Medical Forum / Diseases and Disorders / Sinusitis / October 2004
questions on allergies and sinus expertise in New York
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Tom Rue - 02 Oct 2004 21:58 GMT I haven't posted here for a while (see http://tinyurl.com/3od3d for surgical history.)
At the conclusion of the above thread in August, I had recently undergone my seventh major sinus surgery since 1988 and was feeling discouraged about prospects for improvement. My surgeon had just told me that I'd need a Caldwell-Luc in October to follow up the endoscopic procedure he had just done. Recently, however, based on ct-scan results he reconsidered this recommendation and said he thinks the airway that I have is adequate to treat with irrigation and possibly delivery of steroids and antibiotics via a pick line. (Has anyone else here heard of this delivery route to treat sinuses?) Given the refractory nature of my condition, the withdrawal of his recommendation for surgery #8 was a relief. However, I also felt that it was time for another view.
I have an appointment set for next week with an ENT whom I have not seen before in my local area. I live about two hours upstate from Manhattan. At the same time that I see this new doctor, I'm considering the possibility of consulting someone who is more of a renowned expert in dealing with refractory sinus polyps than the local docs I've seen, although I still feel that I'll need a local ENT for monitoring and routine care.
Can anyone recommend such a physician in or around New York City who accepts BC/BS insurance?
I also recently had allergy testing by an allergist who is board certified both in that field and ENT. The only positive findings were for cat dander and dust mites. I do not have any history of aspirin sensitivity, despite having taken it 2x per day in the past for cardiac prophylaxis, so the allergist ruled out Sempter's triad unless or until aspirin sensitivity appears.
Second question: Has anyone here ever heard of immunotherapy to treat allergies to dust mites or cat dander helping to prevent recurrence of sinus polyps?
Thanks for any help or suggestions.
Tom
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Pamdomania - 02 Oct 2004 22:22 GMT >I haven't posted here for a while (see http://tinyurl.com/3od3d for >surgical history.) > >At the conclusion of the above thread in August, I had recently undergone
>my seventh major sinus surgery since 1988 and was feeling discouraged >about prospects for improvement. My surgeon had just told me that I'd >need a Caldwell-Luc in October to follow up the endoscopic procedure he
>had just done. Recently, however, based on ct-scan results he >reconsidered this recommendation and said he thinks the airway that I >have is adequate to treat with irrigation and possibly delivery of >steroids and antibiotics via a pick line. (Has anyone else here heard of
>this delivery route to treat sinuses?) Given the refractory nature of my
>condition, the withdrawal of his recommendation for surgery #8 was a >relief. However, I also felt that it was time for another view. > >I have an appointment set for next week with an ENT whom I have not seen
>before in my local area. I live about two hours upstate from Manhattan.
>At the same time that I see this new doctor, I'm considering the >possibility of consulting someone who is more of a renowned expert in [quoted text clipped - 7 lines] >I also recently had allergy testing by an allergist who is board >certified both in that field and ENT. The only positive findings were for
>cat dander and dust mites. I do not have any history of aspirin >sensitivity, despite having taken it 2x per day in the past for cardiac
>prophylaxis, so the allergist ruled out Sempter's triad unless or until
>aspirin sensitivity appears. > [quoted text clipped - 5 lines] > >Tom Hello, The only way Amphotericin B will work is if you use it for 3 to 6 months - Did You? I used to get polyp surgeries as many as 4 times a year. My Doc put me on Nasal Chrome; i moved to Florida, then for many years had no polyps problem. Nasal Chrome is excellent for me, so whynot try it for yourself. When i started with it, you needed a prescription. Now then: you must use "real" yogurt; and keep your digestive system perfect. If you donot you shall get polyps . . . i promise . . . If you have Candida, you MUST treat your Candida - MUST - If you donot treat your Candida (or other fungus) you WILL get polyps - promise. + + + + + + + + + + + + + + + + + + + + http://www.biblebelievers.org.au/benjamin.htm MustRead! http://WWW.PAMINIFARM.COM "My people are destroyed for lack of knowledge" Hosea 4:6
Tom Rue - 02 Oct 2004 23:05 GMT > The only way Amphotericin B will work is if you use it for > 3 to 6 months - Did You? For about two years.
> I used to get polyp surgeries as many as 4 times a year. > My Doc put me on Nasal Chrome; i moved to Florida, then > for many years had no polyps problem. Nasal Chrome is > excellent for me, so whynot try it for yourself. When i > started with it, you needed a prescription. What kind of a climate were you in before you moved to Florida?
> Now then: you must use "real" yogurt; and keep your > digestive system perfect. If you donot you shall get > polyps . . . i promise . . . If you have Candida, you > MUST treat your Candida - MUST - If you donot treat your > Candida (or other fungus) you WILL get polyps - promise. I've never been told that I had candida, but I'll bring it up in my next exam.
As to yogurt, I've always liked the taste, either plain or otherwise, and have eaten it fairly regularly for most of my life - sometimes more than other times.
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Steven D. Litvintchouk - 02 Oct 2004 23:57 GMT >>If you have Candida, you >>MUST treat your Candida - MUST - If you donot treat your >>Candida (or other fungus) you WILL get polyps - promise. > > I've never been told that I had candida, but I'll bring it up in my next > exam. This theory that sinusitis is caused by "systemic candidiasis" is mostly advanced by "alternative" practitioners. Mainstream medicine does *NOT* subscribe to that theory.
"The American Academy of Allergy, Asthma and Immunology has strongly criticized the concept of 'candidiasis hypersensitivity syndrome' and the diagnostic and treatment approaches its proponents use. AAAAI's position statement concludes: (1) the concept of candidiasis hypersensitivity is speculative and unproven; (2) its basic elements would apply to almost all sick patients at some time because its supposed symptoms are essentially universal; (3) overuse of oral antifungal agents could lead to the development of resistant germs that could menace others; (4) adverse effects of oral antifungal agents are rare, but some inevitably will occur; and (5) neither patients nor doctors can determine effectiveness (as opposed to coincidence) without controlled trials."
http://www.quackwatch.org/01QuackeryRelatedTopics/candida.html
BTW, reputable "alternative" practitioners (e.g., osteopaths) will tell you that you have to treat this "candidiasis" with prescription antifungal drugs like Diflucan--that the condition cannot be cured with diet alone. So the idea that yogurt is going to cure anything, isn't even accepted by "alternative" practitioners.
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Woody Long - 03 Oct 2004 18:28 GMT > >>If you have Candida, you > >>MUST treat your Candida - MUST - If you donot treat your [quoted text clipped - 21 lines] > > http://www.quackwatch.org/01QuackeryRelatedTopics/candida.html I would disregard quackwatch - it was put together by a clueless retired shrink who does not bother to read the literature. I think a PhD in immunology at Univ Michigan is more credible than a retired shrink. Microbes in your gut could be cause of allergies Posted By: News-Medical in Medical Research News Published: Tuesday, 1-Jun-2004 Printer Friendly Email to a Friend Allergies making your life miserable? Tired of popping antihistamines like candy? Can't go anywhere without your inhaler? The real problem may not be your stuffed-up head. It could be the microbes in your gut.
At the American Society for Microbiology meeting held here this week, scientists from the University of Michigan Medical School will present results of experiments with laboratory mice indicating that antibiotic-induced changes in microbes in the gastrointestinal tract can affect how the immune system responds to common allergens in the lungs.
"We all have a unique microbial fingerprint a specific mix of bacteria and fungi living in our stomach and intestines," says Gary B. Huffnagle, Ph.D., an associate professor of internal medicine and of microbiology and immunology in the U-M Medical School . "Antibiotics knock out bacteria in the gut, allowing fungi to take over temporarily until the bacteria grow back after the antibiotics are stopped. Our research indicates that altering intestinal microflora this way can lead to changes in the entire immune system, which may produce symptoms elsewhere in the body."
If confirmed in human clinical studies, Huffnagle believes his research findings could help explain why cases of chronic inflammatory diseases, like asthma and allergies, have been increasing rapidly over the last 40 years a time period that corresponds with widespread use of antibiotics.
To understand the implications of the U-M research, it's important to know something about the complex relationship between the gastrointestinal, respiratory and immune system in the human body.
Every time you inhale, air flows past mucus-producing cells and tiny hairs designed to trap bits of pollen, dust and spores before they enter the lungs. These trapped particles are swept into the stomach with saliva and mucus as you swallow.
"Anything you inhale, you also swallow," Huffnagle says. "So the immune cells in your GI tract are exposed directly to airborne allergens and particulates. This triggers a response from immune cells in the GI tract to generate regulatory T cells, which then travel through the bloodstream searching the body for these antigens. These regulatory T cells block the development of allergic T cell responses in the lungs and sinuses."
Most of the time, in ways scientists don't completely understand, the GI tract immune system modulates or dampens down the allergic T cells' response to incoming allergens in the lungs, according to Huffnagle. But when antibiotics reduce the bacterial population in the GI tract, the number of yeast and other fungal organisms increases.
In previous studies, researchers in Huffnagle's lab discovered that fungi secrete molecules called oxylipins, which can control the type and intensity of immune responses. Huffnagle says this suggests the intriguing possibility that fungal oxylipins in the GI tract prevent the development of regulatory T cells for swallowed allergens. In the absence of regulatory T cells from the GI tract, T cells in the lungs become sensitized to the presence of ordinary mold spores, pollen or other allergens. The result is a hyperactive immune response, which can produce allergy symptoms or even asthma.
To test Huffnagle's hypothesis, Mairi C. Noverr, Ph.D., a U-M research fellow in internal medicine, gave a five-day course of oral antibiotics to normal lab mice followed by a single oral introduction of the yeast, Candida albicans, to create a consistent, reproducible colony of microbes in the stomach and intestines. C. albicans is normally found in the GI tract, and increased growth of C. albicans in the gut is a common side-effect of antibiotics.
Two days after stopping the antibiotics at a time when the gut bacteria were growing back - Noverr exposed the mice to a common mold allergen called Aspergillus fumigatus by inoculating spores into the nasal cavities of all the mice in her study. She then examined the mice for the presence of an allergic response in the airways and compared results between the mice that received antibiotics and those that did not.
"Mice treated with antibiotics and colonized with C. albicans showed increased pulmonary hypersensitivity to A. fumigatus compared with mice that didn't receive antibiotics," Noverr says. "The inflammatory response grew stronger with every exposure to the allergen."
"After antibiotics changed the mix of microbes in the GI tract, the mice developed an allergic response in the lungs when exposed to common mold spores," Huffnagle explains. "Mice that didn't receive the antibiotics were able to fight off the mold spores."
Huffnagle and Noverr will discuss details of the experiment in a symposia lecture and poster presentation at the ASM meeting. Complete data from the study has been submitted for publication in a future issue of Infection and Immunity.
Huffnagle maintains that disruptions in the growth of bacteria and fungi in the GI tract somehow interfere with the ability of regulatory T cells to dampen the immune response to respiratory allergens. In future research, he hopes to determine exactly how gastrointestinal microbes are involved in the process of immune system modulation.
"We know from laboratory experiments that dietary antioxidants called polyphenols, which are found in fruits and vegetables, can limit fungal growth and that a diet high in saturated fats and sugars slows the recovery of normal gut microflora," Huffnagle adds. "The Mediterranean diet is rich in sources of polyphenols, so it's intriguing that Mediterranean-diet countries have lower rates of allergies, asthma and other inflammatory diseases than Western-diet countries like the United States , Canada and England .
"If we can determine exactly how microflora in the GI tract affect the immune system, it may be possible one day to prevent or treat allergies and inflammatory diseases with diet changes or probiotics dietary supplements of healthy' bacteria designed to restore the normal balance of microbes in the gut," Huffnagle adds. "In the medical community, probiotic therapy is becoming an area of increasing interest."
Until then, Huffnagle emphasizes the importance of a healthy low-sugar diet, with lots of raw fruits and vegetables, after being treated with antibiotics to help restore the normal mix of microbes in your GI tract as quickly as possible. "The old saying, an apple a day keeps the doctor away' may be more true than we thought," he says.
Huffnagle's research has been funded by the National Institutes of Health and a New Investigator Award from the Burroughs-Wellcome Fund. Other collaborators in the research include Dennis M. Lindell, a U-M graduate student in immunology, and Rachel Noggle, a research assistant in internal medicine.
Notes: This is a basic scientific research study conducted in laboratory mice. Much additional research will be required before scientists will know if these results can be applied directly to people. Your physician is the best source of advice for questions about antibiotics and treatment of asthma, allergies and other inflammatory diseases.
http://www.med.umich.edu
Don Brady - 03 Oct 2004 20:04 GMT >I would disregard quackwatch - it was put together by a clueless >retired shrink who does not bother to read the literature. I think a >PhD in immunology at Univ Michigan is more credible than a retired >shrink. You might try addressing the AAAAI quote rather than making an ad hominem attack on somone who cited it.
As for your resarch study, the last paragraph says:
"Notes: This is a basic scientific research study conducted in
>laboratory mice. Much additional research will be required before >scientists will know if these results can be applied directly to >people. " Steven D. Litvintchouk - 04 Oct 2004 00:35 GMT >>I would disregard quackwatch - it was put together by a clueless >>retired shrink who does not bother to read the literature. I think a [quoted text clipped - 11 lines] >>scientists will know if these results can be applied directly to >>people. " There's also a "post hoc, ergo propter hoc" fallacy in this article.
The fact that the incidence of asthma increased during a time in which the use of antibiotics increased too, could well be a coincidence. A lot of other things happened in the last 40 years that might also correlate with the increased asthma.
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Woody Long - 05 Oct 2004 01:00 GMT > >>I would disregard quackwatch - it was put together by a clueless > >>retired shrink who does not bother to read the literature. I think a [quoted text clipped - 18 lines] > lot of other things happened in the last 40 years that might also > correlate with the increased asthma. The study shows that antibiotics cause grevious bodily harm in mice, period. The majority of the time, drug studies in mice translate into similar results in humans. Not 100% of the time, but certainly the majority of the time - that is why researchers do studies with mice, as it would be unethical to do the same study in humans. So it may take a while longer to prove beyond any doubt that antibiotics are also harmful to humans. Are you going to feed them to your children in the meantime?
Once the damage is done there is no cure and the only treatment that helps is continuous lifelong therapy with antifungal drugs, which may stop working after a while.
Human nature is reluctant to admit past mistakes, and the quacks who, with the best intentions, treated our chronic sinusitis with antibiotics do not want to admit the treatment made us worse. I do not expect the situation to change much for the better until the lawsuits hit. We are seeing juries come back with $30Mil+ verdicts against insurers and landlords for exposure to mold in buildings - the same mold that humans lived with for thousands of years and it never made humans sick until the latter half of the 20th century. What do you expect these juries will come back with when it is determined that plaintiffs have been made ill by a nasty fungus INSIDE THEIR BODIES caused by antibiotics manufactured and sold by Big Pharma without any warning in the package insert, and negligently prescribed by doctors despite clear and convincing evidence of the potential for harm? $100Mil?
I am looking forward to this day, as it seems only huge jury awards will convince the medical profession to acknowledge the reality of fungal disease in the sinuses and elsewhere, admit their mistakes of the past, and change their practices accordingly.
Woody
Steven D. Litvintchouk - 05 Oct 2004 03:04 GMT >>>>I would disregard quackwatch - it was put together by a clueless >>>>retired shrink who does not bother to read the literature. I think a [quoted text clipped - 21 lines] > The study shows that antibiotics cause grevious bodily harm in mice, > period. The article you cited doesn't say anything of the sort. All the study showed was an increased allergic response.
> Once the damage is done there is no cure and the only treatment that > helps is continuous lifelong therapy with antifungal drugs, which may > stop working after a while. The article you cited doesn't say anything of the sort.
> Human nature is reluctant to admit past mistakes, and the quacks who, > with the best intentions, treated our chronic sinusitis with > antibiotics do not want to admit the treatment made us worse. Your use of ad hominem attacks and now labels ("quacks") on mainstream medicine, pretty much tells me where you're coming from.
C 'ya.
<< PLONK >>
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ENTconsult - 08 Oct 2004 04:29 GMT re antibiotics and asthma actually the incidence in Asthma in West Germany was much higher than in East German. In West Germany total medical care, total antibiotics anytime the kid sneezed. In East Germany poor medicine, few antibiotics , etc. Yet same population and diet. After the countries combined, same incidence of asthma in both areas. Now they have the same access to antibiotics. the theory is that excess antibiotics chnages the body's reaction to inflammation. Instead of the standard inflammation, a differnt response developed - i.e. asthma.
No asthma in Somalia. Theory. Most persons have hookworm or similar and since the "allergic" system is primarily for worm protection, the system is fully engaged with nothing left over for the asthma .
Murray Grossan, M.D. http://www.ent-consult.com
DreamHarp7 - 08 Oct 2004 17:39 GMT >re antibiotics and asthma >actually the incidence in Asthma in West Germany was much higher than in East [quoted text clipped - 16 lines] >Murray Grossan, M.D. >http://www.ent-consult.com All my sinusitis and "allergies" started after longterm antibiotics..
Woody Long - 09 Oct 2004 01:04 GMT > re antibiotics and asthma > actually the incidence in Asthma in West Germany was much higher than in East [quoted text clipped - 7 lines] > inflammation. Instead of the standard inflammation, a differnt response > developed - i.e. asthma. Exactly. ENTconsult gets it. No single study may prove it beyond a doubt, but when you look at all the evidence together, the argument that antibiotics cause allergies is compelling.
> No asthma in Somalia. Theory. Most persons have hookworm or similar and since > the "allergic" system is primarily for worm protection, the system is fully > engaged with nothing left over for the asthma. Well seeing as the GNP per capita of Somalia is under $200, I doubt there is much antibiotic use. They simply can't afford even the cheapest generics, and certainly not the newer more potent antibiotics commonly used in the US.
> Murray Grossan, M.D. > http://www.ent-consult.com Pamdomania - 09 Oct 2004 01:22 GMT >> re antibiotics and asthma >> actually the incidence in Asthma in West Germany was much higher than in East [quoted text clipped - 23 lines] >> Murray Grossan, M.D. >> http://www.ent-consult.com Hello, Do they die quite young in Somalia, and have high child and infant mortality rate? + + + + + + + + + + + + + + + + + + + + http://www.biblebelievers.org.au/benjamin.htm MustRead! http://WWW.PAMINIFARM.COM "My people are destroyed for lack of knowledge" Hosea 4:6
Pamdomania - 03 Oct 2004 20:52 GMT >>>If you have Candida, you >>>MUST treat your Candida - MUST - If you donot treat your >>>Candida (or other fungus) you WILL get polyps - promise. >> >> I've never been told that I had candida, but I'll bring it up in my next
>> exam. > >This theory that sinusitis is caused by "systemic candidiasis" is mostly
>advanced by "alternative" practitioners. Mainstream medicine does *NOT*
>subscribe to that theory. > [quoted text clipped - 6 lines] >supposed symptoms are essentially universal; (3) overuse of oral >antifungal agents could lead to the development of resistant germs that
>could menace others; (4) adverse effects of oral antifungal agents are >rare, but some inevitably will occur; and (5) neither patients nor >doctors can determine effectiveness (as opposed to coincidence) without
>controlled trials." > >http://www.quackwatch.org/01QuackeryRelatedTopics/candida.html > >BTW, reputable "alternative" practitioners (e.g., osteopaths) will tell
>you that you have to treat this "candidiasis" with prescription >antifungal drugs like Diflucan--that the condition cannot be cured with
>diet alone. So the idea that yogurt is going to cure anything, isn't >even accepted by "alternative" practitioners. Hello, You lost it, sweetheart; go to the end of the line. You said, "antifungal agents could lead to the development of resistant germs". GERMS???!!!! Now, now, hear this: we are talking FUNGUS, not GERM. Fungus is fungus and germ is germ, and never the two shall twain. What you say is true about antibiotics and "germs" (bacteria), but have no interrelations to bacteria (germs). You are mixing oranges with apples.
Another thing is that Candida isnot the only fungus causing trouble in the sinuses, however since Candida can develop into an over-growth (fungus with roots into the membrane of the sinus), so frequently as to become alarming now, it is urgent that every medical entity start taking a good, long, hard looksee at it. Anyone trying to hinder this action should be sued, if not put in jail. Candida is the most common (or popular) right now, because it is the one being found 96% of the time, in sinus sufferers.
Get this straight, bubba, sinus complaints arenot a "disease"; they are a condition (a weakness), which today is beginning to get scary. As all weaknesses, certain healthy conditions and actions of a health nature must be addressed. With sinus we are doing that right now, and one good one is yogurt, because it tones the digestive system, this one thing, yogurt, is only the tip of the iceberg, and here is the rest of the iceberg: http://www.mall-net.com/mcs/afung.html
Doc's think it is wise to address the fungus instead of the infection - stick that in your pipe and smoke it, old-timer . . . and remember this: Where there is irritation; There is blockage; Where there is blockage; There is swelling; Where there is swelling; There is infection.
Considering my Phoma, we can consider our "weakness" to reacting so violently to everything that is natural in nature. In other words you donot "get rid of Candida", you CONTROL it. You cannot "get rid of fungus", as fungus is amongus 24/7. You can only work on the "weakness" within oneself. Fungus can get so bad as to be life- threatening, just as easily as bacteria, and/or they can become chronic, thus causing you to live a half-life, which is what we are all about here at news:alt.support.sinusitis
Another thing Candida isnot, "systemic", in our case. It is as the order of mold spores and has "satellites"
"They" say it is "normal" to have Candida in the body, Yeah, sure, like it is "normal" for a dog to have fleas, and is not "abnormal" until it grows roots and becomes a fungus. Candida is a yeast . . .
How do we get it in our sinuses? I would say in as many ways as we get everything else in our body. One way is to get born with it . . . another way is sex; still another is food; breathing; not washing the hands; and endless other ways. Candida, as all fungus, starts in the soil. It is part of Mother Earth's digestion. It is a parasite. Fungus breaks down earth elements, such as dead trees, foliage, or anything else that falls dead on the soil. The soil is Mother Earth's digestive system. When fungus gets into our sinuses it still tries to do the job God intended for it to do.
Another thingy you obviously donot know is there are two ways of suffering from fungus in the sinuses: when it is rooted (actually digesting us) and when we are allergic to it, of course if we have both conditions: . . . well . . . fun and games . . . + + + + + + + + + + + + + + + + + + + + http://www.biblebelievers.org.au/benjamin.htm MustRead! http://WWW.PAMINIFARM.COM "My people are destroyed for lack of knowledge" Hosea 4:6
Woody Long - 05 Oct 2004 04:25 GMT (5) neither patients nor
> doctors can determine effectiveness (as opposed to coincidence) without > controlled trials." Now this is interesting
http://fampract.oupjournals.org/cgi/content/full/18/3/258
Nystatin (a topical antifungal drug that only treats fungal infection of the mucous membranes) was compared to a placebo in patients suffering with:
"chronic fatigue, poor concentration, impaired memory, respiratory tract symptoms, gastrointestinal distress, pains in muscles and joints, skin problems, recurrent infections, urogenital problems, etc"
Most if not all these symptoms are associated with sinusitis.
"Nystatin was significantly better than placebo in reduction of the overall symptom score (P < 0.003)"
What this means is that nystatin really does help the above symptoms, and the possibility that the results of this study are due to chance is less than 0.3%. In other words you can be 99.7% confident that the results of this study are genuine and not due to chance. Now maybe Barrett considers 99.7% certainty to be "speculative and unproven", but a reasonable person would not.
Anyone who has taken nystatin knows its not a panacea. Although it helps, you never regain the quality of life you had before you were prescribed antibiotics. And if you stop the nystatin, the symptoms it helped come back in full force.
There is NOTHING that completely reverses the damage caused by antibiotics. Not drugs, not yogurt, not dietary changes. Nothing.
> http://www.quackwatch.org/01QuackeryRelatedTopics/candida.html > [quoted text clipped - 3 lines] > diet alone. So the idea that yogurt is going to cure anything, isn't > even accepted by "alternative" practitioners. Pamdomania - 03 Oct 2004 18:35 GMT >> The only way Amphotericin B will work is if you use it for >> 3 to 6 months - Did You? [quoted text clipped - 16 lines] > >I've never been told that I had candida, but I'll bring it up in my next
>exam. > >As to yogurt, I've always liked the taste, either plain or otherwise, and
>have eaten it fairly regularly for most of my life - sometimes more than
>other times. Hello, I was from Pennsylvania.
What kind of yogurt are you using? What does the label say?
I am afraid you willhave no luck with your Doc on the fungus issue. I am actually beginning to believe there is a conspiracy going on about this "fungus in the sinuses". Or you may have a willing Doc only to be bottle-necked at the lab. Getting a proper culture is next to impossible to begin with . . . wanna hear my personal story on that? )-: PS: i didnot know "they" were using Amphotericin B for nasal fungus 2 years ago - how did you apply it, and where did you get it?
+ + + + + + + + + + + + + + + + + + + + http://www.biblebelievers.org.au/benjamin.htm MustRead! http://WWW.PAMINIFARM.COM "My people are destroyed for lack of knowledge" Hosea 4:6
Tom Rue - 07 Oct 2004 00:54 GMT * * *
> What kind of yogurt are you using? What does the label say? I think you misread my post, or confused someone else's with mine. I simply said that I like yogurt.
* * *
> PS: i didnot know "they" were using Amphotericin B for > nasal fungus 2 years ago - how did you apply it, and > where did you get it? It was prescribed by my ENT starting on 11-08-2000 (I still have a copy of the instructions), who spoke to the pharmacist and told him how to mix the compound with amphotoericin which the pharmacy obtained from a local hospital. I had to ask around a bit to find a pharmacist willing to mix the compound. Most pharmacists don't practice chemistry at all; they prefer to just sell packaged goods. I believe my doctor said he knew some researchers at the Mayo Institute who published on the subject.
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Steven D. Litvintchouk - 02 Oct 2004 23:51 GMT > Can anyone recommend such a physician in or around New York City who > accepts BC/BS insurance? As long as you're able to get to NYC, you might want to make an appointment to see Dr. Wellington Tichenor. He's an allergist who seems to know more about sinus disease than most others. He got interested in the issue of chronic sinusitis when first he, and then his wife, developed the condition. Point your browser to
http://www.sinuses.com/
I don't know whether he accepts BC/BS, but you can always telephone him and ask.
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Tom Rue - 03 Oct 2004 00:34 GMT > As long as you're able to get to NYC, you might want to make an > appointment to see Dr. Wellington Tichenor. ***
> Point your browser to > > http://www.sinuses.com/ Thanks Steven. I'll keep him in mind. I've got my appointment with a local ENT next week and will probably hold off making any contacts in the city until I've had a chance to meet with and discuss it with her.
It's interesting that you recommend an allergist rather than an ENT surgeon; or does he also do surgery?
Tom
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Steven D. Litvintchouk - 03 Oct 2004 00:57 GMT >>As long as you're able to get to NYC, you might want to make an >>appointment to see Dr. Wellington Tichenor. [quoted text clipped - 11 lines] > It's interesting that you recommend an allergist rather than an ENT > surgeon; or does he also do surgery? I only recommended Dr. Tichenor because I don't know any ENT surgeons in NYC.
Dr. Tichenor is a big believer in the Mayo Clinic theory of allergic fungal sinusitis. Certainly if you've had seven surgeries, then it's long overdue to find out (if at all possible) just what is causing your never-ending sinus problems. Dr. Tichenor may be able to do that kind of detective work for you.
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blades - 03 Oct 2004 02:27 GMT <snip>
> My surgeon had just told me that I'd > need a Caldwell-Luc in October to follow up the endoscopic procedure he > had just done. <snip>
Isn't Caldwell-Luc considered obsolete as a method of treating sinus disease? -- Bruce
Tom Rue - 03 Oct 2004 03:11 GMT blades <blades49456@sbcglobal.net> wrote in news:eAI7d.13470$Qv5.6603 @newssvr33.news.prodigy.com:
> Isn't Caldwell-Luc considered obsolete as a method of treating sinus > disease? > -- > Bruce Perhaps. His preferred method is endoscopic, but he said in August that there were parts of the maxillary area that he couldn't reach with the instruments that he had. After viewing post-surgery CT-scans, he reconsidered.
I had a couple of Caldwell-Lucs done on me in the late 80s and early 90s. Since then, all my surgeries have been endoscopic.
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Don Brady - 03 Oct 2004 04:35 GMT >blades <blades49456@sbcglobal.net> wrote in news:eAI7d.13470$Qv5.6603 >@newssvr33.news.prodigy.com: [quoted text clipped - 11 lines] >I had a couple of Caldwell-Lucs done on me in the late 80s and early 90s. >Since then, all my surgeries have been endoscopic. With that many surgeries you need second opinions.
Mount Sinai in NY is ranked high in ENT at http://www.usnews.com/usnews/health/hosptl/rankings/specihqotol.htm .
You can get a lost of their surgeons and investigate who is most suitable.
That would eb my suggestion.
Steven D. Litvintchouk - 03 Oct 2004 04:05 GMT > <snip> > [quoted text clipped - 5 lines] > Isn't Caldwell-Luc considered obsolete as a method of treating sinus > disease? For most cases, endoscopic sinus surgery has replaced Caldwell-Luc. But there are a few relatively rare situations in which Caldwell-Luc may still be useful:
1. The sinus disease is located in an area that isn't easy to reach via endoscope, without excessive risk to the brain and optic nerve. (This nearly happened to me with my last revision surgery--fortunately, in the end, he got it all done endoscopically.)
2. The endoscopic surgery did the usual maxillary antrostomy, but sinus drainage is still poor--so Caldwell Luc can easily create a secondary (naso-antral) window into the sinus cavity to assist drainage.
3. The patient has sinus cancer, in which case it's critical that all the malignant tissue be removed. Caldwell-Luc gives you another way into the sinus cavities, to remove all that cancer.
In these kinds of situations, Caldwell-Luc then becomes a treatment of last resort.
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ENTconsult - 03 Oct 2004 20:49 GMT Dr Jordan Josephson, ENT, has written a section in my new book no nasal polyps and his web site is listed at www.ent-consult.com. He is in Manhattan. Dr Wellington Tichenor's site is also listed. He is an allergist specializing in sinus disease. He is also in Manhattan. Murray Grossan, M.D. http://www.ent-consult.com
Tom Rue - 07 Oct 2004 01:11 GMT > Dr Jordan Josephson, ENT, has written a section in my new book no > nasal polyps and his web site is listed at www.ent-consult.com. He is > in Manhattan. Dr Wellington Tichenor's site is also listed. He is an > allergist specializing in sinus disease. He is also in Manhattan. > Murray Grossan, M.D. > http://www.ent-consult.com I met with Dr. Josephson once in the early 1990s, at the recommendation of my ENT at that time. I agree that he has a world class reputation. However, I chose not to see him again when he insisted on full payment by me up front (several thousands dollars; I forget the exact amount). He would not accept any insurance, as I recall; he said it was up to me to try and get reimbursed. I had "good" insurance at the time, and still do -- at least by U.S. standards.
I was not interested in mortgaging my house. I'm still not, but I thank you for the suggestion.
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