Chronic Disorders and CAID

. Posted in SPECIAL PATIENTS

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, there is a high probability that you may also suffer from CAID. Make sure to discuss your CAID symptoms with your primary-care physician as well as your specialists.

IMMUNOCOMPROMISED PATIENTS

If you have been diagnosed with an immunologic deficiency (like AIDS) or are currently on immunosuppressive therapy (including chemotherapy
for arthritis or cancer), your CAID symptoms must be treated with special care. You might find that you are having more frequent sinus infections than before your illness. This may be due to the intrinsic illness or it may be due to the medications that you are taking, because many of them will lower your defense mechanisms.

As you know, you must be vigilant about your overall health: Even the smallest infection can lead to meningitis and/or periorbital infection (which can lead to visual changes or blindness). You will need to follow a preventative regimen and should consult an otolaryngologist as part of your treatment team. Once you have an ENT to advise you, he or she should provide you with a preventative regimen. The preventative regimen I give my immunocompromised patients is as follows:

■ Take all medicines, including your sinus medicines religiously.

■ Undergo daily nasal irrigation; twice daily if your sinus symptoms begin to flare.

■ Seek immediate ENT medical attention as soon as you start to develop any sinus symptoms.

For years, many ENT surgeons were taught that sinus surgery wasn’t advocated for people who also had AIDS, probably due to their perceived short life expectancy. But today’s medicine has overcome this problem: AIDS patients are living longer, fuller lives and can benefit from sinus surgery. What’s more, by following the preventative protocol, and treating sinus infections immediately as they occur, the need for surgery has become more limited as well.

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