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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What do persistent sinusitis and chronic fatigue indicate as per the attached reports?

Answered by
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Dr. Suresh Heijebu

General & Family Physician

Practicing since :2010

Answered : 3576 Questions

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Posted on Wed, 5 Sep 2018 in Ear, Nose and Throat Problems
Question: See attached info (6 attachments). 3 years sinusitis. 4 months chronic fatigue (headaches, total exhaustion, muscle aches & pains, concentration problems, vision problems). Was VERY active prior in life & work. Sleep 20+hrs some days. Need to schedule daily chores (if snow shovelled, can not grocery shop that day... just sleep after). Another CT neuro & sinus scan scheduled the 15th. Multiple chronic diseases suggested by non-professionsls. Requesting opinions & diagnostic suggestions. Thank you.
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Answered by Dr. Suresh Heijebu 2 hours later
Brief Answer:

Reports are suggestive of chronic Obstructive Rhinosinusitis.

Detailed Answer:

Hi,

I can certainly understand your concern.

I have worked through your attached query in detail.

As per your symptoms and lab reports l analysis, there is a significant Obstructive Rhinosinusitis caused predominantly by a deviated nasal septum.

This requires correction by surgical intervention only. Medications cannot cure this condition.

You have already taken excessive medical management whose ill effects are being shown over the scan data.

I advise you to trust your primary doctor and go accordingly.

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Suresh Heijebu 1 hour later
Thank you for the reply. My concern is that the ENT does not feel the headaches, are related to the sinusitis issues. I understand that I have a neuro CT scan scheduled as well & that will give more info. I guess I am wondering if you or other professionals feel these sinus issues could cause all my exhaustion, pain, concentration issues,etc. I am also having difficulty getting a "sound" sleep & am frequently having to urinate at night. I wonder if the slightly elevated ferritin & CO2 & decreased urea are of any significance?? I am also wondering if you could explain the difference between a CT & MRI?? I know this is a bit "all over", unfortunately, that is the nature of my symptoms. Thank you.
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Answered by Dr. Suresh Heijebu 6 hours later
Brief Answer:

Most of your symptoms are directly related to Obstructive Rhinosinusitis.

Detailed Answer:

Hi,

Most of the symptoms which you have a direct correlation with Obstructive Rhinosinusitis.

Urinary disturbances at night require a special mention and that don't correlate with Obstructive Rhinosinusitis.

It's advisable to get a complete Urinary examination, ultrasound abdomen and of necessary a Urodynamic pressure study to identify the cause and to treat accordingly.

Elevated ferritin and CO2 levels could be related to underlying Obstructive Rhinosinusitis leading to disturbances in blood oxygenation.

Elevated urea levels could signify underlying kidney damage and hence a thorough screening through appropriate tests as mentioned above are required.

MRI is more specific for parenchymal brain damage. It can specifically focus the hindbrain structures like Cerebellum and Brainstem in comparison to CT.

CT, on the other hand, is more specific for bony abnormalities of the skull along with parenchymal brain lesions.

Obstructive Rhinosinusitis is predominantly a defect in bony structures in and around the nose and thus HRCT is indicated.

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Kampana
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Follow up: Dr. Suresh Heijebu 14 hours later
Thank you for the detailed reply. I plan to follow up w the diagnostics suggested for the urinary symptoms as well. Thank you for confirming other symptoms mostly have a direct corralation to the sinusitis. Can you please explain if Obstructive Rhinosinusitis can evolve over time?? Last ENT visit ruled out polyps, etc. I am not aware of any injury, etc that may have caused this. I am 34 & it only becam a significant issue the last few years &, more so, the last few months. Also, can you please explain the term HRCT?? Thank you. e
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Answered by Dr. Suresh Heijebu 5 hours later
Brief Answer:

Obstructive Rhinosinusitis worsens with time.

Detailed Answer:

Hi,

Obstructive Rhinosinusitis has a definite propensity to evolve/ worsen over a time period.

Obstructive Rhinosinusitis may not always develop following an injury. It could be developmental as well.

HRCT stands for High-resolution CT scan of paranasal sinuses. It's an excellent diagnostic modality which can that can identify the site and severity of Infection and obstruction.

Take care

Dr Suresh Heijebu
Above answer was peer-reviewed by : Dr. Kampana
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