Sinus Infections
 

I've had a sinus infection for two weeks now. SI's are not uncommon to me, having 2-3 a year at least for as long as I can remember. Most of the time they dissipate within a week or I'd get antibiotics. This SI has progressed from congestion and some slightly yellow discharge to a dark yellow discharge; from thick to runny all of the time.

The Docs here gave me Entex, Flonase, and Naproxsyn (sp?). That had helped with the swelling, but now the discharge is a dark, almost black, yellow with blood. Oh, the taste? Dear God….

So, is this normal? The Docs here claim that it is and its part of the infection breaking up, but it is a new one for me. Sinus pain continues, but the NSAID is helping and Sudafed helps control the drainage. No fever as yet, I just don’t want this to get out of hand here in the Sandbox (bronchitis for example).

Any thoughts?

Commo-
If what you say is accurate about your already diagnosed sinus infection(your symptoms and description seem to support that Dx from my experience) then the medications you are taking are not necessarily treating the cause (etilology) of the condition anymore, but are treating the symptoms only.
First, look at the drugs you are taking:

• Entex- decongestant and expectorant to diminish secretions in sinuses and airway
• Flonase- a corticosteroid that can powerfully prevent your body's inflammatory response BUT consequently your body's immune response to infection. However, can be very effective for allergies.
• Naproxen- a non-steroidal anti inflammatory... for mild aches/pains and obviously inflammation too. Very little decrease in the body's ability to fight infection

FWIW, the flonase can actually cause a marked decrease in your ability to fight off the bacterial infection ( or fungal for that matter). So it could be causing a worsening of the condition or at least prolonging the course.

I would get another exam, discuss with your Doc about the Dx and if he/she still agrees that it has transitioned from congestion to an actual bacterial infection with congestion, then a round of Ab to treat the infection should be warranted. (Amoxicillan and clavulanate acid (Augmentin) is the first line AB that I personally initially write for sinus infections, there are many other valid choices).

The decongestant (entex) and the NSAID aren't a bad option for symptoms management while the AB is working. I just don't like the Flonase. Interested to hear other opinions on this... I may be more of an old schooler on this. I like prescribing sterile saline irrigations, Ab, and a decongestant for a known/existing sinus infection. I would actually only use the flonase BEFORE things got to the infection stage , in an attempt to prevent the severe congestion that can lead to the formation of conditions in the sinuses that lead to a bacterial colony in the "plugged up" sinuses.

Hope that helps Commo-

Thank you Jaw Breaker. I did not know that about Flonase.

Normally at home I was prescribed Augmentim or Biaxin, sometimes an erythomycin Z-pack. My concerns are this getting worse and the fact that I wake up choking on snot.

The medical staff here is... less than friendly. Maybe its because I'm a contractor, I don't know. I'll give them a few days and see if it improves.

Would Predisone and levaquin be appropiate?

I get Sinus Infections on a regular basis.

Generally use Augmentin and Clarinase to deal with it. Also use hot showers, hot wet compresses and saunas to help alleviate the pressure. Find that Chinese Tea has a positive effect as well.

Saunas worked well for me over the summer. Also worked to alleviate (I believe) 'pressure build-ups' in the neck and behind the ears (hard bumps that arise when I am stressed for a long period. Doc hasn't been able to Dx them).

Solid

[QUOTE=CommoGeekThe medical staff here is... less than friendly. Maybe its because I'm a contractor[/QUOTE]


You need an abx course, and one that is the correct sectrum.

Be persistant with the med staff. Maybe go to them everyday until they see you.

ccrn

Again, steroids may take away some or a lot of your symptoms, but IMO are not to be used for routine cases where infection is the known etiology. They REDUCE your bodies ability to fight the infection from the bacteria. They make you feel "better" initially from your congestion, but they may cause a more prolonged or severe infection in the long run. USUALLY, all this doesn't make a difference as a healthy human will still fight off the infection. BUT to me, it is inappropriate. I know a LOT of NP's, MD's, DMD's, etc that will write for steroids to make the patient happy, I just don't see the logic in it if you base it on the actions of the drugs.

Levaquin is a good AB. Again, it is the choice of the Doc and his/her preferences and experiences as to the Ab they will put you on.

Received an email from CG...seems they have blocked his access to PS.com at this time. None too happy right now methinks. But any other responses I will do a copy/paste for him...and hopefully he'll get it resolved.

Antibiotic de jour
 

But Levoquine is a BIG gun that costs serious duckets. Agree with the steroid bit...odd that they are not treating the infection. Are you paying for care??? If so, seems like extra $$$ for an office visit. Not an uncommon practice unfortunately.
With your history, may look into visiting an ENT SGN for some surgical intervention. Many good results in my experience. Others may have a different POV.
Best of luck..

Eagle

Commo to this site is sporadic, depending on the damn Websense filter. (I hate being on the opposite end of the Network....).

Eagle5: no, I don't have to pay for care. I'm supposed to be treated like any other Joe. The Doc I saw is an AF Flight Surgeon and I was the ONLY patient in the clinic at the time. His E-3 door minder needs to brush up on her people skills.

It isn't getting worse, but it isn't getting better. There is an increase in drainage when I lie down, but not coughing or ear aches as yet. I'e also stopped the Flonase and the swelling isn't an issue yet. We'll see in the next few days I guess.

Solid, steam helps me too when I have access to it. I just don't have that luxury right now.

Thank you to all for the replies and especially to Gypsy for being a great Admin Assistant. :)

So, what happens to a contract employee who issues an attitude adjustment to an AF E-3? :munchin

TR

We may find out shortly. This gov't employee/ contractor thing being new to me I guess I rate the same as her O-3 boss. What can they do, put me in a plywood hut, make me go downrange, and work 20 hours a day?

Funny blurb at chow: I walk throught the door and hear, "Sir?". I turn and it is the head count lady.

"Yes ma'am?"

"What are you , a contractor or Army?"

Now, I'm in khaki 5.11s, a t-shirt, sunglasses, ballcap, and a goatee.

"A contractor ma'am, need to see my ID?"

"No, thanks. I just wanted to make sure for the head count."

Any time...can I get you a glass of iced tea? ;)