sinusitis/msg/9f39a823fbc1e20a SignatureSteven D. Litvintchouk Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > > I'm really new to most of this, including the terminology. Is an > > "ENT" an ear, nose and throat person? [quoted text clipped - 10 lines] > Email: sdlit...@earthlinkNOSPAM.net > Remove the NOSPAM before replying to me. Thanks for that information, Steven. I've been reading about irrigation in the group FAQs as well. Mason >> Hello. I just joined this group, because I have had a sinus infection >> for about five-and-a-half weeks, and I was looking for someplace where [quoted text clipped - 31 lines] >help open up the sinuses enough to let them drain and facilitate >healing--if you get lucky. I agree. Levaquin did the trick for me. That, and the Medrol, and the horse pill rx pseudoephidrine. The nasal irrigation, not so much, but congestion has never been a large part of my sinusitis. Rick |
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