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Medical Forum / Diseases and Disorders / Sinusitis / May 2008

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Over two years of being sickly, but I have a theory.

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dygerati - 08 May 2008 21:13 GMT
Alright, I've made a few posts over the last two years but I'lI sum up
my condition as the following progression of symptoms: post-nasal drip
-> brain fog -> headache -> cough.

I now suffer all of these as a chronic condition, and all have been
present for about a year and a half. I've also tried the following
treatments:

Augmentin (2 two week courses, as well as 1 full month)
prednisone (2 two week courses)
levaquin
flonase/allegra (fairly consistently for a long while)
one endoscopic/structural surgery - mainly to correct slightly
deviated septum, but also to simply scope out the going-ons of my
sinuses.
Regular irrigation (the last month or two with baby shampoo) with a
grossan irrigator.

None of these "treatments" had any real effect.

A couple things that may be relevant... The post-nasal drip mentioned
is often times clear/white/opaque with a bit of yellow on occasion. CT
scans have been mostly negative with the exception of the latest one
that showed somewhat clouded sinuses. Lastly, allergy tests were very
positive for everything except for dogs/cats.

Now for the theory...

At the time of the initial symptom(s) I had been living in a certain
room for a few months. This room was an add-on to an aged house and
had very little insulation (if any). In short, I think it was a likely
candidate for a mold infestation, which I am allergic to.

After being exposed to this allergy source for a few months I believe
my cilia would have become exhausted and my defenses would have at
least partially broken down (I also got bronchitis for the first time
around then). This opened the doors for a fungal-infection resulting
from the mold contaminate.

I've long since moved from this location but the infection persisted.
The symptoms I believe are mainly an allergic reaction to the fungal
element that still remain in my sinuses, mild as it may be. This also
provided a bed for a bacterial infection which as come and gone
constantly for the last couple years. This is evidenced by the fact
that I do lose the yellow in my discharge for a week or two after a
round of anti-biotics even though the rest of the symptoms persist.

So, in short, that's the theory. Now what to do about it?

I've gone to my general physician about a prescription for Biaxin &
Sporanox to combat any potential bacterial biofilms as well as the
theorized fungal infection. He was obviously reluctant and wanted to
consult with my ENT who lives 5 hours away. I have yet to hear back, a
week later, so I figured I pass the time by asking for any/all advice
and feedback you guys could offer.

I owe you all a debt of gratitude simply for reading this far, and
I'll be all the more appreciative for any feedback you can offer.
Thanks! :o]
neil0502@yahoo.com - 08 May 2008 22:19 GMT
Have you looked into adding either (or both) grapefruit seed extract
or food-grade hydrogen peroxide to your lavage solution??

I use the GSE pretty regularly (along with 2tsp of sea salt and a full
tank of my WaterPik), and the 35% food grade HP only occasionally
(about 10 drops with the aforementioned full tank).  Both have been
shown to be effective against lots of different bugs (bacteria, virus,
and fungi) in lab studies, but HP is an "oxidant" (like the thing we
take anti-oxidants to prevent), so ... it's better used when needed
than all the time ... or so one theory goes.

I've been reluctant to jinx myself, but I've been in pretty good shape
for nigh unto a couple of months now.

FWIW, and ... because I have NO idea what, if anything, is having any
effect ... I'm:

- irrigating only a time or two a week,

- taking the following supplements: zinc, D3, beta-glucan, N-
AcetylCysteine, bromelain, B12, fish oil caps, cod liver oil (liquid),
and Ester-C,

- getting pretty regular, pretty vigorous exercise ~5x/wk

- doing yoga maybe 3-4x/wk

But ... again ... who knows if anything I'm doing is making any
difference whatsoever.  Could just be seasonal ;-)

I DO think I felt "my best" while on Amoxi AND Sporanox, but ...
between $$$ and long-term /possible/ harm ... if I don't need to .....

Best of luck!
Steven L. - 08 May 2008 22:58 GMT
> Alright, I've made a few posts over the last two years but I'lI sum up
> my condition as the following progression of symptoms: post-nasal drip
[quoted text clipped - 44 lines]
>
> So, in short, that's the theory. Now what to do about it?

What you have described here, practically makes you a poster child for
the Mayo Clinic theory of Allergic Fungal Sinusitis (AFS), which I'm
sure you can google for on your own.

Some physicians, at Mayo and elsewhere, have had some success treating
AFS with fungal irrigation.  That's irrigation with a solution of
Sporonox or amphotericin B.  Note that the correct formula for the
irrigation is NOT easy to make and some pharmacies get it wrong;
Sinucare is one place that gets it right.  Note also that ampho B cannot
be mixed with saline, meaning that irrigating with it is not easy to
tolerate.

Some other physicians have had success treating AFS with oral
antifungals, like Diflucan.  That may account for the success that Dr.
his own bizarre alternative-medicine theory of sinusitis, but it shares
one thing in common with the Mayo theory:  Fungal etiology.

Signature

Steven L.
Email:  sdlitvin@earthlinkNOSPAM.net
Remove the NOSPAM before replying to me.

Steven L. - 08 May 2008 23:01 GMT
>> Alright, I've made a few posts over the last two years but I'lI sum up
>> my condition as the following progression of symptoms: post-nasal drip
[quoted text clipped - 61 lines]
> his own bizarre alternative-medicine theory of sinusitis, but it shares
> one thing in common with the Mayo theory:  Fungal etiology.

Oops, I mistyped that:

That may account for the success that Dr. Robert Ivker ("Sinus
Survival") has had in treating sinusitis.  He has his own bizarre
alternative medicine theory of sinusitis, but it shares one thing in
common with the Mayo theory:  Fungal etiology.

Signature

Steven L.
Email:  sdlitvin@earthlinkNOSPAM.net
Remove the NOSPAM before replying to me.

dygerati - 09 May 2008 04:57 GMT
> > Some physicians, at Mayo and elsewhere, have had some success treating
> > AFS with fungal irrigation.  That's irrigation with a solution of
[quoted text clipped - 3 lines]
> > be mixed with saline, meaning that irrigating with it is not easy to
> > tolerate.

I'd read that efforts were being made to add Sporonox to an irrigation
formula, but didn't know they were readily available via prescription.
Any word on the effectiveness versus the oral form?
Steven L. - 09 May 2008 06:20 GMT
>>> Some physicians, at Mayo and elsewhere, have had some success treating
>>> AFS with fungal irrigation.  That's irrigation with a solution of
[quoted text clipped - 7 lines]
> formula, but didn't know they were readily available via prescription.
> Any word on the effectiveness versus the oral form?

No, I don't know of any scientific studies.

I do know that oral antifungals have a risk of liver damage.  So if you
want to go that route, have a liver function test first.  You don't want
to take oral antifungals if your liver is already having problems anyway.

Signature

Steven L.
Email:  sdlitvin@earthlinkNOSPAM.net
Remove the NOSPAM before replying to me.

dygerati - 10 May 2008 00:07 GMT
On May 8, 2:19 pm, neil0...@yahoo.com wrote:
> Have you looked into adding either (or both) grapefruit seed extract
> or food-grade hydrogen peroxide to your lavage solution??
[quoted text clipped - 6 lines]
> take anti-oxidants to prevent), so ... it's better used when needed
> than all the time ... or so one theory goes.

I picked up a small container of HP at the store, but it looks like
the 3% solution. I suppose this isn't potent enough?
Nexus7 - 10 May 2008 01:00 GMT
> I picked up a small container of HP at the store, but it looks like
> the 3% solution. I suppose this isn't potent enough?

If I put hydrogen peroxide of any concentration in my irrigation
solution, my nasal passages would get so irritated, I wouldn't be able
to breathe through them for days. One dentist told me a 50% solution
in water of store-bought hydrogen peroxide (that 3% stuff) is a good
mouthwash. At that concentration, it tastes distinct and strong, and
fizzes when it hits the sink; if that's any guide.... I'd be extremely
careful with that stuff and mucous membranes.
Murray Grossan - 10 May 2008 05:23 GMT
On 5/8/08 8:57 PM, in article
6d588bfa-da6f-4bad-a4de-9e1fb3e174a4@q27g2000prf.googlegroups.com,

>>> Some physicians, at Mayo and elsewhere, have had some success treating
>>> AFS with fungal irrigation.  That's irrigation with a solution of
[quoted text clipped - 7 lines]
> formula, but didn't know they were readily available via prescription.
> Any word on the effectiveness versus the oral form?

It is much better to use the Amphotericin B in saline.  We use it all the
time for Hydro Pulse delivery.  What you do is clear the nose first with
saline pulsatile irrigation - allowing for better drug contact,  and then
add the Ampho in the saline and use it immediately before it has time to
precipitate out.
Fred - 10 May 2008 13:18 GMT
> Alright, I've made a few posts over the last two years but I'lI sum up
> my condition as the following progression of symptoms: post-nasal drip
[quoted text clipped - 55 lines]
> I'll be all the more appreciative for any feedback you can offer.
> Thanks! :o]

My condition was post nasal drip due to inflammation.  The
inflammation would turn into an infection.  The post nasal drip would
deliver my infection into my brinchial tubes where it would also
become inflamed and infected and then I would have a cough.  I once
had a bronchial cough for over 3 years.  The inflamation would come
from second hand cigarette smoke at the job where I worked.  This hurt
me bad - both physically and psychologically.  Brain fog would also
enter as an issue.  I have fixed most of the problem.  I still have a
bunch of rhinitis that starts as a runny nose in the morning and turns
into post nasal drip.  I can't get rid of it and will just have to
live with it.  I just have to worry about keeping the sinuses clean
and draining and then I can function.
dygerati - 13 May 2008 19:41 GMT
> It is much better to use the Amphotericin B in saline.  We use it all the
> time for Hydro Pulse  delivery.  What you do is clear the nose first with
> saline pulsatile irrigation - allowing for better drug contact,  and then
> add the Ampho in the saline and use it immediately before it has time to
> precipitate out.

Better than the Sporonox in an irrigation solution? In risk of side
effects, or overall effectiveness?

I ask mainly because I'd read that Amphotericin B is difficult to
transport and keep.
dygerati - 16 May 2008 23:19 GMT
Finally heard back from the ENT. It doesn't seem that he approved of
the Sporonox at this juncture, which sucks, but he did prescribe a 3
month stint of Biaxin. Anyone know of any side-effects/etc that I
should be wary of?

Also, anyone know why Dr's seem to be so reluctant to prescribe
Sporonox, or any antifungal? He did actually recommend baby shampoo
irrigations, so he may just know what he's talking about :o].
dygerati - 20 May 2008 18:07 GMT
Biaxin, 500 mg once a day for three months.

Is this is a standard dose/duration? It seems like so very long a
time...
truehawk - 20 May 2008 21:57 GMT
> Biaxin, 500 mg once a day for three months.
>
> Is this is a standard dose/duration? It seems like so very long a
> time...

Go to pubmed.gov and type chronic sinusitis, macrolide therapy..

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