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- Fri Sep 12, 2008 10:54 pm
43 year old female with chronic chest congestion and post nasal congestion w/
drainage x 1.5 years. Been to the Lung Dr. and ENT. After long course of
Levaquin and Prednisone last summer had sinus surgery for the second time
with hopes of resolving the drainage and lung congestion. Surgery worked to
open sinus passages but symptoms continued and have become worse. I cough
up junk on a regular basis throughout the day. Mornings seem to be the only
time of day I feel fine. Had Methocoline challange and results came back fine.
Chest x-rays always show nothing and I can't get my care givers to order a
CT of the lungs, this worries me. My chest always hurts with coughing. ENT
set me up for more allergy testing, I was tested 3 years ago w/ allergies to
dogs, cats, mold #1 on list, grass, ragweed. I recently had another sinus infection
for which they put me on Levaquin for 10 days and developed a temp while on
this medication, was switched to Ceftin and another course of a Medrol dose pack
which after taking, developed more low grade temps. ENT swapped nasal passages for culture.
Please someone help me with this long, long illness.
| John Kenyon, CNA
- Sun Oct 19, 2008 9:50 pm
Hi Cheryl -
Two things come to mind right away given your history and excellent description of the symptoms. First is the mold allergy, which often is a hidden problem. If you're highly allergic to certain molds and they happen to be hiding somewhere in your environment, you'll almost certainly have repeated respiratory infections. So that's one possibility -- one that could require a good deal of detective work to rule in or out.
The other thing that comes to mind is that I notice you carry a diagnosis of GERD. This, sometimes, can contribute to respiratory problems -- usually asthma, but sometimes chronic lower respiratory infections as well. This is because when horizontal (as when asleep) GERD can result in stomach contents being aspirated.
Combine these two, which may be the case, and you'd have seeminly never-ending nasal and chest congestion, one feeding on the other.
One factor that argues mold may be a factor is that you've been treated with some powerful antibiotics yet the problem seems to come right back. What I find just a little odd is the prescribing of steroids (not wrong in itself, but usually contraindicated when an infection is suspected). This is because steroids tend to reduce inflammation and so mask infections, making them appear to be improved, when they're actually still there. In conjunction with or alternating with antibiotics can prove frustrating and sometimes will make things worse. If infection was ruled out, steroids then would be appropriate.
I really think the GERD and mold allergy aspects need further investigation. Since you've had sinus surgery that should have resolved any lingering problems with drainage -- although once in a great while the scarring the results can actually cause the problems to return, so a CT of the sinuses would also be in order, so as to not miss any possible cause. If they won't order a CT of the lungs maybe a CT of the sinuses would fly. There has to be a chain of evidence to support a diagnosis and find the cause so this can be resolved.
Best of luck to you. Please stay in touch and follow up with us as needed.