My ENT doctor recommended surgery to fix my sinuses.  I have a very deviated
nasal septum (probably the result at least partially from several fractures).
One side has approximately 10-15% of normal flow.  Of course I have known this
for years but recently discovered that I suffer from chronic sinus infection,
discovered during an MRI after a severe migraine.  A CT scan subsequently
confirmed the problems in the sinuses.

He wants to do endoscopic sinus surgery on the ethmoid, maxillary, frontal,
and sphenoid, along with nasal septoplasty.

He explained the procedure, and the risks.  What I would like to know is if
there is anyone out there who can tell me "I had this surgery, and it helped
me"?

(I've already heard from a couple who said they had it and it didn't
really help them).

I am a moderately severe asthmatic.  ENT doc says large percentage see some
relief of their asthma after sinus surgery.  Also he said it is not unheard of
that migraines go away after chronis sinusitis is relieved.

I am 42.

Any relevant information is appreciated.

Regards,

Jay Keller
Sunnyvale, California

Did your ENT also tell you that this procedure may remove warts from the soles
of your feet and improve your sex life?

Actually, severe headaches due to stopped up sinuses (plugged ostia) are
possible, and sinus surgery which widens the ostia - from the normal 2
mm to about 10 mm - should relieve this.  There are non-surgical ways,
however, to keep the ostia open (however, in a few individuals, their
ostia are naturally very small), and Dr. Ivker's book talks about this.
The underlying cause of chronic sinusitis is NOT cured by this kind of
sinus surgery, though.

About asthma, that's a little more controversial.  Dr. Ivker, in his book,
"Sinus Survival", *speculates* (and says it's not proven), that many cases
of asthma are triggered by chronic sinusitis due to the excessive drainage
(postnasal drip) from the sinuses.  He's had many patients who've found
relief from asthma when the chronic sinusitis is reduced or eliminated -
not clinical proof, but compelling anecdotal information of this speculation.

Before doing any sinus surgery, first get THE BOOK - it discusses surgery,
as well as a good non-surgical treatment program for chronic sinusitis.

Jon Noring

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Charter Member --->>>  INFJ Club.

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Who are you?  Read alt.psychology.personality!  That's where the action is.

You probably were trying to be facetious but just for the record partial nasal
obstruction is correlated with a number of chronic disorders such as migraine,
hyperthyroidism, asthma, peptic ulcer, dysmenorrhea, and lack of libido (:-) )
[Riga IN. Rev d'Oto-Neuro-Ophthalmol 1957;24:325-335], cardiac symptoms
[Jackson RT. Annals of Otology 1976;85:65-70  Cvetnic MH, Cvetnic V. Rhinology
1980;18:47-50     Cottle MH. Rhinology 1980;18:67-81], and fever, inadequate
{*filter*}intake and electrolyte imbalance [Fairbanks DNF. Otorhinolaryngology Head
and Neck Surgery 1986;94:412-415).

So before you post your inane comments it would be nice if you'd run a MEDLINE
search on the topic say back to 1966. There's been extensive literature on this
for over a 100 years.

I may be in cardiology but I've had a very good working relationship with
my colleagues from ENT.

Josh

Hi.

My wife has aquired some thyroidal (sp?) deficiency over the past year
that gives symptoms such as needing much sleep, coldness and proneness
to gaining weight. She has been to a doctor and taken the ordinary (?)
tests and her values were regarded as low. The doctor (and my wife) are
not very interested in starting medication as this "deactivates" the
gland, giving life-long dependency to the drug (hormone?). The last couple of
monthes she has been seeing a hoemoepath (sp?) and been given
some drops to re-activate either her thyroidal gland and/or the
'message-center' in the brain (sorry about the approximate language,
but I haven't got many clues to what the english terms are, but the
brain-area is called the 'hypofyse' in norwegian.)

My questions are: has anyone had/heard of success in using this approach?
Her values have been (slowly but) steadily sinking, any comment on the
probability of improvement? Although the doctor has told her to 'eat
normally', my wife has dieted vigorously to keep her weight as she feels
that is part of keeping an edge over the illness/condition, may this
affect the treatment, development?

I can get the exact figures for her tests for anyone interested, and I
will greatly value any information/opinion/experience on this topic.

I don't intend this post to be either a flaming of the established
medical profession or a praise for alternatives, I am just relaying
events as they have happened.

Sincerely,

Erik A. Wolff

There are several different types of Thyroid diseases which would cause
a hypothyroid condition (reduction in the output of the thyroid, mainly
thyroxin). Except for ones caused by infections, the treatment is
generally thyroxin pills. Hypothyroid conditions caused by infections
usually disappear when the infection does...this doesn't sound like the
case with your wife.
Thyroxin orally does "shut down the thyroid" through a feedback loop
involving the pituitary (I believe). The pituitary "thinks" that the
correct amount of thyroxin is being produced so it doesn't have to
tell the thyroid to produce more. This process is reversable! I have
Hashimoto's thyroiditis (an autoimmune condition) and was on thyroxin
for approx 6 mo when my endocrinologist suggested I not take the pills
for 6 wks. When I was retested for thyroxin levels, they were normal.
I still get tested every 6mo because the condition might reappear.
The pills are safe and have very few side-affects (& those mostly at
beginning of treatment). Having a baby might be a problem and would at
least require closer monitoring of hormone levels.
Thyroxin controls energy production which explains sleepiness, coldness,
and weight gain. There is also water retention (possibly around heart),
changes in vision, and coarser hair and skin among other things.

I am not a doctor, so I'm sure I mistated something, but the important
thing is that thyroid problems are usually easily corrected and if they
aren't corrected can cause problems in the rest of the body. Get a
second opinion from a good endocrinologist and have him/her explain
things in detail to you and your wife.

- Eileen Bauer

This is ridiculous, and your doctor sounds like a nut, if what is
reported here is what the doctor actually said.  If your wife's
pancreas stops producing insulin and therefore becomes diabetic, she'll
need insulin replacement.  That doesn't mean she's "dependent" on
insulin, anymore than she was beforehand--if her body doesn't make
enough, she'll have to get it elsewhere.  {*filter*}thyroid replacement
hormone therapy is the cornerstone of treatment for hypothyroidism, and
it's really the only effective therapy available anyway.  Plus, it's
cheap.  Taking thyroid hormone when it isn't needed does cause your
thyroid gland to reduce its own production of the hormone, but that's a
_feature_, not a _bug_, and it's irrelevant in any case in the face of
hypothyroidism, because her problem that her gland isn't producing
enough.  There isn't a clinical phenomenon of "thyroid insufficiency"
caused by a sudden discontinuation of exogenous thyroid hormone
analogous to adrenal insufficiency caused by the sudden cessation of
prolonged administration of corticosteroids, so there should be no
worry about inappropriately "suppressing" the thyroid gland.

Homeopathy is nonsense.  Tell her to stop wasting her money, health and time,
and get her to a legitimate doctor who will be in a position to make
a proper diagnosis and recommend the right therapy.

--
Steve Dyer

Perhaps the listlessness caused by thyroid deficiency could mimic
depression, or feeling unable to do anything could cause one to get
depressed, but I know of no specific effect on the brain caused by the
thyroid that would cause depression. Note that weight gain is usually
a symptom of both. Simple {*filter*} tests would indicate if a thyroid
condition is present.

I don't know if depression would cause a reduction in thyroid output,
but I would tend to doubt it. As far as I know clinical depression is
caused by a chemical imbalance in the brain, and that chemical
imbalance has no direct effect on any other part of the body. A regular
everyday depression IMHO should not cause a chemical imbalance in the
body at all.

The pituitary bases its secretions of Thyroid Stimulating Hormone (TSH)
on the level of circulating Thyroxin (there are two types T3 and T4 -
one is used as a reserve and is changed into the other -active- form in
the liver). The ratio of T3 & T4 can be affected by a number of other
hormones (estrogen, for example). Naturally, changing activity of the
body's cells would cause changes in availabilty of free thyroxin, but
the liver and a healthy thyroid should be able to balance things out in
short order.

Good sources for info on the thyroid are the Merk Manual (a physician's
reference book ) although reading it is enough to get one depressed :-)
and the Encyclopedia Brittanica (should be available in your local
library).

I hope this has been of some help.

-Eileen Bauer

There can be. But depression is not diagnositic of thyroid deficiency.
Thyroid {*filter*} tests are easy, cheap, and effective in diagnosing thyroid
deficiencies.

-Jackie-

I'm not sure how cheap they are.  I had one done several months ago and I
remember paying $60 to $90.            

-jm-