Over two years of being sickly, but I have a theory.

[Digerati]

NOTE: I originally posted this on another board some time ago, but I wanted to get your guy's take on it. Thanks!

------------------
Alright, I've made a few posts over the last two years but I'lI sum up
my condition as the following progression of symptoms: post-nasal drip
-> brain fog -> headache -> cough.

I now suffer all of these as a chronic condition, and all have been
present for about a year and a half. I've also tried the following
treatments:

Augmentin (2 two week courses, as well as 1 full month)
prednisone (2 two week courses)
levaquin
flonase/allegra (fairly consistently for a long while)
one endoscopic/structural surgery - mainly to correct slightly
deviated septum, but also to simply scope out the going-ons of my
sinuses.
Regular irrigation (the last month or two with baby shampoo) with a
grossan irrigator.

None of these "treatments" had any real effect.

A couple things that may be relevant... The post-nasal drip mentioned
is often times clear/white/opaque with a bit of yellow on occasion. CT
scans have been mostly negative with the exception of the latest one
that showed somewhat clouded sinuses. Lastly, allergy tests were very
positive for everything except for dogs/cats.

Now for the theory...

At the time of the initial symptom(s) I had been living in a certain
room for a few months. This room was an add-on to an aged house and
had very little insulation (if any). In short, I think it was a likely
candidate for a mold infestation, which I am allergic to.

After being exposed to this allergy source for a few months I believe
my cilia would have become exhausted and my defenses would have at
least partially broken down (I also got bronchitis for the first time
around then). This opened the doors for a fungal-infection resulting
from the mold contaminate.

I've long since moved from this location but the infection persisted.
The symptoms I believe are mainly an allergic reaction to the fungal
element that still remain in my sinuses, mild as it may be. This also
provided a bed for a bacterial infection which as come and gone
constantly for the last couple years. This is evidenced by the fact
that I do lose the yellow in my discharge for a week or two after a
round of anti-biotics even though the rest of the symptoms persist.

So, in short, that's the theory. Now what to do about it?

I've gone to my general physician about a prescription for Biaxin &
Sporanox to combat any potential bacterial biofilms as well as the
theorized fungal infection. He was obviously reluctant and wanted to
consult with my ENT who lives 5 hours away. I have yet to hear back, a
week later, so I figured I pass the time by asking for any/all advice
and feedback you guys could offer.

I owe you all a debt of gratitude simply for reading this far, and
I'll be all the more appreciative for any feedback you can offer.
Thanks! ]

[gcsmithjr]

I'm not sure about your overall theory - it sounds plausible and there's quite a bit of research into the role of fungal infections in chronic sinus problems right now so you could be on to something.

There are, however, two things you should consider. First of all, the research in this area seems to show that topical antifungal agents (typically added to the irrigation solution) are the best course of treatment for fungal sinusitis because oral medications don't get delivered to the sinus cavities very effectively. I was part of the second round of clinical trials and it was kind of a pain to use and didn't see much improvement. The research into this has been led by doctors from the Mayo Clinic so you may want to let your doctor know that so he can find more information.

The second thing that you might check into is the possibility that your symptoms could be caused by Laryngopharyngeal Reflux (LPR). LPR is a form of acid reflux that sometimes doesn't even cause hearburn. The Medical College of Wisconsin has been doing extensive research that has found a link between LPR and chronic sinus problems.

I spent much of last summer with symptoms similar to what you're describing and my ENT suspected fungal sinusitis (which was why I was added to the clinical trial of amphotericin B). Nothing seemed to help until my allergist put me on Nexium for LPR and my sinus symptoms improved dramatically in a week and I've done well since then (still on the Nexium).

[TEdds83]

I do believe that is what I have. I don't always have all the symptoms of acid reflux. Not the common ones. But I know I have it. I already have a zillion allergies. But the reflux can sometimes just be in my mouth. Like my cheeks and gums feel weird or get red. My throat feels tight like there is a ball of phlegm I can't clear. This is a very strange and frustrating thing to deal with. I am on prilosec and I hope I can clear it up. Some days are worse than others.

[gcsmithjr]

Prilosec is great (and the fact that it's available over-the-counter) makes it so easy. My doc did tell me that he sees some significant differences in how patients respond to Prilosec or Nexium or the other similar meds - different people do great on one and poorly on another so, if you don't notice an improvement on the Prilosec after a while, you might find a doc who can prescribe another similar medication.

My doc also mentioned that the standard PrilosecOTC dose may be a little low for many adults so you might ask your doctor about that as well (my doc recommended taking the OTC dose 2x daily, once in the morning, once in the evening).

[TEdds83]

Thanks for the advice. I think I may go to the 2x daily with the prilosec. It just may help me get it under control a bit better.