kathyw wrote:
> 
> It has been almost a year since I corresponded with you and I really
> appreciate your
> response.  Since that time I found an ENT who diagnosed me with chronic
> sinusitis
> because I continued to cough up the brown globs of junk for over a year.  I
> was on numerus antibiotics and quit for a few months, but still had the
> flu-like symptoms and pain behind my nose and even burning in my arms and
> legs.  A pulmonologist diagnosed me with mild bronchiectasis with
> sinopulmonary syndrome.  The ENT had me get a CAT scan and was going to do
> surgery until he got the results back.  This is what they said:
> 
> "The hiatus similunaris of the left maxillary antrum shows moderate
> narrowing and there is some mucosal thickening at the ostium of the left
> maxillary antrum at the base of the hiatus semilunaris compounding the
> narrowing.  No evidence of sinusitis identified at this time."
> 
> A week later while using saline irrigation, the brown globs came out of my
> head.
> I can't keep taking antibiotics because they tear my digestive system up.
> I have a couple of questions if you would be kind enough to answer them.
> 1.  Do you think this CAT scan is significant enough to warrant surgery
> since I
>      still have symptoms?

If you don't get better, yes.



> 2.  I have read, but can't find much information, that the actinomyces that
> was in
>      my tonsils (it formed the sulfur granules) could be in my sinuses.  If
> so, would it
>      show up significantly on a CAT Scan?  

Probably, but you may need to have a culture done from the sinuses.



Would it cause some of the weird
>      symptoms that I have had?  Where can I find more information about it?
> ----------
> > From: Sanguansak Thanaviratananich <[log in to unmask]>
> > To: [log in to unmask]
> > Subject: Re: chronic sinusitis
> > Date: Wednesday, November 05, 1997 11:58 AM
> >
> >
> > Owing to your chronic rhinitis problem, I think the best way for you is
> to
> > consult with the rhinologist who will perform nasal endoscopy for
> > you to examine any possible abnormalities in the nasal cavities and
> > lateral nasal wall. Normal CT findings after adequate antibiotic therapy
> > do not make you sure that there is no abnormalities in the nasal cavities
> > ,that may be the predisposing anatomical factors for sinusitis, without
> > confirm by nasal endoscopy.
> >
> > Regards
> > Thanaviratananich S.
> >
> > On Mon, 3 Nov 1997, kathyw wrote:
> >
> > > I am just a patient who thinks maybe I have chronic sinusitis.  I've
> had
> > > really weird symptoms after getting a URI 3 years ago.  I was really
> > > stopped up, lost equilibrium, and the back of my head hurt. It even
> felt
> > > like it was bobbing some times.  I had a rusty sputum a few times, but
> > > nothing major at that time, but I felt miserable;  have been having
> > > problems ever since;  I have had 2 acute sinus infections with the
> green
> > > junk blowing out my nose;  would take antibiotics and feel better for a
> > > while; have had 2 CAT scans of my sinuses (both were during periods of
> > > feeling better) which were pretty normal.  An allergist at Mayo Clinic
> said
> > > that I had very narrow openings and some congestion.  I also had a
> purulent
> > > postnasal discharge.  He said I might have chronic sinusitis and maybe
> need
> > > a limited endoscopic surgery if I didn't improve on antibiotics.   That
> was
> > > in Feburary of this year.  When I came home I took two rounds of
> Zithromax
> > > and started coughing up rusty sputum for several days.  I then took
> > > Augmentin for 10 days without much relief.  In late may I was treated 2
> > > months with Ceclor for actinomycosis in my tonsils and coughed up
> moderate
> > > amounts of the rusty (occasionally green) sputum; this occurs for
> several
> > > days in the morning and then stops for 2-3 weeks.   I've been on back
> on
> > > Zithromax, Augumentin, and now Levaquin for 6 days.  I haven't coughed
> up
> > > anything in the last two days, feel some better, but not great.  This
> > > hasn't been coming from my nose, but I think postnasal drainage.  My
> lungs
> > > are clear.  My internist now thinks I have chronic sinusitis and said
> that
> > > CAT scans are not always diagnostic.  He referred me to an ENT
> specialist
> > > who does the endoscopic surgery and he wants me to have another CAT
> scan.
> > > I didn't get the idea that he thought I needed the surgery.  I really
> don't
> > > know where to turn now.  I think that whatever is wrong with me is
> related
> > > to this yucky sputum and the infection has been somewhere for a long
> time.
> > > Any input would be appreciated.
> > >
> > >

-- 
Wellington S. Tichenor, M. D.
642 Park Avenue
New York, New York 10021
212 517-6611
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