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Doctors' Answers to "Frequently Asked Questions" - Chronic Sinuitis

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Chronic Sinuitis [posted 12/04/98]
Question: At age 29 my husband started getting severe sinus infections after accidentally taking a 2 nd lifetime pneumonia shot. The reason I mention the pneumonia shot is because he had an allergic reaction to it where his arm swelled up and was red, black, and blue. Up to this point he had never had allergies,rarely had a cold, sick, watery eyes, virtually no allergy symptoms, very healthy. Then immediately after this shot he got an sinus infection that a doctor gave him amoxicillin, it worked for less than a week then he put him on a months dose of doxicycline, then biaxin,zithromax, you name it he has been on it. Basically he has had so many infections he is immune to every antibiotic except cipro as we speak. By this time he had a CT scan ...a cyst and polyps were noted in the sinuses and an ENT performed surgery. The ethmoid, and sphenoid sinuses were packed with polyps, the Maxillary sinuses were blocked by either a cyst on the right and polyps on the left. For a year without anything following the surgery he had no allergy symptoms, no problems. Then like he hit a brick wall he started all over again except now he takes allegra D twice a day, and vancenase twice a day. He has been seeing an allergist and taking shots for 6 months, we have encased all of our matresses with allergy covers, we use an air filter, etc.. He is told by the allergist that he is extremely allergic to cottonwood, cedar, pigweed, and allergic to about all grasses,trees, weeds, pepper, apricots,soy and strawberries. He is very sick right now with a sinus infection and has been on cipro for 7 days and is still coughing up dark green mucus and still not feeling any better. Three days ago his ENT did a CT of the sinuses on him and said his sinuses were open and looked good, he said basically everything is raw and when he has a reaction just swells up and an infection occurs . First he has a sore throat, then postnasal drip, then a small hacking cough, severe headache and before the day is over he has a full blown infection. Allegra D so far has been the only thing that has kept him from getting an infection for over a month until recently he missed 1.5 days dose and got sick. Is this really an allergy thing, do we need to move? and where? I am afraid he is to the point of no antibiotics that can help him due to immunity, he is running out of options any help? Why does there seem to be little drainage and an immediate infection? 

Answer: Once you develop sinus infections, they tend to be recurring. As to the allergy issue, check with your allergist about other locales to live. You might check Places Rated Almanac. They usually have a listing concerning allergens.

Chronic Sinuitis
Question: I experience daily/year round stuffiness and have about a 50%-75% sense of smell. My sense of smell which significantly decreases and when I attempt to pinpoint the origin of any strong smells, or in the case of being around cigarette smoke, my nasal airway seems to close up and become very stuffy, I get a headache and totally lose my sense of smell due to this stuffiness. I have been on drugs like rhinocort, becanese, seldane, seldane-d, claritin-d, saline spray and a few other decongestants and antihistamines without getting any relief at all. I had sinus surgery in 1992 to correct a deviated septum and remove some of the old infected tissue buildup in the ethmoid sinus area. I have been tested negative to allergies. During the winter months I tend to get a sinus infection about once every 3 weeks and not as frequently during the summer. I have a high tolerance to medications and it tends to take a strong medication before I see any relief. The only drug I have ever gotten relief from was a greem nasal spray which was sprayed into my nose before an endoscope exam. This drug immediately dilated the nasal membranes and my nasal cavity was relieved of its stuffiness. Unfortunately the drug only lasted 90 minutes and you cannot get it via a prescription because it has a small amount of cocaine and could possibly lead to an addiction.

Answer: Your comments about chronic sinusitis sound all too familiar. This is a very common problem and unfortunately has limited options. Use of nasal sprays involving steroids and nasal saline is the first line of defense. After this fails, surgery is usually tried with varying success. Some other options that I don't see listed on your medications include the use of nasal cromolyn sulfate which is a drug used in asthma and allergies. Also, some medications can cause chronic symptoms which mimic sinus stuffiness-I would discuss these with your doctor-but, some blood pressure medicines have been known to cause stuffy noses.

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