IV antibiotics just for sinus issues?

[athletixbc]

My sinus specialist has always told me to mix 2ml of Gentamycin antibiotic in with every sinus rinse that I do because then the antibiotic actually gets into the sinuses where it can help. IV antibiotics are fine for the lining of the sinuses, but they do absolutely nothing for mucous/fungus etc. that could be clogging up the inside of the sinuses. Ask the ENT doctor if it would be acceptable to add antibiotics to the sinus rinse bottle instead of IV. It works really well for me.

 

[MotherofCFBoy11yrs]

Hi Jamest, thank you again for the suggestion of using water pick for sinus irrigation. We got the SinuPulse which is essentially the same. My son has been using it since last week and I think it was definitely a good purchase. The first time he used the SinuPulse he had green stuff coming out of his nose when irrigating the other sinus - before that he had been using a manual irrigator (which looks like a big syringe) daily for several months and that dislodged nothing. So the SinuPulse is definitely going deeper in the sinuses even though my son has not had sinus surgery. We will now add mupirocin to the salt solution because the oral abs are not enough to eradicate the staph.

I'm also considering trying JJ Baby Shampoo for a short while (I'm aware of the concerns) because apparently pulsating irrigation + baby shampoo is the best way to break up biofilms.

Using the SinuPulse does add to my daily chores: I boil a pot of water every morning (with such large volume irrigation it's easier than buying sterile water) and I also sterilize the machine every day using chlorine and water mix. But my son likes using it, it is easier than the manual irrigators.

I could not find any definitive comparisions of manual/pulsating irrigators, so I asked the HydroPulse (very similar to SinuPulse) manufacturer and this is what they replied to me the next day:
"Hydro Pulse is designed to restore nasal/sinus cilia. It is not a hose that goes into the nose and certainly not like a squeeze or bulb device. It is used at a steady pressure so that when a comfortable pressure - such as a 5 - is used, the fact that it stays at a comfortable pressure is the reason children can use it and users are comfortable using it. More important, a steady flow is why the sinus material is suctioned out and any added xylitol or other material gets into the sinus cavity. the fancy technical name for this is Bernoulli's Principle.

Once the nasal/sinus cilia are restored by the pulse rate that the Hydro Pulse uses, there is no further reason to irrigate. Because the pulse rate of the Hydro Pulse is designed to match the best rate of normal cilia, that wave action is best to restore good cilia movement. That is why it is ideal for CF, where the pathology is due to poor cilia due to the thick mucus.
Let me know if you have any more questions. Also, please check out my blog at www.grossaninstitute.com"

 

[fel]

I thought I would give an update. I had my sinus surgery (polyps out, extra holes, sinoplasty, reduced turbinates, etc.) and then followed up with sinus rinses with antibiotics and steroids, and am doing a lot better. I still do rinses laying on the floor with my head all the way back to get the liquid to reach the back sinuses. I am going to continue the steroid rinses on a regular basis, or at least whenever I feel the inflammation coming back. This is probably the first time in my life I can breath through my nose.

My son had his version of this same surgery (all the same procedures) last week, just 6 months from the last similar surgery. However, he is so far very swollen and it is hard for him to use the rinses. If he squirts it straight up nothing goes up. If he lays back he ends up swallowing most of it. I am thinking of getting him something like hydropulse, but I wonder how well that would work with someone who has a lot of swelling. It seems to me that until the inflammation goes down, the only thing that will get liquid back there is the use of gravity (putting the head all the way back.) What do you folks do when there is a lot of inflamation?

Thanks!

 

[MotherofCFBoy11yrs]

Hi Fel, I'm glad you can breathe through the nose now, I'm sorry to hear your son is having so much inflammation. Would ibuprofein decrease it? I know it is used with CF long term to fight inflammation (but my son has not used it).

if you get an irrigator I highly recommend a Water Pick, you will need to order a nasal tip separately or make one (I made one by cutting off the tip of one of the standard WP tips and putting Nasaline silicone tip on it while waiting for a proper tip from Ethicare). We bought a Sinupulse first, it was really noisy and badly made. It broke, probably because I was sterilizing it with bleach and water after every use. My son thinks the WP is awesome and it's definitely well made. We have the WP 100.

 

[windex125]

I always used Levaquin for sinus infections as well, did great with them. Then the last time I broke out with hives all over, which I thought werid as I know Cipro is in the same family and I do well with that. Go figure? Readg abt yr. sons sweat tests - well that was me as well. I was diagnosed as a infant then undiagnosed at the age of 8 but constantly sick and failure to thrive, finally in 1998 my doctor sent me to UNC and I had a nasal chloride test done and it was positive for CF. my main issues are my lungs, as a matter fact I only have one functioning the other has been collapsed for yrs. now. Good luck getting this cleared up it sounds extremely uncomfortable, I've been breathing through my mouth for years now, just find it more comfortable. Pat-59/CF

 

[fel]

New update. Younger son is doing a lot better with the prednisone/levaquin rinses, and the inflammation has mostly gone down. It just took a while -- much longer than a standard case. I purchased a Sinupulse from Amazon.com, it arrived broken, and was fully refunded. But now I wonder if we really need one. Based on some of the posters here on the CF forum, our new way of doing the rinses -- on the floor, with head back, giving the stuff time to drip into the sinuses, really seems to work. Of course it feels terrible while doing it, and makes a big mess, but the results are worth it.

Meanwhile older son (diagnosed with CF) got a cold that has exacerbated, and I introduced him to sinus rinses tonight for the first time. He has mostly lung involvement and typically uses his vest and nebulizer with hypertonic. Anyway, on one nostril the rinse wouldn't go anywhere, so I am wondering if he may have nasal polyps as well... My poor husband must feel like he lives with a bunch of hippos -- he now has 3 family members squirting large quantities of liquids out the nose.

Perhaps I should start a new thread on this -- but I am wondering why the CF centers don't seem to handle the sinus issues at all. I mean, they check the lungs, they do the diet stuff, but as soon as you ask them to look at a sinus CT scan, they seem clueless. So now we all need to separately go to an ENT to monitor these issues. Is that typical? To give you an example, before younger son had his (2nd) surgery, the CF center said his sinuses were fine. At the same time the ENT said not only did he have huge polyps and inflamed turbinates and no air clearance at all, he was also missing drainage holes. These contrasting opinions were based on the identical CT scans.

 

[AleksandraKaczynska]

it's tnormal for cf patients to have sinus problems...our cf team monitors this - however for more complex diagnising and such - we need to go to a separate doc or clinic - Our cf teams says who to go too - but it's not part of the cf team.