After Sinus Surgery ?

[ReneeP]

Hello Everyone,

My 6 year old (Kacie) had sinus surgery 3 weeks ago and everything seemed to go fine. Now we are having additional problems and I'm just wondering how common this is. We have been doing nasal washes but they don't seem to be working. We took her back to the dr today and he said there is a huge scab left in there that is now covered with infection. He is extremely concerned about this leading to futher problems. He wanted to put her in the hospital tomorrow and put her to sleep and surgically remove the scab and junk surrounding it. We talked him into waiting until Monday so we can increase the nasal washes and try our best to get her cleaned out without another surgery. We are doing nasal washes around the clock for the next 3 days and when we take her back on Monday, if it's still there he is going to schedule the procedure for the first thing Tuesday morning. She has been on Amoxil since the surgery and today he switched her to Bactrim.

How common is this after surgery? Are we doing something wrong? We've been doing the nasal washes twice a day as we were told to (thou now we're doing them much more often). She's been on antibiotics constantly.... How can she get an infection? Any advice or info??? I feel like I am doing something wrong. I hate to see her suffer like this. She HATES nasal washes and now instead of twice a day we're doing them 10 times or so. Part of me thinks it would be better for her to just go ahead and have the stuff removed surgically but then won't a new scab just grow in it's place? I'm just frustrated...She missed her whole first week of first grade and now is still missing at least 2 days a week for dr appts... She's missed more days than she has attended since school started.

Thanks for any info...

 

[Purplelungs]

Your doing nothing wrong. Sometimes this just happens. Sometimes a packing doesnt get placed right or they slip and can make it to where scabbing occurs. The first sinus surgery I ever had I had to have another a month later because I had a staph infection start growing. After that second one I didnt have any problems for a good while, about 3 years. Some cfers just have such junk growing up there and so bad it is a risk that the infection will come back quickly. Ask if they have to do surgery again if there can put an antibotic in her nose after they clean it up again. Sometimes the doctors will spray down the sinuses with an antibotic. There is even a gel packing (if they have it) they can put with the antibotic that will stay up there a few days longer...and the gel packing will disappear on its own. Also is she on inhaled tobi? If so you can get the regular saline nose spray and put in a vile or two of tobi in it and squirt up the nose. Ask your doctor first of course...this is what my doctor recommends. Its supposed to help fight off te bacteria a little longer.

Amanda

 

[ReneeP]

Thanks Amanda... Good to hear from you.... btw, how are feeling? Did your surgery go well?

As for Kacie, she is not currently on TOBI since she has not cultured pseudomonas for almost 2 years. I do still have some TOBI (I got a couple of extra refills when she still had Medicaid incase we need it in the near future) but she hasn't actually used it since December. If they do end up doing surgery again I'll definately ask about the antibiotic thing. Anything to prevent further problems.

I have one other question, if you don't mind. It's regarding nasal washes. Is she always going to have to do these to prevent any problems? I guess I was originally under the impression this was only necessary while she was having problems, now the dr is talking about this being a lifetime thing...always having to do them just like her vest and enzymes. That thought doesn't sit very well with me because she hates them so badly but if that is reality then I just need to adjust my thinking and learn to live with it. Do you do them constantly or only when you are having problems?

Thanks again!

 

[Purplelungs]

What kind of washes are they? Are they just a bottle or a spray or are you having to actually squirt it up there with a big needless srynge or something? They do like it if you do saline rinses...which is just that saline in a bottle you just sniff up the nose...its just a nose spray. Some will prescribe a nasal steriod thats a nose spray. I have never had to do full on washes as in squirting a bunch of stuff up my nose with something and make a big mess while im at it. except after surgery and generally just a week after. I hate those. But nose sprays arent so bad. If I am understanding correctly what you mean by washes? Maybe after the infection goes away you can go down to a nose spray. Its not bad at all (although some nose sprays have an awful taste when it goes down the throat)...If by washes you are meaning a nose spray...well she will have to get used to it I'm afraid. She shouldnt have to do it 10x a day though once you get over this part. I hope she doesnt have to do washes permanantly. I hope its just a easy simple nose spray at the most.

Amanda

p.s. I am doing good. Did you get my recent email about my email change?

 

[ReneeP]

No, I didn't. Unfortunately I'm not very good at keeping up with my e-mails but I just checked and there isn't one there. I may have just had so many that it stopped sending them to me... hotmail will do that if you're inbox is too full.... I just cleaned it out so I should be good to go for a week or so...lol.

When I say nasal washes, I mean the big, messy, painful, icky nasal washes. She is already on Rhinocort as a nasal spray as well. As far as the nasal washes, we started out when a bulb syringe, like you'd use to clean a baby's nose, fill it with water mixed with non-iodized salt and shoot it up her nose. Now we have had to switch to a bigger syringe. She is having so much water shoved up there I don't know how she breathes. She says it hurts her throat. That's her biggest complaint. And I know all that salt can't feel good on the wounds and scabs in there. It's a very unpleasant experience. The dr says to plan on doing them indefinately though. I just wondered if that's typical.

I'm going to try attaching a pic here since we now have that ability, just to see if I can do it...

Thanks again, Amanda.

 

[kybert]

i do nasal washes all the time. at least once a day everyday permanently. i never found the sprays to be effective enough so i ended up getting a nasopure bottle. all up i end up squirting about 250 mls [1 cup] into my nose. seems like alot but it does the job. if the saline is hurting her it means its either too salty or not salty enough. for me, half a teaspoon of sea salt and half a teaspoon of bi carb to 250 mls of water doesnt hurt. bi carb losens up crusts and mucus by the way.

after sinus surgery having to wash your nose out 10 times a day for a few weeks isnt uncommon. your doc originally said to do them twice a day but that really is not enough. 3 to 4 times a day is the norm after surgery. my last surgery i ended up having to do it about 6 times a day and i had to keep getting crusts pulled out of my nose [not under anaesthetic, he just shoved forceps right up my nose <img src="i/expressions/face-icon-small-shocked.gif" border="0"> ].

 

[anonymous]

My daughter had her first sinus surgery this year (age 11). Following her surgery she had to do nasal washes approximately 6-8 times a day. She had to continue this for about a month and now she does nasal washes twice daily. Even though my daughter never cultured Pseudomonas (prior to surgery) they left drains in her nose for a week and had us flush tobramycin into her sinuses twice a day for a week. They said even though she never cultured it that when they scraped her sinuses during surgery and sent it off for testing that it came back (72 hrs. later) with a light growth.

We were told that she should do nasal washes for the rest of her life. Her surgeon told her that he went it and cleaned everything out but it was up to her to keep things cleaned out by doing the washes. She never got scabs in her nose from the surgery. But, I also have CF and I get scabs up in my nose sometimes when my sinuses are extremely dry. I place Bactroban on a Q-tip and put it up into my nose and they generally go away within a week.

Good Luck

 

[anonymous]

You say she is complaining of the nasal washes hurting her throat? Speak with your doctor about the technique you are using because it should not be running down the back of the throat. Have your child hold her head over the sink and turn to one side. As the water is squirted up into the nostril it should come out the other nostril. We also found that if you talk while doing your washings that this can also cause the water to flow down the back of the throat.

 

[anonymous]

Hey, this is the company my daughter uses since her surgery. She is five, and never had a problem after her surgery. We waited two weeks after surgery before starting with the washes and went straight to four/five times a day. The surgen said she had only 2mm of an opening and has the tinyest nose, after surgery she had 7mm opening. Her eyes are actually too far apart but can't really tell unless you are aware of it. Now she never has a runny nose, well hardly anyway. When we started with the washes after surgery, you should have seen the junk that came out and she does use the 8oz of distilled water with a phbalance of sodium we order from this company. Here is their sight good luck!!!

www.neilmed.com
www.sinusrinse.com or
www.nasalrinse.com

 

[anonymous]

sorry also forgot to mention we also add a pulmocort treatment in the 8ozs. they are little niblelyzers we just crack open and squirt into the bottle. Oh and we do warm up the bottle in the microwave the warm water makes a difference. And breathing properly only through her mouth while taking the wash, will help and your right NO TALKING!!! hehehe