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Suggest Treatment For Nasal Septum Perforation

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Posted on Wed, 5 Aug 2015
Question: My name is XXXXX. in the past 6 to 8 months I have had the following. starting back in September i had a hole form in my septum approx 3 cm in size. it finally stopped, but the doctors had no explanation for it. in November i got Optic Nerve Neuritis for which they put me on a 3 day regiment of I.V. Steroids 1,000 mgs per day which really messed up my system. I couldn't walk well and was i constant pain. I should also tell you that i cannot take medications, they have a periodical reaction on me. For instance Luniest the sleeping pill acted like speed and I was up of 2 days. Welbutin put me into respiratory destress and woke up in the hospital hooked up to a respirator cymbals sducidal, statin drugs kidney failure Metformin Lactic Acidosis. I have come close to dying a couple of times and its always due to medications. At this point i refuse to take any new meds. My nutrients found I have a gene mutation, it is C677T gene mutation. I have been on the the medical food fro 5 month but with little help. 1 month ago i had chest pains and went to the hospital. The LAD and the artery behind the heart were over 85% closed. I was not informed correctly that they changed my plavix to effient which landed me back in the hospital 1 week later due to a TIA. I started cardio rehab last week because exercise has always helped me in the past. the first 3 tines there i have terrible pain in my calfs and legs so much so i have to stop, and this is only after being on it for 5 min. I barely eat or sleep but i have gained over 40lbs and that is a lot for me. Just one year ago I was working out 3 times a week and boxing trice a week. I have no idea what is going on and neither do my doctors. I am at my wits end. I am a successful business owner of 57 years old and except for some problems in my past a fairly healthy one. There has got to be something that ties all this in. And FYI my latest labs came in i have high hemoglobin 18.7and high Heratocrit 53.3 and my doctor wrote beside it (THIS IS NEW OH WELL) I wanted to smack him instead i fired him.my Calcium, serum was 10.5 AST (SGOT) 55 ALT (SGPT) 74 Total Cholesterol is 315 when just last year it was 178. my VIT D is just above 36 and this is taking 100,000 IU of VIT D a week I take 50,000 on Saturday and another 50,000 on Sunday I should also tell you that i am Ashkenazi Jew. I dint drink maybe a single malt every 3 to 6 months and I have never smoked. If you have any ideas PLEASE HELP I have a family to take of and as of late have not been able to.
Thank You;
XXXXX
doctor
Answered by Dr. Ram Choudhary (4 hours later)
Brief Answer:
some details needed

Detailed Answer:
Hi XXXXXXX
Welcome to healthcare magic.
I have read your history of long agony and multiple comorbidities and problems.
Please tell me what do you mean by the hole you have mentioned. I want to know where was it located amongst the body organs.
If you were investigated then please load the investigations especially the blood investigations.
Please let me know these details.
Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ram Choudhary (36 hours later)
The hole formed in my nasal septum so that now there is no separation of my nostrils. I have about a 3.5 cm hole inside my nose. The only advantage is I can have one of those cow bell hanging from my nose. That is not my kind of fashion statement. They checked me for Wangners or something like that and it was negitive. I even had a specialist from SWU he said sometimes these thinks happen for no reason. I wanted 3 month to see this doctor and that was the XXXXXXX I got.i do have a video I can show you, you can see the light entering though the opposite nostril
doctor
Answered by Dr. Ram Choudhary (16 hours later)
Brief Answer:
some investigations needed

Detailed Answer:
Hi XXXXXXX
Welcome back.
You had multiple problems in the recent past and now the coronary occlusion and TIA have further mesh up the things. For the latter two you must get treatment on regular basis. Consult your local cardiologist for that.
Your aching limbs may be due to borderline vit.D I think you should take 60000u weekly till relief comes or lever corrects up to 50.
The nasal septum perforation and the ensuing optic neuritis are pretty intriguingly bizzare.
Please get a biopsy of the margin of the perforation and also get gram stain, ZN stain and culture of the secretions/exudate if any.
Some infections like TB or rhinosporidium can cause such damage.
Wegeners is a common culprit, it had been negative still I would adviseadvise to get ANA, RA,cANCA, cANCA, antiRo and antiLa.Also get CBC, ESR, CRP and VDRL serology to help in deciding the cause.
I hope the work up will help in the diagnosis.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ram Choudhary (1 hour later)
Thanks for your feed back. As to the vit D I am already taking 100,000 I.U. Of vit D a week. That is what got my level above 30. I am under the care of a cardiologist but he only treats my heart issues. Is their anyone who specializes in the body as a whole besides a GP. I also need to know who can order the labs you sent me. Thanks for your help.

XXXXX
doctor
Answered by Dr. Ram Choudhary (1 hour later)
Brief Answer:
internist or MD, Internal Medicine is right doctor

Detailed Answer:
Hi XXXXXXX
Welcome to HealthcareMagic.
You should do sun light exposure of skin, it generates vitamin D naturally. Better do walking or jogging when there is light sun light.
The right doctor having good knowledge of all the body systems is MD, Internal Medicine doctor.
Try to fix an appointment with the specialist physician.
He can recommend the suggested investigations.
I hope the advise will be helpful for you.
Note: For detailed guidance on genetic screening consult a genetics specialist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Ram Choudhary

Internal Medicine Specialist

Practicing since :2001

Answered : 2270 Questions

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Suggest Treatment For Nasal Septum Perforation

Brief Answer: some details needed Detailed Answer: Hi XXXXXXX Welcome to healthcare magic. I have read your history of long agony and multiple comorbidities and problems. Please tell me what do you mean by the hole you have mentioned. I want to know where was it located amongst the body organs. If you were investigated then please load the investigations especially the blood investigations. Please let me know these details. Take care.