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Old 03-06-2013, 03:00 PM   #1
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Dr Says Surgery Will Not Help my Condition

I just went through a 30 antibiotic regimin, and Dr says Ct is clear aside from Frontal Sinus. Says that this needs to be addressed with surgery. She said that the surgery WILL NOT IMPROVE ANYTHING THAT I AM EXPERIENCING - that is, tthe congestion/inflamation.

I can hardly breate through my nose. When this sinusitis started 4 months ago, I could still breathe, and did not have this inflamtation.

I also have still clogged ears, that pop when I am in the car! and I am still dizzy and cannot drive. Very weird.

It wasn't like this before the onset in Nov. I took a short course of antibioitcs in Nov, but I got so sick that I stopped and waited it out till January when I started to feel better. But, it came back with a vengence a few weeks later.

I have done two weeks of Flonase, and a course of Medrol - helped a bit. But, not enough.

I wanted to know:

1) is this Dr crazy?

2) Has anyone had the therapuetic ultrasound done to assist in reducing the nasal inflammation?

Finally, the whole time I was on the antibiotics (Ceftin), I felt some kind of relief after I took the pill within the hour = I could breathe better, felt moister, in and felt draining. Then it was a total shut down of congestion.

This phenomeon went on from day one till the last day. What is going on? The Dr said she has no explanaiton.

Help. I am at my wits end. I have been basically very ill (medicaitons made me ill too) for 4 months and have no life!

Last edited by Teagan4; 03-06-2013 at 03:03 PM.

 
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Old 03-07-2013, 12:09 AM   #2
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Re: Dr Says Surgery Will Not Help my Condition

hey there..sorry to hear about your current condition. i would possibly try a different doctor to get a second opinion. the symptoms you are experiencing (clogged ears, difficulty breathing, etc) does not sound like it can be caused just by congested frontal sinuses alone. your doctor is correct in a sense that surgery will not fix the underlying cause of your inflammations (could be allergy related in which case you should get allergy tested, etc)

i would either take your CT scan to another doctor for second opinion or get a new scan w/ a new doctor. if the scan shows a lot of a congestion there could be a polyp hiding in there which is blockage your nasal passages from air intake/out..

i recently had sinus surgery done (i am 12 days post-op) and my original ct scan showed massive blockage in my right sinuses and nasal passage, but the doctor could not determine if a polyp existed as it was completely covered in the scan. only way to know for sure was to go in w/ FESS surgery and sure enough there was a polyp that was removed from my passage.

let me know if you decide you want to go the surgery route and i can explain in more detail my current recovery process (today is day 12 and has been the best feeling for my sinuses i've felt in over a year and i'm hoping it only gets better from here)...

best of luck

 
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Old 03-07-2013, 04:14 AM   #3
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Re: Dr Says Surgery Will Not Help my Condition

Quote:
Originally Posted by djhyro View Post
hey there..sorry to hear about your current condition. i would possibly try a different doctor to get a second opinion. the symptoms you are experiencing (clogged ears, difficulty breathing, etc) does not sound like it can be caused just by congested frontal sinuses alone. your doctor is correct in a sense that surgery will not fix the underlying cause of your inflammations (could be allergy related in which case you should get allergy tested, etc)

i would either take your CT scan to another doctor for second opinion or get a new scan w/ a new doctor. if the scan shows a lot of a congestion there could be a polyp hiding in there which is blockage your nasal passages from air intake/out..

i recently had sinus surgery done (i am 12 days post-op) and my original ct scan showed massive blockage in my right sinuses and nasal passage, but the doctor could not determine if a polyp existed as it was completely covered in the scan. only way to know for sure was to go in w/ FESS surgery and sure enough there was a polyp that was removed from my passage.

let me know if you decide you want to go the surgery route and i can explain in more detail my current recovery process (today is day 12 and has been the best feeling for my sinuses i've felt in over a year and i'm hoping it only gets better from here)...

best of luck
Thanks for your reply.

I did have allergy testing and it was negative.

I feel like it is not just my nose that is stuffy. It certainly does not feel like stuffiness from a cold. it is much higher and broader into my sinuses.

I just had the CT yestrday and she looked at the fresh image.

I have been using Afrin for almost two weeks( just one suirt at night .5% soluttion), because the not being able to breathe is terrifying for me. I was doing this on a temporary basis, thinking the antibitics would clear it up or the medrol. The medrol did work some, but seems to have reverted since I finished.

My nose is not just stuffy, but there is a lot of heaviness and also pressure. The pain gives me a headache, and I just feel so unwell.

My secretions were never discolored and thick the whole time. Just occasional bit of yellow.

I also had another "attack" about 7 days ago, where everything felt inflamed, had a fever/flu feeling and was szeeing.

Oh yes, I have hardly sneezed a day since November.

What is going on. I am so scared I will be like this forver. I have been so good with the medicaiton for 30 days whcih made me soooo sick. I can't believe the level of suffering.

WOuldn't the frontal sinus infection be aggravating the tissue and gneral infection status? Doesn make sense.

I will write if I decide on surgery. Will definintely get another opinion.

 
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Old 03-07-2013, 11:49 AM   #4
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Re: Dr Says Surgery Will Not Help my Condition

getting a second opinion is something i would prioritize...i would also seriously consider the sinus surgery...my main point is that it is hard to distinguish what is currently in your sinuses by just a CT scan since congestion showing in the scan can hide underlying issues that you can't see, especially since the medications you are taking are not working (doctor could be trying to treat a wrong diagnosis due to a mis-read in the scan)

hope this helps

Last edited by djhyro; 03-07-2013 at 11:50 AM.

 
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Old 03-07-2013, 11:59 AM   #5
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Re: Dr Says Surgery Will Not Help my Condition

I've been where you were at, Teagan4. It will get better, I promise you.

First of all, get off that damn Afrin. You can keep it for just flat out "emergencies," but you shouldn't be using it.

Go get yourself some sudafed - Get yourself a bunch of sudafed 30 mg...In the US, you can get like 96 tablets for just 10-14 dollars. Just make sure it is the pseudoephederine stuff. Phenylephrine sucks.

Also get yourself some loratidine, which is claritin...I also recommend getting some Claritin D 12 hour. This has quite a lot of pseudoephedrine and has some loratidine (or claritin) as well. The Claritin D 12 hour used to be a pretty good "emergency" drug for me. When I was at my worst, I would take it, and it would really help. Otherwise, I usually prefer the smaller, 30-mg tablets of pseudoephedrine. I just don't like to put drugs into my body, and would rather put the least amount possible.

 
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Old 03-07-2013, 12:02 PM   #6
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Re: Dr Says Surgery Will Not Help my Condition

The allergy test being negative means that maybe you have non-allergic rhinitis. I posted my own issues in my own thread, but for me personally, the lack of air flow, and cool air flow, in particular, really tends to cause sinus/nasal irritation of the membranes and congestion/difficulty breathing from my nose.

Oh, and by the way, the Flonase didn't help me either. It's mostly for allergies, which you or I might not have. I also had the same thing with my doctor. After my surgery, I didn't have relief, but he definitely said that another surgery wouldn't do anything...I guess I could understand.

Last edited by Leo255; 03-07-2013 at 12:04 PM.

 
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Old 03-08-2013, 03:20 AM   #7
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gcsjr HB Usergcsjr HB Usergcsjr HB Usergcsjr HB Usergcsjr HB Usergcsjr HB Usergcsjr HB Usergcsjr HB Usergcsjr HB User
Re: Dr Says Surgery Will Not Help my Condition

The doctor is correct that surgery won't improve the congestion or inflammation. Surgery is effective in improving sinus drainage and removing polyps but has no effect on the underlying inflammation.

Unfortunately, it sounds like your doctor hasn't done much to address the underlying problems. You really should see an allergist and probably get a second opinion from another ENT, but there are several things that can help with the underlying inflammation and congestion:

-Daily saline irrigation with a SinusRinse bottle
-Daily Singulair
-Antihistamines and/or allergy shots if you have allergies
-Regular use of the Flonase (it takes time but will help)
-Daily pseudoephedrine (Sudafed) decongestants

As Leo255 said, you have to get off the Afrin. It causes rebound congestion after daily use for as little as a week and the rebound congestion can be worse than the congestion you're taking it for.

The other thing you need to ask a doctor about is a longer course of prednisone. Most Medrol dose packs aren't a high enough dose to address sinus inflammation. You probably need a 3 week course of prednisone to reduce the swelling.

All of this is pretty standard so the fact that your doctor didn't recommend it is a good sign that you find a new ENT, one who has more experience treating sinus disease.

 
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Old 03-08-2013, 10:26 AM   #8
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Teagan4 HB User
Re: Dr Says Surgery Will Not Help my Condition

Quote:
Originally Posted by djhyro View Post
getting a second opinion is something i would prioritize...i would also seriously consider the sinus surgery...my main point is that it is hard to distinguish what is currently in your sinuses by just a CT scan since congestion showing in the scan can hide underlying issues that you can't see, especially since the medications you are taking are not working (doctor could be trying to treat a wrong diagnosis due to a mis-read in the scan)

hope this helps
I have to get the surgery to cure the mucocele on the frontal sinus, regardless. I just was despairing that the ENT said that I would have no further improvement.

It doesn't make sense to say that I am "cured" according to the CT, and then say that there is still infection. And then to conlcude that no further improvement will be made.

Weird. I am on to another opinion and have a recomended surgeron - appt. next week.

 
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Old 03-08-2013, 10:30 AM   #9
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Teagan4 HB User
Re: Dr Says Surgery Will Not Help my Condition

Quote:
Originally Posted by Leo255 View Post
I've been where you were at, Teagan4. It will get better, I promise you.

First of all, get off that damn Afrin. You can keep it for just flat out "emergencies," but you shouldn't be using it.

Go get yourself some sudafed - Get yourself a bunch of sudafed 30 mg...In the US, you can get like 96 tablets for just 10-14 dollars. Just make sure it is the pseudoephederine stuff. Phenylephrine sucks.

Also get yourself some loratidine, which is claritin...I also recommend getting some Claritin D 12 hour. This has quite a lot of pseudoephedrine and has some loratidine (or claritin) as well. The Claritin D 12 hour used to be a pretty good "emergency" drug for me. When I was at my worst, I would take it, and it would really help. Otherwise, I usually prefer the smaller, 30-mg tablets of pseudoephedrine. I just don't like to put drugs into my body, and would rather put the least amount possible.
I know - I am not happy with using the afrin. I am VERY Sensitive to drugs. I had to stop the Flonase after nearly two weeks as I was going insane from the side effects esp the anxiety feeling. Better today after two days off it.

I already have to take some Vistiril to keep the Afrin in check. I was afraid to try the Sudafed because of the same effetcs. Do you think it will give me less palpitiations?

I am also already in rebound from the Afrin. How long does it take to go away?

1) will sudafed give me as much relief as Afrin?
2) How long can I take it?

Thanks SSOOOOOOOO Much.

I know I still have infection. So, all is not lost.

 
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Old 03-08-2013, 10:36 AM   #10
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Teagan4 HB User
Re: Dr Says Surgery Will Not Help my Condition

Quote:
Originally Posted by gcsjr View Post
The doctor is correct that surgery won't improve the congestion or inflammation. Surgery is effective in improving sinus drainage and removing polyps but has no effect on the underlying inflammation.

Unfortunately, it sounds like your doctor hasn't done much to address the underlying problems. You really should see an allergist and probably get a second opinion from another ENT, but there are several things that can help with the underlying inflammation and congestion:

-Daily saline irrigation with a SinusRinse bottle
-Daily Singulair
-Antihistamines and/or allergy shots if you have allergies
-Regular use of the Flonase (it takes time but will help)
-Daily pseudoephedrine (Sudafed) decongestants

As Leo255 said, you have to get off the Afrin. It causes rebound congestion after daily use for as little as a week and the rebound congestion can be worse than the congestion you're taking it for.

The other thing you need to ask a doctor about is a longer course of prednisone. Most Medrol dose packs aren't a high enough dose to address sinus inflammation. You probably need a 3 week course of prednisone to reduce the swelling.

All of this is pretty standard so the fact that your doctor didn't recommend it is a good sign that you find a new ENT, one who has more experience treating sinus disease.

Thanks for the advice. The infection is still in the frontal sinus. She said mucocele. And I can hear the stickiness releasging somewhere along the side of nose mid way up, deep in my face when I roll over in bed.

Never had that before this who episode started in Nov.

I have very little confidence in the ENT. She was pretty short, and was in a hurry the two times I saw her.

She gave me no guidance except to say that my inflammation can be treated topically with steroids. I told her the Flonase did not really work AND I could not continue to take it because of the side effects.

We did not even discuss the medrol. I really think it did work, because I felt as though no air was exchanging deep in the recesses of my head, and then it improved after the Medrol.

The nasal congestion improved but reverted after the packet ended.

Incidntally, the medol did not cause me as many side effects (just felt overstimulated but it was bearable) as the Flonase.

I am going to try Omnaris, but my insurance may not allow for it.

How many of these ENts will I have to see before I get some decent advice?

 
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Old 03-08-2013, 11:14 AM   #11
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Re: Dr Says Surgery Will Not Help my Condition

If he's in there and cleans out the infection why wouldn't you have improvement? I had my surgery Nov 5 and had one infection a few weeks later, treated and cleared up, and have been fine since. This is the FIRST winter I haven't spent sick the whole time in many, many years.

 
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Old 03-08-2013, 03:07 PM   #12
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Teagan4 HB User
Re: Dr Says Surgery Will Not Help my Condition

Quote:
Originally Posted by Bea590 View Post
If he's in there and cleans out the infection why wouldn't you have improvement? I had my surgery Nov 5 and had one infection a few weeks later, treated and cleared up, and have been fine since. This is the FIRST winter I haven't spent sick the whole time in many, many years.
I agree.

That is why I will not have this ENT do my surgery.

Everyone in my family wondered the same thing. That if I still have infection in the frontal sinus, isn't is affecting me?

It was weird, but she said the surgery could be done soon, but not to worry. Just want to prevent complications around the eye etc. But she said twice clearly (and I had my sister with me at the visit who heard same)

"But the surgery will not change anything that you are experiencing."

I had told her my sinus area under my cheecks was feeling puffy and sore, that I still have headaches, clogged ears, dizziness, and a very stuffy nose that I can't breathe well through.

So, when I heard her say I would have no improvement, I freaked out.

Thanks for for the confidence booster

Last edited by Teagan4; 03-08-2013 at 03:08 PM.

 
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Old 03-08-2013, 03:50 PM   #13
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Re: Dr Says Surgery Will Not Help my Condition

I would get another opionion, but before I did that would call and ask the doctor why she said that? She may know something she hasn't shared with you....you know, since "everybody knows that." (I never do, so I have to ask.)

 
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Old 03-09-2013, 02:08 PM   #14
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Teagan4 HB User
Re: Dr Says Surgery Will Not Help my Condition

Quote:
Originally Posted by Bea590 View Post
I would get another opionion, but before I did that would call and ask the doctor why she said that? She may know something she hasn't shared with you....you know, since "everybody knows that." (I never do, so I have to ask.)
Thanks Bea. She is not available to talk, only her nurse. The nurse, whom I have called a number of times about my problems is not helpful. I really give up on the Doc. I just really think she is in a hurry and I have my doubts since day one. As I said I brought my sister both times, and she said she left feeling the dr never had a real conversation = just typed at her computer. She thinks she is a b - itch too. I have rarely said that about a dr. This one has a bad bedside manner, and I swear wears a fake smile when she comes in that looks like a grimace.

I'll let you know what the next Dr says. I go Monday.

 
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Old 03-12-2013, 08:55 AM   #15
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Re: Dr Says Surgery Will Not Help my Condition

Saw my new Dr for another opinion. Will be heading for surgery.

I was given prednisone for 12 days to combat the inflammation. Took the first dose this morning and it seems to be working already.

The dr said that the 19 days of Afrin has certainly contributed to this situtiaotn. I bled like crazy from his scope and even saline was buring me like cxrazy the last few days.

However, I was already inflammed like this last month. The Dr said the frontal sinsus may not be contributing to the overall situation, but can't be sure. Incidentally, this is one of the first places that I had a lump and pain back radiating down my nose and on the bridge of my nose when the whole thing started in Nov.

At any rate, fixing this and the seputum is something I want to do asap, although it was said to me that I do not have to do so immediately.

The dr has a good rep doing guided surgery - he is at a teaching hopsital on the east coast . All I can do is have faith.

I would say that the other ENT should have prescribed prednisone to me instead of letting me just hang and tell me to keep using the flonase. I can't deal with drs who offer no solution.

 
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