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P. S. Ledereich, MD
Doctor

Posts: 43
Joined: Jan 2005
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2/26/05 11:25 PM
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There are many different type of sinus infections: acute, subacute and chronic. They can be caused by bacteria, and they can be caused by fungal infections. They can be allergic in nature, and they can be caused by some anatomical features. Surgery will only correct anatomical blockages of the sinuses. Before considering surgery, I recommend maximal medical therapy, which CAN include (depening on the patient), topical nasal steroids, antibiotics, systemic and topical decongestants, mucolytics, saline drops, amoung many other treatments. It is a fairly common disorder (just take a look at how many different over the counter medications are in the pharmacy - it is a multi billion dollar business!).
Hope this helps
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P. S. Ledereich, MD Family Ear Nose and Throat Care 1033 Clifton Avenue, Suite 204 Clifton, NJ 07013 Telephone: 973 470 8266 144 Route 59 Suffern, NY 10901 Telephone: 845 357 8302
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P. S. Ledereich, MD
Doctor

Posts: 43
Joined: Jan 2005
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3/11/05 12:52 AM
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Hi - see my reply within your letter.
>Let me tell you my experience. One anecdotal experience.
>I had sinus surgery seven years ago. It did absolutely nothing for me. I suffer constantly from infections. I am sorry that you had a miserable time. Just like purchasing a car, sometimes you get a lemon. I do not know who did your surgery, and even if the doctor was the greatest in the world, the surgery may not have been a success in your case. Remember the greatest Healer is the One Above, in whom all refuas are possible. If Hashem had wanted you healed, than it would have been so.
>My father-in-law is a doctor. He told me that it works about 30% of the time. I do not agree with that number.
>Usually doctors give you a prescription for antibiotics for ten days or so. He told me that the body really needs three weeks of antibiotic therapy to rid the body of the infection. This is usually very effective, and is a good options for lots of patients who have acute sinusitis (One week is usually enough).
>What I have been doing for the last several weeks has been a big help. I got a waterpik (which is meant for teeth) it costs about 30 dollars. I mis one teaspoon of sea salt with a gallon of boiled or distilled water. I also add a tablespoon of baking soda. every night before I go to sleep (or before shabbos) I put 12 ounces of this solution in the waterpik and put the tip in my nostril distributing it equally between both sinuses. you must be careful not to sneeze or swallow while the tip is in the nose. Not only is this refreshing but it really helps you clear your nasal passages and you wake up with an almost clear nose! I agree with that 100%. That is an extremely helpful suggestion that I often tell my patients.
>So first of all, make sure that you are on antibiotics for three full weeks. zythromax or ketek works well. Amoxcicillyn (sorry if misspelled) gave me a terrible stomach ache even when taken with food. You probably feel miserable and depressed which is a result of the foginess in your head. In other words, STAY AWAY FROM SURGERY LIKE THE PLAGUE!!! As soon as you start the antibiotics, start the waterpik therapy. If your doctor doesn't liek th solution then ask for a different one. I disagree with that 100%. 1) 3 weeks of antibiotics can be too much for some people 2) using antibiotics too much can cause resistant bacteria. 3) surgery works well for many people (although not 100% for 100% of people)
It sounds like your surgical "cure" was not complete. I would encourage you to seek a second opionion and see if that helps you. Wishing you a refuah sheleimah.
P. S. Ledereich, MD
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P. S. Ledereich, MD Family Ear Nose and Throat Care 1033 Clifton Avenue, Suite 204 Clifton, NJ 07013 Telephone: 973 470 8266 144 Route 59 Suffern, NY 10901 Telephone: 845 357 8302
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P. S. Ledereich, MD
Doctor

Posts: 43
Joined: Jan 2005
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3/23/05 1:00 AM
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see my comments in your text:
>did have a deviated septum which was corrected. I did get other opinions from other doctors after the surgery when >the problem wouldn't go away and so far every single one was of the opinion that surgery is not the best option and >that it should only be tried as a very last resort. I agree with that. Surgery should be tried after failing medical therapy.
>This is not with reference to deviated septums, only regarding widening the sinus cavity. OK - I agree.
>Antibiotics may work in a shorter period of time for some people. However, if a doctor sees that it isn't going away >after ten or two weeks he should be aware that some people need three weeks and not just try another ten days or >two weeks of antibiotics I do not know if I would treat all chronic sinus infections with antibiotics at all. - 1, 2, 3, 4 or more weeks? remember that antibiotics have their own set of issues - resistant organisms, allergies, etc. THis is why antibiotics are a prescription medication, and can even cause deaths! (Hashem Yishmarienu).
Hope you feel better.
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P. S. Ledereich, MD Family Ear Nose and Throat Care 1033 Clifton Avenue, Suite 204 Clifton, NJ 07013 Telephone: 973 470 8266 144 Route 59 Suffern, NY 10901 Telephone: 845 357 8302
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P. S. Ledereich, MD
Doctor

Posts: 43
Joined: Jan 2005
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5/29/06 11:48 PM
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I have never seen that, but certainly csf leaks can occur during sinus surgery. I would suggest you get a second, third even a fourth opinion.
Some ideas for you - without knowing anything specific about your case, may include: a neurology work up, a csf leak nuclear scan check the nasal liquid for glucose consider dyeing the csf, and looking for the dye in the nose looking for a leak if there is an autonomic dysfunction, there are severeal "Jewish" autonomic dysfunctions.
Good luck to you.
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P. S. Ledereich, MD Family Ear Nose and Throat Care 1033 Clifton Avenue, Suite 204 Clifton, NJ 07013 Telephone: 973 470 8266 144 Route 59 Suffern, NY 10901 Telephone: 845 357 8302
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