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Medical Forum / Diseases and Disorders / Sinusitis / April 2004MRSA-Sinusitis
I have chronic sinusitis and recently I have tested positive to MRSA (Methicillin Resistant Staphylococcus Aureus) in my nose. Staph. Aureus is a common cause of sinusitis, treatable by antibiotics. A sinusitis caused by MRSA is not easily treated by antibiotics. (The few antibiotics which eradicate MRSA are understandably not being used for non-critical patients). I have two questions 1) If my chronic infection is MRSA-Sinusitis, is there any hope of eradicating this ? 2) A consultant is recommending FESS (ethmoidectomy) - is such an operation sensible when the area of the operation carries MRSA. Thanks a lot ~ Neil I have chronic sinusitis and recently I have tested positive to MRSA (Methicillin Resistant Staphylococcus Aureus) in my nose. Staph. Aureus is a common cause of sinusitis, treatable by antibiotics. A sinusitis caused by MRSA is not easily treated by antibiotics. (The few antibiotics which eradicate MRSA are understandably not being used for non-critical patients). A sinusitis caused by MRSA is not easily treated by antibiotics. I have two questions 1) If my chronic infection is MRSA-Sinusitis, is there any hope of eradicating this ? 2) A consultant is recommending FESS (ethmoidectomy) - is such an operation sensible when the area of the operation carries MRSA. Thanks a lot ~ Neil" >> <===========================> I suffered from repeated sinus infections for many years. I read about treating the sinuses using hydrogen peroxide on the Internet, and also about irrigating the sinuses with baking soda and Kosher salt on the Internet. I figured, if it is good to irrigate with peroxide, baking soda and kosher salt, what would happen if I tilted my head down, and tried to flood my sinus areas with a mixture of peroxide, baking soda and kosher salt, and let it slowly seep into all areas of my sinuses. It took me quite a while, and a lot of discomfort, finding the correct amount of peroxide to use, but it did cure me completely of sinus infections. I've now been about 30 months without a sinus infection. I've documented my experience in detail in only one place, in order to save myself time and effort, on Healthboards.com. There is an active conversation over there with people who have tried it, and they also share their experiences. While it doesn't work for everyone, it might be worth you taking a look. "Upside down sinus flooding" documentation and discussion: http://www.healthboards.com/boards/showthread.php?t=129210 An addition discussion thread about "upside down sinus flooding": http://www.healthboards.com/boards/showthread.php?t=139765 Thanks a lot for your reply. I must admit to being quite shocked at first by your suggestion. I have realised in the couple of years that some damage is permanent (I have a gammy thumb after a trivial skiing spill). If I put hydrogen peroxide in my sinuses and it causes permanent damage, then I have to live with this for the rest of my life ... Hmmmmm ... Then I realised that surgery is the same ... a complete ethmoidectomy is also permanent damage ... which I must live with whether it causes an improvement or deterioration in my sinus problems. I have thought about your suggestion a lot during the last week and while I am not yet ready to try your method, I do think that I would try peroxide before agreeing to further surgery. Hydrogen Peroxide is really an inspired choice: simple byproducts water,oxygen and the effect is based on the dilution. I assume that this method is most effective after blockages are mostly removed (my ethmoid sinus is full of gunk) otherwise the blockages will stop the peroxide from coming in contact with most of the infection. I am very grateful for your suggestion, I'm not brave enough for it to be top of my list, but it is a welcome addition that I continue to think about. My doctor and various ENT-specialists have run out of suggestions (after nasal cortison and FESS). This is a bleak, depressing position to be in. Now I have some new suggestions, some new hope and *motivation*. Thanks ~ Neil << "Neil Wheatley" <wheatleyneil@bluewin.ch> wrote: I have chronic sinusitis and recently I have tested positive to MRSA (Methicillin Resistant Staphylococcus Aureus) in my nose. Staph. Aureus is a common cause of sinusitis, treatable by antibiotics. A sinusitis caused by MRSA is not easily treated by antibiotics. (The few antibiotics which eradicate MRSA are understandably not being used for non-critical patients). A sinusitis caused by MRSA is not easily treated by antibiotics. I have two questions 1) If my chronic infection is MRSA-Sinusitis, is there any hope of eradicating this ? 2) A consultant is recommending FESS (ethmoidectomy) - is such an operation sensible when the area of the operation carries MRSA. Thanks a lot ~ Neil" >> <===========================> I suffered from repeated sinus infections for many years. I read about treating the sinuses using hydrogen peroxide on the Internet, and also about irrigating the sinuses with baking soda and Kosher salt on the Internet. I figured, if it is good to irrigate with peroxide, baking soda and kosher salt, what would happen if I tilted my head down, and tried to flood my sinus areas with a mixture of peroxide, baking soda and kosher salt, and let it slowly seep into all areas of my sinuses. It took me quite a while, and a lot of discomfort, finding the correct amount of peroxide to use, but it did cure me completely of sinus infections. I've now been about 30 months without a sinus infection. I've documented my experience in detail in only one place, in order to save myself time and effort, on Healthboards.com. There is an active conversation over there with people who have tried it, and they also share their experiences. While it doesn't work for everyone, it might be worth you taking a look. "Upside down sinus flooding" documentation and discussion: http://www.healthboards.com/boards/showthread.php?t=129210 An addition discussion thread about "upside down sinus flooding": http://www.healthboards.com/boards/showthread.php?t=139765 One reply to my original mail suggested flooding the sinuses with hydrogen peroxide. I am naturally cautious and whilst I am a long way from trying this one for myself, but I was pleased to receive the suggestion and I have been mulling it over. Today I did a simple sinus wash (with a bulb-pump) with a salt water and I got water in my right ear. I know that I wasn't doing a sinus flood and I wasn't following the instructions described for the sinus flood. However, it seems to me (IMHO) that for anyone going ahead with this procedure it may be sensible to at least try the procedure four of five times using salt water (dummy runs) before using the recommended mixture. If during the dummy runs you get salt water in your ears then think carefully before commiting yourself to the peroxide. Just a thought. ~ Neil Thanks a lot for your reply. I must admit to being quite shocked at first by your suggestion. I have realised in the couple of years that some damage is permanent (I have a gammy thumb after a trivial skiing spill). If I put hydrogen peroxide in my sinuses and it causes permanent damage, then I have to live with this for the rest of my life ... Hmmmmm ... Then I realised that surgery is the same ... a complete ethmoidectomy is also permanent damage ... which I must live with whether it causes an improvement or deterioration in my sinus problems. I have thought about your suggestion a lot during the last week and while I am not yet ready to try your method, I do think that I would try peroxide before agreeing to further surgery. Hydrogen Peroxide is really an inspired choice: simple byproducts water,oxygen and the effect is based on the dilution. I assume that this method is most effective after blockages are mostly removed (my ethmoid sinus is full of gunk) otherwise the blockages will stop the peroxide from coming in contact with most of the infection. I am very grateful for your suggestion, I'm not brave enough for it to be top of my list, but it is a welcome addition that I continue to think about. My doctor and various ENT-specialists have run out of suggestions (after nasal cortison and FESS). This is a bleak, depressing position to be in. Now I have some new suggestions, some new hope and *motivation*. Thanks ~ Neil I have chronic sinusitis and recently I have tested positive to MRSA (Methicillin Resistant Staphylococcus Aureus) in my nose. Staph. Aureus is a common cause of sinusitis, treatable by antibiotics. A sinusitis caused by MRSA is not easily treated by antibiotics. (The few antibiotics which eradicate MRSA are understandably not being used for non-critical patients). A sinusitis caused by MRSA is not easily treated by antibiotics. I have two questions 1) If my chronic infection is MRSA-Sinusitis, is there any hope of eradicating this ? 2) A consultant is recommending FESS (ethmoidectomy) - is such an operation sensible when the area of the operation carries MRSA. Thanks a lot ~ Neil" >> <===========================> I suffered from repeated sinus infections for many years. I read about treating the sinuses using hydrogen peroxide on the Internet, and also about irrigating the sinuses with baking soda and Kosher salt on the Internet. I figured, if it is good to irrigate with peroxide, baking soda and kosher salt, what would happen if I tilted my head down, and tried to flood my sinus areas with a mixture of peroxide, baking soda and kosher salt, and let it slowly seep into all areas of my sinuses. It took me quite a while, and a lot of discomfort, finding the correct amount of peroxide to use, but it did cure me completely of sinus infections. I've now been about 30 months without a sinus infection. I've documented my experience in detail in only one place, in order to save myself time and effort, on Healthboards.com. There is an active conversation over there with people who have tried it, and they also share their experiences. While it doesn't work for everyone, it might be worth you taking a look. "Upside down sinus flooding" documentation and discussion: http://www.healthboards.com/boards/showthread.php?t=129210 An addition discussion thread about "upside down sinus flooding": http://www.healthboards.com/boards/showthread.php?t=139765 >I have chronic sinusitis and recently I have tested positive to MRSA >(Methicillin Resistant Staphylococcus Aureus) in my nose. That may well have nothing to do with your sinusitis, It is commonly found in normal patients too. Surgery could help if a CT scan shows significant blockages. Othewise, try nasal steroids sprays for a few months... Thanks for your reply A recent MRI scan shows that there are significant blockages, particularly in the ethmoid sinus, but also in the sphenoid and the frontal sinuses. I have used nasal steroids (rhinocort turbohaler) for the last three years. I also have recurring nasal polyps. I have had recurring heavy (15-30 days typically) illnesses (at least 3 to 4 times a year) during the last 10 years. Blood tests reveal little (signs of allergy, nothing dramatic). For the last 6 months I have been almost permanently ill (more than 12 courses of antibiotics) and I have been taking cortison tablets (10mg/day) for the last two months. The antibiotics help but as soon as the course is finished the problem returns. It may be that the MRSA has nothing to do with my sinusitis, this is a fair statement, it avoids narrowing down the horizons without supporting evidence. I am however confronted with various statements that my sinusitis has nothing to do with the MRSA. Definitive statements narrowing the horizons and *without* supporting evidence: Jumping to Conclusions. The statement seems particularly strange when normal SA is so often cited as the most common bacteria present in sinusitis infections. Are these opinions really suggesting that the mutation to oxacylin-resistance is associated with an elimination of the sinusitis-infection ? This seems hardly credible, and no evidence is cited (either way). MRSA seems to be prevalent in the general population (outside hospitals) at least in some countries in europe (particularly the U.K.) Control of the infection may no longer be an option and it is understandable that: 1) The antiobiotics which are still effective should be used with caution to retain that effectiveness. 2) Panic should be avoided. The MRSA Information leaflets typically point out that MRSA is very little danger to healthy people and that you can be a carrier without being infected (typically on the skin and in the nose). Healthy carriers of MRSA will often rid themselves of the bacteria over time and are highly unlikely to contract MRSA. I am sure that this is all very good advice. The advice is directed at two groups of people, the healthy and the infected. Sinusitis sufferers are however another group, we are prone to infections within the sinuses. A healthy carrier has MRSA in their nose without becoming infected, a sinusitis patient with MRSA in their nose is probably going to become infected (within the sinuses) and if the MRSA remains, will become reinfected. In this light the assumption that "the sinusitis is probably nothing to do with the MRSA" seems a mixture of panic-avoidance and wishful-thinking. I have yet to hear any convincing argument. I have no interest in proving the experts wrong, but I am trying to remain positive about a 6-month illness, trying to find some possibilities of therapy which seem to make sense. In the last week I have been taking Cotrim, an antibiotic to which MRSA is sensitive, I stopped yestaday (after 7 days) when I came out in a red rash all over my body (and a very red head). Vancomycin would available as a pre-operation treatment (I heard yestaday) but is not available for non-critical / non-operation patients. My doctor has been very supportive but has run out of suggestions, my ENT-specialist seems keen for me to accept being ill (including deep mental fog) he sees this as my new "normal" life that I should reconcile myself to. I am very grateful for the suggestions sent to my posting. I now have several options to consider in addition to the posterior ethmoidectomy which is offered (but not necessarily recommended) by the ENT-consultant at my local hospital (second opinions collected by my doctor have recommended I avoid this procedure). Additionally it seems clear that part of my sinusitis problems are due to the accretion of matter and blockages within my sinuses. It may be that if I solve this problem that the infections (MRSA or not) will not return. I have ordered a hydro pulse and I hope that this will ease the mechanical drainage problems. ~ Neil > >I have chronic sinusitis and recently I have tested positive to MRSA > >(Methicillin Resistant Staphylococcus Aureus) in my nose. [quoted text clipped - 5 lines] > > Othewise, try nasal steroids sprays for a few months... >Thanks for your reply > [quoted text clipped - 7 lines] >times a year) during the last 10 years. Blood tests reveal little (signs of >allergy, nothing dramatic). Blood tests for allergy are considered unreliable in some views. Skin tests are uusually preferred (but are much more expensive , so you can see the cost appeal of blood tests). >For the last 6 months I have been almost >permanently ill (more than 12 courses of antibiotics) and I have been taking [quoted text clipped - 8 lines] >nothing to do with the MRSA. Definitive statements narrowing the horizons >and *without* supporting evidence: Jumping to Conclusions. It may not matter much what its exact role was or is in you case. Once your sinuses are badly inflamed and full of fluid etc., it may be very difficult to resolve the problem without mechanically clearing them.. By all means try irrigation. If that does not work, surgery may be an excellent choice. ..... >My doctor has been very supportive but has run out of suggestions, my >ENT-specialist seems keen for me to accept being ill (including deep mental [quoted text clipped - 5 lines] >local hospital (second opinions collected by my doctor have recommended I >avoid this procedure). Why did they say to avoid it? They may just have taken the easy course by following what they think was the inclination of the ENT-consultant But I would never have surgery performed by someone who did not strongly recommend it. It lets them off too easily of it does not work out well. What you may or may not know is that there are various schools of sinus surgery. Dr. David Kennedy is the most famous sinus surgeon in the U.S. and he now believes that extensive removal of the fine bony partitioning in the ethmoid sinuses is often necessary to cure difficult cases. Dr. Messerklinger in Austria invented endoscopic sinus surgery. Kennedy learned it from him originally. Ther are other very famous names in Europe including Malte Wigand in Germany. I am sure there are some in Switzerland. I would suggest getting an opinion fromsomeone of that stature..... >Additionally it seems clear that part of my sinusitis problems are due to >the accretion of matter and blockages within my sinuses. It may be that if >I solve this problem that the infections (MRSA or not) will not return. I tihnk that that is probably the case... Thanks for your opinions. My concern about surgery is certainly based on a lock of enthusiasm/recommendation by the specialists in Bern. I am also rather concerned by the reasoning behind the suggestions I receive, most of the advice seems to be based on gut feeling rather than any explanable reasoning. This may of course be a cultural problem (I am English). The second opinion by the head ENT-consultant at the university hospital here in Bern (which is one of the top in Switzerland) was simple: if I want them to operate then they will operate, but without any clear recommendation, any clear explanation of what the operation would entail, what the chances of success/complications would be. I am very grateful for your comments and I shall try to find another specialist using the names you have suggested. ~ Neil On Tue, 27 Apr 2004 17:43:05 +0200, "Neil Wheatley" <wheatleyneil@bluewin.ch> wrote: >Thanks for your reply > [quoted text clipped - 7 lines] >times a year) during the last 10 years. Blood tests reveal little (signs of >allergy, nothing dramatic). Blood tests for allergy are considered unreliable in some views. Skin tests are uusually preferred (but are much more expensive , so you can see the cost appeal of blood tests). >For the last 6 months I have been almost >permanently ill (more than 12 courses of antibiotics) and I have been taking [quoted text clipped - 8 lines] >nothing to do with the MRSA. Definitive statements narrowing the horizons >and *without* supporting evidence: Jumping to Conclusions. It may not matter much what its exact role was or is in you case. Once your sinuses are badly inflamed and full of fluid etc., it may be very difficult to resolve the problem without mechanically clearing them.. By all means try irrigation. If that does not work, surgery may be an excellent choice. ..... >My doctor has been very supportive but has run out of suggestions, my >ENT-specialist seems keen for me to accept being ill (including deep mental [quoted text clipped - 5 lines] >local hospital (second opinions collected by my doctor have recommended I >avoid this procedure). Why did they say to avoid it? They may just have taken the easy course by following what they think was the inclination of the ENT-consultant But I would never have surgery performed by someone who did not strongly recommend it. It lets them off too easily of it does not work out well. What you may or may not know is that there are various schools of sinus surgery. Dr. David Kennedy is the most famous sinus surgeon in the U.S. and he now believes that extensive removal of the fine bony partitioning in the ethmoid sinuses is often necessary to cure difficult cases. Dr. Messerklinger in Austria invented endoscopic sinus surgery. Kennedy learned it from him originally. Ther are other very famous names in Europe including Malte Wigand in Germany. I am sure there are some in Switzerland. I would suggest getting an opinion fromsomeone of that stature..... >Additionally it seems clear that part of my sinusitis problems are due to >the accretion of matter and blockages within my sinuses. It may be that if >I solve this problem that the infections (MRSA or not) will not return. I tihnk that that is probably the case... >My concern about surgery is certainly based on a lock of >enthusiasm/recommendation by the specialists in Bern. [quoted text clipped - 9 lines] >any clear explanation of what the operation would entail, what the chances of >success/complications would be. I agree I would not do it there then. >I am very grateful for your comments and I shall try to find another specialist >using the names you have suggested. Great - you can always call their office and ask if they would recommend anyone nearer to you. Hi Don On a previous posting on this thread you mentioned allergy tests: Blood tests for allergy are considered unreliable in some views. Skin tests are uusually preferred (but are much more expensive , so you can see the cost appeal of blood tests). This mirrors my experience. Nothing significant has been found in any of the blood tests I have done over the last years. Skin tests a year ago showed big reactions to ash and grass pollen but none at all for cats. Strangely in my "everyday allergy testing" (my life) cats cause the most dramatic reaction of all (within a minute I get very itchy around my mouth and arms and my eyes) yet the skin tests show nothing. Allergy testing in general seems to be a bit of a hit and miss affair. I have learned to be very careful around allergy-specialists (if their test doesn't pick it up then it isn't an allergy) so I now have accustomed myself to using the word intolerance (as an unspecific term to describe the symptom rather than the biomechanism causing the symptom (allergy or otherwise)). I am expecting to be corrected about intolerance any time now when intolerance gains a specific meaning among the specialists, but it works for now. Allergy and Intolerances are clearly components of my situation, unfortunately it seems that allergy concerns are in their infancy here in Switzerland and only certain (recognised/treatable?) allergens are taken seriously. Non-allergic intolerance is still considered to be simply bogus (which means that I have stopped mentioning my very real monosodium glutamate intolerance to doctors here). I think that this is different in the U.S. and the U.K. A quality physician in the U.S. or U.K. knows that there is a limit to his/her knowledge and that there is a limit to current medical knowledge (otherwise medical research would be senseless). He/She may not support your view based on experience (that view maybe wrong after all) if he/she has no knowledge about such symptoms: but he/she is unlikely to tell you that you are definitely wrong. In Switzerland generally if a doctor has no knowledge of something (an intolerance problem for example) then it does not exist, and any patient suggesting this is a fool. Of course there are exceptions and to be fair to doctors here it is part of swiss culture to leave no room for discussion with absolute statements rather seek a discussion. The dialectic method is not part of life here (whereas in the US., U.K and Ireland it's the basis of every pub and bar conversation) ~ Neil On Wed, 28 Apr 2004 14:15:52 +0200, "Neil Wheatley" <wheatleyneil@bluewin.ch> wrote: >My concern about surgery is certainly based on a lock of >enthusiasm/recommendation by the specialists in Bern. [quoted text clipped - 9 lines] >any clear explanation of what the operation would entail, what the chances of >success/complications would be. I agree I would not do it there then. >I am very grateful for your comments and I shall try to find another specialist >using the names you have suggested. Great - you can always call their office and ask if they would recommend anyone nearer to you. |
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