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Blood § dizziness
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Blood § dizziness

by Nikel, Oct 23, 2004 12:00AM
Hi there,

I have a couple of questions which I hope you may be able to answer.

I was recently diagnosed as having sinusitis after a viral infection. When I think about it though, I realise that I have probably had a recurrent problem with sinusitis for a numer of years. I would come down with a "mystery" illness every time I got run down or burnt the candle: headache, extreme fatigue, sore throat, coughing yellow junk from the back back of my nose which would clear up over a week or two. However, over the last few months I have frequently just had the coughing up junk problem, usually occuring in the morning when I clean my teeth! I have noticed though that from time to time it is brownish or appears to have blood in it.

After this last bout I was given antibiotics which have gotten rid of the yellow junk problem, but this morning when I had my usual cough, blood came up, bright red and fresh. I am concerned I may  have some sort of nasal cancer as I am a recently quit (social) smoker of 20yrs. Is this something to worry about?

I have also had a condition for 9 weeks called Labyrithitis which affects the inner ear causing dizziness, vertigo, hot flushes, fatigue and anxiety. I noticed some other posts mentioned these very same symptoms. Could the sinusitis be a direct cause of the labyrithitis?

Finally, I had a CT scan to check that it wasn't a tumour causing the dizizness and discovered I have a deviated septum - could this be the culprit of all my problems. Sorry for the lengthy query!

Regards.

by National Jewish, Oct 28, 2004 12:00AM
Your deviated septum could be the culprit of all of your problems.  The sinuses are hollow areas within your head.  The maxillary sinuses are behind your cheeks.  The frontal sinuses are behind your forehead.  The ethmoid sinuses are behind and below the frontal sinuses.  The sphenoid sinuses are behind your nose.  To work properly, mucus needs to drain well from the sinuses.  The nasal septum is a plate of bone and cartilage along the center of the nose.  A deviated nasal septum is shifted to one side.  When your septum is deviated there is less space on the side that the septum leans towards.  Generally this area is squeezed.  A deviated nasal septum may cause blockage of the sinuses on that side to the point that the sinuses do not drain as well.  This can cause swelling of the nasal and sinus passages.  As the sinuses become swollen, the drainage openings that lead from each sinus into the nose become blocked.  Both the swelling and the mucus that collects in the sealed-off sinus can cause pressure.  Since the sinuses and the ears are located near each other it is possible for sinusitis to cause labyrinthitis.  Surgery would return the septum to its usual position in the center of the nose.  This is generally helpful in clearing the blockage and decreasing sinus infections.

Sinusitis is an inflammation of the mucous membranes that line the sinus cavities.  Inflammation of the sinuses could be due to an allergy, an infection, or ongoing exposure to an irritant, such as pollution or smoke.  Symptoms can include a headache or pressure in the area of the sinuses, a stuffy nose, achy teeth, an odor coming from the nose, postnasal drip, cough, sore throat, lightheadedness, constant low fever, and thick, yellow to green nasal drainage.

The best way to identify a sinus infection is with a sinus CT scan, although sinus x-rays are a decent alternative.  A sinus CT scan will also identify if any of the openings that drain your sinuses are blocked.  If your symptoms are due to sinusitis, they will last as long as the inflammation continues.  Here are some ways to clear up the inflammation.  Please check with your doctor to see which of these would work best for you.  Please read our Sinusitis MedFact at http://www.nationaljewish.org/medfacts/sin.html for more information.

The most common cause of sinusitis is an infection, especially when the mucus is green.  Sinus infections can be difficult to treat since they respond slowly.  When any of the openings that drain your sinuses are blocked it will take longer to clear a sinus infection.  If a viral infection is the cause it’s a matter of time until the sinusitis clears on its own.  When a bacterial infection is the cause you may need to take an antibiotic for at least 3 weeks.  Even after the infection is gone, it is possible for the inflammation to linger.  However, inflammation of the sinuses could also be due to an allergy or ongoing exposure to an irritant, such as pollution or smoke.

This inflammation can block sinus drainage, cause increased mucus production, and bleeding that may or may not mix with the mucus.  The mucus may “sit” there, especially when it is thick and become dark in color.  It may not move with coughing.  As the sinus infection clears, this mucus drains from the nose and sinuses down the back of the throat causing a constant or intermittent postnasal drip that can be irritating to the throat.  This mucus can fester sinusitis.

The fat content in dairy products can thicken mucus.  Generally eating dairy products with less fat content is helpful.  Drinking plenty of water will help to thin the mucus so that it moves more easily.  As long as you are not on a fluid restriction you should be drinking 6 to 8 8-ounce glasses of non-caffeine non-alcoholic fluid daily.

An antihistamine can dry up the postnasal drip.  However, it may make the mucus thicker and more difficult to move.  A decongestant like Sudafed® (pseudoephedrine) can thin the postnasal drip and relieve your blocked sinuses by decreasing the swelling so they drain better.  A combination antihistamine-decongestant will do both.  Often a prescription antihistamine and decongestant are taken only when the postnasal drip gets bad.  It may be more helpful to take the antihistamine and decongestant on a regular basis.  Check with your doctor to see which of these would help you more.

A nasal wash helps remove mucus and germs from the nose and sinuses.  This can temporarily decrease the postnasal drip and help your sinuses to drain better.  Please read our Nasal Wash MedFact at http://www.nationaljewish.org/medfacts/nasal.html for more information about this technique.  Share this information with your doctor to see if you would benefit from this daily treatment.

If your symptoms continue, your doctor may recommend a prescription nasal steroid spray.  This can decrease mucus production and improve sinus drainage by decreasing the inflammation in the nose and openings that drain the sinuses.  This generally provides a more lasting decrease in sinus pressure and improves sinus drainage.  To get the most help from a nasal steroid spray use it after doing a nasal wash.  A nasal steroid spray does not provide immediate relief of symptoms.  It may take several weeks of routine use to become effective.  Sometimes it takes the antihistamine, the decongestant, and the nasal wash followed by the nasal steroid spray ALL used routinely to keep the postnasal drip from bothering you.
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