Talk to me about Chronic Sinusitis

Around Labor Day I had bronchitis, the doc put me on a 3 day Z-pack and I was fine. A month later, I suddenly came down with a cold on a Friday. It seemed to be running the course from head to chest very quickly over the weekend, except then it stayed in my chest for a week along with stuffed ears. Then basically I continued coughing (and coughing up) for the next week after that. The following week I was still coughing and now my sinuses ached. I went to the doctor to tell him what was going on, thinking I had a sinus infection (I’m a professional patient) and he agreed, and gave me a 10 day course of antibiotics.

I finished the antibiotics last Wednesday, a week ago. In the middle of that run of medication, I stopped needing to cough but I felt and still feel sinus pressure at random and need to clear my throat a lot. I talked to my doctor when I had 2 days left of antibiotics to say I wasn’t better yet and he said to give it another couple of weeks and if it’s not better it could be Chronic Sinusitis, in which case we resort to x-rays and stuff. My sister suggested I go see an Ear-Nose-Throat (I forget the fancy word) doctor but I don’t know if that’s the right step. At the beginning of all this I kept saying “I just had bronchitis a month ago!” Now it’s “I haven’t been fully well for a month!” This is ridiculous!

I want to know what people’s experiences with CS have been. Does my case sound totally like what happened to you? How bad did it get? Did you see an ENT? Oh and I will at least be seeing my regular doctor again if not the ENT, lest anyone think I’m just gonna blow it off.

I thought I had chronic bacterial sinusitis at one time, and so did my ENT. My MRI scans showed buckets of fluid in the maxillary sinuses. Full court press nasal steroids and antibiotics didn’t do much.

Finally I had a sinus flushing done for diagnostic purposes. A large needle was inserted above my upper teeth and into the maxillary sinuses, and fluid extracted. Clear yellow fluid. Sterile clear yellow fluid. Both maxillary sinuses.

All that damn congestion, and even the thick yellow mucus I was blowing out for years and years was all exudative from allergies! Not from an infection!

I spent the next few years on antihistamines and more nasal steroids, with only a slight reduction of the symptoms.

Finally, at a continuing medical education lecture, I learned that angiotensin converting enzyme inhibitors (a common blood pressure medication I was on) elevated circulating histamine levels! I had my doc change me to another BP med, and voila, no more sinus symptoms!

Save for the occasional cold, I’ve not had sinus trouble in years! No thanks to the medical profession (excepting myself, of course. And the lecturer at the CME)!

YMMV

QtM, MD

(BTW, if one truly has a bacterial sinus infection, one generally needs at least 14 days of antibiotics. Also, chronic bacterial sinusitis is less common than recurrent acute bacterial sinusitis.)

An Ear-Nose-Throat doctor is an “Otorhinolaryngologist”, fyi.

I’ve had chronic sinus problems for the past 2 years. At the onset it was chronic sinus infections. I went to an allergist and he ordered a head CT, but he wasn’t able to see anything except some residual infection. I took my films to an ENT and he immediately saw that I had a deviated septum and a cyst. Surgery corrected both problems…
…until this June when I started getting sinus infections and lots of pressure again. After my 5th infection in 4 months, ENT ordered another head CT which I just coincidentally just got the results of today. I have another cyst in my lower maxillary sinus cavity, but it’s not really causing all my problems this time around according to him. He thinks it’s a symptom of allergies, so I’m scheduled to have a complete series of allergy skin tests done next month as well as have my turbinates cauterized. I’m confident in my ENT’s skills and feel that he will find out the root of the problem.

I think you should go see an ENT. They are the real specialists and will get you on the right course of treatment.

Mods, I meant to put this in IMHO. Kindly move it, please?

QtM, did you get numbed or anesthetized for the injection at least? That’s a frightening thought to do that straight up.

FWIW, I’m medicated for allergies as it is. I take Allegra daily and use Advair daily for asthma treatment which helped with the allergies, too.

I get frustrated sometimes because my teeth are weak as it is, so when I feel pain in the upper row I get nervous that I have another cavity or something. I have to remind myself that it’s the sinus pressure, not that it’s any more fun than dental work.

Just a little local novocaine type med. It was pretty easy. Tho the sensation of the facial bone being crunched thru was interesting. Not painful in any way, but very interesting! And once they had the fluid, and could verify that it was not bacterial or fungal in origin, it gave me a new perspective on my symptomatology.

Are you on leukotriene inhibitors like singulaire or accolate? They’re being used more and more for allergies too, instead of just for asthma. Advair’s a great drug for asthma, but won’t touch systemic allergic reactions.

I was diagnosed with chronic sinusitis about (egads) 25 years ago by my ENT. He figured I never had been able to breathe quite right, and stories from when I was a bottle-fed kid supported that. So they went in and drilled windows in my sinuses. The difference they have made is amazing. I get very few infections any more, and when I do it usually only takes 2 weeks of antibiotics to clear them up.

As a bonus, when things are really bad they can flush my sinuses without a needle. Just stick a couple over-long Q-tips dunked in chemicals up my nose, sit me under a heat lamp for 15 minutes, then stick an itty bitty power washer up there. FOOM! Blasts right through. It’s not a pleasant experience, but it sure feels better when it’s all done.

owie!!!

anybody else have the urge to cradle their face and cringe at the description?

I use one of the funky ayervedic pots with neutral saline in it to rinse out my sinuses regularly, and have very few problems. [especially useful when i have been in a dusty environment, or where there is a lot of air born particulates like a smoky room]

I was diagnosed with a sinus infection by student health in 1999. Did the whole antibiotics thing and no dice. Went home for break and went to my primary care physician who told me that whatever I’d been put on wasn’t effective for sinus infections and put me on zithromax.

Infection died down, I thought all was well.

I’ve had flareups of the same infection ever since. It goes from minor sniffles and post nasal drip to major sickness. As far as the docs and I can figure (after a CT scan, many xrays, different meds, etc) I have allergies (especially to mold) which trigger my infection flare ups.

I’ve had post nasal drip causing upset stomach since I was three, which involved a lot of upper and lower GI scans, more barium than any six year old should have to drink and dietary changes from no milk to no carbonated drinks to more carbonated drinks. This all led to a diagnoses of “Nervous Stomach”. Sigh.

I’ve taken so many Z packs I should have bought stock by now.

So, we’re headed in to year six of this problem with no end in sight and no health insurance, so unless the color of my mucus is bad or I have a fever, I don’t go to the doc for it.

So, sara, a month is nuttin’. :slight_smile:

I have a nice sinus cold right now. It’s the first big one I’ve had in a while, though.

I do recommend seeing a specialist. I saw one for my tonsils and he found a nice polyp that he removed (along with my tonsils) and that seemed to help a lot. So if you have something like that you could get better.

(Anyone know if polyps are likely to come back if you’ve had them before? I am experiencing an increase in sinus pain again recently and I wonder if I have another one, or if it’s just cold season.)

QtM, the only other regular medication I’m on is the birth control pill. I did try Singulair briefly last summer as a treatment for my asthma and it was awful. In the short time I was on it I was moody and my short term memory went wonky. Advair was the next step and my asthma’s been wonderfully under control since then.

Today was a bad day. I woke up stuffy but that might’ve been because the heat was on in my room. The rest of the day I spent clearing my throat constantly and feeling a bit dried out. I drank so much water that I was peeing every like half hour, lol, but that’s the price you pay! I’m definitely gonna call the nearest ENT because it looks like that’s what’s left to do.

Did any of you find you had headaches in addition to the sinus discomfort?

Well I went to the ENT today, and after scoping my nose (“it’s like spaghetti with a light on the end!”) he determined I have a deviated septum! Not that that explains my infections, I don’t think, but he said my nose was inflamed inside. He prescribed Rhinocort and told me to take a decongestant. If the spray doesn’t help by Friday then I call him and the next step is possibly a catscan. :eek:

Is a deviated septum an inherited thing? My mom has one, too, so I found that interesting.