(S)Not Over Yet

So, more than six weeks into this sinus debacle, it's still not over.

I started antibiotic #2 last week, and it seemed like I was having slow but somewhat steady progress.  My right side was still very blocked up, but by the middle of this week I could get some airflow through and hear mucus rattling around in there, but it still wouldn't really blow out.  I generally felt halfway decent for a good portion of the day, but by mid-afternoon I usually had some sinus pressure that traveled from my eye down to my teeth, just on that one side.  Then I'd have a few sneezing episodes during the day, where the sinus pressure would get to be too much, I'd sneeze half a dozen times, and then have to blow my nose constantly for a solid 20-30 minutes.  But it was still better than I'd been, so I was hopeful.  Then on Wednesday night I sneezed and blew my nose, only to find the oddest thing I'd ever blown out.  It was mucus, but it was almost rubbery.  It didn't lose shape when I poked at it (as I had no idea what it was).  It wasn't hard or crusty--just solid with a little give.  It was nasty.  Of course, it came out of my good side, but even still I felt a bit better and started wondering if a mucus blob like that was what was blocking my right side.

Then came yesterday.  I'd felt the previous day like my nose was drying up a bit and felt that might be preventing what was there from coming out.  I figured I'd play around with the meds a bit to see if I could keep things loose without drying things up too much to blow out.  I opted to keep the Mucinex but skip the Flonase, but it backfired badly.  By the afternoon I was miserable again, like middle-of-the-worst-of-it pathetic.  On the bright side, that told me that I was just managing symptoms rather than actually getting to whatever was causing the problem, so that was my red flag to send a note to my doctor that I was going to call the ENT.  Also, the fact that it was consistently worse on one side (while the other was almost normal) was getting concerning to me, based on everything I was reading.

Of course, when I called, they initially wanted to set me up with the same doctor that I worked with on the smell test debacle, because he's a sinus expert, but given my negative association with him after he pretty much suggested nothing to help me, I wasn't interested.  He was booking into January anyway, so no thanks!  They took my info and said they'd call me back with availability for sooner, and maybe five minutes later they called with a last-minute opening for 4pm, which I was thrilled to take!

I got there and gave the nurse the rundown, and then did it again for a resident who was working with the doctor.  He took one look in my nose (not with anything fancy, just something to move my nostril), and said, "Wow!"  So, yeah, not good.  Later he numbed up the area and gave me something to clear it out so they could get a better look, then came back with the doctor, at which point they did an endoscopy to see what was happening.  There was a lot of mucus on the right side (duh) and they thought it looked pus-like (but doesn't most mucus?), which obviously would indicate a lingering infection.  Of course, after nearly two full courses of antibiotics, including one that definitely should have worked, it was unclear why it wasn't clearing.  Anyway, they took a sample for testing to see if there was some sort of antibiotic-resistant bacteria, and then suctioned out a lot of the mucus.  I wasn't really able to enjoy the relief, mind you, because my entire nose and much of my mouth were numb for a solid hour afterward, and it plugged back up after that.  It got extra awkward when I stopped for gas, Carter, and Wegmans and could not really feel my nose run at random.  Sexy.

Much to my dismay, the first course of action was to prescribe me steroids.  I hate prednisone with every fiber of my being, but here we go again.  Bring on the agitation, sleeplessness, dry mouth, and every other crazy side effect.  That should lessen the inflammation and help things get over the hump, though.  Then, based on the lab results, they could prescribe another antibiotic.  Oh, and they gave me the next generation of a NetiPot, a plastic squirt bottle.  I tried that but it couldn't get through the one side so it kept coming out of my mouth.  Gross.

I was still quite congested overnight, but I was finally able to get some decent force to blow on the right side, which hadn't been the case in weeks.  It basically felt like I was hitting a wall--or at least, the majority of the mucus was.  And suddenly I was getting decent, productive blows.  Today I feel significantly better, congestion-wise.  Airflow is considerably easier and there's way less to blow out.  I started out the day feeling a little iffy, but I think that had to do with a rough night of sleep.  We'll see how I feel tomorrow when the early effects of the prednisone start to hit.  But at least the congestion is better and I feel nearly human.

The doctors did say that it was possible that there was just so much happening up there that perhaps even with the antibiotics it just couldn't "break through", and I'm starting to think that's what happened.  Once my sinuses got a little relief from the suctioning, maybe it gave them the leg up they needed to start healing.  I saw a picture on the wall there of how the sinus can close off with swelling in a certain area, and it would effectively trap mucus up beyond it and irritate everything around it.  It made perfect sense and seemed exactly like what I was experiencing with the "wall" preventing the mucus from coming down.  There was no way to get it out, so the inflammation remained and I felt perpetually sick.  No wonder I had so much pressure!  

Adding to that theory is that I got the lab report this morning, and it said, "No organisms found," which I take to mean that there's no bacteria, and presumably no virus either.  The doctor never called, so while I'm not sure what to think, the progress speaks for itself.  Hopefully that visit and the steroids will be all that I needed to get on track.

The thing is, this has already been going on over six weeks, and now I have many days of steroid misery ahead.  Last time it took me a full week after steroids to feel normal, so I'm still looking at multiple weeks before I feel "normal".  By then we'll be well into Christmas season and I'm concerned about so many things.  I've been so sick for so long that I've probably been shirking a lot of less important responsibilities, and I know eventually those could come back to haunt me.  I haven't worked out in weeks and now I'm really out of the habit.  I'm still very tired most of the time, probably in part from the interrupted sleep for weeks on end.  Prednisone makes me miserable to live with most of the time, because I get snappy and easily agitated.  I tend to say things I shouldn't (and not care about the consequences).  I also recall having sleep issues and a horribly dry mouth, and looking back in the blog I had bad dreams, too.  Yay.  Given that I've been on edge anyway and the Christmas season is stressful, I can only imagine what ugly form that will take.  Craig and I have barely spent any time together since this illness started, for a combination of reasons.  He's been working more with his season starting, I've gone to bed earlier, we're both still tired enough to fall asleep with Carter half the time, and obviously any sort of close contact isn't advisable when you have an unknown illness that won't go away.  So, we'll have some rebuilding to do when possible, and hopefully this doesn't do more damage in the meantime if I let the day-to-day issues take over.  I'm usually pretty on edge with the kids as it is, so I'm worried about how much grumpier and shoutier I'll be over the next couple weeks with them.  How will I manage all the stress when I'm agitated, or get enough sleep if I'm already up late and having sleep issues?  I'm just really worried about these next few weeks and how I'll maintain my sanity.  I'm so thrilled to be even close to healthy, particularly considering how I felt about 36 hours ago, but prednisone brings with it a boatload of challenges, too.

Oh, and if that wasn't enough, this all has me thinking about the smell thing again, because if I'm clear of infections and chilling out my sinuses again, maybe I should be trying something new--be it the acupuncture (last night's doctor said the chiropractor has no logical connection to smell--though I still wouldn't mind trying since I know one), or something else I came across called alpha lipoic acid, which is an antioxidant that has had pretty decent results with anosmics like me who seem to have lost smell from an infection of some sort.  I'm debating if I should start it now while on the prednisone or just manage one set of possible side effects at a time (even though the ALA doesn't seem to have any).  We'll see.

Anyway, I can't call this illness over, but it's good to see progress for a change!  It has been far too long and there's finally a real light at the end of the tunnel.