Sinus surgery questions

[Shari]

Hi guys.

I need some advice/direction/support/courage/HELP!

I have terrible sinuses. I am not an ENT specialist, but my google search returned that adults have 2-3cm of space in their sinuses. I have less than 3mm on my right side, a slightly more on my left. They do not drain, thus I have sinus infections repeatedly. I'm on my 4th one this winter. (and this has been a "good" year)

My sinuses and allergies have been VERY bad all of my life. However, when I was pregnant with difficult child 2 is when the constant sinus infections started. Since that time, my allergies went from being really allergic to 4 or 5 things to being allergic to the world. The last test came up over 80% positive, including a lot of foods that were never a problem before. I live (literally, daily) on Benadryl and Sudafed. I had not drawn a breath thru my nose without the aid of those medications for YEARS prior to about a month ago when I took a round of steroids, and for some reason, it made an IMMENSE difference. I haven't had a Benadryl for a month, and its wonderful, but I've taken steroids hundreds of times before without this dramatic of a reaction.

However, being winter and all, I've caught a cold (actually the first one this winter). But, with non-draining sinuses, despite all the zinc, vitamin c, Flintstone, and sinus rinsing, it has turned into yet another infection. After 10 days, I've finally given in and gone to the doctor to start antibiotics. My sinuses are raw, inflammed, infected, and even tho I don't have too much "snot" from the cold anymore, my sinus tissues, being inflamed, are touching, so its the constant feeling of stuffy nose is there and nothing to do about it.

My allergist wants to do sinus surgery. My gp wants to do sinus surgery. I really would like to have a life that doesn't include constant stuffy nose/sore throat/ear pain (this last month has been GLORIUOS!!!! I didn't know life could be so good!) My allergist and gp both say this can only come from the surgery (ie - draining sinuses = not-infected sinuses). But for some reason, this scares me. Besides the fact that its money I don't really have and time off from work when I only get 5 sick days a year (and I have a difficult child, sinus infections or not...needless to say, those 5 days don't go far)

The surgery that would be done involves removing tissue, not getting into bone.

Has anyone had this? Did it help? How was the recovery/scarring/etc? Just any information would be helpful.

 

[SRL]

Yes, Go for it!!! I've had it done and wished I would have had it done years earlier!

I had lifelong allergies, sinus and ear problems. Constant drainage, fluid in the ears, recurring ruptured ear drums, asthma, allergy shots, etc--I had it. Finally when a sinus infection wasn't healing my allergist referred me to an ENT who did the Ct scans which showed inflamed tissue and deviated septum. I went with the surgery he recommended and have seen huge improvement in my symptoms. By the time I had the surgery we'd found pretty good medications to go along with my 12 years of allergy shots so what I really needed was a clean sweep of the sinus tissue. It made a world of difference.

difficult child had the surgery twice (routing the tissue--no septum work). The repeat surgery was needed because we hadn't yet found the definite cause of his problems and the right treatment. Whereas mine were mostly allergy based and we were assuming that was his problem too, what was really going on is that he tripped over from a cold into a sinus surgery very easily. After the second surgery I realized this so now if he doesn't clear up completely after a cold I call in for antibiotics and prednisone--we don't mess around. I'm watching him now as a matter of fact.

The surgery is tougher if you have the septum work done. I had it done on Friday and didn't feel like doing much until Monday. Still had some bleeding with activity. difficult child had his done in the morning and by afternoon I couldn't keep him down.

The surgery will give fresh, uninfected tissue a chance to grow but it will only stay that way with correct treatment--ie identifying the source of the infections, drainage, etc and keeping it at bay. An ENT will also be able to tell if there are polyps or other issues which would make recurrance more likely. My ENT is also more apt to medicate aggressively since we have a history of sinus trouble than most pediatricians or GPs will.

FYI, if you're concerned about costs and time off of work, the gold standard for treatment of sinus surgeries (last time I talked to my ENT) is prednisone coupled with an antibiotic. Have they done any longer courses of both to see if it would clear totally?

 

[Lothlorien]

I had it. It did help reduce the amount of infections that I get. However, I'm dealing with one right now. I know exactly how you feel. If you can schedule the surgery to be done on a Thursday, you can probably be back to work by Monday. Two days off for a surgery has got to be better than repeated sick days.

I would ask more about the surgery. When the doctor did my surgery, he actually drilled two holes. I believe it was into the bones, to add more areas of drainage.

What antibiotics have you been on? Are you using Flonase or one of those sprays? Typically, for my sinus infections, I get Avalox or Levaquin for an antibiotic. They are strong and I need at least 14 days of it, rather than 10. 10 days of a crappy antibiotic will push the infection down, ridding your symptoms for a few weeks, but then in comes back with a vengence. Eventually, impaction can happen, as did in my case. I couldn't even stand up. I was on Percocet for days and on antibiotics for 30 days. When it didn't clear, I had no choice but to go for the surgery.

The only negative to the surgery is that I used to be able to smell anything and pinpoint exactly where it was coming from. My sense of smell is about 80% of what it used to be. I can still smell things that others can't, but can't always pinpoint where it's coming from, which drives me a little nuts, especially when I'm trying to find a child's sippy cup that has gone sour, from them hiding it or dropping behind the furniture.

 

[Shari]

I have deviated septum, too, which I forgot to mention, so that would be done, as well.

I spent the last part of my pregnancy with difficult child 2 on antibiotics to keep infections at bay, they literally recurred as soon as the antibiotics stopped. After he was born, we tried both antibiotics and steroid maintenance therapy. Also tried inhaled steroids which didn't help, either.

Beconase used to help, Flonase does nothing (go figure). Like Loth, I end up on Levaquin a bit more than is comfortable...amoxicillan or anything like that does nothing but make them last longer and harder to get rid of. Like I said, this has been a really good year, but I've still had 4.

So now even after your surgery, you still watch pretty close and nip any lingering colds or "mucous producers" before they get the chance and just automatically hit it with a steroid, also?

 

[SRL]

It's important to get to the root of the mucous producers. It it's allergies and it's not addressed through what usually is a combination immunotherapy, environmental control, and medications, it's more apt to return since it will be continually challenged. If it's from colds, that really depends on how good of control is achieved.

I had my sinus surgery about 5 years ago and up until last week when I made a medication change due to blood pressure problems, I was only using Allergra-D as needed. I'd add Singulaire during colds, but that was mostly to target asthma. I've probably only been on antibiotics for sinuses twice once my ear tube was put in (which was the final piece of my puzzle) and no need for oral steroids. If I quit dairy altogether I could probably have reduced the needs for medications most of the year. I hit difficult child with Singulaire and Extendryl (antihistamine/decong) during a cold, with immediate followup with steroid and antibiotic if symptoms persist.

Since Allegra-D raises pulse rate and BiPolar (BP), I'm trialing a new nasal spray called Veramyst. It's a corticosteroid like the others but in non scented and has a aeresol delivery system. I haven't had to pay for it yet--no doubt it's a million dollars....

Levaquin gave me a major visual hallucination!! Full color kaleidescope before my eyes!

One last thought--I still think there's nothing like the surgery to give the sinuses a fresh start but I just started into chiropractic for neck pain and was pretty skeptical about all the other health benefits. But after 3 visits my breathing was noticably clearer and I haven't been at all careful with dairy.

 

[Abbey]

Eons ago, I was a constant sinus infected person. My ENT doctor was wonderful, but he finally said to me one day that I needed to wean myself off of antibiotics. I was nearly 24/7 on them. My body no longer recognized they were trying to help.

It's gross, but he showed me how to inhale water in the shower, then blow it out. I went cold turkey from medications, and haven't had one since. That's been about 20 years ago.

I do have allergies, but they don't amount to an infection. I just blow my nose continually.

When surgery was suggested for me, I freaked as they said they'd go in through the roof of my mouth and the top of my nose. I'm a wimp, and couldn't do it. (deviated suptem as well)

Good luck with your choice. It seems lots have had positive experiences.

Abbey

 

[Shari]

Abbey,
I left this part out, cause its gross, but the only relief I had as a kid was going to the swimming pool. I don't really know how I learned it, I suppose by trial and error, but I figured out your shower technique. I'd inhale the cold swimming pool water periodically and would be symtom free for the duration of the swim.
More recently I've learned "sinus rinses" which are much the same thing, but using warm saline solution instead of cold pool water. It helps, but still doesn't kill the bugs.

 

[Abbey]

Yep...gross, but it works. He taught me how to inhale warm water, intially with some saline in it. I thought I was going to throw up. But, after a few tries, it worked. I'd gag a bit, but all that 'stuff' would come out.

The other issue is tonsiles and adnoids. Their primary function is to trap and hold infection. Unfortunately, sometimes they are on overload. You might want to have that checked as well.

Abbey

 

[susiestar]

My mom had this done about 2 years ago, inlcuding fixing the deviated spetum. She was not constantly infected, but had quite a lot of sinus infections - she just thought everyone took sudafed all the time.

She has not had much decreased sense of smell, and her sense of taste is better than it had been in years. And she was not a smoker, so that didn't dull her senses.

It wasn't fun, but she says she wishes she hadn't waited so long to do it.

She also isn't sure it was wise to have the upper eyelids lifted (they were obstructing vision and a real safety hazard while driving or doing many things) and the lower lids tucked to help with the same issue.

It was quite a recovery, but she has been more energetic and has had fewer migraines and less intense colds since the surgery.

I hope this helps.

Sorry you are so miserable.

Hugs,

Susie