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    recurring ENT problems
    Snicket123 posted:
    hey guys,

    ive been suffering sinus infections since about 10 years, usually about 4-6 times a year. sometimes accompanied by fever, and/or tonsillitis and bronchitis, i guess about 50 % of the time. im 27 years old now, 7 years ago i had an ENT surgery, where they removed polyps, widened the sinuses and corrected the nasal wall (sry for the lack of terminology). i am a nonsmoker, i do regular sports, if im not sick (which takes at least 2-3 month per year). im my latest round of sinusitis i also developed a Secretory Otitis Media, which is still inplace. i was treated with 5 days of penicillin, which didnt help, and was therefore followed by 7 days of floxacin and novaminsulfon for the pain.
    normal blood tests show no signs of immun deficiency and i really have no explanation as for why i keep getting sick all the time.

    i guess i should also mention i was diagnosed with IBS and ive tried my best to cultivate a healthy bowel flora and keep dietary adjustments. i also rinse my sinuses with a neti pot and salt solution daily when im sick and almost daily when im not, plus in inhale from time to time.
    last but not least i also suffer from regular red eyes, blepharitis comes and goes (i dont wear contacts).

    any input is greatly appreciated.
    Rod Moser, PA, PhD responded:
    Like most people with chronic sinusitis, you have other associated medical condtions....

    • When was you last sinus CT scan? This would be the best way to view you sinuses.
    • Where you ever allergy tested? Underlying allergies can play a huge, contributory role in someone with your array of symptoms.
    • Finally, what medications are you taking NOW for you sinus problems (other than penicillin, which is probably worthless in my opinion)? Are you taking any nasal corticosteroids?
    Snicket123 replied to Rod Moser, PA, PhD's response:
    dear mr moser,

    thank you for your reply, i really appreciate it. i have been allergy tested, i dont have any real allergies. i even tried more expensive testing for food allergies, which also revealed nothing.

    i am not taking any medication as of now, i try only to maintain my sinus inflammation, but it feels like there always is at least a little of it left. i have taken a corticosteroid spray with mometason-17-fuor, which is one of the more common prescribed ones around here. it helped me over the acute phase, but i have never taken it for longer than two weeks.

    finally i had an MRT scan 2 years ago, which did not reveal anything, but lead my ENT to propose another surgery "just to make sure", which did not increase my trust in his expertise to be honest.
    thank you again.
    Rod Moser, PA, PhD replied to Snicket123's response:
    I agree....I would not agree to head back to the operating room unless I had a good 'second opinion" from another ENT. Those surgeries are not fun, as you know.

    One more question: Are you constantly exposed to other people? Frequent contacts with others who may be ill with viral infections could certainly be part of the frequency of your illnesses.
    Snicket123 replied to Rod Moser, PA, PhD's response:
    dear mr moser,

    i am exposed to other people frequently in the last couple of month (psychiatric inpatient clinic, where i am working) but the 7 years before that i think i only was exposed to a "normal" degree, university life included.
    Rod Moser, PA, PhD replied to Snicket123's response:
    This inpatient job could be a factor.....
    Snicket123 replied to Rod Moser, PA, PhD's response:
    guess it could be, but considering ive only done it for a good half year and ive been sick on and off for almost 10 years, i doubt its the most important factor.
    what would your approach be medical wise? do you advise sinusitis patients to use cortikosteroids longterm? do you propose a longer than ususal antibiotic treatment, in case it really is a longlasting bacteria? and how do make sure, that is in fact bacterially and not virally caused?
    thank you again.

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