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Old 07-31-2004, 02:11 AM   #1
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Post I fired my doctor today....chronic sinusitis

Update: I suffer from chronic sinusitis. I went for a third opinion to make my husband happy because he wanted a doctor who would try the non-surgical route first. So I have been on Levaquin (500 mg) and Nasonex for the last month. Today I went for my second appointment with the doctor after 30 days on the meds. and boy did he change his tune. He contradicted everything he said at my first visit. Now my only hope is surgery, but he thinks I may need to see a neurologist to check out my facial pain. I want surgery if it's going to help, but the first 2 doctors I went to described a more thorough surgery. This doctor (who told me my diviated septum wasn't bad) now told me all he would need to do is correct my crooked nose so that I would have sinus drainage. He wouldn't do anything to the sinus itself. Then he told me that my low grade infection couldn't be cured by meds. But it was worth a shot. Previously he said my sinus was normal on the cat scan slides and this visit he told me how irregular my sinus was. This visit was so strange. He wouldn't listen to me. I felt like he was setting me up for more problems than I already have. (like not to mention the side effects from the Levaquin.) I'm worried that he's going to do a minor surgery to only suggest later on that we need to go back in and make it more extensive. And what about the neurologist suggestion. He didn't even investigate the other symptoms I also had. When I said I wasn't comfortable with his surgery suggestion, he just got up and walked out.

I've already made an appointment with doctor number 4. Unfortunately, I won't have room in my schedule to have surgery now. I should have had it done this month if I was going to have it.) Now when the next doctor suggests surgery (depending on whether I like what he has to say or not) I won't be able to do it until next summer when I have a break in my schedule.

The good news is I'm getting a real education about all of this. I can afford to be picky about my doctor. I want to make sure that this is done right the first time. I don't want the doctor to treat me based on my great insurance. (at the last doctor, they asked for a large sum of money after my appointment. I asked them to submit it to my insurance and they fought me on that. When I received my statement from the insurance, the amount they submitted from the insurance was way higher than what they wanted from me. On top of that, I was billed an additional $38.00.)

Vicky

 
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Old 07-31-2004, 06:48 AM   #2
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Re: I fired my doctor today....chronic sinusitis

welcome to the chronic sinusitis club. I've been suffering for 9 months, and I've also had surgery.

Some things you may not be aware of

1. Antibiotics are almost useless against sinus infections, because there is very little blood flow in the sinus cavities. People feel better because of the anti-inflammatory effect of the antibiotic.

2. Once you have had a bad infection that didn't respond to treatment, you are looking at surgery. There is simply no way around it. The soft tissue in the sinuses becomes so damaged and infammed, the only way to get the bacteria out of there is through surgery.

3. Allergies almost always play a role. Immunotherapy is the only thing that really works to contain the allergies. OTC meds are a joke.

4. Levaquin is EXTREMELY dangerous. People have died, ended up with permanent tendon and nerve damage, and have been disabled for years after taking this drug. I have a CD that lists 4000 cases of severe adverse reactions to this class of drugs. And I'm not talking about an upset stomach.

Your best bet is irrigation twice a day. You may want to try hydrogen peroxide for the first couple days just to combat the infection. After that, only kosher salt, baking soda, and room-temperature water.

Do NOT use things like ocean saline spray. These contain preservatives that can aggravate your sinuses. Make your own saline solution.

Prednisone (Medrol) does work, but it has many side-effects, especially if taken for a long time. In your case, I would recommend a dose pack to get the swelling under control. But in all honesty, I would get the nose fixed first.

I've been through everything, and here is my recommendation:

1. Surgery: Nasal Airway Reconstruction (NAR) and a BFESS (Bifrontal Endoscopic Nasal Surgery). Your doctor will decide if you also need a turbinate reduction.
2. Medications: 1 Medrol Dose Pack following surgery (6 days). Augmentin 875MG x2 a day for 20 days after surgery.
3. Irrigation: 4-5 days after surgery, start irrigating, using a machine and the ingredients listed above.
4. Immunotherapy: you might need allergy shots.

The important things here are to make sure the infection doesn't get worse. To stay away from quinolone drugs (Avelox, Levaquin, ****o), and to start irrigating.

The surgery is NOTHING to worry about. I was back to work 3 days afterwards, and I had the most major sinus surgery you can have. I wasn't in any pain at all. The misery you are going through now is 10 times worse than the surgery.

 
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Old 07-31-2004, 08:36 AM   #3
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Re: I fired my doctor today....chronic sinusitis

I disagree with chiggins on several of his/her points.

There are plenty of people who have chronic sinusitis who do not have allergies. A recent study by the Mayo clinic found that for many people, chronic sinusitis is caused by fungus. Fungal sinusitis is treated differently from bacterial sinusitis.

Antibiotics can be helpful in treating bacterial sinusitis. The quinolone antibiotics have particularly good penetration in small areas, such as the sinuses, which is why they are more frequently prescribed for sinusitis than other types of antibiotics. Some people do experience side effects, because they are really strong. I have had very good luck with Levaquin and Avelox.

You are right to try to find a doctor who listens to you and provides you with a diagnosis that makes sense to your condition. If you have not ruled out allergies as a cause of your sinusitis, then you should see an allergist for a full evaluation.

It's likely your facial pain is caused by your chronic condition and that a neurologist may not be able to help, but it would rule out some other possibilities that may be a factor.

Good luck, and keep trying!

 
Old 07-31-2004, 10:08 AM   #4
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Re: I fired my doctor today....chronic sinusitis

Avelox, Levaquin and Cipro are not really antibiotics. They are a form of chemotherapy, very strong, and potentially very dangerous. You can go through one course, not have any problems, start a second course, and end up in the hospital.

These drugs can cause things like peripheral neuropathy, tendinopathy (like bilateral Achilles tendon ruptures), liver damage, heart attacks, Stevens Johnson Syndrome (where your immune system attacks your skin and burns you from the inside out), etc. The average adverse reaction lasts for 6 months+.

After taking Avelox, I ended up with bilateral ulnar neuritis, tendon damage in my wrists, nerve damage in my feet, allergic vasculitis in my hands, muscle twitching, runaway anxiety, and insomnia so bad I got 3 hours of sleep for 3 months. After 4 months, I'm about 85% better, but I would never take one of these drugs again.

The reason why they are heavily prescribed, is that Bayer, and other pharmacutical firms, basically bribe doctors into dolling this stuff out, when a less dangerous drug (Augmentin for instance) would be far more appropriate. My sister-in-law is a drug rep, so I know how it all works.

The Mayo Clinic study is still inconclusive. When I had surgery, they cultured the junk that was pulled out of my sinuses. It was NOT fungus -it was bacteria. Yes, it is possible to get a sinus infection without an allergy, especially if you have a structural defect, like a deviated septum. But 80% of the time, allergies are involved.

I am willing to bet te facial pain is related to the sinuses. I have chronic pressure and dizziness as a result of tissue inflammation in my sinuses, even though there is no infection. Not much I can do.

For more info, go to www.fqvictims.org, and then see if you want to mess around with quinolones. Crack off the street is safer.

 
Old 07-31-2004, 11:10 AM   #5
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Re: I fired my doctor today....chronic sinusitis

I know where my chronic sinus started. My infant son hit me in the nose and soon after I had severe face pain. I went to the dentist so many times only to rule out a tooth abcess. I agree with my doctor fixing my nose (even though he told me that there is nothing wrong with my nose?????), but I also think he should clean out the sinus. In all my research and experience with previous doctors, I think that is the direction I need to go.

I really liked my first doctor, but he was so far away. My second doctor basically confirmed everything doctor number one said. It's just that my husband is looking for an out for this surgery. But in the mean time, I've still been suffering and now I probably won't be able to have this surgery until next summer. I'm self employed and I can't afford to miss work right now.

 
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