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Suggest Treatment For Chronic Sinusitis
Question: Ive been getting chronic sinus infections. I get them almost every month. Im a flight attendant and I cannot fly when I have them. Its too painful. Im going to the allergist for the first time tomorrow. I dont have a GP. I was wondering if the allergist would write intermittent fmla if I ask? My employer does not accept just a doctors note as an exusable absense. Ive never used fmla before but I need it for my last absense to be excused. I already have the paper work how do I go about asking the allergist to fill it out?
Brief Answer:
Allergy Meds, Sinus CT, Balloon Sinuplasty. Together should apply for FMLA
Detailed Answer:
Hi,
Thank you for your query.
1. Chronic Sinusitis by definition is a sinusitis lasting more than 8 weeks despite medical treatment.
2. The allergist should prescribe non-sedating anti-histamines, anti-leukotrines, a steroid nasal spray and steam inhalation for at least two weeks.
3. Neither allergy nor sinusitis fit easily into the FMLA definition of a Serious Health Condition, however taking the combined effect of both allergy and chronic sinusitis in the context of a flight attendant should qualify for intermittent episodes.
4. A Sinus CT will reveal the chronic sinusitis and Balloon Sinuplasty will help reduce the sinus barotrauma while flying, though the allergy will require long term medication to keep under control.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Allergy Meds, Sinus CT, Balloon Sinuplasty. Together should apply for FMLA
Detailed Answer:
Hi,
Thank you for your query.
1. Chronic Sinusitis by definition is a sinusitis lasting more than 8 weeks despite medical treatment.
2. The allergist should prescribe non-sedating anti-histamines, anti-leukotrines, a steroid nasal spray and steam inhalation for at least two weeks.
3. Neither allergy nor sinusitis fit easily into the FMLA definition of a Serious Health Condition, however taking the combined effect of both allergy and chronic sinusitis in the context of a flight attendant should qualify for intermittent episodes.
4. A Sinus CT will reveal the chronic sinusitis and Balloon Sinuplasty will help reduce the sinus barotrauma while flying, though the allergy will require long term medication to keep under control.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Well I get sinus infections more than 6-7 times a year and even when I dont have an infection I still deal with sinus pressure in my head and ears. That is the main reason in needing possible fmla because when I fly with a flare up it hurts my ears really bad. And im worried about my ears and my equillibrium. Could flying with sinus pressue in ears cause a busted ear drum?
Brief Answer:
You do have a genuine problem. This should be treated.
Detailed Answer:
Hi,
Thank you for writing back.
1. This is a common problem with flying as the cabin pressure is similar to 6000-7000 ft above sea level.
2. Ear and sinus barotrauma often occurs together (even without infection). The mechanism is similar. Ear barotrauma is due to Eustachian Tube Dysfunction (ETD) while sinus openings into the nasal cavity (ostia) get blocked, mostly during descent of the aircraft.
3. Middle ear effusions (fluid build-up) and ear drum perforation are possible, but rare with immediate medication.
4. You should get the FMLA, unless your airline is adamant. This should be explained in the context of flying and the fact that you are seeking a permanent solution to this problem as outlined in my previous answer.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
You do have a genuine problem. This should be treated.
Detailed Answer:
Hi,
Thank you for writing back.
1. This is a common problem with flying as the cabin pressure is similar to 6000-7000 ft above sea level.
2. Ear and sinus barotrauma often occurs together (even without infection). The mechanism is similar. Ear barotrauma is due to Eustachian Tube Dysfunction (ETD) while sinus openings into the nasal cavity (ostia) get blocked, mostly during descent of the aircraft.
3. Middle ear effusions (fluid build-up) and ear drum perforation are possible, but rare with immediate medication.
4. You should get the FMLA, unless your airline is adamant. This should be explained in the context of flying and the fact that you are seeking a permanent solution to this problem as outlined in my previous answer.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much. Ive also been experiencing ear aches. Sometimes, for example, if I lay on my right side all night I wlae up with the worst pain in my right ear... And the same happens wirh the left. Im also experiencing a little wetness in my ears and it itches... I notice this mostly in the morning. What could it be?
Brief Answer:
ETD (Eustachian Tube Dysfunction).
Detailed Answer:
Hi,
Thank you for writing back.
1. You probably have a post nasal mucus drip (due to the chronic sinusitis) which interferes with the Eustachian Tube function. The frequency of swallowing reduces during sleep. The Eustachian tube opens mainly with swallowing, hence the ears are worse in the morning. Air conditioning and low humidity will make matters worse.
2. The wetness in the ear must be directly examined by an otoscope or a video-otoscope. You can upload the images here. The itching may be due to irritation of the ears with wet wax or a referred sensation.
3. An Impedance Audiogram (Tympanogram) will help assess the ETD (Eustachian Tube Dysfunction).
4. A nasal endoscopy and a plain Sinus CT Scan can help check for Inferior Nasal Turbinate hypertrophy which is also responsible for ear fullness when you sleep on that side.
5. Start regular steam inhalation and start the allergy medication soon.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
ETD (Eustachian Tube Dysfunction).
Detailed Answer:
Hi,
Thank you for writing back.
1. You probably have a post nasal mucus drip (due to the chronic sinusitis) which interferes with the Eustachian Tube function. The frequency of swallowing reduces during sleep. The Eustachian tube opens mainly with swallowing, hence the ears are worse in the morning. Air conditioning and low humidity will make matters worse.
2. The wetness in the ear must be directly examined by an otoscope or a video-otoscope. You can upload the images here. The itching may be due to irritation of the ears with wet wax or a referred sensation.
3. An Impedance Audiogram (Tympanogram) will help assess the ETD (Eustachian Tube Dysfunction).
4. A nasal endoscopy and a plain Sinus CT Scan can help check for Inferior Nasal Turbinate hypertrophy which is also responsible for ear fullness when you sleep on that side.
5. Start regular steam inhalation and start the allergy medication soon.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
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. Chakravarthy Mazumdar
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