Chronic Sinus infection?

[jlehane3]

What are some methods to prevent and treat sinus infection? I always get it worst in the morning when waking up and have to get the fluids moving with hot liquids like coffee or tea. It seems the upper sinusses are clogged until I start doing physical activity and spit it out after some drainage(thick mucous)green,yellowish or milky colored,then finally clear more towards the end of day.The cycle is similar on a daily basis.It's always hours before the mucous is thin(normal),not syrupy and viscous. The only benefit is I could spit and knock the head off a bird at 30 feet.LOL :wallbash:

[Dr Steve]

What are some methods to prevent and treat sinus infection? I always get it worst in the morning when waking up and have to get the fluids moving with hot liquids like coffee or tea. It seems the upper sinusses are clogged until I start doing physical activity and spit it out after some drainage(thick mucous)green,yellowish or milky colored,then finally clear more towards the end of day.The cycle is similar on a daily basis.It's always hours before the mucous is thin(normal),not syrupy and viscous. The only benefit is I could spit and knock the head off a bird at 30 feet.LOL :wallbash:

Hitting the head off a bird at 30 feet with a loogy sounds supiciously like a superpower to me. Welcome to the world of "Heroes", my friend. :)

Chronic sinusitis is a pain in the ass. I'd be interested in medications that have been tried in your case before commenting too much in detail; hate to reinvent the wheel doncha know.

Most investigators into this feel that chronic sinusitis is accompanied (or even caused by) inflammation in the airways. A cat-scan of the head is a great way to make the diagnosis, though clinically it sure sounds as if this is what you have.

Most Ear Nose and Throat docs will treat chronic sinusitis for 3-4 weeks with antibiotics before giving up on that. The problem is that antibiotics have a really hard time getting into the middle of a sinus filled with fluid, so it takes a LONG time to cure any infection that might be there.

to treat the inflammation, steroid nasal spray works well. to decrease the mucus, atrovent nasal spray is often used. An antihistamine like Claritin, Zyrtec, Allegra or Astelin (which is another spray) will also help to decrease mucus production. There is no role for AFRIN...it works great as a decongestant, but after 5 days you're addicted to it and it quits working. Afrin is great for short-term use in colds but it's garbage when faced with a chronic condition like this.

If you smoke, stop. Seriously, stop.

There is this medication called Singulair that is something called a leukotriene inhibitor...it works as an antiinflammatory agent and is useful in asthma, chronic allergies, and may be helpful in chronic sinusitis as well.

Surgery is usually reserved for cases that don't respond to anything else.


You may have just a badasssss case of allergies, too. There are tests for this.

One thing my patients have had great luck with is saline nasal irrigation. It's a little tricky learning how to do it without the saline going down your windpipe, but it's worth learning. Here's a decent wiki article on the practice: http://en.wikipedia.org/wiki/Nasal_irrigation


I'd see your family health provider. If he/she can't help you, it's time to graduate to an ear, nose and throat doctor. They'll usually have an allergist that they work with as well. Within a month or two, you can have your symptoms well under control.

good luck, hope this helps. sorry for the "stream of consciousness" answer. I'm at work!


your friend,



steve

[TheMojoPin]

I tend to have sinus troubles and chronic infections due to a retaining cyst in my left sinus by my nose/under my cheek. My doctor put me on two nasal sprays, Rhinocort and Astelin, that I use each morning and they've helped dramatically.

[bobsnin]

One thing my patients have had great luck with is saline nasal irrigation. It's a little tricky learning how to do it without the saline going down your windpipe, but it's worth learning. Here's a decent wiki article on the practice: http://en.wikipedia.org/wiki/Nasal_irrigation




My girlfriend would get sinus infections for 3-4 month periods. She would take the month prescription of antibiotics and it helped a little, but not much. She got a Neti Pot and it's made all the difference in the world. You can get them on Amazon for like 15$. Its worth a try.

[TooLowBrow]

dear dr steve,
first time long time, love the show. what are your thoughts/ expiriences with Xlear. jim norton mentioned recently that he tried it and liked it.

WHAT IS IN XLEAR NASAL WASH?

Xlear Nasal Wash contains xylitol, purified water, saline and grapefruit seed as a preservative. Purified water, saline, and grapefruit seed extract (GSE) are found in over-the-counter nasal moisteners that have been used for years. Xylitol is the key ingredient that makes Xlear Nasal Wash so revolutionary and effective

[LaBoob]

She got a Neti Pot and it's made all the difference in the world. You can get them on Amazon for like 15$. Its worth a try.

You stole my post!

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I've been telling people about neti pots for over 10 years now and never get tired of the funny looks on their faces when I explain it. Seriously, it works. Tons of people I've recommended this to either have given me positive feedback, or have recommended it to a friend. Neti!!!

[bobsnin]

You stole my post!

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I've been telling people about neti pots for over 10 years now and never get tired of the funny looks on their faces when I explain it. Seriously, it works. Tons of people I've recommended this to either have given me positive feedback, or have recommended it to a friend. Neti!!!

It's pretty difficult to do at first, but once you get it down, its the best feeling in the world.

[Dr Steve]

dear dr steve,
first time long time, love the show. what are your thoughts/ expiriences with Xlear. jim norton mentioned recently that he tried it and liked it.

I don't know about this particular product, but Xylitol has been looked at in one study in the literature:

Laryngoscope. 2004 Nov;114(11):2021-4. Links
Xylitol enhances bacterial killing in the rabbit maxillary sinus.Brown CL, Graham SM, Cable BB, Ozer EA, Taft PJ, Zabner J.

CONCLUSIONS: Xylitol reduces experimental sinusitis when administered simultaneously with bacteria. Its effect in established sinusitis is less clear. A role may exist for xylitol in nasal irrigation fluid in human disease.

The thing is, this is a RABBIT study...I can't find a single study in humans. It probably doesn't hurt, since Xylitol is simply a sugar-alcohol and should be relatively nontoxic to humans in the small doses used.

[Thebazile78]

My girlfriend would get sinus infections for 3-4 month periods. She would take the month prescription of antibiotics and it helped a little, but not much. She got a Neti Pot and it's made all the difference in the world. You can get them on Amazon for like 15$. Its worth a try.

And if you need relief NOW-NOW-NOW and don't want to shell out for the Neti Pot, use plain saline nasal spray.

Store brand in a squeezy bottle runs about $2 per bottle.
HOWEVER, I prefer Simply Saline, which is about $5 per can because it's compressed-air propelled so there's no risk of your mucus accidentally suctioning back into your bottle of saline.

Also I usually hang my head upside down to do my "irrigation" so that nothing rolls down my throat before I can get to my box of tissues.

[Dr Steve]

And if you need relief NOW-NOW-NOW and don't want to shell out for the Neti Pot, use plain saline nasal spray.

Store brand in a squeezy bottle runs about $2 per bottle.
HOWEVER, I prefer Simply Saline, which is about $5 per can because it's compressed-air propelled so there's no risk of your mucus accidentally suctioning back into your bottle of saline.

Also I usually hang my head upside down to do my "irrigation" so that nothing rolls down my throat before I can get to my box of tissues.

I LOVE simply saline and prescribe it all the time...you won't get that "saline sinus flush" like you do with the saline irrigation pots, but it's great for keeping the membranes moist and thinning out nasal mucus. There's very little downside to nasal saline and you can use it as often as you like, as long as you don't have any contraindications to sticking something into your nose or have end stage congestive heart failure.

I wonder if anyone has ever looked into whether nasal saline has enough salt in it to cause problems with high blood pressure? I'll look into it. Since the goal is to get the saline back OUT of your nose, I can't imagine that you absorb enough to cause a problem. (But I'll check into it, for completeness' sake).

[Dr Steve]

This is all I could find in the medical literature:

The ethanol and sodium chloride content of nonprescription drugs taken in recommended doses does not appear to pose a great hazard.

Postgrad Med. 1991 May 1;89(6):195-7, 201-2.
Nonprescription drugs and hypertension. Which ones affect blood pressure?Bradley JG.
University of Kansas Medical Center School of Medicine, Wichita.

[KingGeno]

Smoking causes TONS of sinus related issues for me.

I suffered from major sinus infections, migraines, vertigo, and pain for many years. About two years ago, I went to an Ear Nose and Throat doctor, and I was diagnosed with a Deviated Septum, and one of my sinus cavities was 80% blocked on that side. THat is was caused all of the problems with vertigo and headaches.

I went on medication, went on got a CT Scan on my sinuses, and everything was verified. Had an EKG test done also, apparently this is needed for the surgery. Jimmy Norton had this test done on Thursday. I also had to get a sleep study done to verify if I had sleep apnea or not. I didn't.

I had my Deviated Septum and Sinus surgery in May 2006. I remember waking up out of surgery, and the FIRST thing I said to the nurse was: "Oh my God! I can open my eyes! I have never been able to open my eyes this wide before!" I instantly knew that it was a success, and I felt great and had NO head or sinus pressure....... I also felt great because I was loaded up on Cocaine. I never knew they have been using Cocaine forDeviated Septum surgery the past 100 years. Crazy.

Pain afterwards wasn't bad at all. I had tubes and packing in my nose, and I had a little pad taped under my nose to catch blood. The WORST WORST WORST part was when I had to get the tubes and packing material out. That was, NO JOKE, like that scene from Total Recall when Arnold is pulling the tracking device out of his nose. I passed out the first time. Man, was that rough and crazy.

I was great for a while, but unfortunately it looks like I have to get some follow-up surgery now. My nose deviated a little again, and that one sinus cavity that was clugged has scar tissue and a polyp now. I am in the process of getting all of that verified. I wake up with a lot of pressure in the mornings again like I did before. It feels like I fell asleep with my head hanging off the bed, and all the fluid is just sitting in my head.

Good luck though.

[TheMojoPin]

Smoking causes TONS of sinus related issues for me.

I suffered from major sinus infections, migraines, vertigo, and pain for many years. About two years ago, I went to an Ear Nose and Throat doctor, and I was diagnosed with a Deviated Septum, and one of my sinus cavities was 80% blocked on that side. THat is was caused all of the problems with vertigo and headaches.

I went on medication, went on got a CT Scan on my sinuses, and everything was verified. Had an EKG test done also, apparently this is needed for the surgery. Jimmy Norton had this test done on Thursday. I also had to get a sleep study done to verify if I had sleep apnea or not. I didn't.

I had my Deviated Septum and Sinus surgery in May 2006. I remember waking up out of surgery, and the FIRST thing I said to the nurse was: "Oh my God! I can open my eyes! I have never been able to open my eyes this wide before!" I instantly knew that it was a success, and I felt great and had NO head or sinus pressure....... I also felt great because I was loaded up on Cocaine. I never knew they have been using Cocaine forDeviated Septum surgery the past 100 years. Crazy.

Pain afterwards wasn't bad at all. I had tubes and packing in my nose, and I had a little pad taped under my nose to catch blood. The WORST WORST WORST part was when I had to get the tubes and packing material out. That was, NO JOKE, like that scene from Total Recall when Arnold is pulling the tracking device out of his nose. I passed out the first time. Man, was that rough and crazy.

I was great for a while, but unfortunately it looks like I have to get some follow-up surgery now. My nose deviated a little again, and that one sinus cavity that was clugged has scar tissue and a polyp now. I am in the process of getting all of that verified. I wake up with a lot of pressure in the mornings again like I did before. It feels like I fell asleep with my head hanging off the bed, and all the fluid is just sitting in my head.

Good luck though.

That's the problem with a lot of sinus-related surgical treatments...they tend to have really bad shots at being permanent or even long term fixes. I'd love to have this cyst removed (actually one in each cheek/nasal sinus, but only the left one is really bad), but apparently there's at least a 50% chance on average of it coming back. I don't want to deal with face surgery for something that has a shitty chance of staying fixed.

[Dr Steve]

The WORST WORST WORST part was when I had to get the tubes and packing material out. That was, NO JOKE, like that scene from Total Recall when Arnold is pulling the tracking device out of his nose. I passed out the first time. Man, was that rough and crazy..

I have video of this being done to my wife...I'll post it to YouTube and link it here if she'll letl me (don't hold your breath). I can verify it was intensely gruesome; she felt so much better after it was done that it was totally worth it to her.

The thing is, if you're miserable, a lot of people will go for the 50% chance of a temporary cure (I'm not sure those are the correct statistics, either...it depends on the surgery and the extent of the problem, etc) rather than live with the 0% chance of cure if they don't have the surgery. It's a tough one. I'm not in favor of making permanent changes to someone's anatomy unless there's just no other viable option. I've known people who had tremendous response to surgery, including my wife. I've known a few that were pretty unsuccessful, too. The thing to do is to talk to your surgeon and ask what the odds are that you'll have a perfect response. Then you have to weigh the odds vs your level of misery to decide whether to have surgery. It ain't always easy, for doctor or patient.

[KingGeno]

I have video of this being done to my wife...I'll post it to YouTube and link it here if she'll letl me (don't hold your breath). I can verify it was intensely gruesome; she felt so much better after it was done that it was totally worth it to her.

The thing is, if you're miserable, a lot of people will go for the 50% chance of a temporary cure (I'm not sure those are the correct statistics, either...it depends on the surgery and the extent of the problem, etc) rather than live with the 0% chance of cure if they don't have the surgery.

It's amazing what they can fit up there in your nose. That was insane. I have never let out a yelp like I did when getting packing out. Even having my dislocated shoulder rolled back in wasn't as bad.

Oh, and I am doing it again and will continue to do so. It is THAT worth it. My life improved tremendously after the surgery. Didn't feel like my head was 50lbs, was able to be more active. It's well well worth it. Insurance covered a lot of it, which is good to know with my current complications.