anybody use Bacroban/Mupirocin in your irrigation solution?

[ncmommy]

Just curious...how much do you put in? Also, the pharmacist dispensed the regular ointment, not the nasal one...is this ok? I've never used anything other than straight saline/baking soda with water. My nose is completely blocked by the end of each day with TONS of nasty green/bloody crusts. Irrigations are a life saver for me, but I'd love to know what others have used to keep down infection and bacteria in their noses.

[pberggren1]

Hi ncmommy:

Welcome to the Forum.

I have had nose and sinus problems from the beginning when I was diagnosed in April 2003.

Most of my nose and sinus problems are increased mucus production in nose and nasal passages, bleeding and crusting in the nose and nasal passages.

I got a Waterpik early on to irrigate the nose with - What a life saver. It is far supperior to the Netipot or Squeeze bottle. You can regulate the flow and pressure. You have to order a seperate nasal attachment. I have used the pure salt and baking soda almost since the beginning as well.

Right now and going back a couple of months my right nostril has been quite raw and sore inside by the septum not too far in from the opening of the nostril.

I have had an ongoing sinus infection for the last year or so.

I saw a different ENT in July, Dr. Mia. He has his own website: www.drmiaent.com (http://www.drmiaent.com)

He prescribed me Pulmicort to spray up my nose with a special syringe and atomizer and bactroban ointment as well to use in a saline rinse in the squeeze bottle. After a week of doing this I greatly improved. My mucus production, crusting, and bleeding went way down. I was also coughing up hard, bloody chucks of dried mucus from my larynx that got there from a chronic post nasal drip. This almost went away completely as well. Also my taste and smell were gone as well for the last year and started to come back after using this stuff as well.

I quit using both in late August because I was having increased irritation in my right nostril and thought that both were irritating the nostril.

I was also puting the ointment directly into the nostril as well.

On a side note, I also had a biopsy on my right nostril as well, so maybe that is why it is irritated.

Green stuff usually means infection, so using the bactroban is a good idea but you may need another antibiotic as well.

[me2]

Good question. I have been irrigating for 30 years. I have never tried mixing bactroban with the salt water. When I have tried to use the bactroban directly it was very irritating to me and made me feel worse than before.
My favorite friend is Alkalol. I mix a 'dollop' in with my rinse water and it is very soothing. I love the stuff big time. Here is what the label says :

"Alkalol is an alkaline saline solution specially formulated to clean and moisturize the nasal passages, dissolve mucous, kill germs and bacteria, and provide natural relief from the symptoms of sinusitis and allergies. "

I credit my use of it with cutting down on infections. I especially use it when I have been out in public. Flush out the ole system. I don't use it all the time anymore on my daily rinse but when I think I have sinus trouble I use it every time until I get better.
No, I do not own stock in the company. I should, I could have gotten back a fortune of my own money over the years. I buy it by the case (12) so I don't run out during times I'm not feeling well.

[Jack]

I'm always a little worried by people who report ongoing symptoms of crusting and bleeding and seem to have accepted it as part of their New Normal. This is because my own experience has been far better than this. I originally had horrendous problems with solid plugs blocking both nostrils and bleeding episodes so bad that I was once hospitalised. The pain was also unbearable and preventing sleep and I even went on to have quite serious, but unnecessary, surgery. However, once the Wegener's was diagnosed and brought under control my nose made a very swift recovery and is now just a bit runny like having a mild cold. I can't remember when I last had to use irrigation to clear it. The reports now concern me because in my own case they would indicate a Wegener's flare.

[elephant]

Irrigation is great to clear the junk out, but agree with Jack. That is one indicator that your Wegeners may be flaring ( crusting and bleeding), and that is something my WG specialist asks when I see her.

[JanW]

I tend to side with Jack. I knew that I had switched over from inflammation to none right about the time my nose stopped crusting. I haven't had anything other than a normal nose for the last four months or so. Granted, my issues were never as bad as some of you.

[Sangye]

Even though I don't have sinus involvement, I agree with Jack that any symptoms with that kind of severity indicate active Wegs. Dr Seo calls it "rumbling Wegs." Maybe not enough to kill you, but enough to do damage and/or make your life miserable. Also, if the Wegs is rumbling, it's a small step before it becomes fully active. That can make it harder to treat and require the major drugs and higher doses of pred.

[ncmommy]

Thanks guys. Jack - I agree with you totally. I have had WG for 18 years now, and for most of that time I was clear of all symptoms, though I needed a alow dose of Methotrexate or Imuran to stay that way. I felt totally healthy, rarely needed to irrigate my nose at all. When I got pregnant with my last child, I chose to go off all meds. I felt great through the whole pregnancy, but had a scary delivery that landed me in the ICU for about a week. I had 4 blood transfusions. Since then, My health has not been the same. My immune system freaked out, I developed psoriasis, several bouts of unexplainable hives, and major sinus issues and joint pain. I'm back on MTX again, and adding Bactrim and low dose prednisone to see if it helps any. I know this is a flare
:sad:
OMG I would be sooo happy if I could smell again. I lost my sense of smell years ago. It came back briefly after I had my nose reconstructed (I had a MAJOR saddle nose), but only for a brief time. Haven't smelled anything since then!

OK...will try the bactroban in my nasal wash. I used to use a waterpick years ago when I was first diagnosed...and I remember loving it. That 8 oz. sinus squeeze bottle from NeilMed is working fine for me now though. Thanks for your feedback!

[Jack]

It does sound very much like a flare to me and should be treated as quickly as possible.
I suppose that because of my own treatment history I'm an advocate of hitting it hard when it shows its head and I think I would be looking for something more aggressive than MTX and low dose Pred. I'm aware of the current move towards more conservative treatment, but I think that there are arguments both ways.

[ncmommy]

Every case is different I guess. MTX and Pred put me in full remission and I stayed well for 15 years. Of course I had limited WG (no kidney or lung involvement). I am thankful my rheumy was conservative back then...MTX was not commonly used at the time (just cytoxan), but I was only 20 and wanted to have a family someday. I have two precious boys now...thanks to her! I imagine if anything gets worse we'll get more aggressive.

Hey - used the bactroban tonight....visualizing those nasty little staph germs keeling over one by one :biggrin1:

[elephant]

Too funny Ncmommy! Wonderful that MtX worked for you!