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Thread: Chronic sinus infections, bronchitis, and nasal rinses.

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    Default Chronic sinus infections, bronchitis, and nasal rinses.

    Chronic sinus infections and bronchitis are very common among us Weggies due to our suppressed immune system, damage to our sinuses from the Wegs and the excess mucous resulting from the damage and our inability of our body to adequately flush our sinuses and nasal passages naturally.

    I had several sinus infections before i even got Wegs which my Weg expert said probably contributed to my getting Wegs in the first place but I have had a lot more since my weg diagnosis.

    The problem is these sinus infections and bronchitis tend to become chronic as the bacteria may develop a resistance to the antibiotics used. These areas are already often inflamed and damaged by the Wegs and the infections just compound the problems and make them worse. And these infections can also be caused by fungus or a virus and our suppressed immune system and damaged tissue in these areas just increase our risk of developing more such infections. Taking antibiotics for chronic infections becomes problematic if the infections are not caused by a bacteria since they will be ineffective and the antibiotics may well lose their effectives from continual usage. The only way to determine the type of infection is to try culture it which is expensive and also time consuming which may actually delay the needed treatment.

    I found out there is no all purpose way to deal with chronic sinus infections apart from general chemicals used to sterilize a hospital roon or OR equipment and these are not suitable for internal use. I found reference to a couple additives for nasal rinses that claimed to be multipurpose but they also seemed very expensive with little evidence to indicate their efficacy.

    The most promising info I found was a person who flooded his sinuses periodically with a strong hydrogen peroxide and saline solution and claimed it cured his infections repeatedly. Alkolol was another nasal additive that was widely promoted as a good solvent to help clean nasal passages. Adding some baby shampoo was also mentioned several times. Adding Betadine to a saline solution was also mentioned to kill any infections. The problem for me was that there was little info on how much to use or how effective these additives would be.

    I also found some suggestion that too much nasal rinsing could be counter productive and actually increase the risk of certain types of infections by removing too much of the protective layers lining the sinus cavities and nasal passages. My local ENT doctor had once told me you can not over do nasal rinsing but he could be wrong.

    I sought some helpful info from my local pharmacist. He told me he was unaware of any commercial product that would do what I wanted, kill off any chronic infections. He also agreed that chronic overuse of antibiotics presented potential problems.

    He said Betadine would work but would be messy. He said hydrogen peroxide seemed to be the safest and easiest one to try and cheapest one too. He thought a fairly high percentage of peroxide to saline water would be safe, up to 50% but this might also be quite uncomfortable.

    He agreed that Alkolol would help with cleaning the passages and had no opinion about baby shampoo as a solvent. He agreed that inhaling steam for several minutes before a nasal rinse should greatly increase its effectiveness.

    So I started experimenting. I would make a regular saline mixture which probably equaled three commercial packets to one 8 oz NeilMed bottle, add a squirt of peroxide, a drop of Johnson Baby shampoo, and rinse away. I usually got lot of blood clots and mucous gunk and some fresh blood on the first rinse and through half of the second bottle of rinse. The third bottle was generally clear so I would then add some Alkolol to end with a clean fresh feeling.

    I think the stuff suggesting a sinus infections has decreased some but i was also taking Azithromycin antibiotic at the same time so that might have also caused any improvement. I found I only add a small squirt of peroxide since more than that seems irritating but the solution is probably not strong enough to really do much antiseptic work in a quick rinse. I think flooding the sinuses with a stronger solution would be much more effective but also much more uncomfortable. I think the baby shampoo does help remove gunk and it only takes a drop or two to really suds up. It doesn't seem to irritate either at a low level.

    Taking a lot Guaifenesin seems to help thin the mucus and reduce the post nasal drip a bit but one needs to generally take the max suggested every day for this to be very effective. I am not aware of any research suggesting continual use is dangerous and I had ENT doctors prescribe it for me for several years on a daily basis for allergies.

    I find drinking a tea with added honey usually help reduces coughing fits for awhile. Of course there are many cough drops on the market too which help as do some hard mint candies.

    Inhaling steam for several minutes seem very helpful especially if done between rinses but it can also be another time consuming procedure. I have a small portable machine that uses distilled water and I set it on a small chair in the shower stall with a towel covering my head to help direct the steam into my nose.

    I find the chronic coughing from the mucus dripping down my throat very exhausting and annoying. As well as the congestion that comes from sinus infections. I think these two symptoms probably are the most common among anyone with Wegs since most people do end up with Wegs attacking the sinuses.

    I would love to hear any techniques people have found to help relieve these annoying symptoms.
    Last edited by drz; 05-05-2018 at 07:06 AM.
    Knowledge is power! Wisdom is using it to make good decisions!

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    Hi drz,
    If you are worried about iodine being messy, you can add some ascorbic acid to the iodine water and it will become clear.
    Iodine is also, good for healing scar tissue.
    http://www.thyroidscience.com/cases/...gen.6.7.08.pdf

    The problems with infection are that we kill off all our good bacteria with antibiotics.
    There are some that use a probiotic in their nasal rinse to put back some good flora.
    Not sure if that is something you would like to try or not, but I have not tried for anything, yet.
    Natural and Effective Sinus Infection Remedy | The Healthy Home Economist

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    Maybe i need to post this elsewhere...but i use to use the nielmed rinse until it went into my inner ear and caused a very painful ear infection. It felt like swimmers ear when it happened..but got very painful so i dont use them anymore.

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    Drz - I can't provide much advice but I'm glad you shared your considerations and trials with us. I have used the Neilmed rinse a few times but it always feels like I'm drowning. I guess it reminds me of the feeling of being hit by a wave unexpectedly. I'm on nasonex to help with nasal inflammation and it makes a huge difference for me. I'm always nervous about putting anything into my sinuses that may make a greater issue. I know that with anything moderation is key. We should wash our hands but if you wash your hands constantly then they can dry out and crack leaving you more exposed than if you washed less frequently. I think the same rules probably apply to sinus rinses.

    As you said, "I also found some suggestion that too much nasal rinsing could be counter productive and actually increase the risk of certain types of infections by removing too much of the protective layers lining the sinus cavities and nasal passages. My local ENT doctor had once told me you can not over do nasal rinsing but he could be wrong."

    I've had chronic sinus infections before dx so I don't think it bothers me too much except I also have a deviated septum. The combination of blocked sinus and nasal passages and a deviated septum leads to snoring which is both embarrassing for me and terrible for my partner. I need to keep experimenting to find a better solution!

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    I am too concerned about doing anything that might make things worse or create new problems for me. Therefore I rule out using anything known to have a risk of causing scarring and figure anything that causes a strong burning or stinging sensation might also be damaging the tissue in the sinuses and nasal passages. That eliminates most of the things mentioned as possible antiseptics. There is no way to be sure you have a safe dosage of such stronger ingredients.

    I also find running a humidifier in my bedroom at night helps reduce drying and related congestion. I try keep my bedroom temp around 66 degrees which seems comfortable for sleeping. I think if it is too warm it increases drying of nasal passages when I snore at night.

    I also decided to only rinse a couple times a day plus whenever I felt I had nasal congestion that was irritating or reducing my breathing since this usually means there is a build up on dried blood clot, which often has mucus plug behind it too. My breathing might still be OK but I usually get some gunk or blood clots coming out whenever i rinse at these times.

    I also will use two or three or even four NeilMed bottles at a time till the rinses look clear and the nasal passages feel open. I will use the Fluticasone Nasal spray only after the rinses. I will some times also add the NeilMed NasoGel for Dry noses when they feel dry but open.

    I think the inhaling steam can be done anytime but seems most effective between rinses. I usually inhale for about 10-15 minutes.

    I find that using frequent nasal rinses seems to relieve or prevent the painful feeling of sinus pressure buildup which has often been rather painful for me in the past. With my present regime I generally feel little pain in my sinuses even when they appear infected.

    I still plan to see an ENT doctor soon to see if they see anything else going on that might be causing or contributing to my sinus problems.

    I wish there was a good way to prevent the mucus dripping down the throat that causes the frequent coughing spells. They can be exhausting. Plus everyone thinks you are running around spreading cold germs and it is hard to explain that you don't have anything contagious.
    Last edited by drz; 01-22-2015 at 05:47 AM.
    Knowledge is power! Wisdom is using it to make good decisions!

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    Hi drz,
    Sometimes, post nasal drip can be due to acid reflux or the pepsin enzyme.
    It can also, be caused by inflammation in the lungs and/or sinuses.
    Have your lungs been checked lately?

    Have tried using juice from lemons in water to drink to help alkalize your system to see if that helps with pnd?

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    I do have GERD and take Protonix twice a day for it. I haven't tried using apple cider vinegar or lemon juice on a regular basis to see if it would help with the GERD. The meds usually seem to control it adequately but I still have some symptoms at times.

    Quote Originally Posted by mrtmeo View Post
    Hi drz,
    Sometimes, post nasal drip can be due to acid reflux or the pepsin enzyme.
    It can also, be caused by inflammation in the lungs and/or sinuses.
    Have your lungs been checked lately?

    Have tried using juice from lemons in water to drink to help alkalize your system to see if that helps with pnd?
    Knowledge is power! Wisdom is using it to make good decisions!

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    Quote Originally Posted by drz View Post
    I do have GERD and take Protonix twice a day for it. I haven't tried using apple cider vinegar or lemon juice on a regular basis to see if it would help with the GERD. The meds usually seem to control it adequately but I still have some symptoms at times.
    My mom has barrett's esophagus and she rarely gets acid reflux pain. She has the silent reflux which can also, cause pnd.
    She still has some pnd sometimes and she is on nexium.

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    As many of you know, I (along with our dearly departed Phil) am an advocate of the WaterPik and/or the SinuPulse Elite devices. I've been using one or the other for over 2 years, and they have been the single best thing I did to keep my sinuses healthy.

    My ENT agrees that you can not rinse too much. The argument that says it rinses off good mucus, etc. is null and void with Wegeners patients with sinus damage. Our lining has bee compromised by the disease and there is not much normal mucosa left in most of us with sinus issues.

    As far as getting on top of the infections. First thing I've noticed that if the disease is semi contained with proper treatment, the staphylococcus aureus bacteria suddenly disappears. There is a plethora of stuff out there about the correlation between weg patients and staphylococcus aureus bacteria. The thing about staphylococcus aureus is that it does mutate. I've had to do a couple different antibiotics to get on top of it. My ENT does a nasal culture every time the infection gets worse, and gets a report from the lab about what works to kill it at that time. This last time, I was allergic to all the pill forms, so he had me dissolving bactroban ointment in saline and using it as a rinse. I've also used Gentamicin solution, commonly referred as "Wilson's Solution".

    Rinsing with an antiobiotic: I've found that once again the WaterPik type device rules! I developed my own way to rinse with the antibiotic rinse. I start the stream very slow on the device, plug the exit nostril (the one without the water wand in it), and slowly let the rinse enter the nose and sinuses. I can tell when the rinse is starting to tickle the back of my throat, and then stop the flow of the WaterPik. Then, I hold it in there for a minute, or as long as I can stand it, and then blow it out all at once. The method allows the antibiotic rinse to sit in there for a while and seep into spaces that it might not get to with a fast in and out like with a NeilMed bottle. My ENT noticed significant improvement when I started doing this. At one point during a visit, he pushed his chair back, looked at me and said, "OK, tell me what you are doing again. I want to know how this has progressed like this." I believe that he is recommending to other patients to do this now too.

    Since holding in the antibiotic worked so good, I started doing the above as part of my daily routine. I fill my sinuses, let the rinse sit in there for a while, then hard blow it out. I repeat that with an entire basin of water (1 liter). The action of the saline sitting in the nose and sinuses loosens and softens up the hard crusting and allows it to come out with a hard blow out of the saline.

    I've tried a couple of the things DrZ mentioned, baby shampoo and Alkalol. I haven't tried the iodine and/or the peroxide. I do like the baby shampoo, especially when there is a flare up going on. It soothes pretty nice. I used a 1% solution, which was 1 teaspoon with 1 liter of water. One thing that DrZ did not mention is that I had one ENT that prescribed steroid vials, used in nebulizers, to mix in with 8 ounces of saline.

    As far as the WaterPik vs. NeilMed bottle: I really believe that the WaterPik and and/or any powered pulsating device is better because it emits a constant steady stream of water over a longer period of time. It is also gentle enough not to flood your eustachian tubes and flood the middle ear. I used to do that all the time with the squeeze bottles. I don't have that drowning sensation that comes from the all at once flood from the bottles either. I can say that I do like the SinuPulse Elite the best between it and a WaterPik. Here's the WaterPik device that I use (click here). Here's a link to the SinuPulse Elite machine (click here). Here is the page of nasal wands and the model numbers of WaterPik devices they are compatible with are listed in the description. The only advantage of the WaterPik is that it is available locally, and you can get another one right away when one wears out. I've also bought one at a thrift store and sanitized it with bleach, soapy water, etc. before using it. Cost from the thrift store was $3.00!! I now have one at my office by a wash sink in my department!

    One more thing before I end this... (-8 Working with my ENT in the office, I've been instructed on how to put a want without the protective tip into my nose. One side, I can insert eh entire 3.5 inches of the wand into my nose and get water directly into the maxillary sinus cavity. Since I have been doing this, the crusting is under control, and the sinus linings (mucosa) has started to recover. My two ethmoid sinuses actually have grown back normal linings. My main sinuses have started to scar over, and get to what my ENT calls a "typical Wegeners nose".

    Oh, I lied--I'm not done yet. Another part of Mike's sinus journey is that I installed a three stage antibacterial water filter under my kitchen sink, connected to a drinking water faucet. This is not in and of itself the cool part. What I did next is. I worked with my plumber and installed a hot/cold "mix valve" under the sink that feeds the filter system. So what I do is set the temperature on the mix valve to how hot I want my rinse water to be. Every morning, I put in my 3 liter pitcher my pre-mixed saline and baking soda mixture (found a good use for all those mini containers that come in the multi-packs of storage containers), prime hot water to teh kitchen sink, flip the drinking water faucet on and fill the pitcher with filtered water that is, as Goldylocks once said, "Just Right". Some will say that distilled water is the only kind to use in the sinuses, but my ENT said tap water is fine; so that makes my filtered water even more "fine."

    OK, time to get back to work. Lunch is over!
    MikeG-2012

    "You never know how strong you are until being strong is the only choice you have"


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    For those of you that get a flooding feeling when using the Neilmed bottle, try humming while using it to irrigate your sinuses. If I forget, I too get the flooding feeling. I think I watched an instructional video on the NeilMed website or youtube, and they suggested that idea.
    We must let go of the life we have planned so as to accept the one that is waiting for us.
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    When sleeping women wake, mountains move.
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