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Old 12-04-2012, 04:45 AM   #1
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over one year "sinus" problems... please help!

Hello!

For over a year now I have been suffering from symptoms that sound exactly like they would be sinus related. Symptoms, that I have every day, include:
- intense pressure behind the nose and cheeks
- when I inhale through my nose, I can feel the pressure building in my sinus area like a vacuum or something is being created and like the air is getting trapped somewhere
- pressure and headaches more pronounced when bending over, but even just walking around brings on the pressure
- dizziness that is not a vertigo/spinning feeling but more of imbalance
- head and face feel very heavy and my neck is sore from feeling like I have to keep it steady all day
- upper jaw aches and feels very heavy, like there is a weight sitting on it
- headaches, every day, at the back of my head (on the right side) and behind my right eye
- throat tightness and PND

The thing is I have had NO nasal discharge, runny nose or anything like that at all this whole time. It feels like everything is "locked" in the area behind my nose. I had a CT scan last year and sinus xray that were both unremarkable. I should say that other than the radiologist, no ENT has looked at it.

After the CT came back normal my doctor basically said it was anxiety. I was so unhappy with that diagnosis because, indeed, I am feeling anxiety when I'm having symptoms that no one can seem to figure out. It didn't start out as anxiety. I tried VRT in case it was an inner ear thing (didn't help), upper cervical chiropractic (didn't help), acupuncture and even travelled to an eye specialist thinking it was a vision issue, got prism lenses that did not help at all!

I then explore the TMj thing. Found a great dentist who made me a 24/7 splint. Been wearing it for over three weeks with no changes whatsoever. However, when he was going through my diagnostic testing with me, he showed my my panoramic xray and said, "Oh, and your sinuses are full, you must have a cold or infection". I told him that I don't have a cold whatsoever. But indeed he said that my maxillary sinuses, esp the right one, has stuff in it. My symptoms are predominantly on the right.

When I brought this up to my GP, we decided to try a stronger antibiotic than the amox I tried last year. This one is still amox but it has another ingredient in it that is supposed to make the amox more effective. I'm also doing the neilmed rinses and a steroid spray. It's been 6 days and still nothing.

So my question is, is it possible to have a sinus problem that doesn't show up on xrays until almost a year later? If antibiotics aren't working, could it be fungus? I had an ENT last year when this first started put a scope down my nose and he said everything was clear. I don't know if it's possible that it would be any different doing it again a year later?

I so appreciate any insight or guidance that anyone can give me. I am so fed up with this!

 
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Old 12-04-2012, 09:19 AM   #2
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Re: over one year "sinus" problems... please help!

Sounds very similar to my situation. I've had constant headache since June, but my sinuses were supposedly clear from the CT scan in August. I had no discharge from my nose, but I believe my infection was "locked in". On second CT scan an infection showed up, but my GP was vague as to where exactly in the sinuses it was. When I suggested ethmoid/frontal sinuses (from where my pain is) he agreed. Only after I started peroxide flooding, did i start to get the disgusting discharge...I think the peroxide flooding unblocked the sinus tubes that were keeping the infection in.

3 different antibiotics haven't touched the infection..I'm now on my fourth and I've had this infection now for at least 5 weeks, if not longer.

To be honest, I don't know what to suggest as I'm still fighting this infection and haven't a clue what else to try. Candida has been suggested, but my doctors don't agree. It's a battle just to get to see a doctor here (waiting list for ENT specialist is 6 weeks).

Only thing I can suggest is to go back to your doctor and try a broad spectrum antibiotic, and maybe peroxide flooding (see sticky) which may help.

 
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Old 12-04-2012, 10:09 AM   #3
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Re: over one year "sinus" problems... please help!

Cold247-

I have a couple of thoughts for you but also want to clarify a couple of things in your post that seem contradictory. You mention that you have PND every day but also say you have "no nasal discharge". PND is nasal discharge that happens to run down the back of your throat so it would be great if you could clarify what's going on there. Also, you say that you had a CT scan but "no ENT has looked at it" which makes me wonder who ordered the CT scan and why.

To answer a couple of your questions, it's certainly possible that the situation in your sinuses could change A LOT over the course of a year (and dental x-rays aren't a very good source of insight into what's going on inn your sinuses to begin with).

It's also important for you to know that an endoscopic exam by an ENT doesn't show what's going on inside your sinuses but helps the doctor see inflammation and infection that might be draining from them, so the fact that the ENT didn't see anything doesn't necessarily mean that nothing was there (which is why I'm curious why the ENT never looked at the CT scan).

It's also good to keep in mind that 6 days on a steroid spray and sinus rinse isn't enough time to see results so give it some more time.

In general, your symptoms could be allergy related or could even be caused by acid reflux (which can irritate the lining of the sinuses and cause inflammation that leads to PND and infections) so you probably need to find an ENT who really understands how to treat chronic sinusitis to take a look at the CT scan, perform another endoscopic exam and try to help you get to the bottom of what's causing all of your symptoms.

It's unlikely that what you're dealing with is fungal - much more likely to be bacterial (amoxicillin is not a very powerful antibiotic and isn't that effective at treating sinus infections) but there may be some underlying inflammation that is keeping the infection from getting resolved so you may need a course of oral steroids to help get the inflammation under control (followed by ongoing use of the steroid spray and saline irrigation).

You might also want to try an antihistamine like Zyrtec or Claritin (they don't make you drowsy and are available without a prescription) and even an oral decongestant like pseudoephedrine to see if that helps with your current symptoms.

 
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Old 12-04-2012, 12:24 PM   #4
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Re: over one year "sinus" problems... please help!

I had similar symptoms to you some years ago and was prescribed SUDAFED by an ENT Specialist. You can buy this without prescription where I live in either liquid/tablet form.
I keep this by me all the time and have found it really helpful in Sinus/Cataarh problems.
Another thing I found very good was "Accupuncture" though you do need a few treatments, but after three I could breathe right down to my shoes.
Hope this helps and good luck,

Solofelix.

 
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Old 12-04-2012, 06:20 PM   #5
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Re: over one year "sinus" problems... please help!

NightWarrior, gcsjr and solofelix.....thank you so much for your great suggestions!

My CT scan that I had a year ago was ordered by my GP. When it came back "normal", and after 10 days of amoxicillin that didn't help, my doctor didn't see any point moving forward with an ENT. My symptom that was the scariest for me at the time, along with the headaches, was the feeling of imbalance so I was finally sent to an ENT for inner ear stuff. By the time I got to him, the "sinus" pressure was becoming more noticeable and though I mentioned to him that my GP ordered a CT scan that didn't show anything, I managed to convince him to do the endoscopic exam. As you know, he said it was "clear" but I didn't realize, as gcsjr mentioned, that it doesn't tell you anything about the condition of the sinuses. I was basically left out in the cold after that with my doctor saying that it was all anxiety, and then I tried to explore other possibilities with chiropractic, VRT, vision-related possibilities and TMJ. As the year progressed, my sinus-area symptoms became more and more pronounced, but I didn't think that going back to my doctor was going to be useful because she was already convinced it was nothing but anxiety. It wasn't until my recent visit to the TMJ dentist when he did a panoramic xray that he noticed opaque areas in my maxillary sinus. So with that in hand, I went back to my GP and she gave me a script for amoxicillin clavulanate. She said that the latter ingredient helps the amox work better.

When I said in my post that I have no nasal symptoms, I guess I was referring to the obvious discharge and drainage that I figured typically comes out from the nose. I do have some PND, though, it's just that none of the mucous is coming OUT of my nose. This also made me second guess the possibility that it was sinus-related because I just figured that everyone with a sinus infection has a stuffed up and/or drippy nose and is constantly blowing. I haven't had anything like that at all.

I am going to a different ENT in a couple of weeks and I was going to ask him to do a sinus culture. I figure that this would at least show a little more specifically what type of infection, if any, is kicking around in there. Does that sound like a good idea? I had looked at the peroxide rinse in the recent past and I'll admit I'm a bit squeamish about it! Maybe I should just get over it and give it a try. The thought of being able to unplug something that really feels locked, almost cement-like, behind my nose and cheeks would be utter joy. I had tried OTC sudafed when this first started and it didn't help.

gcsjr - you mentioned that amox isn't the best antibiotic for sinus infections. Which ones seem to be better? I also have an appointment with an allergist for mid-January to see if there are any allergies at play. It's interesting that NightWarrior had two Ct scans a couple months apart that showed two different things. It seems that it's also important that someone other than the radiologist looks at the scans/x-rays since they can seemingly miss something that may be potentially brewing that only an ENT specialist with catch.

This has been a very long, horrible year for me with this without seeing even a single day of relief. I so appreciate the help from others on this board because you can at least go to these doctors armed with some knowledge and possible direction.

 
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Old 12-05-2012, 07:17 AM   #6
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Re: over one year "sinus" problems... please help!

At the moment I am finding that Sudafed tablets (pseudoephedrine 60mg) and sudofed spray (Xylomtazoline 0.1% w/v) are helping a bit, but not totally eliminating the infected mucus discharge. My ENT specialist is against using these decongestants for more than a few days due to rebound effect, but at the moment they are helping, so I'm using them till the infection is gone.

Peroxide flooding isn't nice, but I've got used to it now, and I'm sure my sinus membranes are less inflamed because of the peroxide. It used to really sting and make my eyes water, but now it's tolerable and I've slowly increased the amount of peroxide. I was at the point where I would try anything.

But I think finding the right antibiotic is the only thing that will get to the infection, and doctors are so reluctant to give antibiotics here. And my doctor kind of shrugged off my suggestion of taking a culture to find the right one. If you can get a culture done, then that should help a lot.

 
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Old 12-05-2012, 02:53 PM   #7
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Re: over one year "sinus" problems... please help!

Quote:
Originally Posted by Nightwarrior View Post
At the moment I am finding that Sudafed tablets (pseudoephedrine 60mg) and sudofed spray (Xylomtazoline 0.1% w/v) are helping a bit, but not totally eliminating the infected mucus discharge. My ENT specialist is against using these decongestants for more than a few days due to rebound effect, but at the moment they are helping, so I'm using them till the infection is gone.

Peroxide flooding isn't nice, but I've got used to it now, and I'm sure my sinus membranes are less inflamed because of the peroxide. It used to really sting and make my eyes water, but now it's tolerable and I've slowly increased the amount of peroxide. I was at the point where I would try anything.

But I think finding the right antibiotic is the only thing that will get to the infection, and doctors are so reluctant to give antibiotics here. And my doctor kind of shrugged off my suggestion of taking a culture to find the right one. If you can get a culture done, then that should help a lot.
I sincerely hope that the latest antibiotic you're on does the trick for you. I've contemplated using the nasal decongestants but worried also about rebound congestion. Perhaps I should give it a try along with the peroxide flush. In any event, I hope we all get better real soon!!

 
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Old 12-08-2012, 02:54 PM   #8
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Re: over one year "sinus" problems... please help!

Quote:
Originally Posted by cold247 View Post
I sincerely hope that the latest antibiotic you're on does the trick for you. I've contemplated using the nasal decongestants but worried also about rebound congestion. Perhaps I should give it a try along with the peroxide flush. In any event, I hope we all get better real soon!!
I'm on day six of Clarithromycin, and I'm pleased to say the mucus has now become clear and less of it. phew. However my nose seems to be constantly running and clogging up every few hours, but much better than it was a week ago. Also much less blood when I flush with saline/bicarbonate, so I think I've made a bit of a breakthrough. I'm going to stop using the decongestant tablets/spray but I'm going to continue with peroxide flooding every morning until I'm certain the infection has gone.

I'm still feeling exhausted and needing to rest a lot. Tried a bit of housework and it knocked me out for 4 hours! But at least I am now able to attempt a bit of tidying up (my house looks like a bomb has hit it!)

Hopefully everyone else will start feeling better soon too.

Last edited by Nightwarrior; 12-08-2012 at 02:55 PM.

 
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Old 12-09-2012, 01:58 PM   #9
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Re: over one year "sinus" problems... please help!

Can I ask you some questions concerning your on going sinus symptoms? Do you get that burning sensation in your nose? Especially with temp changes? Also did your sinus problems vary day to day, some good some bad?

 
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Old 12-09-2012, 04:17 PM   #10
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Re: over one year "sinus" problems... please help!

Quote:
Originally Posted by Nightwarrior View Post
I'm on day six of Clarithromycin, and I'm pleased to say the mucus has now become clear and less of it. phew. However my nose seems to be constantly running and clogging up every few hours, but much better than it was a week ago. Also much less blood when I flush with saline/bicarbonate, so I think I've made a bit of a breakthrough. I'm going to stop using the decongestant tablets/spray but I'm going to continue with peroxide flooding every morning until I'm certain the infection has gone.

I'm still feeling exhausted and needing to rest a lot. Tried a bit of housework and it knocked me out for 4 hours! But at least I am now able to attempt a bit of tidying up (my house looks like a bomb has hit it!)

Hopefully everyone else will start feeling better soon too.
Yaay! That's great to hear. I remember reading on another post that you were at one point taking amitryptiline and I was wondering if you think that this made a difference for you as well? Or do you think it's just the combo of peroxide flushing and the new antibiotic?

I also wanted to ask you about how you do the peroxide flushing. You mentioned that you lay on your back and hang your head over the bed. Then you said I believe you turn your head side to side. I'm trying to picture that and I'm not quite getting it. Are you shaking your head or just gently turning it side to side?

Very happy that you are seeing a light at the end of this horrible tunnel!

 
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Old 12-09-2012, 04:21 PM   #11
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Re: over one year "sinus" problems... please help!

Quote:
Originally Posted by Liquidplasma View Post
Can I ask you some questions concerning your on going sinus symptoms? Do you get that burning sensation in your nose? Especially with temp changes? Also did your sinus problems vary day to day, some good some bad?
Fo me it's more of an intense pressure and aching behind my nose, and cheeks. It sometimes feels like how you'd feel after someone punches you in the nose and you can feel it pulsating/throbbing. My upper jaw also feels very, very heavy like there is a weight sitting on it. My sinus issues don't seem to change based on temperature. They are EVERYday. I have not had even a single day of relief for over one year. I do feel that the latest antibiotic I have just finished up started to scratch the surface of it, but it didn't move beyond that. I'll be discussing this further with my ENT in a couple of weeks.

 
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Old 12-09-2012, 05:51 PM   #12
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Re: over one year "sinus" problems... please help!

I wish you the best of luck please keep us posted especially if you find a cure, good luck!!

 
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Old 12-09-2012, 11:40 PM   #13
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Re: over one year "sinus" problems... please help!

Quote:
Originally Posted by Liquidplasma View Post
Can I ask you some questions concerning your on going sinus symptoms? Do you get that burning sensation in your nose? Especially with temp changes? Also did your sinus problems vary day to day, some good some bad?
I don't recall any burning sensation in my nose. I just had a constant headache that was increasing in intensity and would not respond to increasing opiate/NSAID eg Diclofenec/and flixonase drops. I

didn't really notice my nose, no noticable mucus or stuffiness to begin with. It was all about the headaches which were pretty much the same each day.. Then Amitryptiline worked for a while (about a week while resting), but then the infection got worse, the discharge started and the head pain intensified and it had been that way pretty much for 3 weeks. Even after 7 days of Clarithromycin, I still wake with a mild headache across my eyebrows.

So for the most part no changes with temperature ( though I do know if it gets cold enough to snow here, that going outside would make my nose drip!)

 
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Old 12-10-2012, 12:44 AM   #14
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Re: over one year "sinus" problems... please help!

Quote:
Originally Posted by cold247 View Post
Yaay! That's great to hear. I remember reading on another post that you were at one point taking amitryptiline and I was wondering if you think that this made a difference for you as well? Or do you think it's just the combo of peroxide flushing and the new antibiotic?

I also wanted to ask you about how you do the peroxide flushing. You mentioned that you lay on your back and hang your head over the bed. Then you said I believe you turn your head side to side. I'm trying to picture that and I'm not quite getting it. Are you shaking your head or just gently turning it side to side?

Very happy that you are seeing a light at the end of this horrible tunnel!
Firstly I think the Amitriptyline just took the edge off the pain. One doctor said it wasn't a pain killer but helped painkillers to work. I take it along with a sleeping tablet Zopiclone and that did seem to help if I was at home resting. But as soon as I went back to work the pain got worse ( I think that is coincidental with infection getting worse!)

For the flushing with saline or peroxide, I can't do it on my knees in the bath, so I use another method. I lay on my back with my head off the bed hanging down as much as possible. Then I squirt as much soultion as I can in both nostrils. When my sinuses are clear, I can usually get about 9ml in each. When blocked it's between 3 and 6 ml each side. I lay with my head back for 1-2 minutes, then turn my head slowly to one side and hols it there for 30 seconds to one minute, then slowly roll my head so it is facing the other side, and again hold it there for 30 seconds to one minute. Then I bring my head back to the middle and roll over on to my stomach ( bowl ready on the floor as a lot of solution will pour out) and hang my head down, chin touching bed and hold it there for 1-2 minutes, then turn my head slowly to face the side (30 seconds to 1 minute) then slowly turn my head to face the other direction and hold again for 30 seconds to one minute. At all times I keep my head hanging as low as possible. I return head to middle, and holding the bowl under my nose, lift my self up to kneeling, then sitting position and let the liquid drain for a few seconds before blowing (carefully). If I plow too hard my ears temporarily block.

And What is strange, is some days I get liquid overflow into throat, others I don't.

Time consuming, but it definitely helps.

 
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Old 12-10-2012, 06:24 AM   #15
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Re: over one year "sinus" problems... please help!

Get a second opinion. And a third and fourth until you get an answer. There is nothing worse than when doctors don't take your symptoms or discomfort seriously.

I have also had a horrendous year with my sinuses. If I had listened to my first GP I would never have been diagnosed. It's lucky my symptoms got worse and my new GP was stumped enough to send me to a very good ENT. I have a choncha bullosa and a deviated septum.

My problem is not fungal but I've been reading up on it and everything I can get my hands on where Chronic Sinusitis is concerned. Apparently fungal sinus infection used to be considered quite rare but are becoming more common. I think lifestyle, diet, stress, pollution are all contributing to changes in our immune systems and making people more susceptible to fungal infections. I had a fungal skin infection a few months ago and I didn't even know that fungus could attack your skin.

 
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