Sinusitis so bad it is killing me! (incapacitating in flight!)

TexasFlyer said:
Just took my last Z PAC antibiotic. Now day 11 since this began. Nose slightly better as mostly mucus and not blood, and the blood that is present seems more dried dark red than fresh runny. Headache still there (sharp pains behind eyes and around right temple and on top of head if touched). Going back to urgent care in about an hour again since infection seems to not be gone given these symptoms.
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You might need some more exotic antibiotics. I’m basically not able to use the usual stuff anymore because of my many years of sinus infections pre-surgery. After you’ve taken the same antibiotics over and over again, you develop a tolerance for them and they’re no longer effective. They had to start giving me some really bizarre stuff that is usually only given for extreme infections. The side effect list scared the crap out of me, but they worked, and I never experienced any of the side effects.
 
TexasFlyer said:
Just took my last Z PAC antibiotic. Now day 11 since this began. Nose slightly better as mostly mucus and not blood, and the blood that is present seems more dried dark red than fresh runny. Headache still there (sharp pains behind eyes and around right temple and on top of head if touched). Going back to urgent care in about an hour again since infection seems to not be gone given these symptoms.

I could not get into Dr Lanza. He is only taking referrals from MD's and I do not have an MD referral since my insurance is a PPO and I do not have a MD that knows him to refer me to him. But, his partner who he trained is taking new patients. So I will see her. Hope she is as good as him! Appointment is set for May 7. Will try to get in sooner if possible. But at least this is a step in right direction with the ENT Specialist.

Now just need a good AME in St Pete area. I can Google around, but always appreciate referrals if anyone has experience with a good one that helps on a personal level with aviation health and is just not a medical certificate mill. I assume it is a good idea for my new AME to understand what is going on and advise accordingly and be informed with details from the ENT since this affects my duties.
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Dude, you need to relax. Go to an ENT, he'll probably do a CT scan and likely recommend a sinus surgery. The balloon sinuplasty has become super common and can be done in the ENT office. It's not a terribly long recovery either--maybe a couple weeks at most. Something to definitely consider. Sinus issues can lead to more severe conditions so get that taken care of asap.

The FAA's reaction to your surgery should not be the primary consideration whether or not you get treatment. Just doowit and be healthy.
 
Worse case is May for my ENT appointment. Will get in sooner if possible. Seems to be a good business when booked out that far.

Went to second doc visit today. Same BS. They don't listen. They don't care about my history or story. They just look in nose and ears and throat and listen to me breathe. Acknowledge I still a stuffy mess full of goop. And perscibe me another round of amoxicilian stuff now saying 10 days of that should work since z pack didn't. Then they send me on my way.

Thankfully the conversation I had when making ENT appointment was positive and she told me I never had an exam like they will give me. And they are mailing me a lot of info in advance and want me to write all details that they need retutned no later than a week prior to my appointment. Heck, I spent more time on the phone with the ENT folks than the dang urgent care doc spent diagnoses me to do the same crap that does not work. Looking forward to going to the Nasal Institute!

I also just noticed. Missed too many days of flying. This is my second sick trip block now. So the email of scheduling me with CP and having right to union rep being present for the meeting has been sent to me. Plus this now exhausts my sick pay bank too. This current trip was a very high credit hour trip I really wanted to do since it had great overnights. Oh well. Instead I been stuck still in a hotel (never went home, stuck in base in a hotel still).

Guess now later today I have to call ALPA local rep to discuss plan of action and might as well call ALPA national AME hotline too. Instead of just focusing on getting better. Now I get to figure out this getting better process and job preservation process.

I will keep this post active as I go through this sinus issue process. Here is what I will do:

* I will update each MD and AME appointment and their advice as new knowledge is gained.

* I will update company/ union support (or non support).

* And I will update my line flying status since once my head clears I will likely return to the line, but if this happens again prior to the ENT appointment I will have to then avoid flying completely and file for short term disability until the ENT can hopefully cure me as then I feel I have no other options.

I will do all these updates because maybe someone here has advice and knowledge that is yet to read this. As I appreciate all comments. And will update as well because maybe there is someone else as bad off with a sinus issue as I am on here that is afraid to post online. So this is for you too my friend!
 
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Here is today's update. Very long day, as today is actually now tomorrow already!

Almost 12 hours of doctors and waiting today! Yes again!!!! But finally someone listened. And spent a lot of time with me. And actually seemed concerned.

First. An AME via phone said fly if feel fit, keep self grounding leg by leg if reoccur. Document it all and bring all med records to next med exam. Hope any current scripts work to control it as then all is fine. If not, well then I know what to do.

Second. An MD seen me, got another MD. Seemed a little distraught.

New MD, great guy. Listened to my whole 10+ minute dissertation of my history with this stuff and how bad this current episode is and how it is affecting my career. I starting off with "if I was your pilot, how would you feel since I assume patient safety to him is as paramount as passenger and crew safety is to me."

After a few looks and listens to vitals and oddly no high temp like prior visits but a wholly crap now 145/98 BP which is insane as I am always 125/78- ish (even on the other visits I was close to that). The Doc was not happy with what he saw and that BP change concerned him as the infection even without a temp he said could be advancing to other ares. We talked a little more about medical history and this condition. He was genuine.

He then sent off for a few shots in the butt for me. After awhile he returns and is still clearly concerned. He gives me a couple scripts and then says to hang on for awhile as he has an idea. He came back a long while later and said he knew a RX like 100 miles north that will do what he needs for me as he is concerned the ENT is way out in early May, but said that is also not abnormal. He then flat out said, it is ugly and based on what I saying this will not subside enough on just normal scripts. Plus said to be careful. And right ear drum is bowing out swollen and whole sinus just ugly and very bad infection and yada yada yada. He then faxed scripts to the two different Rx.

So the three shots were these below. And he also advised every 5 to 10 days come back if feeling worse than a dat or two prior.
Ceftriaxone Sodium.
Methylprednisolone Acetate.
Dexamethasone sod Phosphate.

At the CVS I got a few scripts and then had to drive to a special Compounding Pharmacy 115 miles away to get this crazy other stuff! (okay, it was a cool place to watch them actually making medications for people, it was like a lab in the middle of a small town).

Here is what I have to do daily starting now and until I get to the ENT Specialist! Every day, twice a day for 60 days. If it is a pill, take the pill. If a powder or a liquid add to 8oz of distill warm salted water and shake in squirt bottle and then squeeze up nose:
Mupirocin.
Amphotericin B.
Budesonide.
Levofloxacin.
Doxycycline Hyclate.
Azithromycin.
Prednisone.

His last words before making a long drive to the special Rx. DO NOT MISS A SINGLE DOSE! Good luck with the ENT.

The reading material in the pic I bought. Never know when Plan B may be needed. And will keep the brain fresh with new info along with review CRJ and Ops Manuals if somehow out an extended time to keep fresh there too.

The ENT Specialist visit can not get here quick enough! I am already missing flying...
 

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Hell yeah to BiggerPockets, it is an awesome resource.

I think the biggest thing is to not worry about your current job. You aren't the first person to need an extended period to recover. Keep them up to date on the process and all will be fine.
 
Thanks all.

Today. First day with heachacheso mild it is almost an afterthought. So that is progress.

Still blew out stringy nasty wet and dry blood and mucus, so that is still for sure keeping me grounded since no matter how good I feel, until that stuff stops coming out and until nose breathing crystal clear, no flying attempt will be made. Hoping this clears for next week, but time and meds will tell.

Heading out to try to find some sort of plastic ware or carrying compartment box that will allow me to carry a full 6 day supply of thesemeds with me. The tops on vials are just rubber and pop off easy, so have to remain upright and I disturbed.

My plan.
* Get that medical box found sonI can carry 6 day supply of meds with me on trips.
* Once nose and head feels clear and all bloody goop is no longer blowing out of nose, meaning normal to no mucus, I will try a trip block.
* Will assess very carefully leg by leg the state of any nasal, pressure in sinus, or goop changes; calling off trip immediately and proactively if any bodily changes.
* Will then have to remain grounded and give more time before next trip I begin or wait until ENT assessment to see how to proceed depending on timing and other factors at the time of call out.

Waiting on CP to call. The prior email and pic I posted is pretty much what I sent the CP. I am sure they are discussing.
 
CP emailed. They seem on board with my plan and just will keep them informed. Next 45 days will be tough as I have so many meds to take and have to remain very prudent as to my physiological condition before each trip block and before/after every leg. But will fly as I can and will rest as I need to until the ENT Specialists make their recommendations in May. So right now, everything is what it is and will be what it will be. I will update once I get some real news to update, so it may be awhile.
 
TexasFlyer said:
Here is today's update. Very long day, as today is actually now tomorrow already!

Almost 12 hours of doctors and waiting today! Yes again!!!! But finally someone listened. And spent a lot of time with me. And actually seemed concerned.

First. An AME via phone said fly if feel fit, keep self grounding leg by leg if reoccur. Document it all and bring all med records to next med exam. Hope any current scripts work to control it as then all is fine. If not, well then I know what to do.

Second. An MD seen me, got another MD. Seemed a little distraught.

New MD, great guy. Listened to my whole 10+ minute dissertation of my history with this stuff and how bad this current episode is and how it is affecting my career. I starting off with "if I was your pilot, how would you feel since I assume patient safety to him is as paramount as passenger and crew safety is to me."

After a few looks and listens to vitals and oddly no high temp like prior visits but a wholly crap now 145/98 BP which is insane as I am always 125/78- ish (even on the other visits I was close to that). The Doc was not happy with what he saw and that BP change concerned him as the infection even without a temp he said could be advancing to other ares. We talked a little more about medical history and this condition. He was genuine.

He then sent off for a few shots in the butt for me. After awhile he returns and is still clearly concerned. He gives me a couple scripts and then says to hang on for awhile as he has an idea. He came back a long while later and said he knew a RX like 100 miles north that will do what he needs for me as he is concerned the ENT is way out in early May, but said that is also not abnormal. He then flat out said, it is ugly and based on what I saying this will not subside enough on just normal scripts. Plus said to be careful. And right ear drum is bowing out swollen and whole sinus just ugly and very bad infection and yada yada yada. He then faxed scripts to the two different Rx.

So the three shots were these below. And he also advised every 5 to 10 days come back if feeling worse than a dat or two prior.
Ceftriaxone Sodium.
Methylprednisolone Acetate.
Dexamethasone sod Phosphate.

At the CVS I got a few scripts and then had to drive to a special Compounding Pharmacy 115 miles away to get this crazy other stuff! (okay, it was a cool place to watch them actually making medications for people, it was like a lab in the middle of a small town).

Here is what I have to do daily starting now and until I get to the ENT Specialist! Every day, twice a day for 60 days. If it is a pill, take the pill. If a powder or a liquid add to 8oz of distill warm salted water and shake in squirt bottle and then squeeze up nose:
Mupirocin.
Amphotericin B.
Budesonide.
Levofloxacin.
Doxycycline Hyclate.
Azithromycin.
Prednisone.

His last words before making a long drive to the special Rx. DO NOT MISS A SINGLE DOSE! Good luck with the ENT.

The reading material in the pic I bought. Never know when Plan B may be needed. And will keep the brain fresh with new info along with review CRJ and Ops Manuals if somehow out an extended time to keep fresh there too.

The ENT Specialist visit can not get here quick enough! I am already missing flying...
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Doxycycline is the only thing that truly knocks out a sinus infection ..That other stuff is garbage and you’re right they don’t listen ..I’ve dealt with this problem for years.
I have no polyps or deviated septum .I finally found an ENT that listened ..To properly treat the infection requires 4-6 weeks of doxycycline tablets 100 mg ..Flonase helps too .If you’re flying a lot you’re still gonna get an infection at least once a year especially if you have allergies and passengers fly sick now ..They don’t give a • anymore .
A low dose antibiotic like doxycycline is what’s needed ..Not this 10 day crap that most doctors prescribe that send you running to the bathroom . The sinuses are small air pockets within the bony structure of the skull .Thats why it’s tough to get rid of it .
You shouldn’t have any side effects from the doxycycline if you decide to fly while taking it ..The dose is low enough it shouldn’t give you the runs ..Make sure you drink water .


Sent from my iPhone using Tapatalk
 
No better, maybe worse?

Felt decent the last two days. No more headache. No more extreme congestion. Only very light congestion felt as constant slight pressure in my head (almost like feeling like in my skull and ear bones... hard to describe). And sometimes a slight ringing or muffled ear sound along with discomfort in the chest or ears. But those symptoms all mild and 100 times better than I been the last two weeks.

So I decided to give work a try. Felt alert and happy to get back to flying after 2 weeks grounded and laying around doing nothing productive. I packed my roller board and packed my pills into the pill case I bought, packed my mini dosing bottles of liquids and powders and mixers into the lunch box I bought to hold all those items. Filled the large 40 oz thermos to hold 5 days worth of distilled water for mixing my meds. Then went from my hotel where I been staying all this time to the airport....

As soon as I get out of the truck to grab my roller it hits me. I get dry sweats. I get vertigo and nauseous. 15 minutes to show time and this hits me! How could this be? I felt fine until that moment. I sat back in the truck for a few minutes, watching my show time grow near. Frustrated I call scheduling and call off sick for the whole trip. This is terrible. I am confused. Best to have happened on the ground versus in the air, but what is going on?

I sat in the parking lot about 35 minutes until good enough to where the motion of driving would not make me sick. Emailed the chief pilot and HR and union what just happened since I am feeling lost and now getting depressed as this episode today has frustrated me and has me concerned. I then drove back to the MD, but it was too late. He was not in since it was late in the day (near 4:45pm). I did not want a new MD to see me since I need continuity with MD's at this point. Time to make an appointment with a primary care physician since the urgent care system will no longer cut it (will make PCP appointment today to get all this documented and on file in one place).

Since no MD today, I got dinner and found long term housing that is more affordable in the hotel in base. Then fell face first onto the bed and slept for 6 hours out of frustration and to calm down. And now here I am. Still feel pressure in my head, still have occasional ear ache/ ringing, and still have occasional tight chest. And if move my head briskly around I can hear and feel the junk as it feel like I have water in my head. Not sure why this stuff is still stuck up there and affecting me. Frustrated.

The plan.
Get a Primary Care Physician appointment.
File FMLA or STD since it become clear I can not fly and this crap hits me random.
Try to accelerate my appointment at the Nasal Institute.
During the wait for the Nasal Institute Specialists, see if there are tests we can begin doing (which once I get a PCP they can recommend that).

Not sure what else to do. Hope you all had a better day. My day was not very good...
 
That sounds horrible. I have nothing to contribute, but just know there are people reading your updates and cheering for you. I'm sorry your body is apparently pissed at you but hope you kick whatever's going on in the ass!
 
Everyone has issues that they have to work through from time to time, so you’re definitely not alone. Hopefully this is just a blip on the radar and you can get it resolved quickly. Good luck and try to stay positive!
 
Today seen my first PCP. A lot seems to have been accomplished. He was great. Actually the whole staff was great. He listened to the whole history of my sinus struggle. I wrote a 2 page history of what is going on and he read the whole thing I wrote.

Only issue he found other than ear and sinus congestion, throat irritation, and mild sinus infection lingering is high blood pressure. But since that has not been a historic issue he said my regiment of current meds may be causing that. He did some blood work in the office that will get sent out for analysis.

He was okay with my current regiment of pills and sinus rinse meds. He also prescribed me Montelukast Tablets daily. He said this allergy medication with the sinus rinse meds over the next few weeks should produce some results since the OTC stuff did not work for me historically.

He took FMLA paperwork to complete and send in. He also suggested I may not want to fly until full diagnosis and treatment runs it course, but ultimately that is my decision if at some point I feel my head has cleared enough to attempt flying. Then he suggested if I plan to fly, test flying a few legs as a passenger first may be an idea as a way to assess my fitness to fly before a trip block.

He also referred me to an Allergy and Immunization Specialist that was outside my insurance plan, so will try to find one of same credentials that is within my insurance plan. The Doc said the ENT Specialist in May I have set up is more the surgery spectrum and the Allergy and Immunization Specialist is more the non surgery treatment spectrum. So I need to be working with both.

He also ordered a CT scan. Those folks will call me within a few days to set up the appointment.

So productive day. Seems things are moving along.
 
NEUROLOGIST. Anyone know a Neurologist that specializes in Migraines in the Tampa / St Pete area?

At my Allergist today we concluded I am allergic to the world. But since I been taking Claritin with no positive result, I should stay on the newly prescribed Montelukast Tablets and also take 2 Sufafed daily as well. Said that may help, but after a full exam and CT Scan I was told I should seek a Neurologist that has expertise in Migraine Headaches. She feels my sinus issues are brought on by the congestion mixed with barometric changes in the plane, but the Montelukast with Sudafed combo may help that. She also seen a few issues on the CT the ENT Specialist will address. But the migraine headache she also feels is brought on from barometric changes in the plane and said that is why I need a Neurologist as anything she can suggest would be drugs that I can not take while flying.

So that is today's chapter in the saga. And keeping this summary short since my headache is pounding again....
 
Many years ago I had this friend with an incredible migraine type headache that had persisted for many months. They finally caved and went to a neurologist who prescribed my friend career ending anti serizure medication. Needless to say this friend wanted a different solution.

Instead he found a naturopathic type neurologist that quickly discovered the issue - a pinched nerve in their neck - causing occipital neuralgia. A few days of massages and the headaches disappeared. Moral of the story - the vast majority of our issues are self correcting and there is little need for all these prescribed drugs.

Honestly if I were in your shoes I would immediately stop with all these drugs. Who knows what effect that will have on you long term (I too used Flonase and recently became aware of the cataract issue, hoping I don't get them too) and they seem to be having little effect anyway. I would move (temporarily) to an area of the country with little allergies - such as the south west - and start cutting out typical food allergens as well such as dairy and bread.
 
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TexasFlyer said:
I hate to write all this, but I have nowhere else to turn. I usually can use OTC products to kick this (nasal spray, sinus rinse, and decongestants). But this has caused me to miss a lot of work (2nd week off line right now and getting worried about my job reliability!).

I finally went to a doc for this because I had the worse headache ever and I can not describe the pain of a knife in my head and eyes! Yet, the doc did not seem not to care about this reoccurring issue that has got to this bad now (this time a serious sinus infection). Gave me a few shots in the hip a week ago and antibitics and sent me on my way. But I still feel awful!!!!

This will be long, but bare with me. Hoping someone has advice for me because I am out of options and really need to know what to do! Hate to post this here, but feel I have nowhere else to turn.

Here is what happens 3 to 4 times a year and it puts me down for like 2 weeks. And this time, it took an emergency trip to the urgent care to see that doc in the middle of a trip block since this always incapacitates me.

Over time my sinus get clogged. So far clogged that even a sinus rinse does not get the stuff out that is in my head. It seems to be a slow process that takes many weeks and I really do not realize it until the day it hits the limit and incapacitates me. It happens out of nowhere. Always while flying. And always in the manner I am going to describe here. And this happens with no warning, on a random trip leg and then it is all over!

1) ON CLIMB OUT: I get dizzy. I get dry sweats. I get nauseous. I hear mucus moving in ears. I feel pressure in my head. I can not function. I can not do my job. I am incapacitated. I let the Capt know I am feeling ill and he takes over for the rest of climb out as both PF and PNF.
2) LEVEL OFF AT ALTITUDE: After a few minutes I tend to fairly rapidly start to feel better. I then take my job back as PF or PNF. As quick as I got sick, I get better! Usually in cruise I just have pressure in my head I can still feel at this point but really not much else of an issue. But this feeling is false, as the descent is going to hurt very badly.
3) DESCENT: Simply all hell breaks lose. Completely incapacitated again so Capt is now once again single pilot. Happens pretty quickly upon initiating descent. But different symptoms, the worse! I end up with ear hissing and mucus moving again. I also end up with a headache and ear ache and top of nose ache and top of throat ache. These aches I can not even describe other than feeling like being stabbed by a sharp knife. The pain is absolutely awful. And then my eyes feel the same like a knife stabbing and pushing them from the inside out. IT IS AWFUL.
4) LANDING: Usually on approach, as quick as all this pain happened. It is gone! It goes away. But this is only temporary since if I do another leg, now every time I fly this process will reoccur until I go load up on meds for like 2 weeks. But it is only a temp fix since within 10 to 12 weeks, the whole thing happens again and again and again with no warning!!!!

This is clearly a safety issue and health issue and at this point I am crying for help. I have no clue what to do or who to go see. And this current time is so bad I am about ready to go to the ER tomorrow due to the following:
1) I have had a severe headache for the 7th day now. So this is my second trip I just called out sick for.
2) For 7 days now I have filled up several bags full of mucus so thick it is pretty much a solid mucus (not liquid). And the mucus is dark yellow and green and completely coated in various colors of bright to dark red from blood. I cough this out. I blow this out.
3) For about 3 days now my eyes seep of sticky mucus.
4) For 2 days now I have a very tight chest and constant chest pain right in the middle (feels like heart burn and pressure, but lower than where I would get such).
5) When I blow my nose or cough, I can not describe how much my head and chest hurts. My head hurts with that sharp knidge edge pain even with or without touching it and that pain sometimes goes to my ears and throat and top of nose as well (more so on right side of head versus left for some reason).
6) I sometimes get chills and my heart races from time to time for no reason and a slight fever comes and goes.

All this the same crap I been dealing with for a couple years, but this time 100 times worse!!!! And the shots and antibiotics the clinic gave me appear to have not worked.

I will kick this mess I have going on right now. But I need to know what to do and who to see and how to get this resolved. I can not be putting my crew and passengers at risk with this ongoing condition that is now getting very severe!
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Have you tried nasal/sinus irrigation (saline solution)? It might help, but don't do it if you're going to continue to keep attempting to fly. It could make things significantly worse with pressure changes.
 
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