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Hi ENT Specialist , I Am A Retired Pharmacist So
Question: Hi ENT specialist, I am a retired pharmacist so I am not completely ignorant of my problems. 14 years ago I had sinus surgery (prefrontal sinus) if I remember correctly for chronic sinusitis which didn’t respond to various antibiotics including one continuous treatment with Augmentin for 30 days. Post surgery I seemed to be better but I still have periodic bouts of sinus infections I guess from seasonal rhinitis and various colds and whatever else would compromise my immune system. Also, I can tell that some critical structural anatomical features were removed during surgery because during intense physical training requiring deep breathing my nasal passages collapse and I have to augment my breathing through my mouth which of course dries my mouth out which is also bothersome. Also, the ENT told me that the cilia in the sinuses didn’t grow back very well post surgery so this could be part of the problem. Periodically, when I’ve had these bouts of recurring sinus infections of which I’ve got one going on right now, either I use XXXXXXX Med salt water nasal rinse first or the ENT who did the surgery gave me an Rx of budesonide 1mg/500ml sterile water irrigation rinse which I have used to quiet down the infection. Nothing that I use ever gets rid of the infection entirely because I always am clearing/blowing junk (yellow colored discharge) out of my nose every morning even in the best of times plus my nose just runs a lot until about 2PM. Actually, the Rx sinus irrigation rinse that I felt worked the best had the steroid plus an antibiotic (clindamycin I think) but that ENT who did the surgery says that from the literature he didn’t think the antibiotic is warranted anymore. Lately, this current infection was triggered by according to the ER doctor, a viral infection so no antibiotics were prescribed. My symptoms were persistent non-productive cough, low grade intermittent fever, headache/tenderness at the base of my skull and with no pain from tapping the Dr’s finger on the bones of my forehead and below the eye socket, plus I had general overall malaise with muscle/joint ache.I was also given Hycodan cough syrup. With this kind of medical history background what would be your advice?
Hi ENT specialist, I am a retired pharmacist so I am not completely ignorant of my problems. 14 years ago I had sinus surgery (prefrontal sinus) if I remember correctly for chronic sinusitis which didn’t respond to various antibiotics including one continuous treatment with Augmentin for 30 days. Post surgery I seemed to be better but I still have periodic bouts of sinus infections I guess from seasonal rhinitis and various colds and whatever else would compromise my immune system. Also, I can tell that some critical structural anatomical features were removed during surgery because during intense physical training requiring deep breathing my nasal passages collapse and I have to augment my breathing through my mouth which of course dries my mouth out which is also bothersome. Also, the ENT told me that the cilia in the sinuses didn’t grow back very well post surgery so this could be part of the problem. Periodically, when I’ve had these bouts of recurring sinus infections of which I’ve got one going on right now, either I use XXXXXXX Med salt water nasal rinse first or the ENT who did the surgery gave me an Rx of budesonide 1mg/500ml sterile water irrigation rinse which I have used to quiet down the infection. Nothing that I use ever gets rid of the infection entirely because I always am clearing/blowing junk (yellow colored discharge) out of my nose every morning even in the best of times plus my nose just runs a lot until about 2PM. Actually, the Rx sinus irrigation rinse that I felt worked the best had the steroid plus an antibiotic (clindamycin I think) but that ENT who did the surgery says that from the literature he didn’t think the antibiotic is warranted anymore. Lately, this current infection was triggered by according to the ER doctor, a viral infection so no antibiotics were prescribed. My symptoms were persistent non-productive cough, low grade intermittent fever, headache/tenderness at the base of my skull and with no pain from tapping the Dr’s finger on the bones of my forehead and below the eye socket, plus I had general overall malaise with muscle/joint ache.I was also given Hycodan cough syrup. With this kind of medical history background what would be your advice?
Brief Answer:
Probably a viral infection, follow the advice below.
Detailed Answer:
Hello dear and welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.
I read carefully your medical history.
I see that you have recurrent sinus infections, which are a characteristic of chronic sinusitis.
Regarding the latest symptoms I agree with your doctor.
The symptoms seem to be related to a viral infection and no antibiotics are needed.
The low grade fever and muscle ache confirm this diagnosis.
So, I would recommend to use anti-inflammatory medication such as Ibuprofen 400 mg three times a day.
I recommend to continue using saline nasal sprays for local relief.
I recommend to use a vitamin C supplement to boost the immune system.
I also recommend to drink liquids and rest.
Only if the symptoms continue for more than three to five days, antibiotics may be needed.
In this case I recommend Azithromycine 500 mg one tablet a day for three days.
It is a prescription medication,so you should consult your doctor before using it.
Hope I have answered your query. Let me know if I can assist you further.
Probably a viral infection, follow the advice below.
Detailed Answer:
Hello dear and welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.
I read carefully your medical history.
I see that you have recurrent sinus infections, which are a characteristic of chronic sinusitis.
Regarding the latest symptoms I agree with your doctor.
The symptoms seem to be related to a viral infection and no antibiotics are needed.
The low grade fever and muscle ache confirm this diagnosis.
So, I would recommend to use anti-inflammatory medication such as Ibuprofen 400 mg three times a day.
I recommend to continue using saline nasal sprays for local relief.
I recommend to use a vitamin C supplement to boost the immune system.
I also recommend to drink liquids and rest.
Only if the symptoms continue for more than three to five days, antibiotics may be needed.
In this case I recommend Azithromycine 500 mg one tablet a day for three days.
It is a prescription medication,so you should consult your doctor before using it.
Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by :
Dr. Raju A.T
Brief Answer:
Probably a viral infection, follow the advice below.
Detailed Answer:
Hello dear and welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.
I read carefully your medical history.
I see that you have recurrent sinus infections, which are a characteristic of chronic sinusitis.
Regarding the latest symptoms I agree with your doctor.
The symptoms seem to be related to a viral infection and no antibiotics are needed.
The low grade fever and muscle ache confirm this diagnosis.
So, I would recommend to use anti-inflammatory medication such as Ibuprofen 400 mg three times a day.
I recommend to continue using saline nasal sprays for local relief.
I recommend to use a vitamin C supplement to boost the immune system.
I also recommend to drink liquids and rest.
Only if the symptoms continue for more than three to five days, antibiotics may be needed.
In this case I recommend Azithromycine 500 mg one tablet a day for three days.
It is a prescription medication,so you should consult your doctor before using it.
Hope I have answered your query. Let me know if I can assist you further.
Probably a viral infection, follow the advice below.
Detailed Answer:
Hello dear and welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.
I read carefully your medical history.
I see that you have recurrent sinus infections, which are a characteristic of chronic sinusitis.
Regarding the latest symptoms I agree with your doctor.
The symptoms seem to be related to a viral infection and no antibiotics are needed.
The low grade fever and muscle ache confirm this diagnosis.
So, I would recommend to use anti-inflammatory medication such as Ibuprofen 400 mg three times a day.
I recommend to continue using saline nasal sprays for local relief.
I recommend to use a vitamin C supplement to boost the immune system.
I also recommend to drink liquids and rest.
Only if the symptoms continue for more than three to five days, antibiotics may be needed.
In this case I recommend Azithromycine 500 mg one tablet a day for three days.
It is a prescription medication,so you should consult your doctor before using it.
Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by :
Dr. Raju A.T
Hi Dr. Gurabardhi, I realize that you are probably an excellent doctor and no offense but you did not address the main issue which is my recurrent sinus infections with constant drainage and colored discharge and you are not an ENT specialist whom I originally wanted to answer my query. I realize that the current infection was probably viral but the end result is the same, with the same symptoms I always get so if you could pass this along to an ENT then I would be grateful. I would like an ENT to discuss my future options, comment on the steroid sinus rinse, whether or not I should get another CT scan and actually spend money to go to an ENT and what can be done if anything about the continual drainage I have and whether or not either that balloon procedure, polyp removal or some other surgery could possibly be warranted. Also, I sleep on my left side so my left sinuses are always clogged in the morning and sometimes cause me to wake up due to the congestion.
Hi Dr. Gurabardhi, I realize that you are probably an excellent doctor and no offense but you did not address the main issue which is my recurrent sinus infections with constant drainage and colored discharge and you are not an ENT specialist whom I originally wanted to answer my query. I realize that the current infection was probably viral but the end result is the same, with the same symptoms I always get so if you could pass this along to an ENT then I would be grateful. I would like an ENT to discuss my future options, comment on the steroid sinus rinse, whether or not I should get another CT scan and actually spend money to go to an ENT and what can be done if anything about the continual drainage I have and whether or not either that balloon procedure, polyp removal or some other surgery could possibly be warranted. Also, I sleep on my left side so my left sinuses are always clogged in the morning and sometimes cause me to wake up due to the congestion.
Brief Answer:
You have to direct your query at 'Ask a Specialist' section.
Detailed Answer:
Hi again dear,
Thank you for your appreciation.
As a general and family physician, I treat commonly chronic sinusitis.
Nasal corticosteroids are the first line of treatment in my daily practice.
The steroid sinus sprays have a local effect and reduce nasal inflammation.
Sometimes oral corticosteroids may be needed.
Antibiotics are prescribed only if we suspect a bacterial infection.
Nasal endoscopy is the first examination recommended to confirm the state of inflammation.
CT is recommended only if we don't get enough information through endoscopy.
If you need another opinion from an ENT specialist, you have to direct your query at 'Ask a Specialist' section.
Wish you all the best.
Take care dear,
Dr.Dorina Gurabardhi
You have to direct your query at 'Ask a Specialist' section.
Detailed Answer:
Hi again dear,
Thank you for your appreciation.
As a general and family physician, I treat commonly chronic sinusitis.
Nasal corticosteroids are the first line of treatment in my daily practice.
The steroid sinus sprays have a local effect and reduce nasal inflammation.
Sometimes oral corticosteroids may be needed.
Antibiotics are prescribed only if we suspect a bacterial infection.
Nasal endoscopy is the first examination recommended to confirm the state of inflammation.
CT is recommended only if we don't get enough information through endoscopy.
If you need another opinion from an ENT specialist, you have to direct your query at 'Ask a Specialist' section.
Wish you all the best.
Take care dear,
Dr.Dorina Gurabardhi
Above answer was peer-reviewed by :
Dr. Raju A.T
Brief Answer:
You have to direct your query at 'Ask a Specialist' section.
Detailed Answer:
Hi again dear,
Thank you for your appreciation.
As a general and family physician, I treat commonly chronic sinusitis.
Nasal corticosteroids are the first line of treatment in my daily practice.
The steroid sinus sprays have a local effect and reduce nasal inflammation.
Sometimes oral corticosteroids may be needed.
Antibiotics are prescribed only if we suspect a bacterial infection.
Nasal endoscopy is the first examination recommended to confirm the state of inflammation.
CT is recommended only if we don't get enough information through endoscopy.
If you need another opinion from an ENT specialist, you have to direct your query at 'Ask a Specialist' section.
Wish you all the best.
Take care dear,
Dr.Dorina Gurabardhi
You have to direct your query at 'Ask a Specialist' section.
Detailed Answer:
Hi again dear,
Thank you for your appreciation.
As a general and family physician, I treat commonly chronic sinusitis.
Nasal corticosteroids are the first line of treatment in my daily practice.
The steroid sinus sprays have a local effect and reduce nasal inflammation.
Sometimes oral corticosteroids may be needed.
Antibiotics are prescribed only if we suspect a bacterial infection.
Nasal endoscopy is the first examination recommended to confirm the state of inflammation.
CT is recommended only if we don't get enough information through endoscopy.
If you need another opinion from an ENT specialist, you have to direct your query at 'Ask a Specialist' section.
Wish you all the best.
Take care dear,
Dr.Dorina Gurabardhi
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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