ijah

Hi Steven,

in a previous thread titled 'fast acting nasal spray with minimal
rebound effects?', we had an exchange in which you said...

*****
What else is your doctor doing for you besides prescribing Flonase? If
you have been diagnosed with sinusitis, then you may need to be
treated much more aggressively besides just steroid nasal sprays. I
soon reached the point when the Flonase wasn't getting into my left
nostril at all because it was completely shut. Then I had to go for
surgery.

What was your exact diagnosis? And besides Flonase, what else is your
doctor doing for you? What did your CT scan show?


-- Steven L.
*****

i meant to reply but never got around to it.

anyway, i'm most interested and wondering if you'd be willing to share
your case history. how is it that you got to the point where your left
nostril was completely shut?

can you paint a picture for us? when did problems start, what where
symptoms, what treatments, what helped, what didn't help, what surgery
did you opt for, how did that go, did it help, etc.

as far as my case goes, i've been desperately trying to find someone
who gives a shit. the apathy is staggering. i can't seem to get anyone
to work with me agressively to troubleshoot the problem. very
half-hearted efforts are the most i can dredge up. i've had to
doggedly pursue matters and be extremely persistant in following up.
Damn near every course of treatment has come at my
suggestion/insistence and the only way i've been able to make these
suggestions is based on the clues i've gotten from this group. thank
god for alt.support.sinusitis and Dr. Grossan. it was a couple weeks
before anyone even suggested an antibiotic. during that time, i beat
them to the punch and put myself on a course of penicillin VK. that
seemed to knock out the basic 'sinus infection' that started my
current crisis, but i know it didn't wipe the slate clean. i went from
congested, with yellow/brown mucus and that 'sick' feeling to no
mucus - or very little and it is clear or a little milky white but
bone dry, extremely swollen nasal passages and near complete blockage
due to the inflammation. so, it doesn't seem really like my 'sinuses'
are involved at all now or any kind of typical sinus infection. it's
just big time swollen turbinites from what i understand. but WHY -
what is triggering, keeping these babies swollen?

Flonase - that seemed to help greatly after a few weeks use - now,
very limited effectiveness. next, a fairly worthless very low level
course of prednisone - 10mg per day for 5 days. then a course of
Cefuroxime Axetil antibiotic, next a bam/bam course of prednisone
60mg/day for three days, 40mg/day for three days, 20mg per day for
three days. I really felt like this second course of prednisone was
starting to bite on the third day, but once i started tapering off my
condition stagnated - got no better - maybe a little worse. then we
had a five day Z-Pack of antibiotics. finally, i insisted on a CT
scan, which i got last week. got a call from my ENT's office and they
left a msg which simply stated - 'Your CT scan was clean' - gee thanks
- could you give me a little more insight than that MAYBE - for crying
out freakin' loud. I'm gonna follow up on this. tried to get more info
about it, but they never called me back. i will persist. after the CT
scan i decided to try another ENT. had first appt with him a couple
days ago. he prescribed Singulair tablets - which i guess is supposed
to help with inflammation and Astelin nasal spray which i guess is for
combating non-specific type allergens/irritants. i got no other
guidance from him and there are no future plans to do anything - no
follow up appts - nothing. i'm just hanging out here, praying everyday
to be able to keep a little trickle of air flowing thru one or either
nostril. not sure what angle to try next.

thanks for listening.

please let me know about your case if you don't mind sharing.

steven litvintchouk

It's a long story.

When I took a new job in 1984, I moved into a new locale and bought a
home there. It's too bad I didn't spend lots more time looking around
the neighborhoods before buying my home because within a year I started
to notice something. Whenever I would come home from work, my nose
would instantly start to stuff up mildly. Even before I drove to my
house, as soon as I drove back to my town, this would happen. And the
next morning, when I would get in my car and drive out of my town to go
to work in another town, my nose would unclog again. (I have since
traced this phenomenon to a polluting factory a couple of miles from my
house that I didn't know was there; it's not easy to spot from where I
live).

In January 1991, I got my first sinus infection following a simple cold.
My primary care physician (PCP) prescribed Bactrim and it went away.
But then when I got my next cold 8 months later, the same thing
happened--sinus infection, Bactrim. I started getting sinus infections
after other colds. And then I even got a sinus infection without a
cold. But so long as antibiotics like Bactrim and Cipro cleared the
infections, I didn't complain.

Then a *very* odd thing happened. In late September 1993, I caught a
simple cold. This cold didn't turn into a sinus infection and it seemed
to go away by itself. Since I thought I had just gotten over it, I took
a flu shot that my employer was giving out. Within 5 hours of taking
the flu shot, I got a terrific flood of thick yellow mucus pouring down
the back of my throat that seemed to come out of nowhere. I was
literally ******* and choking on it. Even with my past sinus
infections, I had *never* experienced anything like this. (I have
always wondered if this could be a coincidence. If you search Google
for NGs like this one, you will find similar "idiosyncratic" reactions
to flu shots that seem to have triggered bizarre sinus problems or other
bizarre problems in a very few people.)

So I went back to my PCP and again he put me on antibiotics. But this
time, the symptons never completely stopped. My left nostril remained
completely stuffed up. He tried several antibiotics, steroid nasal
sprays, nothing worked.

My sinus infections were now much worse. Again and again I would get
that thick yellow flood of mucus pouring down the back of my throat; I
would wake up in the middle of the night ******* and choking. The
antibiotics would stop this symptom but my left nostril remained
completely clogged.

I went to several ENTs but they all said my CT scan "didn't look too
bad" so they did nothing.

Eventually I found an ENT who was willing to diagnose me with chronic
sinusitis, based on my symptoms. This guy knew that even CT scans
aren't 100% reliable and there's a 5% chance of false negatives. So he
was willing to *disregard* the CT scan and do surgery on me based on my
symptoms and history alone.

And it's good thing he did, because when he went into my sinuses he
found real sinusitis that the CT scan had missed.

The surgery definitely helped. But I have never completely rid of
myself of yellowish post nasal drip from my left nostril, resulting in a
chronic cough I have never been able to completely shake. There is one
pair of ethmoids that he didn't touch, and I've always wondered if
that's the problem. But he says it isn't.

The moral of the story is: There is no 100% definitive way to diagnose
sinusitis except to go for surgery and let the surgeon go into all your
sinuses and have a look around. Because in order to push that endoscope
all the way into every sinus you have to be anesthetized and they only
do that with surgery.

So where things stand now is I really need to find another ENT who will
also diagnose me with sinusitis and agree to operate despite another
negative CT scan. So far, I haven't found one.

I seem to be in the unlucky 5% of the sinus sufferers for whom the CT
scan is negative.


-- Steven L.


By now you have probably read my story.

If you can travel, you should consider going to see either of the following:

Dr. Wellington Tichenor, in New York City
http://www.sinuses.com
He used to post here.
Go to his website and read how sinusitis should be treated:
http://www.sinuses.com/md.htm

Or the Mayo Clinic in Minnesota.

Or search the U.S. News website for a list of the other hospitals with
the best otolaryngology departments.

Good luck.


-- Steven L.

johnny1000

Steve... What an interesting story that sure draws parallels to mine.
...I think I've always had some sinus problems. Even as a little kid,
I was always snorting. However, In 1983, I developed this abscess type
pain directly below my right eye. It was terrible. After a few days, I
went to the Doc. and was prescribed some amoxil. Cleared it up within a
few days. Right up until the late nineties, I didn't have too much
problem. ...Then I too opted for the flu shot. I think in /98. Four days
later I developed sinus problems that have never left. ....Of course,
that was the last flu shot I've had, as even the first one I had the
year before, I felt under the weather for a few days. .....I've just
had another flair-up a few weeks ago. Normally, my Doc. gives me 3 weeks
of 250 mg. Levaquin. ...This time he decided to try 500 mg. per day.
It's worked much better. ...Jon

ijah

<snip>

<snip>

Yikes. A flu shot, eh? I completely forgot about my flu shot. My
current crisis started right after a flu shot. I got the flu shot and
about 36 hours later started having flu like symptoms. my doc assured
me that the shot didn't cause them, that flu symptoms don't come until
3-5 days after you 'catch it'. So, coincidence?
<snip>


what kind of surgery was it?

ijah

another tie-in with a flu shot in your case. Steven Litvintchouk's
case ramped up to the max after a flu shot. my serious problem going
on three months duration started shorly after a flu shot.

coincidence? what might this indicate? a lingering infection/pathology
triggered by flu shots - a virus?

steven litvintchouk

Please search the Google archive of this NG for more examples of bizarre
reactions like mine.


Septoplasty, bilateral maxillary antrostomy, and double ethmoidectomy.

-- Steven L.

steven litvintchouk

Flu shots have more in them than just the flu antigen. (It's the flu
antigen you make antibodies for, so then you're immune to the flu.)
But flu shots have other so-called "junk DNA" as well. For example, if
you're allergic to eggs, you can't take a flu shot because it's made
from eggs and some of the egg DNA ends up in the shot.
As part of the manufacturing process, other "junk DNA" ends up in the
shot as well. Those vaccine components are all listed in the
manufacturer package insert that your doctor got, but when your doctor
gave you the flu shot he didn't show you that do***ent, right?
We probably reacted to the junk DNA that was in the shot that year.


Here are some more folks who had such problems:


"Hello....I have had the flu shot for the last 4 years, excluding last
year. Everytime I get the shot, within a couple of days, I develop a
"mini" flu which
seems to last a few days. A couple of years ago, however, when I had the
shot, my sinuses took an immediate turn for the worse and had me on
antibiotics for weeks. ...I decided not to have the shot last fall ...I
think it increases the congestion in me, just enough, to aggravate the
underlying condition."
http://www.google.com/groups?q=+%22flu+shot%22+group:alt.support.sinusitis&hl=en&lr=&ie=UTF-8&oe=UTF-8&scoring=d&selm=CZaC6.6655%24FY5.532152%40www.newsranger.com&rnum=10

"Whoever ever since I had the flu vaccination a week ago (winter soon
here down under) I have had pain in a different area of my sinus's, it's
like I have a serve headache all the time. Normally pain is in left
sinus as the infections home is in my left middle ear. At present both
sides have been aching and right between the eyes."
http://www.google.com/groups?hl=en&lr=&ie=UTF-8&oe=UTF-8&selm=3AD90E1C.81D0BA7D%40pmassociates.com.au

"I have often wondered if it was because of the Swine Flu Shot I got
circa 1976 caused me to have sinus problems. I never had them before I
got that shot. "
http://www.google.com/groups?hl=en&lr=&ie=UTF-8&oe=UTF-8&selm=B929A498.7F9C%25tommylane%40earthlink.net

"I already have Benign Positional Vertigo which began after I
received a flu shot in 1992. I heard it reported (very quietly, via a
nurse I knew at Scripps in San Diego) that many people suffered
vestibular side effects from that years shot. "
http://www.google.com/groups?q=+%22flu+shot%22+group:alt.support.sinusitis&hl=en&lr=&ie=UTF-8&oe=UTF-8&scoring=d&selm=20020114135230.12283.00001089%40mb-mu.aol.com&rnum=6

"On Monday, I got a flu shot just like I do every year since 1990
(except when pregnant). About 10 minutes after the shot, I started to
feel bad. Normally, I get swollen and red at the injection site and
usually my elbow and neck are a little stiff for a day or two. This
time I got nauseated, light headed, *extremely* fatigued, shaky, hot and
sweaty if I move around at all, headache, fever, memory problems (which
I attribute to fatigue), and pain in chest like smoke inhalation. If I
move around a lot, I cough, aggravating asthma. Worked on Tuesday, came
home early Thursday, stayed home today-Friday. Saw the doctor. She can't
figure it out."
http://www.sleepnet.com/apnea4/messages/472.html

"Almost 1,000 Canadians have suffered adverse reactions to the flu vaccine
in the past two months, Health Canada has revealed. That's nearly 80 times
as many as for the same period last year. While the outbreak, dubbed
oculo-respiratory syndrome, is well under
control -- resulting in only four hospitalizations and no deaths -- it has
set off alarm bells among public-health experts, who worry about the
country's ability to respond to a genuine crisis. "
http://www.whale.to/m/flu8.html

-- Steven L.

charles39847

I've got the dry completely blocked stuffed up crappy feeling.

I came down with a bug October 1st. Kicked it pretty easily (5 days
on Zpak). I was almost 100% and I got the flu shot in early November.
I remained at the almost 100% status until Dec 24th. I don't think
that the flu shot had any affect on my problems.

But then again, who the hell knows.

don brady

In that particular case you might want to go to U.Penn for a consultation at
least.

Dr. Kennedy and the others there believe that opening up the ethmoids
completely is key to resolving long-term chronic sinusitis. They have been the
main advocates of that form of comprehensive ethmoidectomy. They are somewhat
at odds with Mayo on that.

ijah

<snip a bunch of other excellent references re: flu shots and sinus
problems>

Steven,

thanks for the research and well organized do***entation of all this.

thanks for taking the time and effort to put it all together.

excellent post.

iJah