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	<title>Comments on: Chills Etc.</title>
	<atom:link href="http://susiemadrak.com/2008/04/19/02/28/chills-etc/feed/" rel="self" type="application/rss+xml" />
	<link>http://susiemadrak.com/2008/04/19/02/28/chills-etc/</link>
	<description>Keeping a jaundiced eye on the corporate media.</description>
	<pubDate>Sun, 12 Oct 2008 07:01:42 +0000</pubDate>
	<generator>http://wordpress.org/?v=2.6</generator>
		<item>
		<title>By: tessablue</title>
		<link>http://susiemadrak.com/2008/04/19/02/28/chills-etc/#comment-141384</link>
		<dc:creator>tessablue</dc:creator>
		<pubDate>Sun, 20 Apr 2008 20:51:14 +0000</pubDate>
		<guid isPermaLink="false">http://susiemadrak.com/?p=24532#comment-141384</guid>
		<description>Caduceus, thanks so much for the medical information. You were very thorough with your explanations and treatment recommendations. Your patients are fortunate.
Susie, I used to have chronic sinus infections, and I know how dreadful they can be. Hope you feel better soon. I really appreciate the info. on your site.</description>
		<content:encoded><![CDATA[<p>Caduceus, thanks so much for the medical information. You were very thorough with your explanations and treatment recommendations. Your patients are fortunate.<br />
Susie, I used to have chronic sinus infections, and I know how dreadful they can be. Hope you feel better soon. I really appreciate the info. on your site.</p>
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		<title>By: JJ</title>
		<link>http://susiemadrak.com/2008/04/19/02/28/chills-etc/#comment-141343</link>
		<dc:creator>JJ</dc:creator>
		<pubDate>Sun, 20 Apr 2008 02:43:54 +0000</pubDate>
		<guid isPermaLink="false">http://susiemadrak.com/?p=24532#comment-141343</guid>
		<description>Hurrah for the new car!</description>
		<content:encoded><![CDATA[<p>Hurrah for the new car!</p>
]]></content:encoded>
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	<item>
		<title>By: Linda</title>
		<link>http://susiemadrak.com/2008/04/19/02/28/chills-etc/#comment-141338</link>
		<dc:creator>Linda</dc:creator>
		<pubDate>Sat, 19 Apr 2008 22:57:19 +0000</pubDate>
		<guid isPermaLink="false">http://susiemadrak.com/?p=24532#comment-141338</guid>
		<description>Are you kidding, john? I'd give my right arm for a doctor like that. Oh, yeah..... that's probably what it would cost since I don't have health insurance.</description>
		<content:encoded><![CDATA[<p>Are you kidding, john? I&#8217;d give my right arm for a doctor like that. Oh, yeah&#8230;.. that&#8217;s probably what it would cost since I don&#8217;t have health insurance.</p>
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		<title>By: john</title>
		<link>http://susiemadrak.com/2008/04/19/02/28/chills-etc/#comment-141332</link>
		<dc:creator>john</dc:creator>
		<pubDate>Sat, 19 Apr 2008 21:35:21 +0000</pubDate>
		<guid isPermaLink="false">http://susiemadrak.com/?p=24532#comment-141332</guid>
		<description>that was the return of marcus welby if i ever heard it or maybe a little love potion for the infectious disease doc &#38; the sinus blogger</description>
		<content:encoded><![CDATA[<p>that was the return of marcus welby if i ever heard it or maybe a little love potion for the infectious disease doc &amp; the sinus blogger</p>
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	<item>
		<title>By: caduceus</title>
		<link>http://susiemadrak.com/2008/04/19/02/28/chills-etc/#comment-141313</link>
		<dc:creator>caduceus</dc:creator>
		<pubDate>Sat, 19 Apr 2008 16:31:13 +0000</pubDate>
		<guid isPermaLink="false">http://susiemadrak.com/?p=24532#comment-141313</guid>
		<description>I probably shouldn't be doing this, and please remember that you get what you pay for, and you probably know all this anyway, but you're one of my favorite never-met-or likely-to people so here goes:
I don't play a doctor on TV, I just am one.  Infectious disease.  

Sorry to hear about your sinusitis.  Miserable thing.  However, the fact that you also have severe conjunctivitis (weeping eye) makes me think that in your case the cause is viral as it is the vast majority of sinusitis.
That does not mean that you should not take the antibiotic.  It's my opinion that most sinusitis, even viral,  is symptomatically improved by a short course of antibiotics because by the time the patient gets to the doctor they have developed some bacterial overlay due to pH changes, swelling of the mucous membranes, and partial to complete blockage of the ostia.  
However, it also means that the most treatment is symptomatic since the main cause, the virus, will not be affected by the antibiotic.  The mainstay of therapy is sinus drainage.  Long hot showers are very helpful.  The moist steam is most effective.  A child's cold steamer, if you sit right in front and breathe the vapor, can help, but if they've been in use for a bit they're all contaminated by molds so may aggravate allergies.  Another trick is to boil water in a large pot, &lt;b&gt;take the pot off the stove&lt;/b&gt;,  put it on a sturdy table, pull up a chair, cover head, shoulders and pot with towel and  inhale the hot steam.  Use caution here.  Steam can be very hot so come out for cooling and air if you feel faint or are uncomfortable.
Warm moist packs to the sinuses.
Oral decongestion (pseudoephedrine hcl 60mg q 6h) if your blood pressure and nervous system can stand it.  Take for 5-7 days only.  No benefit in more.
Pain relief:  Can you take NSAIDs? If so I like naproxen (Aleve, but many store brands/generics available)  May take 2 OTC tabs (440 mg) q 12h.  or if you have OTC ibuprofen (Motrin) use 800mg (4 tabs) q6h.  One or the other, not both.  Take them with food or milk, I don't care what the box says, to decrease nausea. And don't take aspirin with NSAIDs.  Decreases effectiveness, increases side effects.
Add acetaminophen (Tylenol) 1000 mg q 4h prn.  If you have something around with codeine or hydrocodone may sub 1 tab of that for 500mg acetaminophen.

Finally, this is the one time when nasal decongestant sprays are useful.  DON'T, DON"T use them for more than 3 days.  The nasal mucosa gets "addicted" to them, and that's a real mess.  I like oxymetazoline (Afrin) 2 sprays each nostril q 12h.  Aim the first puff toward the inner corner of the eye on the same side and the second puff toward the top of the opposite ear.  Even if you don't notice much clearing it helps.

Let's see.  When the fever has been gone for 24h continue the antibiotics for 24h  longer only.   Latest thinking is that this helps decrease emergence of resistant bacterial strains. 

Oh.  And don't worry about transverse myelitis.  Awful, awful complication (questionable - association not proven) of something, but may not be viruses, probably associated with patient idiosyncrasies, and vanishingly rare.  Thank god.

Rest and get well.</description>
		<content:encoded><![CDATA[<p>I probably shouldn&#8217;t be doing this, and please remember that you get what you pay for, and you probably know all this anyway, but you&#8217;re one of my favorite never-met-or likely-to people so here goes:<br />
I don&#8217;t play a doctor on TV, I just am one.  Infectious disease.  </p>
<p>Sorry to hear about your sinusitis.  Miserable thing.  However, the fact that you also have severe conjunctivitis (weeping eye) makes me think that in your case the cause is viral as it is the vast majority of sinusitis.<br />
That does not mean that you should not take the antibiotic.  It&#8217;s my opinion that most sinusitis, even viral,  is symptomatically improved by a short course of antibiotics because by the time the patient gets to the doctor they have developed some bacterial overlay due to pH changes, swelling of the mucous membranes, and partial to complete blockage of the ostia.<br />
However, it also means that the most treatment is symptomatic since the main cause, the virus, will not be affected by the antibiotic.  The mainstay of therapy is sinus drainage.  Long hot showers are very helpful.  The moist steam is most effective.  A child&#8217;s cold steamer, if you sit right in front and breathe the vapor, can help, but if they&#8217;ve been in use for a bit they&#8217;re all contaminated by molds so may aggravate allergies.  Another trick is to boil water in a large pot, <b>take the pot off the stove</b>,  put it on a sturdy table, pull up a chair, cover head, shoulders and pot with towel and  inhale the hot steam.  Use caution here.  Steam can be very hot so come out for cooling and air if you feel faint or are uncomfortable.<br />
Warm moist packs to the sinuses.<br />
Oral decongestion (pseudoephedrine hcl 60mg q 6h) if your blood pressure and nervous system can stand it.  Take for 5-7 days only.  No benefit in more.<br />
Pain relief:  Can you take NSAIDs? If so I like naproxen (Aleve, but many store brands/generics available)  May take 2 OTC tabs (440 mg) q 12h.  or if you have OTC ibuprofen (Motrin) use 800mg (4 tabs) q6h.  One or the other, not both.  Take them with food or milk, I don&#8217;t care what the box says, to decrease nausea. And don&#8217;t take aspirin with NSAIDs.  Decreases effectiveness, increases side effects.<br />
Add acetaminophen (Tylenol) 1000 mg q 4h prn.  If you have something around with codeine or hydrocodone may sub 1 tab of that for 500mg acetaminophen.</p>
<p>Finally, this is the one time when nasal decongestant sprays are useful.  DON&#8217;T, DON&#8221;T use them for more than 3 days.  The nasal mucosa gets &#8220;addicted&#8221; to them, and that&#8217;s a real mess.  I like oxymetazoline (Afrin) 2 sprays each nostril q 12h.  Aim the first puff toward the inner corner of the eye on the same side and the second puff toward the top of the opposite ear.  Even if you don&#8217;t notice much clearing it helps.</p>
<p>Let&#8217;s see.  When the fever has been gone for 24h continue the antibiotics for 24h  longer only.   Latest thinking is that this helps decrease emergence of resistant bacterial strains. </p>
<p>Oh.  And don&#8217;t worry about transverse myelitis.  Awful, awful complication (questionable - association not proven) of something, but may not be viruses, probably associated with patient idiosyncrasies, and vanishingly rare.  Thank god.</p>
<p>Rest and get well.</p>
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	<item>
		<title>By: MrSnrub</title>
		<link>http://susiemadrak.com/2008/04/19/02/28/chills-etc/#comment-141304</link>
		<dc:creator>MrSnrub</dc:creator>
		<pubDate>Sat, 19 Apr 2008 15:20:57 +0000</pubDate>
		<guid isPermaLink="false">http://susiemadrak.com/?p=24532#comment-141304</guid>
		<description>My last sinus infection became walking pneumonia.  Take care of yourself.</description>
		<content:encoded><![CDATA[<p>My last sinus infection became walking pneumonia.  Take care of yourself.</p>
]]></content:encoded>
	</item>
	<item>
		<title>By: zuzu</title>
		<link>http://susiemadrak.com/2008/04/19/02/28/chills-etc/#comment-141301</link>
		<dc:creator>zuzu</dc:creator>
		<pubDate>Sat, 19 Apr 2008 14:51:13 +0000</pubDate>
		<guid isPermaLink="false">http://susiemadrak.com/?p=24532#comment-141301</guid>
		<description>Feel better.  Get some rest.</description>
		<content:encoded><![CDATA[<p>Feel better.  Get some rest.</p>
]]></content:encoded>
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	<item>
		<title>By: Susie</title>
		<link>http://susiemadrak.com/2008/04/19/02/28/chills-etc/#comment-141298</link>
		<dc:creator>Susie</dc:creator>
		<pubDate>Sat, 19 Apr 2008 14:26:16 +0000</pubDate>
		<guid isPermaLink="false">http://susiemadrak.com/?p=24532#comment-141298</guid>
		<description>Yeah, I'm getting another car and I have to sell this one.</description>
		<content:encoded><![CDATA[<p>Yeah, I&#8217;m getting another car and I have to sell this one.</p>
]]></content:encoded>
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		<title>By: JJ</title>
		<link>http://susiemadrak.com/2008/04/19/02/28/chills-etc/#comment-141296</link>
		<dc:creator>JJ</dc:creator>
		<pubDate>Sat, 19 Apr 2008 13:48:07 +0000</pubDate>
		<guid isPermaLink="false">http://susiemadrak.com/?p=24532#comment-141296</guid>
		<description>You're selling your car?  Please tell me this is a good thing.</description>
		<content:encoded><![CDATA[<p>You&#8217;re selling your car?  Please tell me this is a good thing.</p>
]]></content:encoded>
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	<item>
		<title>By: arbitrista</title>
		<link>http://susiemadrak.com/2008/04/19/02/28/chills-etc/#comment-141288</link>
		<dc:creator>arbitrista</dc:creator>
		<pubDate>Sat, 19 Apr 2008 10:39:20 +0000</pubDate>
		<guid isPermaLink="false">http://susiemadrak.com/?p=24532#comment-141288</guid>
		<description>Same thing happened to me last weekend. I feel your pain. Good luck!</description>
		<content:encoded><![CDATA[<p>Same thing happened to me last weekend. I feel your pain. Good luck!</p>
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