Talk Cancer

Question:

<richard.epst…@alum.mit.edu> wrote: > The images you posted do not have Left and Right labeled. They were > obtained coronally, presumably with you laying on your stomach with > your chin up. Most CT scanners "flip" the images in that case. Based on > the reading by the Radiologist, the images are indeed "flipped". When > printed out, the images would normally be as if you were looking at the > patient (the patient’s left is on your right). Since they were not > flipped in your jpeg images, the patient’s left is on your left. > Therefore, you have more mucosal thickening in your RIGHT maxillary > sinus, not your left.

Um, his problems are mainly left-sided.. The report also noted the anomalies were mainly on the left. > To respond to multiple prior posts, the Radiologist is a doctor.

Right, so what else is new..? > His or her reading is correct and appropriate. It is not "gobbledy-gook". > It is appropriate communcation between him/herself and the ordering > physician.

Then this communication should be privy to those individuals and not handed to the patient or placed on the internet for discussion. In the time it takes for a lay-person to find out what its all about he could be half-way through treatment for his sinusitis.. >Most ENT’s will also look at the images themselves. "A picture > is worth a thousand words."

But only to those who understand what they see.. > An MRI of the brain is not an MRI of the sinuses. While the sinuses are > sometimes seen on an MRI of the brain, they are not evaluated in detail > and would not usually be commented on, except where there are striking > abnormalities. MRI is in general very tailored to the body part in > question.

The report may be, but the imaging is not so selective.. Which is what I meant. Had there been something abnormal in the sinuses that are often imaged with the brain (sphenoid, ethmoids, frontal) then I’m sure it would have been commented on. > For instance a foot and an ankle are two totally different > studies in MRI. > If your ENT wants an MRI of the sinuses, they could of course order > one. However, CT is usually the preferred test, and for most people, > MRI would not add anything.

I’m sure its not needed, the CT imaging was quite informative.   :-/ If easily available I’d rather use the MRI than CT in pediatric sinuses though.. Ray

Response:

Michael Wilson III <mike5…@REMOVETHIScomcast.net> wrote: – Hide quoted text — Show quoted text -> "Ray Laughton" <rlaugh…@invalid.com> wrote in message > news:1ha6zn4.10fmxoa1ae95blN%rlaughton@invalid.com… > > Michael Wilson III <mike5…@REMOVETHIScomcast.net> wrote: > > > I called today and found out that the radiologist did in fact give > > > impressions, I just needed to go and pick them up. Here they are: > > > http://home.comcast.net/~mike5566/impressions.html > > > I’m not sure what any of that means, but I’m very relieved to know I’m > not > > > imagining it. > > LOL!  But I’m surprised they missed the sinus problem in the MRI, its > > usually visible there too. > > > This has been going on for several years, a feeling of > > > pressure behind my nose and above my left molars. I had gotten tested > for > > > TMJ, had an MRI done on my brain, and gotten a laryngoscopy, none of > which > > > showed any problems. > > > Thanks to all who took the time to respond, it is nice to have a second > > > opinion. > > Yea, well mine was short, sweet and understandable. As I recall there > > were also problems with your teeth (malocclusion) which I’m sure you > > know about and a slight septum deviation but I understood your sinuses > > were the problem so I concentrated on them. > > A page of gobbledy-gook and no diagnosis are OK – (well, understandable) > > when you’re being paid by the hour and half a dozen lawyers are > > breathing down your back. I sorta feel sorry for my yank colleagues, all > > the Porsches in the world dont make up for the way they have to work. > > Ray > > BTW – Did you have a cold when you went for the CT? > No, I did not have a cold when I went for the CT. Actually since the onset > of this problem I have had colds very rarely.

Well you must have had a ’stuffy’ feeling in the left nostril that day, the air spaces are minimal.. > Is it normal to have the teeth jutting into the sinuses like mine are? I > thought that looked a bit strange.

Lets say its not unusual, the upper molar roots on both sides go quite far in. As long as you prevent an infection getting to the roots of the teeth and avoid taking a right hook on the jaw, ie no trauma you’ll be ok..  :-/ > Also my sinuses looked rather large and > oblong compared to the other ones I saw, but my only comparison is to single > snapshots, not a series. I wish I could get my hands on some other CT series > to get a better feel for what is normal. Maybe I will ask a professor at one > of the local med schools.

No need, all your sinuses are normally formed. > What do you mean by malocclusion? I had braces when I was younger and have > worn my retainer faithfully since then. But I haven’t been back to the > orthodontist for a checkup in a long time, perhaps it’s time to schedule > one.

Well, this is getting out of my field but your upper jaw is wider than the the lower jaw. On the left (assuming standard projection) the upper/lower teeth almost missed each other on some photos, AFAIR.   Ray

Response:

The images you posted do not have Left and Right labeled. They were obtained coronally, presumably with you laying on your stomach with your chin up. Most CT scanners "flip" the images in that case. Based on the reading by the Radiologist, the images are indeed "flipped". When printed out, the images would normally be as if you were looking at the patient (the patient’s left is on your right). Since they were not flipped in your jpeg images, the patient’s left is on your left. Therefore, you have more mucosal thickening in your RIGHT maxillary sinus, not your left. To respond to multiple prior posts, the Radiologist is a doctor. His or her reading is correct and appropriate. It is not "gobbledy-gook". It is appropriate communcation between him/herself and the ordering physician. Most ENT’s will also look at the images themselves. "A picture is worth a thousand words." An MRI of the brain is not an MRI of the sinuses. While the sinuses are sometimes seen on an MRI of the brain, they are not evaluated in detail and would not usually be commented on, except where there are striking abnormalities. MRI is in general very tailored to the body part in question. For instance a foot and an ankle are two totally different studies in MRI. If your ENT wants an MRI of the sinuses, they could of course order one. However, CT is usually the preferred test, and for most people, MRI would not add anything. -Rich

Response:

"Ray Laughton" <rlaugh…@invalid.com> wrote in message

news:1ha6zn4.10fmxoa1ae95blN%rlaughton@invalid.com… – Hide quoted text — Show quoted text -> Michael Wilson III <mike5…@REMOVETHIScomcast.net> wrote: > > I called today and found out that the radiologist did in fact give > > impressions, I just needed to go and pick them up. Here they are: > > http://home.comcast.net/~mike5566/impressions.html > > I’m not sure what any of that means, but I’m very relieved to know I’m not > > imagining it. > LOL!  But I’m surprised they missed the sinus problem in the MRI, its > usually visible there too. > > This has been going on for several years, a feeling of > > pressure behind my nose and above my left molars. I had gotten tested for > > TMJ, had an MRI done on my brain, and gotten a laryngoscopy, none of which > > showed any problems. > > Thanks to all who took the time to respond, it is nice to have a second > > opinion. > Yea, well mine was short, sweet and understandable. As I recall there > were also problems with your teeth (malocclusion) which I’m sure you > know about and a slight septum deviation but I understood your sinuses > were the problem so I concentrated on them. > A page of gobbledy-gook and no diagnosis are OK – (well, understandable) > when you’re being paid by the hour and half a dozen lawyers are > breathing down your back. I sorta feel sorry for my yank colleagues, all > the Porsches in the world dont make up for the way they have to work. > Ray > BTW – Did you have a cold when you went for the CT?

No, I did not have a cold when I went for the CT. Actually since the onset of this problem I have had colds very rarely. Is it normal to have the teeth jutting into the sinuses like mine are? I thought that looked a bit strange. Also my sinuses looked rather large and oblong compared to the other ones I saw, but my only comparison is to single snapshots, not a series. I wish I could get my hands on some other CT series to get a better feel for what is normal. Maybe I will ask a professor at one of the local med schools. What do you mean by malocclusion? I had braces when I was younger and have worn my retainer faithfully since then. But I haven’t been back to the orthodontist for a checkup in a long time, perhaps it’s time to schedule one.

Response:

Micheal, How did your ENT appt go?

Response:

"tyshock" <tyler.scha…@gmail.com> wrote in message

news:1139929110.862550.282190@g44g2000cwa.googlegroups.com… > Micheal, > How did your ENT appt go?

Sorry it took so long to reply. My appointment was fine, he prescribed oral steroids and a five day course of the antibiotic Ketek (telithromycin). It seemed to help at first, peaking around 10 days when I began augmenting with saltwater rinses, and low salt diet + increased water intake (to thin mucus). But that stopped working shortly after. Now I am back to the usual. He wanted to do surgery if it failed but first I want to give antibiotics another try. Plus my appointment isnt’t for two more weeks so I have some time to kill. Here is what I plan to do for the next two weeks, beginning today. 1. Amoxicillin 1000mg + Clarithromycin 500mg twice daily (google "Prevpac") 2. Grossan Irrigator twice daily. 3. Rhinocort 2 sprays per nostril, twice daily. 4. Steam inhaler once daily. 5. final four days only: Low salt diet + increased water intake 6. final four days only: Afrin 2 sprays per nostril, once daily 7. final four days only: Oral steroids (prednisone) which I have left over. it was giving me bad side effects so I didn’t take all of it. Disclaimer: Don’t try this at home before asking your doctor. I didn’t ask my doctor, but I am reckless and don’t particularly care what happens to me.

Response:

On 3/9/06 2:17 PM, in article tPydnShK9N34NI3ZRVn…@comcast.com, "Michael – Hide quoted text — Show quoted text -Wilson III" <mike5…@REMOVETHIScomcast.net> wrote: > "tyshock" <tyler.scha…@gmail.com> wrote in message > news:1139929110.862550.282190@g44g2000cwa.googlegroups.com… >> Micheal, >> How did your ENT appt go? > Sorry it took so long to reply. My appointment was fine, he prescribed oral > steroids and a five day course of the antibiotic Ketek (telithromycin). It > seemed to help at first, peaking around 10 days when I began augmenting with > saltwater rinses, and low salt diet + increased water intake (to thin > mucus). But that stopped working shortly after. Now I am back to the usual. > He wanted to do surgery if it failed but first I want to give antibiotics > another try. Plus my appointment isnt’t for two more weeks so I have some > time to kill. > Here is what I plan to do for the next two weeks, beginning today. > 1. Amoxicillin 1000mg + Clarithromycin 500mg twice daily (google "Prevpac") > 2. Grossan Irrigator twice daily. > 3. Rhinocort 2 sprays per nostril, twice daily. > 4. Steam inhaler once daily. > 5. final four days only: Low salt diet + increased water intake > 6. final four days only: Afrin 2 sprays per nostril, once daily > 7. final four days only: Oral steroids (prednisone) which I have left over. > it was giving me bad side effects so I didn’t take all of it. > Disclaimer: Don’t try this at home before asking your doctor. I didn’t ask > my doctor, but I am reckless and don’t particularly care what happens to me.

Why the low salt diet??? What is that supposed to do?

Response:

- Hide quoted text — Show quoted text -Michael Wilson III wrote: > "tyshock" <tyler.scha…@gmail.com> wrote in message > news:1139929110.862550.282190@g44g2000cwa.googlegroups.com… >> Micheal, >> How did your ENT appt go? > Sorry it took so long to reply. My appointment was fine, he prescribed oral > steroids and a five day course of the antibiotic Ketek (telithromycin). It > seemed to help at first, peaking around 10 days when I began augmenting with > saltwater rinses, and low salt diet + increased water intake (to thin > mucus). But that stopped working shortly after. Now I am back to the usual. > He wanted to do surgery if it failed but first I want to give antibiotics > another try. Plus my appointment isnt’t for two more weeks so I have some > time to kill. > Here is what I plan to do for the next two weeks, beginning today. > 1. Amoxicillin 1000mg + Clarithromycin 500mg twice daily (google "Prevpac") > 2. Grossan Irrigator twice daily. > 3. Rhinocort 2 sprays per nostril, twice daily. > 4. Steam inhaler once daily. > 5. final four days only: Low salt diet + increased water intake > 6. final four days only: Afrin 2 sprays per nostril, once daily > 7. final four days only: Oral steroids (prednisone) which I have left over. > it was giving me bad side effects so I didn’t take all of it. > Disclaimer: Don’t try this at home before asking your doctor. I didn’t ask > my doctor, but I am reckless and don’t particularly care what happens to me.

Why don’t you just do what the ENT specialist says without "augmenting" with any of your own solutions? You said yourself that the prednisone and antibiotics were helping before you started rinsing. I suspect that you have chronic sinusitis which you continue to irritate by rinsing/flushing/spraying various solutions up there. Sometimes your body just needs to heal. If you truly "don’t particularly care what happens to (you}," then quit whining and live with it. I’m not a doctor but I do work in health care and see lots of patients like you – chronic complainers who simply prefer to complain about their symptoms rather than follow their doctors advise. Andrew

Response:

"Murray Grossan" <hydro…@adelphia.net> wrote in message

news:C037893F.3A8D%hydromed@adelphia.net… – Hide quoted text — Show quoted text -> On 3/9/06 2:17 PM, in article tPydnShK9N34NI3ZRVn…@comcast.com, "Michael > Wilson III" <mike5…@REMOVETHIScomcast.net> wrote: > > "tyshock" <tyler.scha…@gmail.com> wrote in message > > news:1139929110.862550.282190@g44g2000cwa.googlegroups.com… > >> Micheal, > >> How did your ENT appt go? > > Sorry it took so long to reply. My appointment was fine, he prescribed oral > > steroids and a five day course of the antibiotic Ketek (telithromycin). It > > seemed to help at first, peaking around 10 days when I began augmenting with > > saltwater rinses, and low salt diet + increased water intake (to thin > > mucus). But that stopped working shortly after. Now I am back to the usual. > > He wanted to do surgery if it failed but first I want to give antibiotics > > another try. Plus my appointment isnt’t for two more weeks so I have some > > time to kill. > > Here is what I plan to do for the next two weeks, beginning today. > > 1. Amoxicillin 1000mg + Clarithromycin 500mg twice daily (google "Prevpac") > > 2. Grossan Irrigator twice daily. > > 3. Rhinocort 2 sprays per nostril, twice daily. > > 4. Steam inhaler once daily. > > 5. final four days only: Low salt diet + increased water intake > > 6. final four days only: Afrin 2 sprays per nostril, once daily > > 7. final four days only: Oral steroids (prednisone) which I have left over. > > it was giving me bad side effects so I didn’t take all of it. > > Disclaimer: Don’t try this at home before asking your doctor. I didn’t ask > > my doctor, but I am reckless and don’t particularly care what happens to me. > Why the low salt diet??? What is that supposed to do?

Your right, there is no point to the low-sodium diet. It was more of a trial and error thing at first. Around two days after taking my last antibiotic I was doing a lot of salt water rinses (this was before I purchased the Grossan) because initially they made me feel much better, if only for a short time. Then for no apparent reason things began to worsen, to the point where I was not getting any sleep whatsoever and feeling like crap. I’m still not sure why that happened but decided I might be getting too much sodium. The next day I dramatically increased my fluid intake and lowered the sodium in my diet. This helped immensely. It could have helped because of the low sodium diet, the increased fluid intake, or both. But the following studies lead me to believe it was not the low sodium diet: http://tinyurl.com/hwks7 http://tinyurl.com/fb374 http://tinyurl.com/h3ew6 I am going to increase both my water and sodium intake to higher than normal (but not super-high) levels. Chicken soup is basically lots of water and lots of sodium, right? And doctors always recommend increased fluid intake. Plus it just makes sense. If my body doesn’t want all that sodium or water it can just excrete it in the urine. But if it needs more, it has no way of getting it.

Response:

"Ray Laughton" <rlaugh…@invalid.com> wrote in message

news:1hac5ax.1hh1k4s1icdse4N%rlaughton@invalid.com… – Hide quoted text — Show quoted text -> Michael Wilson III <mike5…@REMOVETHIScomcast.net> wrote: > > "Ray Laughton" <rlaugh…@invalid.com> wrote in message > > news:1ha6zn4.10fmxoa1ae95blN%rlaughton@invalid.com… > > > Michael Wilson III <mike5…@REMOVETHIScomcast.net> wrote: > > > > I called today and found out that the radiologist did in fact give > > > > impressions, I just needed to go and pick them up. Here they are: > > > > http://home.comcast.net/~mike5566/impressions.html > > > > I’m not sure what any of that means, but I’m very relieved to know I’m > > not > > > > imagining it. > > > LOL!  But I’m surprised they missed the sinus problem in the MRI, its > > > usually visible there too. > > > > This has been going on for several years, a feeling of > > > > pressure behind my nose and above my left molars. I had gotten tested > > for > > > > TMJ, had an MRI done on my brain, and gotten a laryngoscopy, none of > > which > > > > showed any problems. > > > > Thanks to all who took the time to respond, it is nice to have a second > > > > opinion. > > > Yea, well mine was short, sweet and understandable. As I recall there > > > were also problems with your teeth (malocclusion) which I’m sure you > > > know about and a slight septum deviation but I understood your sinuses > > > were the problem so I concentrated on them. > > > A page of gobbledy-gook and no diagnosis are OK – (well, understandable) > > > when you’re being paid by the hour and half a dozen lawyers are > > > breathing down your back. I sorta feel sorry for my yank colleagues, all > > > the Porsches in the world dont make up for the way they have to work. > > > Ray > > > BTW – Did you have a cold when you went for the CT? > > No, I did not have a cold when I went for the CT. Actually since the onset > > of this problem I have had colds very rarely. > Well you must have had a ’stuffy’ feeling in the left nostril that day, > the air spaces are minimal.. > > Is it normal to have the teeth jutting into the sinuses like mine are? I > > thought that looked a bit strange. > Lets say its not unusual, the upper molar roots on both sides go quite > far in. As long as you prevent an infection getting to the roots of the > teeth and avoid taking a right hook on the jaw, ie no trauma you’ll be > ok..  :-/ > > Also my sinuses looked rather large and > > oblong compared to the other ones I saw, but my only comparison is to single > > snapshots, not a series. I wish I could get my hands on some other CT series > > to get a better feel for what is normal. Maybe I will ask a professor at one > > of the local med schools. > No need, all your sinuses are normally formed. > > What do you mean by malocclusion? I had braces when I was younger and have > > worn my retainer faithfully since then. But I haven’t been back to the > > orthodontist for a checkup in a long time, perhaps it’s time to schedule > > one. > Well, this is getting out of my field but your upper jaw is wider than > the the lower jaw. On the left (assuming standard projection) the > upper/lower teeth almost missed each other on some photos, AFAIR. > Ray

My appointment with the ENT isn’t until tomorrow. But for the past week I’ve been taking Rhinocort and Sudafed. They seemed to help at first but have since stopped working, even after upping the dose. Two nights ago I started doing salt water rinses, they reduce the sinus pressure and also give me a slight mood lift??? Unfortunately the improvement is short lived and I experienced a bad rebound effect several hours afterwards where the pressure grows much stronger. I gave it one last try tonight adding a few ml of hydrogen peroxide to the salt water. Overall the results were the same. One thing I noticed with the rinses was an ammonia smell. I thought it must be impurities in the salt, but using the "no preservatives" saline spray from the pharmacy produced the same results, as did adding hydrogen peroxide to the mix. There are plenty of other people who have posted this problem but no one seems to know what is causing it. The only suggestion offered up is an excess of baking soda, but I didn’t use any baking soda. My guess is that the infection is caused by anaerobic bacteria, many of which produce ammonia. It’s far fetched I know, but either way I want to get on an antibiotic. Since this problem began five years ago I have taken antibiotics a total of once, when I had my wisdom teeth removed. I remember it being a good few days but the painkillers were surely responsible for much of that.

Response:

- Hide quoted text — Show quoted text -Don Brady <dbr…@pobox.com> wrote: > On Fri, 3 Feb 2006 19:03:19 +0100, rlaugh…@invalid.com (Ray Laughton) wrote: > >Don Brady <dbr…@pobox.com> wrote: > >> A caution is in order. > >Always a good idea. > >> The radiologist’s report and the informal comments here are just a rough > >> starting point – they are not medical opinions. > >Gee thanks for cutting me some slack here.  :-/ > Oh I was not directing my comments at your posts at all. > >> A medical opinion can only given when the sinus specialist studies the > >> original images in connection with an endoscopic exam. > >Huh? > >Do you really think one can only diagnose a sinusitis by endoscopy? > >Normally a simple x-ray is sufficient. > >We’re talking about a simple infection or inflammation of the sinuses > >here, not cancer > How are your ever 100% sure until you examine the patient?

Well I learnt this stuff in the country hospital setting, where one can still chat with the patients..  The X-ray alone is too little. Of course if the referring colleague  has take the time to include a good history then its easy. > >. CT is already over-the-top as far as  rad. dose to the > >lenses go, it should be reserved for difficult cases. > >If the sinusitis doesnt improve after treatment THEN the endoscopy and > >maybe the CT is justified, both time-wise and radiation-wise. > I was not advocating the CT.  It was already done.  

I realize that, you were advocating the endoscopy. > I was just saying do not > rely on it *alone* until the physician sees it and interprets in conjunction > with a nomal clinical visit and pateint history.

See above > Nasal endoscopy is done routinely now.   Pehaps you have experience in other > fields where it is more difficult?   In any case, I was just using it as an > example of something that would be done by the physician, that the radiologist > cannot do.  

It was a few years ago, nasal endoscopies were not routine (in fact they were quite traumatic and thus seldom used) in that setting. The radiologist diagnosed, his words were chiselled into stone and formed the basis of the therapy. We were the diagnostic gods..  :-/ Nowdays all you get from them are ‘impressions’, it seems (do they train in art galleries?) Ray

Response:

A caution is in order. The radiologist’s report and the informal comments here are just a rough starting point – they are not medical opinions. A medical opinion can only given when the sinus specialist studies the original images in connection with an endoscopic exam.

Response:

Don Brady <dbr…@pobox.com> wrote: > A caution is in order.

Always a good idea. > The radiologist’s report and the informal comments here are just a rough > starting point – they are not medical opinions.

Gee thanks for cutting me some slack here.  :-/ > A medical opinion can only given when the sinus specialist studies the > original images in connection with an endoscopic exam.

Huh? Do you really think one can only diagnose a sinusitis by endoscopy? Normally a simple x-ray is sufficient. We’re talking about a simple infection or inflammation of the sinuses here, not cancer. CT is already over-the-top as far as  rad. dose to the lenses go, it should be reserved for difficult cases. If the sinusitis doesnt improve after treatment THEN the endoscopy and maybe the CT is justified, both time-wise and radiation-wise. RL

Response:

- Hide quoted text — Show quoted text -Ray Laughton wrote: > Don Brady <dbr…@pobox.com> wrote: >>A caution is in order. > Always a good idea. >>The radiologist’s report and the informal comments here are just a rough >>starting point – they are not medical opinions. > Gee thanks for cutting me some slack here.  :-/ >>A medical opinion can only given when the sinus specialist studies the >>original images in connection with an endoscopic exam. > Huh? > Do you really think one can only diagnose a sinusitis by endoscopy? > Normally a simple x-ray is sufficient.

For sinusitis, the percentage of false positive results from X-rays is known to be roughly around 40%, compared with around 10% for CT scans. medind.nic.in/ibd/t04/i1/ibdt04i1p9o.pdf > If the sinusitis doesnt improve after treatment THEN the endoscopy and > maybe the CT is justified, both time-wise and radiation-wise.

In today’s managed care, patients typically get referred to ENTs only after multiple courses of antibiotics and steroids have failed. — Steven D. Litvintchouk Email:  sdlit…@earthlinkNOSPAM.net Remove the NOSPAM before replying to me.

Response:

- Hide quoted text — Show quoted text -Steven L. <sdlit…@earthlinkNOSPAM.net> wrote: > Ray Laughton wrote: > > Don Brady <dbr…@pobox.com> wrote: > >>A caution is in order. > > Always a good idea. > >>The radiologist’s report and the informal comments here are just a rough > >>starting point – they are not medical opinions. > > Gee thanks for cutting me some slack here.  :-/ > >>A medical opinion can only given when the sinus specialist studies the > >>original images in connection with an endoscopic exam. > > Huh? > > Do you really think one can only diagnose a sinusitis by endoscopy? > > Normally a simple x-ray is sufficient. > For sinusitis, the percentage of false positive results from X-rays is > known to be roughly around 40%, compared with around 10% for CT scans.

Probably because so few radiologists get to see them anymore.. > medind.nic.in/ibd/t04/i1/ibdt04i1p9o.pdf > > If the sinusitis doesnt improve after treatment THEN the endoscopy and > > maybe the CT is justified, both time-wise and radiation-wise. > In today’s managed care, patients typically get referred to ENTs only > after multiple courses of antibiotics and steroids have failed.

It’ll pass. We’re only beginning to find out the long-term effects of all this AB use in kids. As for steroids in kids, or steroids for adult sinusitis that matter…. ridiculous. RL

Response:

On Fri, 3 Feb 2006 19:03:19 +0100, rlaugh…@invalid.com (Ray Laughton) wrote: >Don Brady <dbr…@pobox.com> wrote: >> A caution is in order. >Always a good idea. >> The radiologist’s report and the informal comments here are just a rough >> starting point – they are not medical opinions. >Gee thanks for cutting me some slack here.  :-/

Oh I was not directing my comments at your posts at all. >> A medical opinion can only given when the sinus specialist studies the >> original images in connection with an endoscopic exam. >Huh? >Do you really think one can only diagnose a sinusitis by endoscopy? >Normally a simple x-ray is sufficient. >We’re talking about a simple infection or inflammation of the sinuses >here, not cancer

How are your ever 100% sure until you examine the patient? >. CT is already over-the-top as far as  rad. dose to the >lenses go, it should be reserved for difficult cases. >If the sinusitis doesnt improve after treatment THEN the endoscopy and >maybe the CT is justified, both time-wise and radiation-wise.

I was not advocating the CT.  It was already done.  I was just saying do not rely on it *alone* until the physician sees it and interprets in conjunction with a nomal clinical visit and pateint history. Nasal endoscopy is done routinely now.   Pehaps you have experience in other fields where it is more difficult?   In any case, I was just using it as an example of something that would be done by the physician, that the radiologist cannot do.   I was mostly just talking about terminology, in case the original poster thought (or was that you – I have lost track) he was done now.

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- Hide quoted text — Show quoted text -Michael Wilson III wrote: > "Steven L." <sdlit…@earthlinkNOSPAM.net> wrote in message > news:ZgrEf.4826$Nv2.3290@newsread1.news.atl.earthlink.net… >>Michael Wilson III wrote: >>>I got a sinus cat scan because of constant pressure above the roof of my >>>mouth. I am not sure if the radiologist looked at it, and if they did > they >>>did not give their impressions. I received a disc with the images, > however. >>>My appointment with the ENT to get diagnosed is not for another week, > and I >>>am getting very anxious to know the results. Could anyone provide some >>>insight? Here are the images (use Page Up and Page Down keys to flip >>>through): >>>http://home.comcast.net/~mike5566/ >>>All standard disclaimers apply, I know not to trust advice given on the >>>internet, etc. This is only to ease my mind until my appointment with > the >>>ENT. >>[Disclaimer:  I'm NOT a doctor or radiologist, just a patient who's been >>there, done that] >>What I see looks like sinusitis, particularly on your left side.  The >>rule of thumb is that the black areas represent wide open space (which >>is what you want to have in your sinuses); the white/light-gray areas >>represent tissue or fluid (which you don’t want filling up your >>sinuses).  So what I see is: >>Left ethmoid sinuses whose ducts are almost completely blocked by polyps >>and cysts. >>Significantly thickened sinus linings suggestive of inflammation and >>perhaps infection. >>And you’ve got a large polyp in your left maxillary sinus, which I think >>is blocking the duct from draining. >>Your right side doesn’t look too bad though. >>You have a deviated septum, but it’s not as deviated as mine was. >> From this CT scan , I’ll bet your symptoms are mostly on your left >>side–feeling of stuffiness, particularly above the left side of the >>bridge of your nose. >>– >>Steven D. Litvintchouk >>Email:  sdlit…@earthlinkNOSPAM.net >>Remove the NOSPAM before replying to me. > I called today and found out that the radiologist did in fact give > impressions, I just needed to go and pick them up. Here they are: > http://home.comcast.net/~mike5566/impressions.html > I’m not sure what any of that means, but I’m very relieved to know I’m not > imagining it. This has been going on for several years, a feeling of > pressure behind my nose and above my left molars. I had gotten tested for > TMJ, had an MRI done on my brain, and gotten a laryngoscopy, none of which > showed any problems. > Thanks to all who took the time to respond, it is nice to have a second > opinion.

I think you should make sure that your ENT looks at these films himself, and doesn’t rely on the radiologist’s opinion alone.  I’m more interested in what your ENT has to say than what the radiologist has to say.  Because your ENT can combine what he sees on the CT scan with everything else he knows about you–patient history, other tests–to make a more precise diagnosis. — Steven D. Litvintchouk Email:  sdlit…@earthlinkNOSPAM.net Remove the NOSPAM before replying to me.

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On 2/2/06 5:28 AM, in article 1ha4ypo.1w02qhj1721d4wN%rlaugh…@invalid.com, – Hide quoted text — Show quoted text -"Ray Laughton" <rlaugh…@invalid.com> wrote: > Michael Wilson III <mike5…@REMOVETHIScomcast.net> wrote: >> I got a sinus cat scan because of constant pressure above the roof of my >> mouth. I am not sure if the radiologist looked at it, and if they did they >> did not give their impressions. I received a disc with the images, however. >> My appointment with the ENT to get diagnosed is not for another week, and I >> am getting very anxious to know the results. Could anyone provide some >> insight? Here are the images (use Page Up and Page Down keys to flip >> through): >> http://home.comcast.net/~mike5566/ >> All standard disclaimers apply, I know not to trust advice given on the >> internet, etc. This is only to ease my mind until my appointment with the >> ENT. > Pansinusitis, left>re. > The mucus membranes in your left nasal cavity also quite swollen, you > probably have a cold.

Doesn’t look too bad, looks like the kind tha clears with medication.

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I got a sinus cat scan because of constant pressure above the roof of my mouth. I am not sure if the radiologist looked at it, and if they did they did not give their impressions. I received a disc with the images, however. My appointment with the ENT to get diagnosed is not for another week, and I am getting very anxious to know the results. Could anyone provide some insight? Here are the images (use Page Up and Page Down keys to flip through): http://home.comcast.net/~mike5566/ All standard disclaimers apply, I know not to trust advice given on the internet, etc. This is only to ease my mind until my appointment with the ENT. P.S. Tilt was -21.5 degrees, if that helps any.

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Michael Wilson III <mike5…@REMOVETHIScomcast.net> wrote: > I got a sinus cat scan because of constant pressure above the roof of my > mouth. I am not sure if the radiologist looked at it, and if they did they > did not give their impressions. I received a disc with the images, however. > My appointment with the ENT to get diagnosed is not for another week, and I > am getting very anxious to know the results. Could anyone provide some > insight? Here are the images (use Page Up and Page Down keys to flip > through): > http://home.comcast.net/~mike5566/ > All standard disclaimers apply, I know not to trust advice given on the > internet, etc. This is only to ease my mind until my appointment with the > ENT.

Pansinusitis, left>re. The mucus membranes in your left nasal cavity also quite swollen, you probably have a cold.  

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>From an absolute layman’s perspective———

On 0032 and 0033, your lower septum looks deviated to the left.  This may be contributing to the bad swelling on the left side.  It also looks like something is going on in the left maxillary.  Do you have tooth pain in your left upper teeth (molar region)?  The left ethmoids also looked like a bit of something was going on.  To what degree, i don’t know.  The ethmoids are hard to judge for this layman.

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Michael Wilson III wrote: > I got a sinus cat scan because of constant pressure above the roof of my > mouth. I am not sure if the radiologist looked at it, and if they did they > did not give their impressions. I received a disc with the images, however. > My appointment with the ENT to get diagnosed is not for another week, and I > am getting very anxious to know the results. Could anyone provide some > insight? Here are the images (use Page Up and Page Down keys to flip > through): > http://home.comcast.net/~mike5566/ > All standard disclaimers apply, I know not to trust advice given on the > internet, etc. This is only to ease my mind until my appointment with the > ENT.

[Disclaimer:  I'm NOT a doctor or radiologist, just a patient who's been there, done that] What I see looks like sinusitis, particularly on your left side.  The rule of thumb is that the black areas represent wide open space (which is what you want to have in your sinuses); the white/light-gray areas represent tissue or fluid (which you don’t want filling up your sinuses).  So what I see is: Left ethmoid sinuses whose ducts are almost completely blocked by polyps and cysts. Significantly thickened sinus linings suggestive of inflammation and perhaps infection. And you’ve got a large polyp in your left maxillary sinus, which I think is blocking the duct from draining. Your right side doesn’t look too bad though. You have a deviated septum, but it’s not as deviated as mine was.  From this CT scan , I’ll bet your symptoms are mostly on your left side–feeling of stuffiness, particularly above the left side of the bridge of your nose. — Steven D. Litvintchouk Email:  sdlit…@earthlinkNOSPAM.net Remove the NOSPAM before replying to me.

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I’m absolutely impressed by the responses here. I looked at the images too, but all I can see is adjacent humming birds taking nectar out of a couple of flowers.   …Jon

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"Steven L." <sdlit…@earthlinkNOSPAM.net> wrote in message

news:ZgrEf.4826$Nv2.3290@newsread1.news.atl.earthlink.net… – Hide quoted text — Show quoted text -> Michael Wilson III wrote: > > I got a sinus cat scan because of constant pressure above the roof of my > > mouth. I am not sure if the radiologist looked at it, and if they did they > > did not give their impressions. I received a disc with the images, however. > > My appointment with the ENT to get diagnosed is not for another week, and I > > am getting very anxious to know the results. Could anyone provide some > > insight? Here are the images (use Page Up and Page Down keys to flip > > through): > > http://home.comcast.net/~mike5566/ > > All standard disclaimers apply, I know not to trust advice given on the > > internet, etc. This is only to ease my mind until my appointment with the > > ENT. > [Disclaimer:  I'm NOT a doctor or radiologist, just a patient who's been > there, done that] > What I see looks like sinusitis, particularly on your left side.  The > rule of thumb is that the black areas represent wide open space (which > is what you want to have in your sinuses); the white/light-gray areas > represent tissue or fluid (which you don’t want filling up your > sinuses).  So what I see is: > Left ethmoid sinuses whose ducts are almost completely blocked by polyps > and cysts. > Significantly thickened sinus linings suggestive of inflammation and > perhaps infection. > And you’ve got a large polyp in your left maxillary sinus, which I think > is blocking the duct from draining. > Your right side doesn’t look too bad though. > You have a deviated septum, but it’s not as deviated as mine was. >  From this CT scan , I’ll bet your symptoms are mostly on your left > side–feeling of stuffiness, particularly above the left side of the > bridge of your nose. > — > Steven D. Litvintchouk > Email:  sdlit…@earthlinkNOSPAM.net > Remove the NOSPAM before replying to me.

I called today and found out that the radiologist did in fact give impressions, I just needed to go and pick them up. Here they are: http://home.comcast.net/~mike5566/impressions.html I’m not sure what any of that means, but I’m very relieved to know I’m not imagining it. This has been going on for several years, a feeling of pressure behind my nose and above my left molars. I had gotten tested for TMJ, had an MRI done on my brain, and gotten a laryngoscopy, none of which showed any problems. Thanks to all who took the time to respond, it is nice to have a second opinion.

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