DEAR DR. DONOHUE: What causes sinus, and how is it best treated. Every year I have to go on antibiotics because of my sinus. Is there any way to take care of the problem once and for all? Is my sinus the cause of my headaches? – R.T.

ANSWER:
Sinusitis, an inflammation of one or more of the sinuses, is a common condition, but people often ascribe to it symptoms not caused by it.

The sinuses are hollow spaces in the skull. They’re lined with cells that secrete mucus. The mucus, under normal circumstances, drains out of the sinuses and into the nose. When a sinus is inflamed, swelling blocks mucus drainage, and that’s the root of the problem.

Acute sinusitis lasts less than a month. Viruses or allergic reactions usually cause it. Antibiotics don’t have a place in treatment at the start. Drainage of the inflamed sinus is the answer. With acute sinusitis, a clear drainage trickles down the nose or into the back of the throat. The areas of the face over the sinuses might be tender, but a pounding headache is an unusual symptom. Decongestants to promote drainage are the treatment. If allergy is to blame, then antihistamines also have a role to play. If symptoms persist longer than 10 days, bacteria have probably invaded the sinus, and antibiotics are justified.

Chronic sinusitis is a stuffed sinus that has been that way for longer than two months. It features a thick post-nasal drip and dull pain over the sinuses. Here, more drastic measures have to be taken to open the sinuses’ drainage channels. A doctor can enter the sinus through the nose with a scope and instruments to enlarge the drainage channel. Laser beams are sometimes employed. A balloon-tipped catheter is another way to widen the sinuses’ opening. Antibiotics for a few weeks are usually indicated. Cortisone steroids in a nasal spray shrink swollen tissues. Constant headaches are not a common sign of chronic sinusitis.

DEAR DR. DONOHUE: I am 95 and a widower. From birth I have had only one testicle. This did not interfere with my having a normal sex life. Several weeks ago, in the middle of the night, I felt a sensation of something dropping into my scrotum with a plop. The urologist who examined me found that I now have both testicles. My question is, will this affect my sex life? To your readers who may snicker at my question because of my age, I say I still have many opportunities for sex. What do you say, Doctor? – O.M.

ANSWER:
One testicle that has not descended into the scrotum at birth is not at all unusual. If it doesn’t come down in early infancy, the usual recommendation is to bring it down so it doesn’t become cancerous. You obviously have had no cancer changes.

Having the testicle descend at age 95 is most unusual. You could be a medical first and might qualify for the record book.

I say hooray for you. The newly descended testicle will not interfere with your sex life.

DEAR DR. DONOHUE: I have had blood clots in my right leg twice, and both times I had a pulmonary embolism. The first time was in 1967, when I took birth-control pills. The second time was in 1989, when I took low-dose estrogen after removal of my uterus and ovaries. What lasting effects did these clots have on my leg veins? Are they still there, or are they dissolved? – M.S.

ANSWER:
Small vein clots can become incorporated into the vein wall. Slightly larger clots break up with only traces left behind. With large clots, a new channel often burrows through them, and blood flow through the vein returns. The process is called recanalization, and it can take up to a year to complete.

In some people, the clot damages the vein and the vein’s valves. These people suffer a range of symptoms from mild, painless leg swelling to incapacitating swelling. In the latter case, the skin turns brown, leg wounds heal slowly and the leg is quite painful. The condition goes by the name post-thrombotic syndrome. Your last clot happened 17 years ago. It’s not likely you’ll face any trouble now.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com


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