I frequently get sinus infections, and they’re really annoying and usually last for at least a couple weeks. Is there any way to prevent getting them? And if I do get them, how can I get rid of them quickly?
“Sinus Pain” Los Angeles, CA
There are many causes of sinusitis. The most common is a bacterial or viral infection. Another common cause is food or environmental allergies, especially mold sensitivity. Both causes need to be addressed by your physician. There are many prescription medications and over-the-counter preparations for both prevention and treatment of sinusitis. However, I find a homemade herbal nasal spray more effective. (Relax, it’s easy!) Mix five drops of each of the following herbs in a 30-milliliter nasal spray bottle: eucalyptus, usnea, echinacea, sage, juniper and grape seed extract. Another herb that is most useful prepared in both capsule and tea is stinging nettles. A diet rich in vitamin C can also be helpful. In no time, you’ll be free from infection and sniffles! —PF
PERFECT TIMING
I’m HIV-positive but not on meds yet. Every infected guy I know seems to have started treatment at different times with different CD4 counts. What’s going on?
Phil DeSoto, TX
When HIV-positive individuals should start treatment has been a moving target since the disease’s beginning. Treatment regimens are regularly scrutinized and have changed as our knowledge of HIV’s effect on the immune system deepens. Last year “when to treat” guidelines were adjusted again. Now new rules say medications should begin when CD4 cells (they fight infections) fall to 350. Previous guidelines said wait until CD4 cells fell to between 350 and 200. Why raise the bar to 350? HIV-positive people not in treatment may have healthy immune systems but are at increased risk for non-AIDS-related complications. Starting treatment at 350 (or so) prevents further immune system damage that compromises defenses against tuberculosis, non-Hodgkin’s lymphoma, Kaposi’s sarcoma, neuropathy, cancers and pre-cancers caused by human papillomavirus (HPV). HIV-positive people can more frequently experience heart, kidney and/or liver disease. If you already have HIV-associated nephropathy, a form of kidney disease, or need treatment for chronic hepatitis B virus (HBV) infection, the new rules encourage early treatment. Some drugs used to manage HBV are also highly active against HIV. Earlier treatment may also reduce your viral load sooner. (Viral load is a measure taken through a blood test showing how much HIV saturates your blood.) Originally, both CD4 cells and viral load—usually 100,000 or higher—were used as twin numbers determining when treatment started. The new rules no longer rely on viral load. The reason is that some infected people may experience rapid CD4 decline regardless of viral load, making early treatment valuable protection against fast-dropping CD4 cells. —FP
SIDE EFFECT MALFUNCTION
A couple of months ago I was diagnosed with rheumatoid arthritis with fibromyalgia and have been prescribed the pain medication Lortab (10 mg) three times a day. Since treatment, I have experienced erectile dysfunction, and I’m only 36! Is this permanent or temporary on these meds? Also, are there any other meds that are safer without the side effects?
JBO via Internet
Your diagnosis of two autoimmune disorders, rheumatoid arthritis and fibromyalgia, is not uncommon. The causes can be infections (viral and bacterial) as well as heavy metal intoxication with mercury. The medication Lortab is a combination of both hydrocodone and acetaminophen. Although sexual dysfunction is not a reported adverse reaction of Lortab, I have seen this in my practice. Lortab has its effect on the nervous system and can cause anxiety, fear and mood changes. These side effects can affect your libido as well as cause erectile dysfunction. Other narcotic pain medications have the same effect. The erectile dysfunction should only be temporary while on these medications. Finding out the cause of both of your conditions is more important. To optimize your health, a change in diet is essential. Try consuming more green leafy vegetables and fewer simple carbohydrates. Supplements like methylsulfonylmethane (MSM), digestive enzymes and herbs like white willow bark, boswellia, green tea and ginger can be effective. Acupuncture can also be an effective treatment for pain management, as can certain massage techniques. Try not to rely on any narcotics, which can cause both physical and psychological dependence. —PF
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