Flare VS Infection

[Brooke]

Hello -

About a month ago I was having lots of green gunk come out during my sinus rinse and I think that led to my chest area. My dr ordered a sputum sample and I had MRSA with streptococcus pneumoniae. I was put on Zyvox for 2 weeks for that. I was better until yesterday when my nose seemed to be more stuffy and now the green gunk is back in my sinuses. I don't have a fever and am feeling over all pretty good. Just seeing if anybody has had similar problems or how do you tell infection vs flare?

Thank you,

[Psyborg]

We are having similar problems in different areas aren't we? :)

Too much of a newbie here, I have no idea how to differentiate things yet.

[Brooke]

Thank you for the reply, I'm not exactly a newbie but I still feel like I don't know wg very much!

[Psyborg]

The only thing I feel 100% I can tell now is the pain. The Wegs pain is very distinct and different from strain or other pain I sometimes get. Almost a warmth to the pain for lack of a better term (for me anyway). Like my knees have that weird dull ache but also feel warm from the inside out, even though they are normal temp to the touch. Not sure if that makes any sense, but when I have it in my finger, wrist, or shoulder its the same way.

[Brooke]

I do not have any joint problems luckily. Doesn't sound like fun and I hope your pain goes away.

[Psyborg]

It's not really disabling like it was in May/June for me. I actually got to the point that I had to sit on the stairs and shuffle down on my butt because my legs hurt so bad...that's when I finally went to the hospital and was admitted. I'm guessing I'm going to always deal with this on at least a light level. I could be wrong but from what I understand it'll never be completely back to "normal". Could be totally me misunderstanding the process though :)

[elephant]

Brooke, sounds like you need to get to a ENT and have them scope up your nose and get a culture ( cotton swab). Had this done so many times at the ENT office. I think it could be Wegeners because it is getting inflammed in your sinuses and then it can cause an infection. When was you last CT scan of your sinuses?

[Brooke]

Hi Elephant -
I had a CT the middle of September 2010 when I was at Mayo but I think that was just the chest, I'll have to check on that. I did see the ENT while I was there and he said my sinuses looked much better since my last visit (End of March 2010) before my Rituxan infusions (May 2010). He said there was just one tiny spot (I think it was blood) in the sinuses that looked a little inflammed. He really didn't seem too concerned at the moment since it had improved so much.
So a Wegener's flare can cause sinus infection as well?

[elephant]

If your wegeners is acting up in the maxillary sinuses it can get inflamed and can't drain properly ( the sinus can get convoluted...bunched up) out...with the immunosuppressants that we our on lowers are immune system and were more prone to get sinus infections.
You probably need another CT scan of your sinuses.

[Brooke]

If I got another CT of my sinuses, how would they be able to tell if it was inflammed due to Wegs or if it was infection?

[elephant]

They would compare your last CT scan and see if this one is worse or causing havoc in other sinuses. They also can use the scope ( long black thing) and check to make sure your sinuses ( maxillary opening) are open enough. If you keep getting sinus infections they need to really check it out. The drug you were on is very strong! So you should have your ENT do another culture and check for fungi too.

[Brooke]

I think I will give ENT a call tomorrow. Yes, that Zyvox is very strong, you would think that would have taken care of it.
I did call my dr at Mayo but she is out until Monday, I go back to see her in December for a visit.

[elephant]

Hope it goes well for you Brooke, let me know how you are doing.

[marta]

Hey Brooke, just had this talk with my doc in the hospital today. I told her that while I was sick at home and my sinuses were acting up the discharge from my nose was clear and fluidy, but the post nasal drip that I would work out (in the most unpleasant way) and spit out was greeny brown and more solid. She said that the clear is what's normal for a sinus infection but she thinks that the coloured solid stuff is Wegs related.
Hope that helps.

[me2]

I thought clear was normal for not being infected and color meant something else was going on- especially green. I know I have had the rainbow of colors (except blue) from my sinus's over the years.

Which comes first the WG or the infection? I think it can go either way , meaning it is possible to start with one and end up with both. In my opinion, if sinus is the only symptom the easy way to find out is to treat for infection first and then see where you are at.

If you have damaged sinuses like I do it is possible you need to become diligent in rinseing your sinus's twice a day with saline , baking soda and Alkalol.
Alkalol is mildly antiseptic and a mucus solvent. I love the stuff. I have been using it for decades. I credit the end of my sinus infections (primarily caused by structural damage from WG to my sinus's) with the beggining of my regular use of Alkalol. My local drug store carries it. They recommend a 50 percent solution but I find that to be way too strong and just use less than 25 percent.

I found an interesting link that lets you pick your sinus goop color Learn more about mucus (http://www.sinuswars.com/mucus.asp)

[elephant]

You can have clear drainage and still have a infection. I agree with Me2, staying on top of your sinus rinses is great. Thanks for the Alkalol advice, is it a prescription?

[me2]

I agree Elephant you can have clear stuff and still have infection. For me , most of the time I get color with infection, clear raises the likely hood that it might be just WG. Alkalol is not prescription. I usually find the best deal online now and buy large quatities so I dont run out or have to think about it. But when I'm low I just grab it off the shelf from local pharmacy. If yours doesn't have it they might be able to order it for you.
I have had eye infections too thanks to WG and Alkalol is wonderful for those too. I make a tiny eye size compress and it feels so soothing and I think helps clear up the infection. Not a cure maybe but helps soak gunk out and that helps with healing. Likeany infection , things need to move and flush out.

[Jack]

The mucus that I cough up is an unpleasant yellow colour, but the cultures come back negative. It does not seem to change much so I guess that is just the way it is.

[me2]

I cough up yellow too Jack. For me I know it is my baseline . If it changed color I would be concerned. I think these things about color are guidelines and not automatic indicators, although I hve never had green not be infection. Sinuses are hard to figure out but for me lungs have been even more difficult. Maybe because I have less experience with infection in them than I do with sinuses. Like someone else was saying the difference between WG and infection also feels different. I don't always know , but most of the time I now know which it is. Unfortunatly this is through LOTS of experience - even at that though I don't always know . WG doesn't make ANYTHING easy to figure out. Just when you think you have something that works for you WG changes. Its like an insurgent that keeps adapting to my intelligence.

[Sangye]

Several years ago a research study disproved the "yellow/green is bacterial and clear is viral" belief about mucus colors. I didn't read the study to see if it was a good one, though.

[Brooke]

I am actually feeling a little better today. I woke up with a headache, felt like my sinuses were full, that kind of headache. I did my sinus rinse (neilmed is what I use about 2-3 times daily) and took some ibuprofin and my antibiotics. About 15 minutes later I was feeling pretty good. I don't have any wheezing or cough, just some green gunk coming out of my nose during sinus rinse. I think I will wait a couple of days because it seems like this is getting a little better.
It is hard for me to tell weg vs infection, especially a lot of people at work have been sick so maybe I just keep catching something from them. I hope that is the case vs a wg flare.