Patient Testimonial – Chronic Sinus Infections
by Cynthia
I would like to thank Cynthia for taking the time to write the testimonial below. Viva Las Vegas!
Where to start? I always seemed susceptible to sinus infections. When I was young, I think they were classified as heavy colds. Growing up in the Northeast lent itself to lots of respiratory issues. As a child, I was at the doctor often and diagnosed with “allergies” or a “cold” and sent home. Every visit ended with “if she is not better in a week, bring her back.” I don’t think that there was ever a time where I did not return a week later, even sicker. The doctor, surprised every time, would give me an antibiotic that would help clear me up. I would cross my fingers that my illness was “real” like strep throat so that I could get an antibiotic right off the bat and wouldn’t have to suffer for a week. Even at 6 and 7, I knew that something was wrong and not being addressed.
My mother, who was in nursing school, asked many questions, as she couldn’t understand why I was always getting sick. Eventually, at her urging, my immune system was tested, as best as it could be in the 70’s. Of course, I tested low and was given a series of gammaglobulin shots which hurt and didn’t work. I was a happy-go-lucky kid and heard time after time, “well she doesn’t look sick.”
Fast forward a few years to my college years. I went to school in Boston and still suffered from “colds” as I was diagnosed by the campus clinic. Nobody believed me when I told them how I felt. It was always “just a cold” which would always turn into something that needed antibiotics later. If I could only have back the hours and hours lost on headaches due to these untreated sinus infections and lack of energy.
At this point, I was referred to an Ear Nose and Throat (ENT) doctor in New York, who stated that I had a deviated septum, which was causing swollen tissue in my nose. Ok, this was interesting. Finally a cause? He prescribed a series of cortisone shots up my nose to shrink the swollen tissue. He said it was a new procedure that might help. He also wanted me to see a neurologist about my headaches that he said were not sinus related. After an MRI of my brain, which presented no issues, I was sent home with an anti-depressant, because there was no medical reason for my headaches. It was all in my head so to speak.
This was the status quo for many years. In my 20’s I started seeing an internist that did believe that I had a pre-disposal to sinus issues. His solution was to give me an antibiotic prescription with 11 refills that he would prescribe every year. This helped. One, someone was listening to me and two, we at least had a plan for me to get through life. At least when the sinus infections started, I had something to take that would make them go away.
The only problem was that I was still exhausted all the time. Like I was unplugged. I thought that this was just me and I was defective in some way. This doctor also diagnosed me with migraines and prescribed Fioricet which helped and Imitrex, when it became available. I was now operating at 50% at least, which was fantastic as far as I was concerned.
In my 30’s I married and moved to Atlanta. When I moved there, Atlanta was in a drought, so nothing really changed except that I could no longer see my old doctor anymore. This was the era of “No antibiotics! They are bad for you and you will become immune!” So, let’s just say, my new doctor, we’ll call him “Dr. Feelgood” gave me anything but antibiotics. Armed with my age-old complaints, he would give me antihistamines, heavy pain pills and whatever else he could think of but no antibiotics. Sometimes on the weekends, when I couldn’t take the sinus pressure anymore and thought that my head would explode, I would go to an Urgent care where I might get antibiotics. I felt progressively worse. By now, I was resigned to the fact that this was my life. I had daily excruciating headaches.
After a few years, the drought ended and the rains came and never stopped. I was constantly sick. My doctor said no to antibiotics. I gave up on him and went to the Urgent Care again. I found that by seeing different doctors each time I went, I was given different antibiotics and steroids were added. This helped but not for long. The sinus infection was back within a few weeks. This went on for a year or so. Finally, at one fateful visit, the head of the clinic, after looking at my enormous file, took interest in my case and asked if she could try a few things. She started taking blood during each visit and noted that even though I was on heavy antibiotics, my white cell count was still elevated. She also tried IV antibiotics just in case I couldn’t metabolize pills and that didn’t work either. My white count stayed elevated. She then said that she thought I had an infection somewhere that these antibiotics were not working on and referred me to an ENT doctor that she said could help.
During my first visit with the ENT, he ordered an MRI of my head/sinuses. He also said that he wanted me to talk to his colleague, an Infectious Disease Doctor, who, in the meantime, should be able to help me with my sinuses. I met with Dr. AndrewPugliese who took a full history during my first examination. He listened to my whole story and actually believed me! I was pretty surprised because I was used to being told that it was all in my head. After this exam, he said that he felt that he could help me. He was going to put me on two different IV antibiotics that I could administer at home. He also said that I would be given an IV port that would stay in until my regimen was over. I was stunned!
He had blood work results but my MRI results were not back yet. He said that he could tell from my history and symptoms that I had chronic sinusitis that was not being cured by regular antibiotics. When my MRI came back, he’s asked how I was feeling. I told him that I was feeling the same. Worn out, constant headaches, and lots of facial pressure, which by this point was pretty normal for me. I expected him to say that the MRI showed nothing. I was shocked by what he said next. The bones in my face and head had become infected from the constant sinus infections. He then told me that the IV antibiotics had been the best decision and that it should resolve the problem.
I stayed on the IV antibiotics for 3 months. I visited with Dr. Pugliese and his staff every week. In the meantime, the ENT performed sinus surgery, fixing my septum, removing turbinates and enlarging the draining areas. I started to feel improvement during the course of antibiotics, steroids, and antihistamines. A follow-up MRI showed that the bone infection was cleared! I was so thankful!
Although the bone infection had cleared, I continued to get sinus infections. Allergy testing showed that I was extremely allergic to mold, which we had tons of in Atlanta. My immune system had also taken a beating, most likely due to the illness. Dr. Pugliese ordered immune treatments for me each month. Even though my bone infection was gone, I was still struggling with sinus infections, low energy, and a lowered immune system. The immune treatments just weren’t working for me. There had to be another solution.
One day, during a visit, Dr. Pugliese looked at me and said I had become a product of my environment. I was surrounded by a mold, which I was very allergic to. It triggered an allergic reaction that was too great to stop, which would then cause sinus infections. The allergy was so great that I had a hard time draining. I was really worried that I would never be free of sinus problems. Dr. Pugliese worried that I might run out of effective antibiotics as well. He then said that I had to move to a drier climate. I never thought that I would have to move for my health. Ever. He then suggested some dry parts of the country. Some of his clients had moved and said that they saw great improvement. It seemed like there was no other choice. I told my stunned family. We all agreed to try something drier.
I had an uncle that had moved to Las Vegas years earlier because he needed a drier climate. So, I planned a trip and decided to stay a month. My mom and daughter came with me. What happened next was just amazing to me. Within a few days, I felt really good. Really, really good. I couldn’t remember the last time I felt this good! A few days later, after asking Dr. Pugliese if it was ok, I stopped taking all of my medicine (antibiotics, antihistamines, decongestants, and prednisone). I just didn’t need it. I even got a little energy back. It was great! The decision was made. We needed to move. When I went back to Atlanta a few days later, I found that I needed to take all of my medicine again within a few days of arrival. I just couldn’t believe it. The mold was definitely not my friend.
After we moved to Las Vegas, I met with a new Infectious Disease Doctor. Within a few months, he “fired” me and told me that I could go find a primary care doctor. My immune system was better and I had no sinus infections at all. I even started to get my energy back. My sinuses drained like everybody else’s and I didn’t feel unplugged any more. After some testing, the doctor determined that some of my respiratory immune systems never developed, which was why I could never fight a cold on my own. I really wish I had known that years earlier!
If it wasn’t for Dr. Pugliese, I truly feel like I wouldn’t be here today. He was the first doctor that ever listened and believed me. By my history and symptoms, he knew that an aggressive course of IV antibiotics and close monitoring would be the best course of action against my chronic sinusitis. He also knew when it was time for me to stop trying to live in a place that was just plain bad for my health.
Today, I have my life back, thanks to Dr. Pugliese. I work full-time (couldn’t do that for years), I’m a wife and mother, and I run rings around everybody. I don’t even nap anymore! Yes, I get a couple of sinus infections a year, but the amazing thing is that they go away with normal treatment. I can now go into crowds which I used to avoid because of my immune system. Antibiotics still work for me, too. Thank goodness Dr. P had the presence of mind to tell me to move. I just can’t thank him enough for treating me AND for giving me my life back!!!
