SPECIAL PATIENTS

SPECIAL-NEEDS PATIENTS

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There are two distinct issues for those who suffer from sinus disease as well as other chronic illnesses. First, you need to know if your seemingly unrelated chronic illness is actually causing your chronic airway - digestive inflammatory disease (CAID). Second, you need to know if the treatments you are following for your chronic illness are compatible with the treatments and remedies for CAID. For instance, people with immune disorders

Syndromes Related to CAID

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Special Syndromes of SinusThese sections discuss special situations that stem from CAID symptoms and/or their treatment, and as they relate to various other disorders.

NASAL POLYPS

CAID itself can cause an anatomical change to the interior of the nose. I frequently see patients who have developed nasal polyps; benign tumors that occur when chronic inflammation causes the membranes of the sinuses and nose

SAMTER'S TRIAD

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Although Samter’s triad is rare, when it is present it can be insidious. This syndrome includes chronic sinusitis with nasal polyposis, asthma, and aspirin allergy. This syndrome can look different in each case, because it presents with a disparate set of symptoms. These sufferers usually complain of nasal congestion, lack of sense of smell and taste,

KARTAGENER'S SYNDROME

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Kartagener’s syndrome is a hereditary syndrome. It is characterized by recurrent upper - and lower-respiratory tract infections due to abnormal ciliary structure and function. This disease is also known as immotile cilia syndrome. Its main characteristic is that the ciliated hair cells on the mucous membranes have impaired movement and therefore can not clear the mucus in the sinuses. Patients with Kartagener’s syndrome

SARCOIDOSIS

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Sarcoidosis is a multisystem inflammatory disorder in which the body forms noncaseating granulomas - benign masses that form in the lungs,
sinuses, nose, skin, and occasionally the parotid glands. This disorder commonly affects young adults. Thorough examination of the body on a systemic level is critical to determine if the disease has spread to other organ systems. For example, sarcoidosis

SCUBA DIVERS AND FREQUENT FLYERS

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I treat many patients with ear and sinus problems resulting from either scuba diving (or snorkeling, or just plain diving into the water) or frequent air travel. Changes in altitude or changes in the depth of the water that you reach are tied to changes in the pressures that your body experiences. With these changes, all of the cavities in your body need to equalize

WEGENER'S GRANULOMATOSIS

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Wegener’s granulomatosis affects the respiratory tract from the nose and sinuses to the lungs. It also affects the kidneys. This disease is a systemic inflammatory disease whereby the body creates autoantibodies: antibodies that attack your own organs and body structures. In the nose, sinuses,

Chronic Disorders and CAID

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The following sections discuss chronic conditions that can make individuals more susceptible to infection, thus making them more prone to having problems with CAID. These patients require special treatment considerations. If you have been diagnosed with any of the following,

CANCER PATIENTS

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Radiation therapy that is delivered to the head and neck area can result in xerostomia, a chronic dry-mouth condition that is caused by damage to the salivary glands. You might also experience dryness to the mucous membrane in the nose and sinuses. The treatment protocol is very similar to the treatment of Sjogren’s syndrome: frequent

DIABETES

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It is widely believed that people with type 1 or type 2 diabetes are more prone to infection than their nondiabetic peers. Infection undoubtedly impairs blood sugar level control. For people with diabetes, controlling blood sugar levels not only is important for controlling the illness

RHINOCEREBRAL MUCORMYCOSIS

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Rhinocerebral mucormycosis is a severe and potentially fatal fungal infection. This fungus typically affects people whose immune system is weakened by disease, such as uncontrolled diabetes, and/or AIDS. It is rarely found in someone with normal immune status. The symptoms of rhinocerebral mucormycosis include pain,

LUPUS

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Lupus is another autoimmune disease in which the body’s defense mechanisms attack the body itself. It is thought to affect about 1 person in 1,000, with women nine times more likely to be affected than men. Although it can occur at any age, it usually appears in the late teens or early 20s.

Just

CYSTIC FIBROSIS

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Cystic fibrosis is a relatively rare inherited disease that affects the lungs and digestive system. The disease is chronic and progressive. In the past, it was believed that all cystic fibrosis patients succumbed to their disease by the age of 20. However, we are now finding that many of these

PATIENTS ON BLOOD THINNERS

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Some people with congenital heart defects, including those that have had heart valve replacements, a stroke, a blood clot in the legs, or have had

complicated surgeries may need to take daily anticoagulants, popularly known as blood thinners. These medicines slow blood clotting and are used to prevent major

Special Needs for Every Generation

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Each stage in life can also affect the course of treatment for CAID. Whether you are currently pregnant, in your later years, or caring for a child, read the following sections to make sure you are following the appropriate course of action.

PREGNANCY

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As any pregnant woman can tell you, along with the complicated change in her hormones comes body swelling. The changes in a woman’s body during pregnancy are designed to ensure the fetus adequate nutrition through the placenta and to protect the mother from trauma and blood loss at the time

INFERTILITY

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I believe that failure to conceive and carry a pregnancy to full term can be caused by changes in body temperature (low-grade fevers stemming from chronic sinus infections), drops in oxygen saturation, and the transient bacteremia that can occur with CAID. I’ve had a few female patients who have told me that they couldn’t get pregnant until their sinus problems were resolved. Some underwent in vitro fertilization, which failed before resolving the sinus problem. After

OLDER PEOPLE

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Many older men complain that their nose is constantly running. Others complain that their nose runs when they eat certain foods.

This symptom can be treated by your primary physician; however, these problems can be caused by a testosterone imbalance or by other endocrine disorders like hypothyroidism and gigantism. If you are suffering from this

CHILDREN

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CAID can affect children as well as adults. Very often, children are misdiagnosed by parents and well-meaning pediatricians as having yet another runny nose or just having a cold. Yet many of these children are congested all year long and are probably suffering from CAID.

A child’s sinuses and nasal passageways are inherently smaller than an adult’s and, therefore,

CAID vs. Tonsils and Adenoids

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Tonsil and adenoid issues can also occur with chronic sinus infections with acute exacerbations. For kids with a constant yellow-green mucus and stuffy and runny nose, the infection can drain to the lymph nodes, which includes the neck nodes, tonsils, and adenoids. These children typically can’t ever breathe through

This initial hit of inflammation would probably lead you to believe that you had come down with a simple cold.