Sinusitis: A Frequent Worry for Cystic Fibrosis Sufferers
By Dennis Thompson Jr.
HealthDay Reporter

(April 23, 2004 - HealthDayNews)
Andrea Eisenmann has struggled with cystic fibrosis since she was 9 months old.

A defective gene in her body promotes the creation of a thick, sticky mucus that clogs her lungs and could cause a potentially fatal lung infection.

It's a miserable disease, one that left her feeling winded after walking a flight of steps. But Eisenmann's misery was compounded by horrible headaches and raw sinuses, symptoms not directly attributable to cystic fibrosis.

"I've always had a really bad cough, and bad sinuses," said Eisenmann, a 39-year-old graphic designer from New York City. "I always was really skinny. I tried to stay active, because I felt like that kept the mucus out of my lungs. Always had a horrible cough, and thick mucus."

Those problems are due to sinusitis, or chronic sinus infections, and Eisenmann isn't the only cystic fibrosis patient who has had to contend with the condition. It's a common side effect of cystic fibrosis, and doctors estimate as many as 80 percent of people with CF struggle with sinus problems.

Cystic fibrosis affects approximately 30,000 children and adults in the United States, according to the Cystic Fibrosis Foundation. More than 10 million Americans are unknowing, symptom-less carriers of the defective gene that causes the disease. An individual must inherit two defective cystic fibrosis genes -- one from each parent -- to have CF.

In Eisenmann's case, as with many cystic fibrosis patients, her painful sinus infections took a back seat to her daily struggle to catch a breath.

"I would get frequent sinus infections, and I would take antibiotics, but it was always my chest I was preoccupied with," she said.

Eisenmann would have to sleep a lot, taking frequent naps. She tended to get sick very easily, and any infection she caught would fester very fast. She also suffered frequently from uncomfortable headaches.

These symptoms are common for cystic fibrosis patients who have sinusitis, says Dr. Noreen R. Henig, director of the Adult Cystic Fibrosis Center at Stanford University.

"Probably close to all cystic fibrosis patients have some degree of sinus disease," Henig says.

"The extent to which they suffer varies from person to person."

Henig says cystic fibrosis and sinusitis are linked because the protein that is affected by the genetic disorder is also very active in the sinuses. "If you think of the upper respiratory tract in its entirety, it's easy to see why the sinuses are affected as the lungs are."

Most people with cystic fibrosis develop sinus symptoms, usually between the ages of 5 and 14 years, Henig says. These people complain of:

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There are a number of ways to treat sinusitis, Henig said. These can include oral or nebulized antibiotics, nasal steroids, saline or antibiotic flushes, or antihistamines and decongestants. In severe cases, surgery to open up the sinuses might be required.

Eisenmann spent years using nasal irrigation to rinse out her sinuses. She also used a nasal nebulized antibiotic therapy as part of the 22-medication regimen required by her health problems.

She ended up having a lung transplant five years ago when her cystic fibrosis became life-threatening. Immediately after her transplant, her doctor recommended she have a second surgery to open up her sinuses.

"He said the mucus in my lung was like taffy," Eisenmann said. "He said, 'If you don't get sinus surgery, you will keep getting infections.' "

In the surgery, Eisenmann's doctor broke down the walls separating the different chambers of the sinus to reduce pressure. "He went in there and he broke down about 60 walls in there and just tried to make it one big area," she says. "He made these windows that could drain out, and he also took all the mucus out."

Both surgeries were a success. "I'd say that my cystic fibrosis and my sinus problems are both much more under control," she said.

As a result, Eisenmann's quality of life has improved dramatically. "I enjoy eating more. I enjoy not having to worry that I have to walk up a flight of stairs," she said. "Everything was a mountain I had to climb over."

Eisenmann still has to perform a nasal flush on herself twice a day, along with two doses of a nasal nebulized antibiotic inhalant. But she said she's fortunate the surgery helped her, compared with people she knows.

"Some people have such bad sinus problems they have innumerable sinus operations," she said. "They can't seem to get it right. Even though their lung function isn't compromised, they can't live with themselves."

SOURCES: Andrea Eisenmann, New York City; Noreen R. Henig, M.D., director, Adult Cystic Fibrosis Center, Stanford University, Palo Alto, Calif.

(republished with permission of HealthDayNews)
http://www.sinuspharmacy.com/news_sinusitiscysticfibrosis.html

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