Saturday, June 29, 2013

Chronic Sinusitis and Intravenous Antibiotics

Intravenous (IV) antibiotics are an option for a narrow segment of patients with Chronic Sinusitis. I am now considering if they are appropriate for my condition.

I had another frontal sinus surgery recently. A new steroid eluting stent was used to "prop open" the lumen into the frontal sinus. The stent is biodegradable and dissolves in a month or two. I had very narrow lumens which had to be drilled out. This procedure takes time to heal due to a significant amount of tissue/bone trauma. I am mostly recovered and now feeling about like I did before the surgery. Unfortunately, I don't feel significant improvement. There is still significant tissue inflammation and hyper sensitivity to many types of pollen and other allergens. Even though the lumen has been opened up, the swollen tissue decreases the size of the opening so it is nearly closed.

A mucus culture is being prepared right now. I suspect the results will come back with a bacteria that has already been treated with oral antibiotics. My doctor has seen improvement using IV antibiotics in rare cases. I may be one of those cases. Actually, I did respond well to IV antibiotics a number of years ago so I am interested in trying it again. Needless to say, a vast array of other treatments and procedures have been tried which has left this as the next option. So I'll wait for the results and I may be starting a PICC line (a type of home use IV line) soon.

I am very interested in hearing from anyone who has used IV antibiotics to treat a chronic sinusitis. Please comment freely.

Wednesday, May 8, 2013

Chronic Illness Reading

I have been reading about chronic illness in books from the library during the past few days. It's quite interesting to see that Chronic Sinusitis (CS) is rarely mentioned. Many of the books talk about Invisible Chronic Illness (ICI) and how they are difficult to diagnose and treat. So CS most certainly fulfills the definition of a Chronic Illness, but just doesn't make the cut for being actively discussed. I would argue that CS is an Forgotten ICI. Here is one resource on PBS that mentions Chronic Sinusitis. I'm sure there are others, but I just haven't spent much time searching as of yet.

But all in all, I'm finding that the books do discuss emotions and events that are shared by anyone with a Chronic Condition. For example, the process of diagnosing the cause of health problems is just so familiar to me. It took me years to realize and ultimately conclude that my sinuses were causing not all, but many issues that plagued my lack of good health. Treating the condition is also discussed which is just such a huge topic as well.

I will be discussing these issues in more detail as I get further along in my reading. Stay tuned...

Thursday, May 2, 2013

What Is A "Wimpy" Chronic Illness?

Change of format today....

What are the top 10 Chronic Illnesses?
Arthritis, Cancer, Kidney Disease, Diabetes, Epilepsy, Heart Disease, HIV/AIDS, Mental Disorders, Lung Diseases and Stroke.

Why isn't Chronic Sinusitis in the list?
Because it's a wimpy chronic illness.

What does wimpy mean anyway?
Well it means rarely fatal. It also means that the symptoms are less severe. It means don't whine about your symptoms because they are minor compared the top 10. (urban dictionary meaning: feeble, not very important)

Is Chronic Sinusitis really wimpy?
Of course not. But... I sometimes think of the top 10 when I'm feeling sorry for myself, or when I get depressed. It reminds me to keep my condition in perspective. It motivates me to be the best I can be each day despite my chronic symptoms.

Thursday, April 18, 2013

Polyps in Frontal Sinus

I am now suspecting that polyps are a significant cause of my hypersensitivity to almost any pollen and my chronic sinusitis. The pressure and mucus have worsened in the frontal while the maxillary is not so bad with mucus that is more clear than green. This has lead me to suspect that there is a unique issue within my frontal sinus. It could be old mucus or fungus, but the mucus cultures have been more clear recently. In fact I didn't have any significant bacteria on one culture. If I had old mucus or fungus, you would observe the bacteria in the culture.

This leaves some other causes like polyps or "other masses". Other masses are not observed in any recent sinus CT scans. My doctor says the CT indicates much of my frontal is full or either mucus and/or polyps. So in my opinion, this pretty much narrows down to polyps as the more likely cause of inflammation and pressure. I have had polyps in my maxillary and ethmoid sinuses and I recall the symptoms. First, polyps can cause sinus flare ups at any time.  Second, polyps cause symptoms that don't react as predictably as traditional allergy symptoms or bacterial based sinusitis. And polyps never subside completely unlike allergies. This agrees with my symptoms.

So, I plan to have surgery soon to clean-out whatever is in the frontal sinuses. We'll see if it turns out to be polyps or not. I may have a steroid-eluting stent in my sinus as well to abate the inflammation. Although surgery is never fun, I am cautiously optimistic about this procedure because a significant cause of my issues may finally be addressed.

Monday, April 1, 2013

What do you think?

I read different forums and blogs about allergies and sinusitis. It continues to amaze me how many different symptoms and issues occur. I sometimes think that my writings are too narrowly focused. I'd like to hear from you to see what bothers you with your sinuses.

For instance, my previous posting discussed how my bone structure in my skull is likely the largest contributing factor to my ongoing sinus issues. But I fully realize that each of you may have totally different triggers. You may have radically different symptoms that drive you nuts. You may have sinus issues every once in a while or every day.

I would encourage you to leave a comment on how you feel about sinus issues. Or maybe you have comments about me. I think we'd all like to hear some feedback.

I will continue writing, of course. Have a good day and hang in there with whatever symptoms annoy you.

Friday, March 29, 2013

Peeling the onion that is sinusitis

I don't know about you, but I have found that longer term sinus issues are rarely straight forward. It's pretty unusual to find one trigger (cause) driving one symptom (effect). My sinusitis is provoked by pollen, diet, exercise, sleep, mind/body state and lots and lots of other things. Indeed many healing arts look at a myriad of issues in the mind and body that need to be balanced or brought back into a holistic balance.

Invariably, I attempt to tie triggers to symptoms even though its really complex. A common analogy for analyzing triggers and symptoms is to think of an onion. Then start peeling off each layer as each trigger and symptom are found. In reality, the problem is more like peeling a room full of onions at the same time .

This complex web of interconnected triggers is just too... well, complex. So, recently I have been focusing on just what I think are my 3 major trigger areas: diet/gut flora, anatomy, and natural anti-inflammatories. But, is there one single issue that is the largest influencer of all other issues? Well for me, my less than optimal sinus anatomy is the largest factor driving my triggers and symptoms. If my anatomy was remedied, I think that gut flora (assisted by probiotics) and natural anti-inflammatories would have a much more beneficial effect. Right now probiotics and anti-inflammatories have marginal effect on me.

That is why I have been writing about stents and procedures more recently that are focused on remediating my anatomical weaknesses. Anatomy is my first layer of the onion. It all comes down to what is the first layer of your onion, if you even know. What is the trigger that starts the whole process to developing sinusitis. To be frank, I am actually just guessing about my first layer, but at least its an educated guess after years of observing which trigger causes which symptoms. How about you? Do you have a first layer of your onion?

Thursday, March 21, 2013

Frontal Sinus Stent outcome

Well, the procedure to place a stent in my frontal sinus opening in-office was not successful. It turns out that the opening is too small to place a stent. A balloon was used to dilate the opening, but the bone has re-grown after my previous surgery and balloons can only dilate soft tissue, not bone. This was disappointing needless to say.

This essentially leaves revision frontal sinus surgery as my only real option. My anatomy is the limiting factor in drainage. Apparently I am one of the difficult cases. At least, this explains why supplements, diet, probiotics and lots of other remedies have little to no effect on my chronic rhinosinusitis. What I mean is that the frontal sinus opening is so small that any allergy or irritant can cause inflammation which keeps the opening closed or nearly closed most of the time. So my frontal sinus is not able to freely drain on a consistent basis. The bone regrowth around the opening caused a smaller opening over time. The restricted opening leaves my sinus without the ability to drain and is a major cause of the sinusitis. In fact I believe that the restricted opening to my frontal sinus is the largest contributor to my chronic sinusitis, though probably not the only cause.