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Old 10-24-2008, 03:16 PM   #1
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Sinus Test with Delayed Reaction

I was wondering if anyone has experience this. I have been having chronic sinus problems for years and recently went to see two allergist.

The first allergist did a ***** test on my back and it came back negative to everything with a slight reaction to Bermuda Grass. She also had me get a blood test to test for food and common allergens which all came back negative. She recommended an ENT.

So, off to see the ENT. ENT prescribed a few rounds of antibiotics and nothing much has changed. ENT suggest surgery to "clean" out the infection. I ask if he could recommend another allergist because I want to exhaust all options before surgery.

Off to allergist number two who does a ***** test on my forearms and some ID tests on my left shoulder as well. No reactions to these test and they send me on my way.

About 30 hours after these tests I noticed that I have been itchy on my left forearm and left shoulder. Also feel dizzy and have a horrible headache. I check and notice two spots on my forearm that appear to be mosquito bites and four on my shoulder where I had the ID tests.

I call the allergist and the nurse answers. She states this is odd because I should of had an immediate reaction. She grabs my chart and then proceeds to ask where the red spots are on my arm so she can compare what I say to what was injected there. She goes "Wow, that is all trees" meaning that the spots that was irritating was where she injected trees or where I was *****ed with tree allergens.

She puts me on hold to ask the DR what it could be. She comes back and says you are fine, you don't have allergies and that it may just be irritated and to put some cortizone on it.

Now, I am not a DR but that is some coincident don't you think? Every doctor I have been to told me that all the symptoms I have are that of a person with allergies but all the test contradict the symptoms.

I have read some medical journals where they discuss delayed allergic reactions but most seem to dismiss this stating that any iGE reaction should be immediate and all allergy tests only test for iGE responses.

RAST testing was negative as well.

Is it possible to have a delayed reaction to this type of allergy testing?

Could the delayed response be related to how ones metabolic rate?

I have read about LRA tests by ELISA/ACT but it seems doctors dismiss this test.

My CT scans does show a mass in the right maxillary sinus that two radiologist did not even mention described it as maxillary sinus disease without fluid and a third radiologist stated it was retention cysts and polyps.

At a loss but I feel I have allergies and I don't want to do the surgery only to have temporary relief if any.

Thanks for any help on this.

Last edited by ganz2008; 10-24-2008 at 03:25 PM.

 
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Old 10-25-2008, 04:23 AM   #2
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Re: Sinus Test with Delayed Reaction

Quote:
Is it possible to have a delayed reaction to this type of allergy testing?
It's not very likely that you would have a delayed reaction 30 hours after the testing. Did the nurse say anything about the histamine control? When they do the testing one of the things they test is pure histamine (which everyone reacts to). Assuming you reacted normally to the control, it's hard to figure why the other reactions would have been so delayed.

Quote:
ENT suggest surgery to "clean" out the infection.
I'd strongly recommend you get a second opinion before surgery. First of all, if you don't get the underlying cause of your sinus issues under control the surgery may only be a short-term fix. Second, there are medical options you should exhaust first.
-A short course of oral prednisone which should help reduce the inflammation in your sinuses and get them draining properly again.
-Daily sinus irrigation with a SinusRinse bottle or neti pot to help rinse irritants and stagnant mucus from your sinuses.
-Daily use of a steroid nasal spray (Rhinocort AQ, Flonase, etc.) to reduce inflammation.
-A daily leukotriene inhibitor like Singulair (which seems to help reduce the inflammation, particularly in people with nasal polyps).
I always recommend that people see an ENT who specializes in treating people with chronic sinusitis because the medical management is just as important as the surgical intervention.

Quote:
I feel I have allergies
Have you tried taking a daily antihistamine like Claritin or Zyrtec to see if it helps with your symptoms?

Quote:
My CT scans does show a mass in the right maxillary sinus that two radiologist did not even mention described it as maxillary sinus disease without fluid and a third radiologist stated it was retention cysts and polyps.
Are they looking at the same CT scan or different scans? Retention cysts are fairly common (they're present in about 10% of the people who have a sinus CT scan), and are simply a mucus gland that becomes blocked and retains mucus. They don't require surgery unless they become large enough to prevent proper drainage. Polyps are fluid-filled areas of swelling in your sinuses that can prevent proper drainage but they can often be treated medically if they're not severe (oral prednisone will shrink them, and a combination of a steroid spray and a leukotriene inhibitor can help prevent them from recurring).

Again, I'd find another ENT who's willing to work with you to exhaust the medical treatment options before recommending surgery.

 
Old 10-25-2008, 12:55 PM   #3
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Re: Sinus Test with Delayed Reaction

Quote:
It's not very likely that you would have a delayed reaction 30 hours after the testing. Did the nurse say anything about the histamine control? When they do the testing one of the things they test is pure histamine (which everyone reacts to). Assuming you reacted normally to the control, it's hard to figure why the other reactions would have been so delayed.
Yes, I did react to the histamine control. I just found it odd that it appeared that the things I reacted to were all tree allergens.

Quote:
I'd strongly recommend you get a second opinion before surgery. First of all, if you don't get the underlying cause of your sinus issues under control the surgery may only be a short-term fix. Second, there are medical options you should exhaust first.
Good point. I have been hesitant to dive right into surgery because I don't feel I know exactly what is wrong yet.

Quote:
-A short course of oral prednisone which should help reduce the inflammation in your sinuses and get them draining properly again.
-Daily sinus irrigation with a SinusRinse bottle or neti pot to help rinse irritants and stagnant mucus from your sinuses.
-Daily use of a steroid nasal spray (Rhinocort AQ, Flonase, etc.) to reduce inflammation.
-A daily leukotriene inhibitor like Singulair (which seems to help reduce the inflammation, particularly in people with nasal polyps).
I did have two courses of prednisone with the first two courses of antibiotics I had. One for a pill a day for a week and the other was two pills a day for 1 week and down to 1 pill a day for a week. When I was on prednisone, I felt great. In fact, I had the most energy I had in years during those two weeks.

I have been doing neti pot rinse as well. Along with Flonase. One thing I noticed is some days when I do the neti pot rinse the water comes out very fast and other times one nostril will it will trickle slowly out. I assume indicating inflammation.

I recently added Astelin (anti-histamine spray) along with Flonase and my sinus do feel good but I still have post-nasal drip. I am also using Alegra daily again. I am not sure why Astelin and Alegra make me feel better if I don't have allergies.

Another odd thing to note is that I noticed the eczema I have on my face goes away when I use the Alegra.

Quote:
I always recommend that people see an ENT who specializes in treating people with chronic sinusitis because the medical management is just as important as the surgical intervention.
Thanks, I will seek a second opinion. The ENT I am seeing now is highly rated for surgery, but if that is all he knows, then I should do as you say and seek out another ENT's opinion.

Quote:
Have you tried taking a daily antihistamine like Claritin or Zyrtec to see if it helps with your symptoms?
.

I was first told to take Claritin 3 years ago and that did nothing. I can't take the Claritin D though as I get heart palpatations. Alegra seemed to help. But my latest experiment of Alegra, Astelin and Flonase seems to help the most. I have about 10 different pills and sprays that I have been prescribed that neither of them seem to do anything alone.

Quote:
Are they looking at the same CT scan or different scans? Retention cysts are fairly common (they're present in about 10% of the people who have a sinus CT scan), and are simply a mucus gland that becomes blocked and retains mucus. They don't require surgery unless they become large enough to prevent proper drainage. Polyps are fluid-filled areas of swelling in your sinuses that can prevent proper drainage but they can often be treated medically if they're not severe (oral prednisone will shrink them, and a combination of a steroid spray and a leukotriene inhibitor can help prevent them from recurring).
Yes, they all had access to both CT scans. I just found it odd that the first two said without fluid levels because I would of thought cysts and polyps would indicate fluids being present. But I may be interpeting that wrong.

Quote:
Again, I'd find another ENT who's willing to work with you to exhaust the medical treatment options before recommending surgery.
Thanks for taking the time to reply, I really appreciate it.

 
Old 10-25-2008, 03:38 PM   #4
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Re: Sinus Test with Delayed Reaction

Quote:
I just found it odd that the first two said without fluid levels because I would of thought cysts and polyps would indicate fluids being present.
The reference to "without fluid levels" is an indication that there is no mucus that has collected in your sinuses (so they're filled with air, which is good). Cysts and polyps are different because they're anomalies (not fluid buildup).

 
Old 10-25-2008, 06:54 PM   #5
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Re: Sinus Test with Delayed Reaction

Gosh this sounds like a nightmare. i do not know what I would have done if allergy tests did not show my allergies when I had them done. I was so sick and desperate to help.

I have had sinus surgery and did fine with it. They cleansed the sinus's while making the opening larger in upper/inner nose to help with drainage. I cant say what to do, but if seeking another ent. is an option, I would do that. Constant suffering is no fun and you are wearing down your immune system not dealing with this.

Surgery helped for a while then I got into pattern of sickness again and went for allergy testing to find out i was highly allergic to many things. I now get 5 shots a month and will for life. They are a life saver and rarely do I get sick and I can even fight off colds (usually) without antibiotics.

 
Old 10-25-2008, 10:41 PM   #6
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Re: Sinus Test with Delayed Reaction

Quote:
Originally Posted by gcsmithjr View Post
The reference to "without fluid levels" is an indication that there is no mucus that has collected in your sinuses (so they're filled with air, which is good). Cysts and polyps are different because they're anomalies (not fluid buildup).
OK, thanks for clarifying. The two radiologist (who originally) that read my CT's did not mention the cysts or polyps. This came from the third radiologist who reviewed the first two readings.

Here is the exact "impression" from the first two.

Impression:
Moderate mucosal disease in the right maxillary without fluid levels.
OMU's Patent although narrow due to the presense of prominent Haller cells.
Right and to a lesser extend left maxillary sinus disease without fluid levels.

 
Old 10-25-2008, 10:49 PM   #7
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Re: Sinus Test with Delayed Reaction

Quote:
Originally Posted by sickofpain2 View Post
Gosh this sounds like a nightmare. i do not know what I would have done if allergy tests did not show my allergies when I had them done. I was so sick and desperate to help.

I have had sinus surgery and did fine with it. They cleansed the sinus's while making the opening larger in upper/inner nose to help with drainage. I cant say what to do, but if seeking another ent. is an option, I would do that. Constant suffering is no fun and you are wearing down your immune system not dealing with this.

Surgery helped for a while then I got into pattern of sickness again and went for allergy testing to find out i was highly allergic to many things. I now get 5 shots a month and will for life. They are a life saver and rarely do I get sick and I can even fight off colds (usually) without antibiotics.
Yes, it has been a nightmare. I dealt with it for years not really thinking anything because I felt this is just how I feel. Then in February this year, for about 3 weeks I felt great. Had tons of energy, my sleep schedule was good as I was getting solid rest and insomnia was gone and that is when I realized something has to be wrong. I am on a mission to feel like that again.

Also during all of this my ENT noticed I had a lump on my parotid gland. I had a biopsy as well and thank God it turned out not to be cancer.

My ears feel full all the time as well. My ENT said this will go away once I get rid of the sinus problem. Part of me wonders if the problem is my ears and the post nasal drip is coming from that.

All I know is since March I have had 4 to 6 rounds of various antibiotics and I still feel like crap.

 
Old 12-21-2009, 12:30 PM   #8
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Re: Sinus Test with Delayed Reaction

Bump.

I'm having the same unusual delayed reaction issue. I had a large (1 1/2" x 2") red non-bumpy reaction to the cockroach injection test that started about 40 hours after the test. Also similar but smaller dime-sized reactions to dust mites. These were just slightly itchy, and lasted for about three weeks, after which there was dry skin in the affected areas for two more weeks. I just got retested and had similar but smaller reactions (maybe 1/2" circle for the cockroach and 1/4" for the mites). It's only been three days, so I don't know if these will last as long. For at least the first day after each test, I had absolutely no reaction at all. My allergist says he has not seen a reaction like this in his 30 years of work.

I'd be interested if anyone else has had similar experiences, or if anyone knows what this means.

The reason for the tests is that I have severe nasal allergies. Sometimes, without antihistamines, my nasal passages feel like the have been doused in gasoline and lit on fire, and drip clear water (it is thin enough to be called water rather than mucous) at an alarming rate. Most days I have some post-nasal drip and possibly some congestion. Treatment with Nasonex and Astepro pretty much keeps it to that tolerable level, but when it gets bad sometimes it will take 75mg or so of Benedril to get me to near-normal.

 
Old 04-27-2011, 10:48 AM   #9
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Re: Sinus Test with Delayed Reaction

I've run into the same situation myself. I've had allergy testing done in the past in a different state and I've been allergic to several things including mold and trees. On Monday morning I had the skin test done on my back and reacted to none of the allergens. I also had injections done on my arm and was told I'm allergic to dust mites only, no pollen, yet I have reactions most of the time when I'm outside. I explained to my doctor that the last time I had the skin test done, several hours later I had a terrible itch inside of my legs, an itch that I couldn't scratch or get to. I was told at that time that it can sometimes happen if a person has more of a systemic reaction to what they're allergic to. I took benedryl and it went away. This doctor seemed to have no idea how that type of reaction could have been possible.

This time, by Monday evening I was sick to my stomach, which is often a symptom when my allergies get really bad, my body feels sick all over. Tuesday morning I woke up with 11 reaction sites on my back, bumps surrounded by redness from a half inch to 2 inches in size. I had already taken the anithistamine and prednisone perscribed by my dr the previous day, before I noticed the bumps and redness on my back.

I called my doctor and of course didn't hear back from a nurse until around 3pm who told me to come back in. I was concerned that if I start getting shots, which I plan to do, the serum will be wrong because I hadn't reacted wtihin their normal 30 minute timeframe, so what's the point in taking the shots?

When I went back to the clinic the nurse looked at my back and told me that it wasn't a reaction to the skin test at all. She said it was purely coincidental and had nothing to do with the back test. Seriously? I've never had a rash on my back before and you're going to tell me it has nothing to do with all of the allergens that were just scrapped into my skin yesterday? She said they've had patients that experience this same thing in the past and the doctor always says it has nothing to do with the skin test, but she'd be sure to let my doctor know anyway and call me back. That was almost 24 hours ago, no call back yet.

From everything I know about this particular doctor, he is top in his field and the clinic is well respected. I felt like he took the time to ask me about my situation but did not listen to what I was saying when I explained the types of reactions I get that may be completely different than what anyone else would get. Now I feel like I have allergies to things that I won't get treated for.

I've been reading other blogs and sites that say a delayed reaction is typically something that cannot be treated by shots anyway. That is an answer I can accept if it's correct. I'll just hope that the prescriptions I got from the doctor will help those also. But to have a healthcare professional tell me that the doctors of that particular clinic do not make the connection between a rash and the skin test was beyond my comprehension. This is the type of situation that makes people not trust the healthcare profession. I understand that what I experience may not fit into the box that they're trying to put me in, but does that mean it should be dismissed altogether? If I didn't feel as sick and miserable as I do I guess I could accept this, but unfortunately I feel like I need to start over and hope for a better result so I can have a better quality of life.

 
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