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Medical Forum / Diseases and Disorders / Sinusitis / February 2008heading to infection land
hi all, just want your opinions. my lungs flared up on me about a week ago & are still mildly barking, not much progression to any significant infection there that i can tell. but in the last couple of days, my head is heading to infection land - sinuses full, discharge still white, but thick. since the last flare in august, things have been manageable. i've definitely got hormonal problems/complications with this as well as the usual neuro components & allergies. been doing the most basic preventative & self-treatment: irrigation, probiotic, hydration, steam, hot compresses. with the last flare, i went to the doc early & experimented with about 10 days of azithro - things cleared. should note that using azithro over a longer course of time (did that in the summer after the bad spring infection) didn't seem to change the manifestation of the overall sinus symptoms, which seem to just come & go with no significant acute effects or lasting chronic effects. do i jump on this early with antibiotics? wait until? go with the usually prescribed antibiotic treatment course? experiment with the azithro? this hasn't felt viral at all & i've felt fine other than the lung stuff & now the sinus stuff. i'm a bit reluctant to irrigate with too much unusual stuff as my nasal passages are so over reactive (all of me is so over reactive) & they have been very unhappy in the past with such interventions (=further inflammation=worse problem). also, since i have tinnitus, are there specific antibiotics that are more of a concern in this area? i believe that the tinnitus is also connected to the hormonal/neuro malfunction. don't want to make that worse! ellen > hi all, > [quoted text clipped - 29 lines] > > ellen Ellen, I know that Biaxin can induce tinnitus, perhaps that's true of the other macrolides, I don't know. Risking sounding like a broken record, have you tried a few 10,000 iu doses of vitamin D3? Those levels don't come close to toxic and anecdotally (and for me, personally), it's dramatically effective in improving the whole mess down to a non issue, for weeks now, anyway. Time will tell how long that lasts or if I need to repeat those levels for acute infections. Get well soon! Susan > x-no-archive: yes > [quoted text clipped - 46 lines] > > Susan susan, no broken record at all - just my thick skull (maybe that's it!). was actually going to pick up some vitD3 supps today based on your experience. i don't have any notes though as to whether you had a specific recommendation for brand, etc. i have to ease into any supplements generally to avoid GI distress. glad you're feeling better & thanks for the good wishes. ellen > susan, > [quoted text clipped - 3 lines] > specific recommendation for brand, etc. i have to ease into any > supplements generally to avoid GI distress. Not a brand, but to get gel caps and take with food that has fat in it for best absorption. HTH, Susan > x-no-archive: yes > [quoted text clipped - 12 lines] > > Susan indeed. i'm sure you'll be getting the follow up. ellen > no broken record at all - just my thick skull (maybe that's it!). was > actually going to pick up some vitD3 supps today based on your > experience. i don't have any notes though as to whether you had a > specific recommendation for brand, etc. i have to ease into any > supplements generally to avoid GI distress. Sigh. Here we are again .... staring down the Big Question. 1) I DID start taking 5,000 of D3 about 3wks ago. Doing okay so far, but ... I actually attribute that to the tiny animist idol that I constructed in the yard, and to which I've been /fervently/ praying for all my waking hours. If a photo might suffice, I can send you one; 2) With alllll the caveats that everybody has so reasonably proffered here .... what about a culture?? It may or may not pick up what's getting at you. It may or may not drive a definitive course of treatment. It may, however, give you some more info on which to make a decision; 3) How about zinc and vitamin C in addition to your usual regimen? I think there are buffered/far 'gentler' forms of C that might induce less distress; 4) Naps? I think Steven talks about the sleep issue. Ditto sunshine ... if there is any. That certainly is where we get most of our D, too. 5) I have to check every pill that I consider for ocular side effects (photophobia, itching, watering, dryness, etc.). Whatever you look at, you may want to google IT, along with "prescribing information filetype:pdf" That almost always yields the actual PI from the manufacturer. Scan for Adverse Effects, or search for "tinnitus." Obviously, even if it's a post-marketing thing withOUT causality established .... that would raise a flag or three for me. Fingers crossed..... Neil On Jan 23, 1:22 pm, neil0...@yahoo.com wrote: > 1) I DID start taking 5,000 of D3 about 3wks ago. Doing okay so far, > but ... I actually attribute that to the tiny animist idol that I > constructed in the yard, and to which I've been /fervently/ praying > for all my waking hours. > > If a photo might suffice, I can send you one; LOL! please do! i can't believe it because i do the same thing. except mine is in the bushes & we dance around it: (should be able to locate it in 1st 15 seconds or so, if not, stop clip before blindness ensues): http://www.youtube.com/watch?v=buC1hI9Ial0 > 2) With alllll the caveats that everybody has so reasonably proffered > here .... what about a culture?? It may or may not pick up what's > getting at you. It may or may not drive a definitive course of > treatment. It may, however, give you some more info on which to make > a decision; don't think i'm actually infected. yet. will know soon. or later. then will come the q - deal with open to discussion pcp or no talking allowed ent? > 3) How about zinc and vitamin C in addition to your usual regimen? I > think there are buffered/far 'gentler' forms of C that might induce > less distress; good points. i have used that other form of C with success or lack of distress. > 4) Naps? I think Steven talks about the sleep issue. Ditto > sunshine ... if there is any. That certainly is where we get most of > our D, too. yeah, by the way, did you sleep well? no sunshine except in my heart. at intermittent intervals. followed by clouds. > 5) I have to check every pill that I consider for ocular side effects > (photophobia, itching, watering, dryness, etc.). Whatever you look [quoted text clipped - 3 lines] > Obviously, even if it's a post-marketing thing withOUT causality > established .... that would raise a flag or three for me. i really need to do this. thanks for what should have been obvious. > Fingers crossed..... appreciate that. now must run out to get supplements & baking supplies. or maybe a bakery cake if i really do love dh on his birthday. did really try to make him a nice meal last night but we got a phone call just as we sat down to eat. it was the classic individual anti-crime initiative backfires saga. the good news is that the individual is fine, but it's hard to know whether of not to keep dinner warm after a '___ just shot himself in the f***ing thigh.' call. > Neil > Sigh. Here we are again .... staring down the Big Question. > > 1) I DID start taking 5,000 of D3 about 3wks ago. Doing okay so far, > but ... I actually attribute that to the tiny animist idol that I > constructed in the yard, and to which I've been /fervently/ praying > for all my waking hours. Neil, you may not need to take it continually; I've stopped. It has a very long half life, and it's a type of steroid, so it may have potential for suppression over the long term, in high doses *if* you're not deficient. Next time you have labs done, consider testing 25(OH)D, not 1,25 D. Susan > x-no-archive: yes > [quoted text clipped - 14 lines] > > Susan Kool and the Gang. Thanks. > hi all, > [quoted text clipped - 22 lines] > (all of me is so over reactive) & they have been very unhappy in the > past with such interventions (=further inflammation=worse problem). For most folks who are otherwise healthy, an uncomplicated sinus infection does not require antibiotics. BUT that's not you, unfortunately. As I recall, you already have a past history of sinus problems. And it sounds like you may be developing a touch of acute bronchitis as well. If that's so, then you ought to get an antibiotic. It will knock down the bacterial overgrowth a bit and shorten the infection by a bit. Don't expect miracles from it. Have you tried N-acetyl-cysteine supplements as a mucolytic to improve drainage and loosen the phlegm in your airways? For me, at doses of 1200 mg per hour in the morning (two 600 mg capsules per hour), it works far better than Robitussin or other such meds. I'm surprised how much gunk comes out of my windpipe by using that stuff. > also, since i have tinnitus, are there specific antibiotics that are > more of a concern in this area? The most worrisome ones are Vancomycin, gentamicin*** and tobramycin. Otic effects from Zithromax are quite rare (case reports) but not unheard of. *** (Whether *topical* irrigation with gentamicin solution can cause such systemic effects is controversial. The Cleveland Clinic stopped recommending gentamicin irrigation, after they found that enough of it was getting into the bloodstream from the nose to cause systemic side effects in a few unusually sensitive patients.)  SignatureSteven L. Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > > hi all, > [quoted text clipped - 55 lines] > Email: sdlit...@earthlinkNOSPAM.net > Remove the NOSPAM before replying to me. thanks steven. yeah, nothing uncomplicated. & i think i crossed the border into infectionland this evening. the bronchitis element is fairly new, though i did have it in the spring. as i recall, the augmentin knocked that out quickly but not the sinus portion. didn't know about the n-acetyl-cysteine. guess i call either my pcp or the ent in the morning. no dancing in the garden. ellen > guess i call either my pcp or the ent in the morning. no dancing in > the garden. Some have theorized that it wasn't really helping anyway. "Blasphemous heathens," I call them. Feel better. Your stuffy/snot-nosed friends are all pulling for you. > thanks steven. yeah, nothing uncomplicated. & i think i crossed the > border into infectionland this evening. the bronchitis element is [quoted text clipped - 4 lines] > guess i call either my pcp or the ent in the morning. no dancing in > the garden. Here's a slide presentation on NAC in Adobe Acrobat format: www.healthcare.uiowa.edu/research/sfrbm/papers/virtual%20school%20papers/Ercal-N AC.pdf Try the NAC if you can. I haven't found anything that works better for clearing out my windpipe from yellow gunk. If you do, make sure you take it with food or with a full glass of water--it can cause heartburn on an empty stomach. SignatureSteven L. Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > > thanks steven. yeah, nothing uncomplicated. & i think i crossed the > > border into infectionland this evening. the bronchitis element is [quoted text clipped - 18 lines] > Email: sdlit...@earthlinkNOSPAM.net > Remove the NOSPAM before replying to me. thanks steven. i think i dodged the lung part of this. but i'm going to look at this & keep it filed for the future (which is often nearer than i think). ellen just an update - saw pcp & we're going to throw the azithromycin at it since i had such great success in aug in knocking an infection down & out with it. it didn't impact my tinnitus then or when i took it at the lower doses over the extended time to see i responded to daily macrolide treatment, so i'll keep my fingers crossed. think i dodged the bronchial infection, but may be starting with some ear stuff. thanks all & take care, ellen another aside, though i may have noted it earlier it can always bear repeating. when i saw the last ent, one of the top docs at the premier university here, he was advocating irrigation & probiotics, but wouldn't discuss macrolides -calling it 'hypothetical.' then he talked about antibiotic overuse... > just an update - saw pcp & we're going to throw the azithromycin at it > since i had such great success in aug in knocking an infection down & [quoted text clipped - 11 lines] > but wouldn't discuss macrolides -calling it 'hypothetical.' then he > talked about antibiotic overuse... Well, he's absolutely right to worry about antibiotic overuse. Low-level macrolides are going to create a breeding ground for antibiotic-resistant bacteria, right in your large intestine. It's the same reason why putting antibiotics in cattle feed on a regular basis is problematic. SignatureSteven L. Email: sdlitvin@earthlinkNOSPAM.net Remove the NOSPAM before replying to me. > Well, he's absolutely right to worry about antibiotic overuse. > Low-level macrolides are going to create a breeding ground for [quoted text clipped - 6 lines] > Email: sdlit...@earthlinkNOSPAM.net > Remove the NOSPAM before replying to me. i don't disagree at all that antibiotic overuse has been a problem. i make every effort to buy meat & poultry from sources where the animals have been treated humanely & not blasted with hormones, antibiotics, etc. that whole agri/industrial system complex is ultimately a disaster for all of us. it seems like at least some doctors are now more careful in prescribing antibiotics. i used to try to ride everything out without them & have not improved the quality of my life with that approach. but i still straddle the 'when do i jump to them' fence, even knowing my sinus picture isn't straightforward & is probably helped by early intervention. daily low dose macrolide treatment did not help my situation, but it does seem to dramatically impact the quality of life of some of the people here. i don't know what that means long term for those individuals or for us collectively. so maybe i am naive in saying this, but i think in those situations i would err in favor of the macrolides & a chance at a more normal life if all else has failed & if it is judiciously prescribed. & to continue to lobby for cutting antibiotic use as a matter of course in industrial agriculture & for wise use in health/medicine. ( & getting rid of antibacterial soap?) what do i know.... just my opinion. ellen Steven, Macrolide resistance hasn't been an issue with low use for chronic sinusitis or panbronchiolitis: nor for pulsed use in cystic fibrosis to prevent or minimize pseudomonas colonization. The macrolides are not being utilized to "cure" an infection in this case, but to disrupt biofilms, decrease viral and bacterial adherence, and as anti-inflammatory modulators. Judy ok - haven't started on the abx (azithromycin). have upped vitD3, but not up to 10,000 IU yet. sucking on teabags till i can find pecans. all the usual rest of the stuff. think i cleared the lungs & sinuses are much better. minimal discharge but over the past few days some ear pain in one ear. this includes soreness to touch behind the ear (like on the bone). it seems like i had this last time & when i mentioned it to the ENT he said it was TMJ, which didn't seem right to me. not used to fighting ear stuff & don't want to wait too long with it. any suggestions? i think this is day 3 or 4 & that symptom seems a little worse. thanks, ellen > ok - haven't started on the abx (azithromycin). have upped vitD3, but > not up to 10,000 IU yet. sucking on teabags till i can find pecans. [quoted text clipped - 11 lines] > thanks, > ellen If I were dealing with ear stuff and had zithro I would take it. The antibiotic will make your ears ring a bit. I would also suck on some prilosec. > If I were dealing with ear stuff and had zithro I would take it. > The antibiotic will make your ears ring a bit. > I would also suck on some prilosec. geez, elizabeth, that prilosec suggestion was prescient. how did you know about impending upper gi issues, or were you recommending that based on some other effect? also, since the zithro seems to be working, any suggestions for length of treatment? ellen > > If I were dealing with ear stuff and had zithro I would take it. > > The antibiotic will make your ears ring a bit. [quoted text clipped - 7 lines] > > ellen When the bug dies, or is threatened, I think, it releases enterotoxins. 3 weeks or longer, the tea or tannins,pecan shell dust to rip off the film. Keep taking the zithro until the cells lining your sinuses that have been penetrated slough off and are replaced. Otherwise it comes back. Prilosec for your stomach, and some Lecithin to spare your liver. > > also, since the zithro seems to be working, any suggestions for length > > of treatment? [quoted text clipped - 11 lines] > Otherwise it comes back. > Prilosec for your stomach, and some Lecithin to spare your liver. just another check in on this art of chasing an infection. i was making steady improvement until a couple of days ago when i got the weather/hormonal storm effects playing on this thing. so a few days of additional inflammation & then dryness has made me fall back some as far as symptoms ( ie- clogged up & now an increase in mucus & cough, etc) guess i'm at around day 8 on the zithro. cough is bad again, but my overall state isn't entirely wretched. suggestions for when to admit the course of treatment is failing (i'm always bad at judging that)? if it comes to that,then what ax do you suppose gets prescribed? snotty but curious, ellen Ellen, It may be time to go to another antibiotic, classic next choices would be either a quinolone--avelox, levaquin, or possibly augmentin. IMO, you're treading water, but maybe not beating this thing. The classic first lines are ceftin/augmentin, consider biaxin/ azithro, but if you've been exposed to antibiotics the second line is augmentin or quinolone. Per Sanford's infectious disease guide. But, mileage does vary. Feel better. Judy > Ellen, > It may be time to go to another antibiotic, classic next choices [quoted text clipped - 6 lines] > Feel better. > Judy thanks, judy. i did put a call into the pcp & she wanted me to stay the course for a few more days with the zithro. i think those other mitigating factors have calmed down some & the last few days have been better again. this is always so difficult to navigate through. just feel like i have so little control over any of it. but i appreciate as well the primer again on standard abx course with it all. the mileage may vary on treatment, but the sinusitis sure is consistent about running us over. ellen |
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