Friday, February 8, 2013

Treating Sinus Infections (new guidelines)

Oh, the joys of cold and flu season. For moms still in the trenches, this season comes with a special brand of misery. About the time the children you've nursed back to health feel better, you're battling extreme exhaustion. Now sick yourself, you have to deal with hungry, energetic, mess-making children who don't understand how awful you feel.

Crawling in bed to drink fluids and rest is impossible. At this point a mother is at the Lord's mercy, unless her own mother or sister live nearby.

My children are all significantly better and despite my attempts at avoiding sinus infection, I was up with extreme facial pain last night (classic sinus-infection symptom). Each time I get one of these nasty infections, I research what I can do from home, and when I should see a doctor.

Advice has changed and now aligns with the supposedly "mainstream" thinking on ear infections. That is, more than 90% of sinus infections are caused by viruses, not bacteria, so antibiotics won't cure them. Moreover, using antibiotics will contribute to the production of "super bugs".

Taking a mucous culture to determine if the infection is viral, bacterial, or fungal, is not practical, since only a part of the sinus cavity is considered sterile--the part enclosed in bone that's impossible to culture. So doctors who prescribe antibiotics do so as a "just in case" precaution for very old or very young patients, or because the patient is demanding an antibiotic.

Both sinus and ear infections can lead to extreme pain, making it hard to accept that doctors can't help. Living with pain isn't something we expect in this modern-medicine era.

There are a number of things we can do to battle the infection without a doctor's help, however.

Sinus Infection Treatments: What Helps and What Hurts? 

~ Promote drainage by inhaling steam over a pan of hot water, 2 - 4 times a day (not on the stove).

~ At night use a steam vaporizer.

~ Drink a lot of fluid to help promote drainage by thinning the secretions.

~ Use an expectorantExpectorants are drugs that help expel mucus from the lungs and respiratory passages. They help thin mucous secretions, enhancing drainage from the sinuses. The most common is guaifenesin (contained in Robitussin and Mucinex). Note that an expectorant is different than a cough suppressant. A cough suppressant is used to stop a dry, irritated cough to promote better sleeping. Productive (mucous) coughs are necessary to prevent bronchitis and pneumonia, and they should not be stopped, but encouraged. Never use a cough suppressant for a productive cough.

~ Use over-the-counter (non-saline) nasal sprays and decongestants with caution. After 2 or 3 days, they can hurt more than help, due to a rebound effect. A decongestant dries up secretions by reducing the swelling in nasal passages; it's the swelling that produces excess mucous. But as the process works, the decongestant also thickens the mucous, making it harder to expel.  So use a decongestant only at the beginning of your respiratory infection, and sparingly after.

~ Unless you're sure your problem is caused by allergies, avoid antihistamines, especially Benedryl, which tends to thicken the mucous.

~ Relieve the pain with ibuprofen, which reduces inflammation, thus promoting drainage. Tylenol will help with pain, but not with inflammation.

~ If you suffer from recurrent sinus infections, your doctor may prescribe a steroid nasal spray to help maintain open sinuses. Our sinuses inflame because of illness, or because of allergy, or because of a foreign body presence. If the narrowing of passages (swelling of passages) is due to allergy especially, you may be given steroids, such as prednisone.

Natural, Safe Decongestant Practices (found here):

~ One simple home remedy that may serve as a natural nasal decongestant is inhaling steam. Pour some boiling water in a large bowl. Place a large towel over your head, which should also drape the vessel. Inhale the trapped steam by taking deep breaths. The same method also serves as a natural expectorant.

~ Make a mix of salt (1/4 tsp.), baking soda (1/4 tsp.), and water (8 ounces). Stir well and pour the solution in a nasal dropper. Closing one nostril, squirt the dropper into the other and inhale deeply ensuring the solution reaches the sinus cavities. Thereafter, blow your nose gently and repeat for the other nostril.

~ Prepare some black tea, as usual, and add half a teaspoon of cayenne pepper in it. The active ingredient in the pepper, that is capsaicin, helps in reducing swelling and inflammation. So drinking the tea will soothe the nasal passages, and make the mucus thin and loose thus, stimulating drainage, and clearing up the congestion.

When To See A Doctor: 

According to this March, 2012 article, here are signs that your problem is bacterial, and that a doctor visit is necessary:

How to tell if it's bacterial

A sinus infection, properly called acute rhinosinusitis, is inflammation of the nasal and sinus passages that can cause uncomfortable pressure on either side of the nose, and last for weeks. Most sinus infections develop during or after a cold or other upper respiratory infection, but other factors such as allergens and environmental irritants may play a role.
According to the guidelines, a sinus infection is likely caused by bacteria, and should be treated with antibiotics, if any of these criteria are met:
  • symptoms last for 10 days or more and are not improving (previous guidelines suggested waiting seven days)
  • symptoms are severe, including fever of 102 degrees Fahrenheit or higher, nasal discharge and facial pain lasting three to four days in a row
  • symptoms get worse, with new fever, headache or increased nasal discharge

Last, but definitely not least, pray my sister. Ask your family to pray too. These infections are nasty, nasty, nasty. You deserve not only prayer, but lots of sympathy. :)



Margie said...

I swear by the saline nasal rinse. I buy a kit that has a bottle and prepared saline packets, but you can always make your own. I boil and cool the water, mix and rinse. Years ago a nurse practitioner recommended this to me and it works well. Also I had a dr that swore by saline nasal spray. Just salt and water nothing else. I prefer the rinse personally but the spray works well too. Take care my friend and I hope you find some relief.

Christine said...

Thank you, Margie. I appreciate the suggestions. I did forget to boil the water. Hopefully I won't regret that...