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Old 10-01-2008, 02:07 PM   #1
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I feel worse not better, chronic sinusitis:-(

I am using a nasal spray daily (nasonex), steaming, sinus irrigation twice daily, antihistamine when I remember and cutting out wheat in my diet.

The last couple of days have been bad, I am suffering with clogged ears every day, never the same one it seems to jumps sides. Today I have had a clogged up right ear, shooting pains around back of right ear and down back of head occasionally. When I bend forward I have a congestion type feeling, not pain just pressure. I have this every single day and I am just told to live with it but its making me very concerned that this will lead to a complication if left. Surely things should be getting better not worse?

My CT scan showed a thin layer of congestion in a few of my sinuses, maxillary and ethnoid (sp?) especially on the right. ENT called it mild to moderate sinus disease and told me to use pain killers and nasal sprays as it didn't warrant surgery,

I suffer with anxiety and find it hard to not worry, I know that complications such as the absesses and meningitis are rare and my ENT consultant said in all of his years in this profession he had never seen a case of it from sinusitis he said if anything it occurs with ear disease so to not worry at all yet I still do. I feel like I am a time bomb waiting to go off

I just do not understand chronic sinusitis, can anyone explain a few things to me so I can relax a little maybe? I have had so much help from this forum and I appreciate people taking their time to reply to me.

What I don't understand is what I have read about chronic sinusitis. I understand that acute is sudden and very painful but what I have read about chronic is that its less painful, more like pressure, discharge from the nose etc.... but I have read that it needs antibiotics and I do not understand why i haven't been prescribed them. Both ENT and my GP say I do not need them as I would have a fever and green gunk from my nose if I had an infection but from what I have read about chronic it hasn't said any of these things. Why are my consultant and GP saying I don't need antibiotics if I have chronic sinusitis? as I said from what I have read thats the treatment for it so that is why I am concerned.

My ENT cons told me that if I had an infection my CT scan would of shown all grey in all my sinuses, he said as mine just had a thin layer in a few and plenty of black it was not infected. Is this right?

I started with all of these symptoms a few years ago, had a CT scan and all was fine. Then this year it flared up again but I had a virus in July/August, cough and abit of a snuffle nothing major but since then I had this congestion on bending forward and clogged up ears again which hasn't gone so ENT did a CT scan and found the sinuses had mucus in them.

I had allergy testing done and found out I am allergic to a few things, wheat being the main one so I have illiminated it from my diet, no improvement so far. The ENT cons said up my nostril did look allergic, purple rather than pink??

I am just so concerned, I hate having the constand clogged up ear jumping sides, pains now and again behind the ear and back of head, had these alot today but thought as its got quite cold here in the UK and a sharp wind maybe it was that. I seem to get worse sinus symptoms in cold wet weather. Can sinusitis be caused by bad weather and allergies???

My husband came with me to ENT last week and he said that he was sure the ENT cons said that my sinuses are inflamed not infected, is that not the same thing?

Sorry for all the questions but I am so worried about leaving this if it is an infection. I got a book out from the library today about allergies and sinus problems and all it talked about was chronic sinusitis being an infection

 
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Old 10-01-2008, 10:36 PM   #2
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Re: I feel worse not better, chronic sinusitis:-(

Quote:
Originally Posted by Essica View Post
I just do not understand chronic sinusitis, can anyone explain a few things to me so I can relax a little maybe? I have had so much help from this forum and I appreciate people taking their time to reply to me.
I will try to help as best I can.

Quote:
What I don't understand is what I have read about chronic sinusitis.
Sinusitis is the inflammation of the mucous membranes in your sinuses / nose. "Acute" sinusitis is any condition that resolves itself in four weeks or less. Conversely, "chronic" is a condition that lasts twelve consecutive weeks or longer. These cases are obviously more severe, thus, are almost always caused by either a predisposition, or the development of serious allergies. Allergies can develop at any time in a person's life. It is often region, or geography related....Some areas are much worse than others. For example, dry areas (U.S...Midwest) have few problems.

Antibiotics are only needed if you have an infection. An infection is caused by bacteria. People with sinusitis are more prone to infections because the inflammation and drainage can create a perfect host for bacteria to grow. Conversely, sinuses that drain properly aren't as likely to create a bacteria friendly area.

Quote:
My ENT cons told me that if I had an infection my CT scan would of shown all grey in all my sinuses, he said as mine just had a thin layer in a few and plenty of black it was not infected. Is this right?
Yes, that is correct. The thin layer at the bottom of your sinus is like a deposit or permanent area of mucus....Think of it as like the stuff in the bottom of a drain...A little bit of stuff get stored at the bottom over time. The black area of the CT scan is "open" space, which is good. Open areas show up black on x-rays.

Quote:
I started with all of these symptoms a few years ago, had a CT scan and all was fine. Then this year it flared up again but I had a virus in July/August, cough and abit of a snuffle nothing major but since then I had this congestion on bending forward and clogged up ears again which hasn't gone so ENT did a CT scan and found the sinuses had mucus in them.
Sinus trouble can develop @ any time in one's life....You may be "predisposed", meaning it runs in the family / gene pool. I have friends who are in their 40s and 50s and all was fine....One day, they developed severe allergies.

Quote:
I had allergy testing done and found out I am allergic to a few things, wheat being the main one so I have illiminated it from my diet, no improvement so far. The ENT cons said up my nostril did look allergic, purple rather than pink??
Yes, some allergies can be from food. But, most are from the environment...Grasses, trees, animals (cats are really bad for some people), and most of all....Molds. Mold is everywhere, and I mean everywhere. The color he referred to is that of our skin inside your nose. Pink skin is "normal" or not irritated. If irritated, it looks purplish in nature.

Quote:
I am just so concerned, I hate having the constand clogged up ear jumping sides, pains now and again behind the ear and back of head, had these alot today but thought as its got quite cold here in the UK and a sharp wind maybe it was that. I seem to get worse sinus symptoms in cold wet weather. Can sinusitis be caused by bad weather and allergies???
The cold, wet weather brings out all the molds. I'm not familiar with the environment in the U.K, but a good hard freeze or very cold winter is an allergy sufferers good friend. Cold weather kills most of the allergens. However, the natural environment creates new allergens, but the cold ensures there are less overall.

Quote:
My husband came with me to ENT last week and he said that he was sure the ENT cons said that my sinuses are inflamed not infected, is that not the same thing?
No, they are not the same thing. "Inflamed" means just that....inflamed or irritated. When your sinus area, throat and etc. are subject to all of these allergens, or irritants, it becomes irritated, or inflamed. Conversely, "infected" means bad bacteria. Think of an infection as like a infected hang nail or cut which gets yellow puss or drainage. It's the same thing in your nose/sinus area....When it gets "infected", you get puss, yellow drainage & etc. As a general rule, clear drainage is ok....Colored drainage is often infected. This is why one needs to see a Dr. as only he/she can tell.

I would recommend getting hooked up with a good ENT and allergist and between them, they can put you on a good plan to live your life. The key to living with allergies is PREVENTION. Once you become irritated, the only thing Docs can do for you is throw meds at you....Decongestants, antihistamines, pain medicine, & etc. These all help lessen the SYMPTOMS, but the root problem is still there.

Prevention helps prevent the irritation to start with. Did the allergist talk to you about shots? Shots help about 50-60% of patients....The shots are essentially serum or anti-irritants. The serum they inject builds up your tolerance to whatever is irritating you so you don't have reactions. There are also some meds on the market that help with prevention as well. Your ENT and/or allergist can go over all of these with you to determine what's best for you.

Lastly, those with allergies should always have a "retreat" or "safe haven" in which to occupy. For example, your bedroom is probably where you spend the most of your day (at least 8 hours), so it should be super clean. In general, a very clean house will always be to your benefit. More specifically, hardwood floors, tile, & etc are always better than carpet. Carpet harbors all the nasty allergens. Try to keep dust down to a minimum....Use good grade filters in your furnace which trap allergens. Make sure there are no molds in your bathroom and kitchen area. You get the idea....I could go on and on. I would research this area heavily as you can have a major impact via your living quarters.

Quote:
Sorry for all the questions but I am so worried about leaving this if it is an infection. I got a book out from the library today about allergies and sinus problems and all it talked about was chronic sinusitis being an infection
No problem. I'm glad to help any way I can. Please let me know if you have any more questions and I'll try the best I can. I'm no expert by any means, but as a person who suffers like you do, I've learned a lot over time and I'll be glad to support you any way I can.

Regards,

Ex

Last edited by Executor; 10-01-2008 at 10:40 PM.

 
Old 10-02-2008, 12:10 AM   #3
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Re: I feel worse not better, chronic sinusitis:-(

Thank you so much Ex, I really really appreciate your support.

So if I suffer daily with this is does not mean its an infection? ie it won't kill me

So if I get an infection I would be very stuffed up, yellow/green from my nose and I would have a temperature? the ENT said if I suddenly became very stuffed up and couldn't breath out of my nose then it meant that all of the sinus cavities were now grey if on a scan so therefore infected.

I had an ige blood test taken for allergies that showed I was allergic to wheat, hazelnut, shrimps, celery, grass pollen, mould and nettle sting pollen. I was told i am not allergic to dust mites??I don't know how reliable these ige tests are but I am also on the waiting list for the scratch tests on the NHS.

I am also having accupuncture, ouch! I will try anything

Noone has mentioned allergy shots to me but when i have the tests done on the NHS I shall ask.

I am keeping a diary of my symptoms, both my sinus and stomach as I suffer with very bad wind pains, always have done.

The weather in the UK is pretty rubbish most of the time. Our summers don't last more than 5 minutes and at the moment its very wet, cold and windy. As soon as I got out in that kind of weather I have bad sinus pain and ear aches. My mum is the same, she says she suffered in her late 20s like I am doing but she doesn't so much now.

I just wish I could relax and learn to live with this but instead I worry everyday because of the pain that it will spread and cause a serious life threatening infection

Thanks again, I know I am a total worrier which is very annoying

 
Old 10-02-2008, 07:52 AM   #4
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Re: I feel worse not better, chronic sinusitis:-(

Quote:
Originally Posted by Essica View Post
So if I suffer daily with this is does not mean its an infection? ie it won't kill me
No, it doesn't mean it's an infection. Your daily troubles are the result of the sinus tissues being "irritated" on a regular basis. So, when you go outside for example, and get exposed to the pollen, it irritates your sinuses...Thus, causing all your symptoms. An "infection" is when the tissue actually gets infected with a bad germ / bacteria, and puss / yellow discharge is the result.

Quote:
So if I get an infection I would be very stuffed up, yellow/green from my nose and I would have a temperature?
Yes, a temperature is a big sign of an infection. Also, infections usually cause lots of swelling and pain...The area would be very tender to the touch (your cheek and forehead areas).

Quote:
I had an ige blood test taken for allergies that showed I was allergic to wheat, hazelnut, shrimps, celery, grass pollen, mould and nettle sting pollen. I was told i am not allergic to dust mites??I don't know how reliable these ige tests are but I am also on the waiting list for the scratch tests on the NHS.
The tests are very reliable. It sounds with your case, that you're allergic to a variety of things. I would also suspect that not all are equal...Meaning that you are more allergic to some things than others. From your list, it appears as if the grass and mold are the two biggies. And, unfortunately, they very tough, if not impossible, to avoid.

Quote:
I am also having accupuncture, ouch! I will try anything
As bad as you say you feel, I would try just about anything....Assuming it's reasonable.

Quote:
The weather in the UK is pretty rubbish most of the time. Our summers don't last more than 5 minutes and at the moment its very wet, cold and windy. As soon as I got out in that kind of weather I have bad sinus pain and ear aches. My mum is the same, she says she suffered in her late 20s like I am doing but she doesn't so much now.
I think the weather is your main culprit, really. Depending on the severity of one's allergies, you just may to adopt a different lifestyle...Don't go outdoors as much, or alter your activities based on the weather. The wind is your enemy because it "stirs" everything up....It can also blow things up your nose, which isn't good, obviously. And, as I said previously, it's very hard to avoid grasses and mold. I would do some research on allergies in your area and the worst times. Quite often, some of the big weather forecaster models now also predict allergy scores each day to alert you ahead of time.

As I suspected, you have a predisposition due to your gene pool. This is very common.

Quote:
I just wish I could relax and learn to live with this but instead I worry everyday because of the pain that it will spread and cause a serious life threatening infection:
Please try to relax and realize that there is nothing you can do about your condition, except adjust your lifestyle. Is there a possibility you could move? Again, I'm not familiar with the geography of the U.K....But, here in the U.S., some regions of the country are much, much better for allergies than others. For example, the dry midwest is best, followed by the coastal areas (saltwater).

One last thing you might try is some sort of surgical mask. If the weather there is that bad (wind & all), try wearing a mask over your nose and mouth...You might find it to work wonders. I know it may cause a few "looks", but if it makes a big difference in how you feel, then who cares?

Take care, and let me know if I can be of any help further.

Regards,

Ex

 
Old 10-03-2008, 12:31 AM   #5
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Re: I feel worse not better, chronic sinusitis:-(

Thank you so much Ex, all excellent information and advice, I really appreciate you taking the time to reassure me.

When I found out I had chronic sinusitis I thought oh god I am going to get a complication and die I worry alot as you can tell.

Hopefully now I can relax a little and realise that meningitis is very unlikely to happen and it only would if I had an infection for a long time and before it got to that stage I would get antibiotics from my doctor.

I have no fever, my mucus is clear from my nose and the only thing I do have is the blocked ears every day which I am hoping if Iignore a little it will get better, I think the fact that I focus on it makes it feel worse because yesterday when at my friends I didn't notice it at all so maybe my anxiety is making it feel worse.

I shall see how the eliminating wheat goes, heres hoping it improves things but nothing so far after a week.

Thanks again.

 
Old 10-03-2008, 09:42 AM   #6
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Re: I feel worse not better, chronic sinusitis:-(

Quote:
Originally Posted by Essica View Post
Thank you so much Ex, all excellent information and advice, I really appreciate you taking the time to reassure me.
Glad I could be of some help.

Quote:
When I found out I had chronic sinusitis I thought oh god I am going to get a complication and die I worry alot as you can tell.
I understand how you feel. What people don't understand about it, is that it's a daily thing...Constantly having to deal with it. And unfortunately, allergies tend to get worse as we age, so it can wear on you a bit. However, with a good plan, one can battle them very successfully. I would really work on the prevention aspect....You know how the saying goes..."An ounce of prevention is worth a pound of cure."

Quote:
Hopefully now I can relax a little and realise that meningitis is very unlikely to happen and it only would if I had an infection for a long time and before it got to that stage I would get antibiotics from my doctor.
Yes, Meningitis is very, very rare. It's mainly caused by sinus fluid leakage to the brain.

Quote:
I have no fever, my mucus is clear from my nose and the only thing I do have is the blocked ears every day which I am hoping if Iignore a little it will get better, I think the fact that I focus on it makes it feel worse because yesterday when at my friends I didn't notice it at all so maybe my anxiety is making it feel worse.
Sounds as if all is well....Or as good as it can be given the circumstances. I would work with your ENT and allergist on your plan for attacking this thing. For me, I have a daily regimen of decongestants and antihistimines that work pretty well. I take them every AM as soon as I wake up. It's become part of my daily routine. They do a pretty good job of battling the symptoms. Singulair has worked best for me as it prevents the histimine action in one's body. From there, I try to prevent or stay away from as much of the irritants as I can. I use the mask on real windy or cold days. It works wonders.

Take care, and please let me know if I can help further.

Regards,

Ex

 
Old 10-03-2008, 05:01 PM   #7
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Re: I feel worse not better, chronic sinusitis:-(

Thanks again ex,

When you say - Yes, Meningitis is very, very rare. It's mainly caused by sinus fluid leakage to the brain.

I thought that meningitis only occured in rare circumstances of a bacterial infection that is left untreated for a very long time? is this what you meant? sorry to ask.

It seems mine is inflamation so I am hoping I can just carry on living with it and it doesn't turn into an infection.




Quote:
Originally Posted by Executor View Post
Glad I could be of some help.



I understand how you feel. What people don't understand about it, is that it's a daily thing...Constantly having to deal with it. And unfortunately, allergies tend to get worse as we age, so it can wear on you a bit. However, with a good plan, one can battle them very successfully. I would really work on the prevention aspect....You know how the saying goes..."An ounce of prevention is worth a pound of cure."



Yes, Meningitis is very, very rare. It's mainly caused by sinus fluid leakage to the brain.



Sounds as if all is well....Or as good as it can be given the circumstances. I would work with your ENT and allergist on your plan for attacking this thing. For me, I have a daily regimen of decongestants and antihistimines that work pretty well. I take them every AM as soon as I wake up. It's become part of my daily routine. They do a pretty good job of battling the symptoms. Singulair has worked best for me as it prevents the histimine action in one's body. From there, I try to prevent or stay away from as much of the irritants as I can. I use the mask on real windy or cold days. It works wonders.

Take care, and please let me know if I can help further.

Regards,

Ex

 
Old 10-03-2008, 11:57 PM   #8
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Re: I feel worse not better, chronic sinusitis:-(

It's caused by bacteria that leaks into the brain via the sinuses. It's not caused by an untreated infection. It is very, very rare, overall.

With the sinuses, only a Doctor is qualified to tell you if you have an infection or not, but the two main tell tale signs are fever and colored (yellowish) discharge. Area tenderness is also a sign, but can also be present for general sinus stuffyness & etc.

Conversely, allergies produce clear drainage and no fever. Sometimes an infection won't cause a fever, but it always produces colored discharge. As a general rule, the greater the discharge, and the thicker in color, the worse the infection. Bad sinus infections can result in some very thick yellow mucus / puss. They can also be very painful and produce monster headaches.

Allergies tend to predispose someone to sinus infections due to all the watery discharge and fluid buildup. All the excess moisture & etc. in the sinuses provides a near perfect environment for bacteria to grow. You may have read articles or seen shows that promote the use of a nasal pot (looks like a small sugar bowl with a handle) or "flushing" system....This flushes the sinuses of all the junk and reduces the likelihood of bacteria growth.

I know it sounds kinda gross, but think of your sinuses as a puddle of water....The longer it sits there, the more likely stuff will start to grow in it. That's when the infection sets in.

Hope this helps, and take care,

Ex

Last edited by Executor; 10-04-2008 at 12:00 AM.

 
Old 10-04-2008, 12:35 AM   #9
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Re: I feel worse not better, chronic sinusitis:-(

HI,

I kind of feel more worried now, I was told by a few others on this forum that meningitis is caused by a bacterial infection that is left untreated for a long period of time and I would have a fever/green discharge so I felt reassured that I don't have those symptoms. Meningitis is a huge worry for meas I suffer anxiety but being told all of that was kind of starting to relax me a little about living with this,.

I use a sinus rinse bottle everyday but I still suffer with daily congestion but my ENT cons and GP have told me to carry on and live with it as I was only diagnosed with mild to moderate sinus disease, he said it was a thin layer of congestion/inflamatation in a few sinuses which did not require antibiotics.

My worry is that if the congestion isn't coming out of the sinuses then it will lead to bacteria and I will one day just go bang

 
Old 10-04-2008, 10:29 AM   #10
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Re: I feel worse not better, chronic sinusitis:-(

Essica:

Executor's information about meningitis is not quite correct - below is a paraphrase of information from the American Rhinologic Society that addresses your concern:
The incidence of complications from sinusitis have dramatically decreased due to the widespread use of antibiotics. However, in certain circumstances bacterial infections may spread and cause complications. The sinuses are separated from the intracranial cavity by a layer of bone. If an infection passes through this bone it may infect the tissue and fluid that lines the brain, causing "meningitis".
In order for there to be any risk of developing meningitis you would have to have an active bacterial infection that doesn't respond to (or isn't treated with) antibiotics long enough for the bacteria to penetrate the bone that separates the sinuses from the brain.

As your doctor told you, it is very rare - I hope this will help you stop worrying.

 
Old 10-04-2008, 06:39 PM   #11
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Re: I feel worse not better, chronic sinusitis:-(

Quote:
Originally Posted by gcsmithjr View Post
If an infection passes through this bone it may infect the tissue and fluid that lines the brain, causing "meningitis".

In order for there to be any risk of developing meningitis you would have to have an active bacterial infection that doesn't respond to (or isn't treated with) antibiotics long enough for the bacteria to penetrate the bone that separates the sinuses from the brain.
This is exactly what I said, but not quite to this level of detail. It's not caused by a simple untreated infection. It has to leak into the brain. As Smith says, you should stop worrying.....As we've discussed all along, it's very, very rare. If you have any question(s), you should see a Doctor as they know best.

Best of luck to you,

Ex

Last edited by Executor; 10-04-2008 at 06:42 PM.

 
Old 10-05-2008, 06:48 AM   #12
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Re: I feel worse not better, chronic sinusitis:-(

Thanks very much, I shall stop worrying now I understand what you mean, sorry to of sounded abit thick.

I guess it would take a very bad infection to get through the bone and leak into the brain.

I don't have any sinus pain as such, just a blocked ear every day that jumps sides and my GP even thinks that is TMJ but I am not so sure

ENT said from my CT scan my images did not show infection just inflammation as the sinus cavity was mainly black with some grey linings at the bottom of the sinuses which he called congestion/inflamation. My only concern was if it was an infection I am carrying around I should be taking anti bs but as you say I don't have coloured mucus or a fever at all so it must be allergy related.

I was just very confused about what I read on the internet about chronic sinusitis on medical sites, it was saying chronic should always be treated with antibiotics which is why I was very concerned that I wasn't given anything other than a nasal spray.

ENT told me to go back to see him in December and he will re scan me if I feel no better or worse.

 
Old 10-05-2008, 10:01 AM   #13
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Re: I feel worse not better, chronic sinusitis:-(

Yes, I would stay in regular contact with the ENT. More than likely, you'll battle "allegies" for a while, if not forever. It is possible to outgrow them, however. The point being, it would be good if you could learn your "triggers" and what works for you. As we discussed earlier, "prevention" is the best avenue, IMO.

Re: infections, as long as you don't have the classic symptoms, all the congestion and clear runny nose is just a functionality of your allergies...That's why I take a regular regimen of antihistimines and decongestants....Helps battle them (for me). At the first sign of an infection, I go see my ENT because I want to battle the possible infection early. Many people wait far too long to see a Doctor, and they are literally fuming with colored discharge (I know it sounds gross...sorry).

I think you'll adjust over time....Right now, you're probably in a bit of shock because you're having to deal with these new symptoms that can be problematic. Until someone has to deal with what you're talking about, they really have no idea. Allergies can be a real pain in the butt. But once you get a good regimen down, and learn what works and what doesn't, you'll be in good shape. You'll also learn what the triggers are and how they effect you.

Take care, and best of luck to you. You're doing a great job @ trying to obtain as much information as you can....information is power.

Regards,

Ex

 
Old 10-05-2008, 12:19 PM   #14
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Re: I feel worse not better, chronic sinusitis:-(

Thanks Ex,

It does help to understand because when a GP gives you a leaflet and it says possible complications of chronic sinusitis are brain absesses and mengingitis it scares the c**p out of you, I know it did me. My auntie had meningitis so I have always worried about it

I am laying of wheat, in the last week ive had it once so not doing too bad. I am taking my meds/sprays daily and irrigation.

So unless I notice yellow or green ozzing from my nose and a temp then I won't worry because it is infection if left that can spread to the brain, thats my understanding of it now.

It is so strange though that daily its just my ears that cause me concern. Its not pain its just a clogged feeling and sometimes tickly like water tricking inside?? my GP said possibly TMJ or just tension as I am a very stressed person, hehe. I have no pain or fever so I guess my ears are not infected??

Thanks again. I don't know what I would of done without the support of others on here.

 
Old 10-06-2008, 09:17 AM   #15
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Re: I feel worse not better, chronic sinusitis:-(

Having a bad day today, since yesterday ive had alot of fullness in my ears, no pain as such but still the odd tickly feeling down them and nasal stuffiness on one side.

I feel so worried again worrying what if ive now an ear infection but my mum told me they hurt and I would really know about it.

 
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