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Suggest Treatment For Elevated ESR Levels Before A Surgery
Question: 1. ENT Surgeon in Calgary planning Endoscopic Sinus Surgery with probably Sinoplasty, April 6 2015
2.He Started Clarithromycin- 500 mg one daily upto surgery and have already have taken this for around 40 days- does this is ok and required for safe side of surgery? Does this can give any side effects? Detailed opinion.
3. At the same time – he started AMOXI CLAV 875/125 MG Twice days – before 7 days of surgery and 7 days after of surgery, does this is on safe side—and does can be taken along with Clarithromycin before surgery –on safe side—
4. He also asked for Prednisone 30 mg for 7 days before surgery- does this on safe side.will help in surgery
5. My latest ESR was 23, does these above medicines for elevated ESR?
6.He also asked Neti Rinse with Pulmicort Nebule 0.5 mg/once daily, have started last 12-15 days ,feeling that like some hair like movement is /center travels from center of forehead and pain started on backside of head-after few minutes it goes away, should I continue this ,.
does use of this effects /betterment outcome and during surgery.
suggest its safety and efficacy?
Using FURAMIST AZ nasal spray- Fluticasone furoate and azelastine hydrochloride nasal spray of CIPLA, Most of time it reach to throat and giving very unusual taste and irritating taste- should I continue with it or stop it,
7.a) He was of opinion that they will assess- pre surgery evaluation for Anesthesia, cardiology, Lungs—he was telling that the surgery will be done in Operation Theatre not day surgery- and will observe for night in case they see oxygen level concerns—keeping in view severe Obstructive Sleep Apnoes- ,will Surgery can give any serious concerns during surgery and afterward?
b) What type of Anesthesia is recommended in Obstructive Sleep Apnoea? for this surgery and safe
8 .My IgM and C4 was high , does these can intervene and creates problems- during surgery and afterward? I am also low on Hb, you can please evaluate latest blood work?
9. I am diabetic, hypertension please suggest its effects on surgery, has nodule 5 mm on lung , guide its effects on surgery. Does bleeding will happen during surgery—
2.He Started Clarithromycin- 500 mg one daily upto surgery and have already have taken this for around 40 days- does this is ok and required for safe side of surgery? Does this can give any side effects? Detailed opinion.
3. At the same time – he started AMOXI CLAV 875/125 MG Twice days – before 7 days of surgery and 7 days after of surgery, does this is on safe side—and does can be taken along with Clarithromycin before surgery –on safe side—
4. He also asked for Prednisone 30 mg for 7 days before surgery- does this on safe side.will help in surgery
5. My latest ESR was 23, does these above medicines for elevated ESR?
6.He also asked Neti Rinse with Pulmicort Nebule 0.5 mg/once daily, have started last 12-15 days ,feeling that like some hair like movement is /center travels from center of forehead and pain started on backside of head-after few minutes it goes away, should I continue this ,.
does use of this effects /betterment outcome and during surgery.
suggest its safety and efficacy?
Using FURAMIST AZ nasal spray- Fluticasone furoate and azelastine hydrochloride nasal spray of CIPLA, Most of time it reach to throat and giving very unusual taste and irritating taste- should I continue with it or stop it,
7.a) He was of opinion that they will assess- pre surgery evaluation for Anesthesia, cardiology, Lungs—he was telling that the surgery will be done in Operation Theatre not day surgery- and will observe for night in case they see oxygen level concerns—keeping in view severe Obstructive Sleep Apnoes- ,will Surgery can give any serious concerns during surgery and afterward?
b) What type of Anesthesia is recommended in Obstructive Sleep Apnoea? for this surgery and safe
8 .My IgM and C4 was high , does these can intervene and creates problems- during surgery and afterward? I am also low on Hb, you can please evaluate latest blood work?
9. I am diabetic, hypertension please suggest its effects on surgery, has nodule 5 mm on lung , guide its effects on surgery. Does bleeding will happen during surgery—
Brief Answer:
seems to be pansinusitis
Detailed Answer:
Hi,
I had gone through your question and understand your concerns that you are having sinus and lung issues.
Based on your clinical details and reports, it occurs to be chronic pan sinusitis with polypoidal mucosa with restrictive lung disease with nodule in lung.
The reports are old (nov 2014), need fresh investigations to measure the severity of present status.
Answers and solutions for your queries.
1. Tab. Clarithromycin, usual dose for sinusitis is 500mg twice daily for only 10-14 days. It causes diarrhea, itching, dizziness and cardiac conduction defects in elderly people.
2. Tab. AMOXI CLAV 875/125 MG usual dose for sinusitis thrice daily for 7-10 days, depending on the severity.
Yes. it can can be taken along with Clarithromycin (no interaction).
In my opinion, your treating doctor might have started these both drug regimens in view of both lung, sinus and polyp issues.
3. Predsinolone, is a steroid, indicated pre-operatively to shrink the polyp, to lessen the bleeding during surgery (it is safer dose).
4. No. Medications will not increase ESR.
5. Neti rinse is a saline spray, helps in draining thick secretions and loosening of thick crusts. Pulmicort nebulization is a steroid used primarily to prevent bronchospasm as a maintains treatment in asthma or lung disorders.
Yes. You get slight discomfort and head-ache during the procedure. Continue the same, as per your treating doctor. They also help in smooth anesthesia (induction and extubation) of your surgery.
6. Unusual taste and irritating taste- common with nasal sprays (FURAMIST -AZ). These medication need to be taken even after the surgery to prevent recurrence. kindly bear it.
7. Elderly man, obese, with lung problem need cardio-pulmary evaluation with ECG, Spirometry, Echo-cardiography and sleep studies (obstructive sleep apnea).
Yes. In case of obstructive sleep apnea, general anesthesia with endo tracheal intubation required.
In good, skilled anesthetist, its not the big task.
8. IgM and C4 indicates infection. surgery helps in relieving the infection. Low hemoglobin (Hb) needs to be corrected with oral supplements and blood transfusion depending on the levels. You need iron supplements.
9. Do not worry. Diabetes and hypertension can be managed with insulins and anti hypertensives by an anesthetist. Related to nodule in lung need pulmonologist consultation and CT scan of chest. It does not cause any bleeding during the surgery.
Hope this answers your question, if you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.
Wishing you good health.
seems to be pansinusitis
Detailed Answer:
Hi,
I had gone through your question and understand your concerns that you are having sinus and lung issues.
Based on your clinical details and reports, it occurs to be chronic pan sinusitis with polypoidal mucosa with restrictive lung disease with nodule in lung.
The reports are old (nov 2014), need fresh investigations to measure the severity of present status.
Answers and solutions for your queries.
1. Tab. Clarithromycin, usual dose for sinusitis is 500mg twice daily for only 10-14 days. It causes diarrhea, itching, dizziness and cardiac conduction defects in elderly people.
2. Tab. AMOXI CLAV 875/125 MG usual dose for sinusitis thrice daily for 7-10 days, depending on the severity.
Yes. it can can be taken along with Clarithromycin (no interaction).
In my opinion, your treating doctor might have started these both drug regimens in view of both lung, sinus and polyp issues.
3. Predsinolone, is a steroid, indicated pre-operatively to shrink the polyp, to lessen the bleeding during surgery (it is safer dose).
4. No. Medications will not increase ESR.
5. Neti rinse is a saline spray, helps in draining thick secretions and loosening of thick crusts. Pulmicort nebulization is a steroid used primarily to prevent bronchospasm as a maintains treatment in asthma or lung disorders.
Yes. You get slight discomfort and head-ache during the procedure. Continue the same, as per your treating doctor. They also help in smooth anesthesia (induction and extubation) of your surgery.
6. Unusual taste and irritating taste- common with nasal sprays (FURAMIST -AZ). These medication need to be taken even after the surgery to prevent recurrence. kindly bear it.
7. Elderly man, obese, with lung problem need cardio-pulmary evaluation with ECG, Spirometry, Echo-cardiography and sleep studies (obstructive sleep apnea).
Yes. In case of obstructive sleep apnea, general anesthesia with endo tracheal intubation required.
In good, skilled anesthetist, its not the big task.
8. IgM and C4 indicates infection. surgery helps in relieving the infection. Low hemoglobin (Hb) needs to be corrected with oral supplements and blood transfusion depending on the levels. You need iron supplements.
9. Do not worry. Diabetes and hypertension can be managed with insulins and anti hypertensives by an anesthetist. Related to nodule in lung need pulmonologist consultation and CT scan of chest. It does not cause any bleeding during the surgery.
Hope this answers your question, if you have additional questions or follow up questions then please do not hesitate in writing to us. I will be happy to answer your questions.
Wishing you good health.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
Answered by
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