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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Suggest treatment for coughing up of white mucus and sinusitis

Answered by
Dr.
Dr. Arnab Banerjee

Critical Care Specialist

Practicing since :2012

Answered : 1281 Questions

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Posted on Thu, 1 Sep 2016 in Medicines and Side Effects
Question: Hi There.

Ok I started to come down with a cold/Flu on around 20th July which initially I thought was just a bad bout of hayfever, To cut a long story short after coughing up two weeks of white bubbled mucas and after my nose behaved more like a tap for two weeks I started to beat the symptoms apart from one.. My head started to cloud and become foggy. I suffer quite often from sinusitis and most times this is what manifests after I have had a cold. I went to my GP who perscibed a week of clarithromycin and upon these not really doing much I was given another week. At the same time I was doing all I could do to make myself feel better.. Lots of vitamins, eating well and some exercise.. As well as that antibiotic I have been steaming my sinusis daily and using Avamys nasal spray. I returned to the GP yesterday to explain that the antibiotics had not worked and all she did was change my spray to "Mometasone"
My current symptoms are mainly that my head feels completely stale, I feel totally withdrawn and havent much enthusiasm for anything even enjoyable things. My personality has just been totally wiped out and I feel like I'm exsisting and not living. Sleep does not really refresh me and my tempreture seems to be fluctuating all the time.. I find that by hydrating regularlly and eating well I regain parts of my former self but after a while I crash again .. Everything just seems a mental struggle at the moment and my quality of life is awful.
I'm pretty sure this is the old enemy sinusitis but what has worried me now is that the antibiotic course has done absolutely nothing whereas before it has been quite effective just as Doxycicline worked for a little while then was not effective the second time round. I've an appointment to see the specialist next thursday and am hoping for a scan but my fear is that I cant wait that long and would really like to know what I can do to shift this horrible fog or to ease symptoms or what antibiotic can beat this this time around? I should add that I suffer from hayfever, allergic Rhinitis and have certain food allergies.. Please help.
Also have been coughing up very small chunks which are now small but consistent I assume because the antibiotic worked to a certain extent. Nose is totally dry and bad post nasal drip.
doctor
Answered by Dr. Arnab Banerjee 5 hours later
Brief Answer:
you need to get clinically examined and investigated thoroughly ..

Detailed Answer:
Hello XXXX, Welcome to HCM,

I've gone through your query and understand your concern..

So sorry to hear all those trouble you've been through so far..

Yes, as per your description it seems like a chronic sinusitis only, but now got complicated with a secondary bacterial infection as well as some component of allergic response too..

Well the coughing may or may not be due to allergic response but since you've mentioned the history of hay fever, allergic rhinitis and certain food allergies, it can be an super added cause too..

Moetasone spray was also given considering the allergic perspective as it's a potent steroid..

However, at this moment I'd also strongly suggest you to avoid any further antibiotics therapy as it seemed your suffering from the after effects of the prolonged therapy(antibiotic therapy can be initiated only after specific relevant investigations and a thorough clinical check-up)..

You haven't mentioned which type of specialist are you going to see, however in my opinion you should see a Pulmonologist for a detailed evaluation in to this..

Please be strong, have faith in yourself, you can beat it..

As of now , just continue the steam inhalation (alternating Vicks and plain steam) and Mometasone spray..

You can also consider saline nebulization as it'll soothe your nasal and respiratory tract mucosa..

Alternatively you can also discuss with your doctor regarding switching over to Salbutamol nebulization instead of Mometasone spray (if it's not showing improvement despite this therapy) as it's having deeper penetration in the respiratory tract and better outcome in primarily allergic response..

Please also start taking a PPI/antacid like Cap PANTOPRAZOLE 40 mg once daily before breakfast to prevent any underlying acid-reflux(if not taking already)..

Chlorhexidine mouth wash thrice daily is also needed to be started since mometasone therapy has been initiated..

Yes all those fatigued, drained out exhausted feelings are due to combined effects of Chronic sinusitis and such a prolonged heavy course of antibiotics, don't worry you'll get over them within a while..

The visit to the Pulmonologist is extremely important at this point as he/she'll not only clinically examine you thoroughly but also will run several specific investigations in this regard (including a Repeat CBC, absolute Eosinophil count, CRP, chest X-ray, CT scan of the para nasal sinus as well as thorax , throat swab and nasal swab gram stain, culture sensitivity, Sputum for AFB, and/ pulmonary function test, if not done already)..all these will help to narrow down the exact cause or the cumulative factors which is causing this..since you've mentioned the history of food allergies, it'd be the right time to get a comprehensive Allergy panel testing to know exactly what all things are you allergic to, please discuss this with the Pulmonologist..

I've tried to make it as simple as possible for you to understand, please let me know if there's any further doubts/queries, I'll be glad to clarify..

Take Care
Kind Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Arnab Banerjee 6 hours later
Thank You very much.. I'm seeing my ENT Specialist next Thursday... I will show him your message... What is an Pulmonologist? Im not sure there is one where I live in Jersey?

I very much hope your right regarding that my symptoms will pass because right now my head is seriously frazzled..

How many times per day should I be steaming my face?

Thanks,
XXXXX
doctor
Answered by Dr. Arnab Banerjee 2 hours later
Brief Answer:
You're always welcome to have my suggestions..

Detailed Answer:
Hello Mr XXXXXXX Welcome Back,
Thanks for following up with the details,

A Pulmonologist is a Doctor who specializes in lungs and respiratory tract disorders, it's okay if you can't find anyone in XXXXXXX just go ahead with the scheduled appointment with the ENT specialist..

Yes, please do so..

You can try steam inhalation three to four times a day, it'll provide a lot of relief from your ongoing symptoms..

Also try to remain well hydrated(drink a lot water, XXXXXXX warm preferably), and warm liquids like chicken soups, broths, porridge, hot menta tea etc.

Let me know how you stay in the due course..

My Best Wishes
Take Care
Kind Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Arnab Banerjee 10 hours later
Awesome thank you for your help on this, I will try with those things but what would be the best antibiotic or cause of action if this doesnt help?? At present my foggy stale void state comes in waves, usually quite good in the morning with crashes late afternoon onward.. I have heard that Elderberry honey and lemon works amazing in killing illness?
doctor
Answered by Dr. Arnab Banerjee 2 hours later
Brief Answer:
antibiotics to be decided only after clinical examinations & investigations

Detailed Answer:
Welcome Back Mr XXXXXXX

The antibiotics are of vast varieties, and depend on the micro-organism, area of focus, growth in culture sensitivity, the antibiogram of your area, overall body response and several other factors..all these are necessary to determine the exact genre of antibiotics, so my advice will be to let the specialist examine and investigate you at first and let him/her decide if there's any need to initiate antibiotic therapy..

Yes, Elderberry honey and lemon in warm water is a very traditional method of healing, yes you can try having this twice daily..

Let me know how you stay in the due course..

For future reference you can always get in touch with me, below is my direct follow-up link through which you can contact me anytime anywhere, I'll be happy to help -

http://www.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=71041

Take Care
Kind Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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