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Medical Forum / Diseases and Disorders / Sinusitis / January 2004Do I need Antibiotics?
I caught a bug in early October (yellow mucous, sore throat, cough etc....). 5 day treatment of Zithromax and the sore throat went away immediately but I don't think I ever fully recovered. For the next 2 1/2 months my nose was extrememly dry, irritated and swollen. There would be times when I would feel almost 100% but then my nose would dry up again and become irritated and congested -- my throat was sometimes scratchy etc... I never thought I needed antibiotics again because the discharge was clear and when ENT's looked in my nose all of them said that I should just rinse with saline and keep it moist -- in other words it doesn't look that bad so just wait it out. I irrigate daily and use Breathe-Ease gel often during the day. Is it possible that there is still some type of bacterial infection and antibiotics may be needed. Is it possible for a bug to hang on this long --- also, why are there times when I feel almost 100% but then I get slammed again from hour to hour. Here are my current symptoms (going on for a few months) 1- Dry irritated nose 2- Post nasal drip 3- When my nose is not feeling dry it feels swollen and congested. I blow my nose often during the day --- the discharge is completely clear (except maybe slightly yellow first thing in the AM). 4- It's often worse when I'm inside in the heat. Feels better when I'm outside in the cold. 5- If inside for extended periods of time, I start to feel almost dizzy and tired and have to lay down. My sinuses are 100% clear. There is no swelling, no inflamation of any kind as indicated by my CT Scan. This is 100% in my annoying nose. Most all the posts here show antibiotics for sinusitis but what if my sinuses are clear ---- How about the best antibiotic based on my post here? Levaquin, Z-Pak, Ceftin etc.... My doctor is not going to have a clue so I'd rather just go to him with a recommendation for an antibiotic. Thanks so much. -Charles > I caught a bug in early October (yellow mucous, sore throat, cough > etc....). 5 day treatment of Zithromax and the sore throat went away [quoted text clipped - 36 lines] > Ceftin etc.... My doctor is not going to have a clue so I'd rather > just go to him with a recommendation for an antibiotic. From "Sinus Survival," a book by Dr. Robert Ivker: "....complaints such as 'Doctor, I have had this "cold" for the past three weeks now' (or the past month, or several months, or in a few cases, a year or more). These patients actually had sinusitis, and only after they had completed a course of antibiotics were they able to rid themselves of their 'cold'." And that's acute sinusitis--it can last for months. Chronic sinusitis can be permanent. I hate to be the bearer of such bad tidings, but a lot of us chronic sinusitis sufferers on this NG started out the same way--an ordinary cold that for some unknown reason triggered chronic trouble and we've never been completely cured since. That's why that's called "*chronic* sinusitis". IMO, the 5-day Zithromax course is just a marketing gimmick. To completely clear a sinus infection, you may need antibiotics for at least 3 weeks. Your nose is probably inflamed and sensitive from whatever it is that's bothering you. It's not surprising that indoors, Another antibiotic is worth a try. Try Levaquin. For a minimum of 3 weeks. Good luck. -- Steven L. > > I caught a bug in early October (yellow mucous, sore throat, cough > > etc....). 5 day treatment of Zithromax and the sore throat went away [quoted text clipped - 65 lines] > > -- Steven L. "...Until I saw another (after many 5-min consutations with others) local ENT in Jersey. I went into his office complaining of chronic sinusitis and every time I used the word sinusitis he got aggravated. "stop saying sinusitis -- just tell me your symtoms". After a review of my CT scan and my symtoms (which presented no problems under the eyes, near the jaw) he suggested that not only do I not have sinusitis but perhaps I never had sinusitis in the past! I had a slightly deviated septum and enlarged turbinates (actually huge turbinates). He prescribed "Astelin" and sent me on my way. I don't know if I was just getting better on my own or if the "Astelin" proved a miracle drug but I was then symptom free for 6 months." ... Looking back into Charles Stanton previous posts, the deviated septum and hypertrophy turbinate happened to be there which i believe was masking the primary cause/s of his problem which were overlooked by doctors. It could have been acid leakage from the stomache which irritated his nasal membrance, or it could have been other irritants (from food/drink or in the air) which should had been agrressively investigated. The surgery that he underwent was a stab in the dark, but he had it done becuase doctors convinced him that it would do no harm! After surgery he 's still suffering from the same symptoms more or less with the additional dryness and other problems due the scarred/reduced mucosa system and a weaken septum. >> "...Until I saw another (after many 5-min consutations with others) > local ENT in Jersey. I went into his office complaining of chronic [quoted text clipped - 25 lines] > less with the additional dryness and other problems due the > scarred/reduced mucosa system and a weaken septum. Please remember that my symptoms are definitely "less severe" since the turbinate surgery. Prior to the surgery I would have intense pain in the center of my forehead and every time I went to tie my shoes I felt like I was going to pass out because I got so lightheaded bending over. In addition, the post nasal drip was so terrible that my cough would last for months and my stomach became very upset. After surgery I no longer have pressure in the center of my forehead & the PND is still present but much less severe. I had surgery in Dec 2002 and was 100% clear until Oct. 2004 (thought I was cured for good). I haven't gone this long without a flare up in 12 years. Over the past several years, I saw about 4 allergists in the area and had all types of blood tests, allergy test etc... and I am allergic to nothing. My symptoms persisted for years regardless of where I lived (4 different locations). The turbinate reduction was sub-mucosal, the membrane was never touched. The septoplasty was probably not necessary...sometimes I regret throwing this in but I'm not convinced that this had any affect either way. There are many who believe that long term use of prescription nasal sprays (Nasal steroids etc...) have a much worse affect on the mucosa than any sub-mucosal surgery. So in summary, I'm not ready to say that the surgery was a mistake. If I had to do it all over again, I really don't know what I would do. There were a few ENT's who said not to bother with the surgery -- they just wanted to treat it with long term anti-biotics, nasal sprays, etc... What is the lesser of 2 evils? >There are many who believe that long term use of prescription nasal >sprays (Nasal steroids etc...) have a much worse affect on the mucosa >than any sub-mucosal surgery. Can you indicate any references to such a belief? > >There are many who believe that long term use of prescription nasal > >sprays (Nasal steroids etc...) have a much worse affect on the mucosa > >than any sub-mucosal surgery. > > Can you indicate any references to such a belief? I can't point you to any references but I do vividly recall a few ENT's saying that long term Nasonex, Nasocort, Vancenase etc... can be drying to the nose. Very long term use every single day may cause nasal bleeding & dryness. They didn't volunteer this info. to me....I remember asking it because I was concerned that I was on these steroids for years and years -- I wanted to know any potential side affects. All these products indicate nasal bleeding as a potential side affect (although rare), so at the time I thought it made sense. This is probably a question for Dr. Grossan or another ENT on this board. So, is it OK to use nasal steroids every single day for years and years and years. I know some people who do this and I used to do it. Ask 10 different ENT's and you'll probably get a 50-50 split.....I'm just guessing but can only tell you based on my personal experience with my ENT visits. > From "Sinus Survival," a book by Dr. Robert Ivker: > [quoted text clipped - 24 lines] > > -- Steven L. Thanks very much for your post. When I think "infection" I automatically think of discolored discharge, sore throat, loss of appetite and all those gross infection type things. Is it possible then to have an infection and not have discoloration of mucous, no sore throat? My complaint is 100% in my nose. It just feels like crap. It is dry & irritated most of the day. Then it gets clogged and stuffy. Then it gets dry, then it feels OK...then it gets weird again. Does this sound like it could possible be a low grade infection just hanging around in my nose? Am I looking at this all wrong? I've been treating my nose as the problem. Since I feel dry and crappy I'm thinking it must just be a problem with my nose. Because I am over the symptoms of sore throat and discolored discharge, I'm assuming that the infection is gone. Maybe not. Thanks again Steven...I very much value your opinion. BTW.......I've been reading about Bactroban and antibiotics in the irrigator? Do you like this option better than oral antibiotics? Regards -Charles >> From "Sinus Survival," a book by Dr. Robert Ivker: >> [quoted text clipped - 30 lines] > then to have an infection and not have discoloration of mucous, no > sore throat? Are you absolutely sure that your post nasal drip is not discolored? It could be intermittent, it could be draining only at night when you're asleep, etc. Note also that while acute sinusitis usually means bacterial infection, chronic sinusitis doesn't have to involve a bacterial infection. It's simply a long-lasting inflammation of the sinuses. I presume you've tried steroid nasal sprays to try to knock down that inflammation in your nose? > Thanks again Steven...I very much value your opinion. BTW.......I've > been reading about Bactroban and antibiotics in the irrigator? Do you > like this option better than oral antibiotics? No. typically you irrigate with the antibiotic solution 2-3 times a day. But you can't irrigate with plain saline at other times because that might wash the antibiotic out that you had irrigated with before. And I like to irrigate frequently when I need real symptomatic relief. -- Steven L. I'm having some reactions after taking abx for an infection, sometimes it takes a while to clear up the symptoms, I think. I got a culture that came up clear, maybe you could get one from your ent to see what's happening in there. Otherwise it's just guesswork and you may be taking strong abx unnecessarily. Since it usually happens inside in the heat, have you thought of using a humidifier? Drying in the nose can be a major source of irritation and thus the clear mucous draining. << I caught a bug in early October (yellow mucous, sore throat, cough etc....). 5 day treatment of Zithromax and the sore throat went away immediately but I don't think I ever fully recovered. For the next 2 1/2 months my nose was extrememly dry, irritated and swollen. There would be times when I would feel almost 100% but then my nose would dry up again and become irritated and congested -- my throat was sometimes scratchy etc... I never thought I needed antibiotics again because the discharge was clear and when ENT's looked in my nose all of them said that I should just rinse with saline and keep it moist -- in other words it doesn't look that bad so just wait it out. I irrigate daily and use Breathe-Ease gel often during the day. Is it possible that there is still some type of bacterial infection and antibiotics may be needed. Is it possible for a bug to hang on this long --- also, why are there times when I feel almost 100% but then I get slammed again from hour to hour. Here are my current symptoms (going on for a few months) 1- Dry irritated nose 2- Post nasal drip 3- When my nose is not feeling dry it feels swollen and congested. I blow my nose often during the day --- the discharge is completely clear (except maybe slightly yellow first thing in the AM). 4- It's often worse when I'm inside in the heat. Feels better when I'm outside in the cold. 5- If inside for extended periods of time, I start to feel almost dizzy and tired and have to lay down. My sinuses are 100% clear. There is no swelling, no inflamation of any kind as indicated by my CT Scan. This is 100% in my annoying nose. Most all the posts here show antibiotics for sinusitis but what if my sinuses are clear ---- How about the best antibiotic based on my post here? Levaquin, Z-Pak, Ceftin etc.... My doctor is not going to have a clue so I'd rather just go to him with a recommendation for an antibiotic. Thanks so much. -Charles>><BR><BR> Sue M. |
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