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Medical Forum / Diseases and Disorders / Sinusitis / April 2004Sick of my sinuses
I posted earlier in March about having 6 sinus surgeries. Well I had my 7th one the very end of March. Usually when I have surgery I see a dramatic difference after, especially after the packing comes out. I know that things stay swollen for a a few weeks. But I'm still having the horrible sinus pain I had before the surgery and my etsachin tubes are still plugged up. My ENT doc took some of the packing out earlier this week. But my nose just doesn't feel that great. I'm using the irragator for my nose. But it burns and gives me severe sinus pain for hours and hours after. I'm not sure its supposed to be like that. Yesturday I was throwing up and spitting up old blood clots. I called the doctor and they said it was normal. Why was this surgery so differnt in terms of how I am feeling after? I felt so good after the 6 others ones. This time I'm getting frusrated. My doctor said its too early to tell anything. I see him again in another week. But they may need to go back in and drain my estachin tubes and remove a fairly large cyst in my right maxillary sinus. I have been on antibiotics and painpills now since October and I'm just sick of it. I'm trying to be patient but its tough when I've been through this over and over again. Any advice? >I posted earlier in March about having 6 sinus surgeries. Well I had >my 7th one the very end of March. Usually when I have surgery I see a [quoted text clipped - 15 lines] >patient but its tough when I've been through this over and over again. > Any advice? You might have some type of aenorobic (reactive) infection. This will only cause swelling and repeated surgeries. Antibiotics s/b whatever the pathogen is susceptible too. The bacteria is hard to get to.(ie. sinuses will not be punctured) On patients requiring multiple surgeries, despite proper treatment, we check for immune deficiencies. Murray Grossan, M.D. http://www.ent-consult.com > On patients requiring multiple surgeries, despite proper treatment, we check > for immune deficiencies. In her case, DEFINITELY! In previous posts, she had said that she has been sick with chronic sinusitis since she was a 7 year old child; that she gets all manner of colds and sinus infections frequently; etc. She's a candidate for immunological testing. -- Steven L. I was told that I have a suppressed immune system (unknown reason) and that is why I fight this chronic infection. They did a ANA Titer on me, with was positive with homogenous stain... since that doesn't fit Lupus, the doctor just gave me more antibiotics and dropped the matter. How do you go about finding a Immune Doctor and do any of the treatments really help??? > On patients requiring multiple surgeries, despite proper treatment, we check > for immune deficiencies. > Murray Grossan, M.D. > http://www.ent-consult.com > I was told that I have a suppressed immune system (unknown reason) and that > is why I fight this chronic infection. They did a ANA Titer on me, with was > positive with homogenous stain... since that doesn't fit Lupus, the doctor > just gave me more antibiotics and dropped the matter. How do you go about > finding a Immune Doctor and do any of the treatments really help??? Many large teaching hospitals have a Department of Allergy and Immunology. In there they have immunologists. Some of them are experts in allergy, and others (the ones YOU want) are experts in immune disorders. Make sure that you have located an actual expert in immune disorders before you make an appointment to see that immunologist. The only treatment I know of that works for Common Variable Immunodeficiency (CVID) is monthly intravenous immunoglobulin (IVIG). It's very expensive; some insurance companies won't pay for it; and you have to be on it indefinitely. -- Steven L. >I was told that I have a suppressed immune system (unknown reason) and that >is why I fight this chronic infection. They did a ANA Titer on me, with was >positive with homogenous stain... since that doesn't fit Lupus, the doctor >just gave me more antibiotics and dropped the matter. How do you go about >finding a Immune Doctor and do any of the treatments really help??? I think that you need to find out the reason. Mayo is very good at this kind of thing if you are near Minnesota, Florida, or Arizona.... Both the immunologist specialist and the infectious disease specialist are up on treating persons with immune deficiency problems. Unfortunately this is still in the "art" stage, and is not like getting penicillin for strep throat. There are differences in how these are diagnosed and treated, but at least you have a direction to go instead of just more surgery. Murray Grossan, M.D. http://www.ent-consult.com Start with a concerned primary care or DO doc and do complete blood test/ workup. Describe all symptoms. Have them check your thryroid as well. See an allergist too if you suspect this. Or an endocrinologist. Educate yourself, irrigate and don't give up (which is the hardest part given how much the problem can drain you). You can improve dramatically (if not cure yourself) with persistence and determination! I did. I don't get sinus infections anymore after much persistence: surgeries, many visits, etc. It's worth it, but you have to keep trying. Good luck. > I was told that I have a suppressed immune system (unknown reason) and that > is why I fight this chronic infection. They did a ANA Titer on me, with was [quoted text clipped - 7 lines] > > Murray Grossan, M.D. > > http://www.ent-consult.com > I posted earlier in March about having 6 sinus surgeries. Well I had > my 7th one the very end of March. Usually when I have surgery I see a [quoted text clipped - 15 lines] > patient but its tough when I've been through this over and over again. > Any advice? Dr. Grossan is absolutely right about being tested for immunodeficiency. You had said in previous posts that you have been sick with sinusitis since you were a child; that you seem to get frequent colds and frequent sinus infections; etc. That's a red flag for some kind of immunodeficiency. You should see a board-certified immunologist with expertise in immune disorders (who is NOT just a glorified allergist): "Any patients with chronic sinusitis, which is poorly responsive to treatment, should have an extensive immunological evaluation including immunoglobulin levels, possible IgG subtypes, and antibody testing. Pneumococcal, diphtheria, and tetanus antibodies should be tested before and after Pneumovax and diphtheria/tetanus immunizations***. Evaluation should be done by an immunologist familiar with testing as results can be difficult to interpret. Briefly, 12 different subtypes of the pneumococcal antigen should ideally be tested with an adequate rise in the antibody titer to determine that the patient has responded to the vaccine. In cases where an immunodeficiency is found, monthly immunoglobulin (IVIG) therapy may need to be initiated. Selected patients may occasionally warrant IVIG despite normal antibody levels. Such patients must be selectively chosen by experienced clinicians, as IVIG is extremely costly." http://www.sinuses.com/search_site.cgi?fname=postsurg.htm&db=s&skw=immunoglobuli n&method=and#link ***Another and simpler set of challenges that some immunologists use, is to use just the pneumovax immunization and a special "PRP" vaccine which consists of killed Hemophilus Influenzae bacteria--this has to be specially ordered. -- Steven L. >> I posted earlier in March about having 6 sinus surgeries. Well I had >> my 7th one the very end of March. Usually when I have surgery I see a [quoted text clipped - 45 lines] >consists of killed Hemophilus Influenzae bacteria--this has to be >specially ordered. Agree with all post. remember some bacteria can be in the sinus tissue causing inflamation. Many bacteria cannot be tested for. I suggest an antibiotic irrigation if the above immunological evaluation does not come up with anything. What do you have to loose? sinus buster seems to help |
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