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Old 04-28-2009, 09:24 AM   #1
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What To Do Next...Don't Want Sinus Surgery...

I've been struggling with sinus pain (and chronic cough) since December 2008. My regular doctor finally sent me to an ENT a couple of months ago. I had a CT scan with the regular doc that showed my left maxillary sinus was completely blocked. I do no have any structural abnormalities or polyps...

After my first round of antibiotics with the ENT, they took another CT scan, but the right maxillary was completely blocked. They even did a second CT scan with a penny taped to my head to make sure they had the correct side.

After another course of a different antibiotic, I went back for a third CT scan. I felt like I didn't have much, if any, sinus pressure at this point. I've never run any fever. CT scan still shows right side is blocked although there is some open air where there wasn't before.

The doc (who still doesn't believe the original CT scan showed blockage on the left even though you can see where I'm missing a tooth which verifies which side is which) gave me another round of the same antibiotic and pretty much told me to call him when I make a decision. I feel like my decision is either sinus surgery or no sinus surgery...

I don't feel like my questions were completely answered although he did finally say he DIDN'T think it was allergy-related since I was only ever affected one side (or the other), but I'm still on the fence about calling back and asking to be tested for allergies.

I guess my question is, based on everyone's experiences, what are my best next options? I should point out, I still have occasional sinus pressure, I still feel drainage down my throat constantly (but no nasal congestion) which I'm assuming causes my cough, AND my ears pop whenever I yawn or sometimes when I swallow (doc says never any fluid in my ears).

Thanks!

 
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Old 04-28-2009, 10:41 AM   #2
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Re: What To Do Next...Don't Want Sinus Surgery...

Quote:
based on everyone's experiences, what are my best next options?
You have several options to consider before surgery.

First of all, you should definitely get tested for allergies (by an allergist, not an ENT) and should get on some kind of treatment regimen if you have positive allergy tests.

Second, you should buy a SinusRinse bottle and start irrigating your sinuses daily (they're available at any national drugstore chain). I'm not sure if your ENT mentioned this to you already but, if he didn't, you might want to consider seeing a second ENT. Saline irrigation is one of the best, easiest and cheapest things to do and most ENTs strongly recommend it to their patients who are dealing with chronic sinus problems.

Third, you should probably be on a daily nasal steroid spray like Flonase or Rhinocort. This will help shrink the inflammation in your sinuses and help them to drain (again, this is one of the first things most ENTs recommend, so if your doctor didn't you might get a second opinion).

Fourth, you might consider getting evaluated for acid reflux. Acid reflux can cause, or aggravate sinus symptoms for some people.

Finally, you should ask about a course of oral steroids. They're stronger than the sprays and can help shrink the swelling in your sinuses so that things begin to function normally again.

The biggest challenge in your situation is giving your sinuses a chance to begin functioning normally again, all of these things will help that to happen. I realize you may not have put all of the details of what your doctor has recommended in your post, but if the only treatment you've had is 3 rounds of antibiotics and 3 CT scans there is no way you should be considering surgery, you need to find a doctor who can help you exhaust all of the medical options before he recommends surgery.

 
Old 04-28-2009, 11:25 AM   #3
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Re: What To Do Next...Don't Want Sinus Surgery...

I knew I would forget some details (as I was in a hurry AND kept getting interrupted), and so I did!

About allergy testing - I believe I was told there is an allergist in the ENT office...should I go somewhere else?

I have a SinuCleanse Pot which I use at least once a day, sometimes twice. I do feel better when I do it at least twice a day, but the ENT suggested I cut back to once every two days (after he couldn't explain my infection switching sides).

I do have Flonase spray but honestly, I'm not good about using it everyday. I will make sure I use it regularly.

I'll keep the acid reflux in mind...although I really do not ever have any of those symptoms.

Oral steroids - I got a shot and a week (I think) of oral steroids my first ENT visit. Aren't these the ones that cause weight gain? Funny thing...I actually lost weight while taking them.

I'm sure I've still forgotten something. Thanks so much for your input.

 
Old 04-28-2009, 01:55 PM   #4
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Re: What To Do Next...Don't Want Sinus Surgery...

Quote:
About allergy testing - I believe I was told there is an allergist in the ENT office...should I go somewhere else?
If the person in the ENT office is a board certified allergist/immunologist you should be fine. Do not rely on an ENT or GP who has some allergy training

Quote:
I have a SinuCleanse Pot which I use at least once a day, sometimes twice. I do feel better when I do it at least twice a day, but the ENT suggested I cut back to once every two days (after he couldn't explain my infection switching sides).
You might try a Sinus Rinse bottle - they work much better than the pots do. As for cutting back, you really should be irrigating at least daily and maybe more.

Quote:
Oral steroids - I got a shot and a week (I think) of oral steroids my first ENT visit. Aren't these the ones that cause weight gain? Funny thing...I actually lost weight while taking them.
They only cause weight gain if you're on them for an extended period of time but it sounds like you've had at least one round (although a week is a fairly short round of steroids).

It sounds like allergy testing would be the next thing for you (and maybe trying a different antibiotic).

 
Old 04-29-2009, 11:53 AM   #5
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Re: What To Do Next...Don't Want Sinus Surgery...

Thanks for all your advice...I called the ENT office and they said their certified allergist is a nurse. I've heard such good things about the doctor at the allergy clinic in town that I went ahead and made an appointment there (2 weeks from now).

Asked the ENT for an extension of antibiotic (either the same or a different one) and another round of prednisone, and without too much trouble, they're calling it in. They are switching me back to Levaquin, which I was on when I started seeing him back in early March.

My Sinus Rinse bottle is also on its way...had to order one after I checked a few places in town and couldn't find it.

We'll see how things go from here!

 
Old 04-29-2009, 01:09 PM   #6
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Re: What To Do Next...Don't Want Sinus Surgery...

It sounds like you're headed in the right direction, particularly seeing an allergy specialist (instead of the nurse at the ENT's office).

Hopefully you'll start to improve soon.

Best wishes.

 
Old 05-08-2009, 11:16 AM   #7
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Re: What To Do Next...Don't Want Sinus Surgery...

Ugg! All this is such a pain isn't it?? I too am faced with the prospect of surgery. My allergist seemed to want to convince me it was the only option I had if I didn't want rounds and rounds of strong antibiotics but we're at a loss as to what I can take. (As I've tried them ALL). But , I was glad when the ENT presented me with other options, though he didn't seem to place too much stock in the daily oral steroid sprays...But, he too said if my problems are caused by allergies I may want to try to control that in addition to the surgery (I am looking at some anatomical issues though, too).

I would definitely consider all possible areas before trying the surgery. This could just be me, since I have had a crazy amount of surgeries in my life, but still, it sucks to be faced with the option of surgery for your nose and that may not even be a garuantee!
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Old 08-10-2009, 09:47 PM   #8
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Re: What To Do Next...Don't Want Sinus Surgery...

Hi. I hear you on the surgery thing. I have heard mixed things about successfulness and recovery time.

I have also heard of a less invasive and newer procedure called Balloon Sinuplasty. Have you done any research there?

I wish I had a first or even a second hand account for you. But it definitely peeked my interest.

I wish you all the best, take care and BE WELL!

 
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