getting worse before it gets better?

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uselessemailacct@yahoo.com - 02 Oct 2007 01:53 GMT

I'd been having severe facial pain on the right side of my face for
months. I went to the dentist (and had a couple root canals and
extractions when the pain didn't subside), periodontist (who said my
gums were fine), and my GP (who said it didn't appear I had TMJ).

I finally got to the ENT who did a CT scan which he said showed I had
chronic sinusitis in my maxillary sinuses and behind my eyes (not sure
if he meant frontal or ethmoid, since I haven't been in for a follow-
up yet). He started me on Allegra, Augmentin XR (1000mg 2xday for 2
weeks) and Nasacort. I've been taking these for 5 days, and the pain
seems to have spread to the other side of my face. The pain is mainly
in my cheek bones. I also now have post nasal drip, which I never had
before - in fact, I never really had any "sinus" symptoms before.
Also (sorry to whine so much) I'm extremely fatigued. My follow-up
with the ENT isn't for another couple weeks.

Is it supposed to get worse and more painful before it gets better?
I'm tired of swallowing Advil like it's candy.

Thanks!
Vivian

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blades49456 - 02 Oct 2007 02:26 GMT

If normal treatment doesn't resolve the problem, ask a rheumatologist
about autoimmune vasculitis such as Wegener's granulomatosis,
Churge-Strauss syndrome etc.

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Steven L. - 02 Oct 2007 04:32 GMT

> I'd been having severe facial pain on the right side of my face for
> months. I went to the dentist (and had a couple root canals and
[quoted text clipped - 13 lines]
>
> Is it supposed to get worse and more painful before it gets better?

No, that does not sound good.

Chronic sinusitis can be extremely stubborn. If your case were
responsive to the Augmentin, you should have experienced significant
improvement in symptoms by now. Instead, it seems like your infection
is spreading to the other side of your head--not a good sign.

You may need a stronger antibiotic (such as Levaquin or Avelox),
possibly in conjunction with oral steroids like Medrol to knock down the
congestion and inflammation. (Oral steroids are more powerful than
Nasacort.)

Why wait to see your ENT? After you've taken a full week of Augmentin,
if there's no improvement, phone him and tell him you're getting worse,
and ask him to phone in a prescription for some other antibiotic like
Levaquin or Avelox. Because when you see him next, he'll probably
prescribe those for you then anyway.

But some cases of chronic sinusitis, like mine, need surgery to
physically remove the blockage.

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judy.n - 02 Oct 2007 13:28 GMT

I would let your ENT know how you're doing after 5/6 days of
Augmentin. Possibly you now have post nasal drip because you're
actually draining. Pain may not be a treatment failure. Personally,
I'd call the prescribing MD, and let them know how you are, and see
what they advise.
Judy

> uselessemaila...@yahoo.com wrote:
> > I'd been having severe facial pain on the right side of my face for
[quoted text clipped - 40 lines]
> Email: sdlit...@earthlinkNOSPAM.net
> Remove the NOSPAM before replying to me.

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uselessemailacct@yahoo.com - 02 Oct 2007 16:18 GMT

Thanks for the replies. I kinda thought the PND might mean the
inflamation was going down, but then when the pain spread it didn't
seem right. I'm calling him, but I know he works in Urgent Care on
Tuesdays and won't get back to me until tomorrow.

I have another question - I had a kind of mild ear infection (for
months) that does seem to have cleared up this past week. Is it
possible for the sinuses to drain out of the ears? I was getting a
little drainage and a lot of the pain seemed to radiate to or from
there.

This sinusitis stuff is so new to me - I still won't believe it until
I see the CT scan, LOL.

Vivian

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Steven L. - 03 Oct 2007 06:57 GMT

> Thanks for the replies. I kinda thought the PND might mean the
> inflamation was going down, but then when the pain spread it didn't
[quoted text clipped - 4 lines]
> months) that does seem to have cleared up this past week. Is it
> possible for the sinuses to drain out of the ears?

Sinus infections and even common colds can travel right up the
Eustachian tube into the inner ear.

http://www.nlm.nih.gov/medlineplus/ency/images/ency/fullsize/19596.jpg

That's why it's critical to not blow your nose hard when you have an
infection; you can end up pushing germs right into your Eustachian tubes.

Some folks develop labyrinthitis, resulting in severe vertigo and
dizziness. At least that didn't happen to you.

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