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Suggest Treatment For Chronic Sinusitis, Narcolepsy And Cataplexy
Question: I've had repeat sinusitises to the point where they no longer responded to antibiotics. After very diligent care and every treatment you can imagine, I have cleared up even dry mouth and no longer contract bronchitis or pneumonia. I remain with residual drainage that originates at the top of my scalp and still pours down each side of the face flooding my sinuses with mostly clear, foul tasting sputum. When these become blocked, congestion ensues and I cough to the point where I have muscle spasms (severe)< then I need to treat them, and crash because of exhaustion. I am a nurse and there is not one measure I haven't tried, Yogic, chiropractic, lymph node massage, outside of conventional treatment. I'm Ok if I'm in the shower or my scalp is wet, but 3 hours in a hot shower or holding a showerhead sitting down is a killer. Also I have narcolepsy and cataplexy and have coughed for hours. I know gentle coughing is in order but hot and bitter sputum trigger hypopharyngeal spasms that set off the rest of my respiratory system and cause asthmatic attacks. The chiropractor does cranial massage and it's amazing how I can feel secretions trickle down underneath my scalp. Drs. are surprised I made it and agree I have exhausted every type of treatment. Today an elderly woman told me an old Italian women put slices of potatoes on her head when she was 5 years old and it broke up her typhoid fever and she could hear sizzling going on in her head and that broke it up once and for all. Well I tried it today, KI took a brand new pair of underwear put some potatoes on my head and taped it with that wide cellophane tape, no sizzling and it didn't work. So there you go doc, just when you thought you heard them all. My question is this, since the scalp responds so well because of osmosis and capillary action, is there any scalp treatment I can use? I thought about using vicks or eucalyptus oil on the top of my head to mimic the shower routine. This area of involvement would coincide with the posterior end of my sinuses. My other consideration is would it pass through the blood brain barrier and cause problems like it does with mucous membranes? I cough for hours on some days. Thank you. Every specialist possible has seen me.
Brief Answer:
Vicks scalp treatment may be innaffective
Detailed Answer:
Hi. Sorry to hear that you have been suffering from this problem for such a long time. Your efforts in trying to deal with this condition is very commendable.
Coming straight to your questions, I believe that vicks or eucalyptus oil as scalp treatment may not effect your illness as it appears that the problem lies within the sinuses and these may not reach the sinuses in adequate amounts through the scalp. However using these does not cause any significant absorption into the blood stream or cross the blood brain barrier. The actions are generally local and may lead to capillary dilatation but most of it doesn't get absorbed into the blood stream.
In my opinion your symptoms are strongly suggestive of atopy or a state of hypersensitivity to allergens. Your history of asthma, bronchitis, chronic cough, easy hypopharyngeal spasm to mucous secretions and chronic post nasal drip point significantly towards an allergic process. These can precipitate recurrent sinusitis which can be infective in nature.
In my opinion if there is a recurrent sinus disease that has not responded to conventional treatment, one must rule out anatomical factors and allergy since these will not respond to any of the approaches that you have tried. They may temporarily relieve you of your symptoms but never go away until the underlying cause has been addressed.
If I were your treating ENT specialist then I would ask for a CT scan of your Paranasal sinuses just to look for any bony abnormalities such as a concha bullosa, blocked ostia, enlarged turbinates or hypotrophied sinuses. If you have had a CT in the past then it would be useful to look for these. If there are any such factors present in your scan then they will need to be addressed surgically. No amount of alternate therapy or scalp treatment can change physical anatomy.
The next step in your management is to evaluate you for allergies. Two points for a reality check 1. Allergies may never go away. They may only be temporarily managed so your expectations need to be realistic. You can try desensitisation to known allergies and that may have variable benefits. 2. It is not necessary that you must have sneezing and itching for it to be allergic rhinitis. Constant mucous post nasal drip is a very clear sign of allergy and a foul taste suggests fungal involvement and it may be a condition known as allergic fungal rhinosinusitis or AFRS.
In my opinion I would advice the following to treat you form your illness
1. CT Paranasal sinuses for anatomical changes and sinus involvement
2. Nasal secretions to be sent for allergic histopathological assessment and fungal stains
3. A skin prick test to determine allergens
4. Absolute eosinophil count
If any of these are positive or show a finding that contributes to the disease then you will need endoscopic sinus surgery for anatomical corrections and/or life long steroid nasal sprays with oral mast cell stabalizers and antihistamines.
If all of these are negative then you can continue to explore alternate therapies and continue with anything that works for you.
Hope this helps. Would like to follow up on your progress and if you do get these tests, I would like to see the results and continue further advice. Do let me know if I can answer any other questions.
Vicks scalp treatment may be innaffective
Detailed Answer:
Hi. Sorry to hear that you have been suffering from this problem for such a long time. Your efforts in trying to deal with this condition is very commendable.
Coming straight to your questions, I believe that vicks or eucalyptus oil as scalp treatment may not effect your illness as it appears that the problem lies within the sinuses and these may not reach the sinuses in adequate amounts through the scalp. However using these does not cause any significant absorption into the blood stream or cross the blood brain barrier. The actions are generally local and may lead to capillary dilatation but most of it doesn't get absorbed into the blood stream.
In my opinion your symptoms are strongly suggestive of atopy or a state of hypersensitivity to allergens. Your history of asthma, bronchitis, chronic cough, easy hypopharyngeal spasm to mucous secretions and chronic post nasal drip point significantly towards an allergic process. These can precipitate recurrent sinusitis which can be infective in nature.
In my opinion if there is a recurrent sinus disease that has not responded to conventional treatment, one must rule out anatomical factors and allergy since these will not respond to any of the approaches that you have tried. They may temporarily relieve you of your symptoms but never go away until the underlying cause has been addressed.
If I were your treating ENT specialist then I would ask for a CT scan of your Paranasal sinuses just to look for any bony abnormalities such as a concha bullosa, blocked ostia, enlarged turbinates or hypotrophied sinuses. If you have had a CT in the past then it would be useful to look for these. If there are any such factors present in your scan then they will need to be addressed surgically. No amount of alternate therapy or scalp treatment can change physical anatomy.
The next step in your management is to evaluate you for allergies. Two points for a reality check 1. Allergies may never go away. They may only be temporarily managed so your expectations need to be realistic. You can try desensitisation to known allergies and that may have variable benefits. 2. It is not necessary that you must have sneezing and itching for it to be allergic rhinitis. Constant mucous post nasal drip is a very clear sign of allergy and a foul taste suggests fungal involvement and it may be a condition known as allergic fungal rhinosinusitis or AFRS.
In my opinion I would advice the following to treat you form your illness
1. CT Paranasal sinuses for anatomical changes and sinus involvement
2. Nasal secretions to be sent for allergic histopathological assessment and fungal stains
3. A skin prick test to determine allergens
4. Absolute eosinophil count
If any of these are positive or show a finding that contributes to the disease then you will need endoscopic sinus surgery for anatomical corrections and/or life long steroid nasal sprays with oral mast cell stabalizers and antihistamines.
If all of these are negative then you can continue to explore alternate therapies and continue with anything that works for you.
Hope this helps. Would like to follow up on your progress and if you do get these tests, I would like to see the results and continue further advice. Do let me know if I can answer any other questions.
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. Vinay Bhardwaj
Answered by
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