Given the Undeniable Link Between Chronic Sinusitis an Fungi,

Given the Undeniable Link Between Chronic Sinusitis an Fungi,

Why is it Still So Hard to Find an ENT that will Treat for Mold & Mycotoxins?

By Cesar Collado,

Dr. Dennis is always looking to take mold off of the table for his chronic sinusitis patients, because experience has taught him that this strategy yields the best results for most patients, and also does no harm for those with other or additional issues to fungus/mold. Since we now believe that up to 96% of chronic sinusitis may be caused by fungus or mold, this technique is a sound and proactive approach. (Note: The origin of this percentage will come later in the text.) To that effect, one unique strategy employed by Dr. Dennis during sinus surgery is to take tissue specimens from the infected sinus for the lab to later culture for mycotoxins.

By the time a Dr. Dennis performs surgery on sinuses, lots of evidence that furthers Dr. Dennis’s strategy for the need to identify and address mycotoxins has already been done in the months and weeks leading up to the surgery. For example, to determine the need for surgery in the first place, advanced imaging (CT scans) must reveal specific abnormalities and evidence of mucous thickening. These scans can also reveal fungus growing in the sinus.

In addition, patient symptoms, urine mycotoxin testing, or other circumstantial evidence revealed during a detailed review of the patient’s diagnostics, medical, and home history has also been gathered. Any indication or evidence of water damage in their indoor living spaces is of particular note during this phase.  Then, physical symptoms such as tremors, ataxia, vertigo, and headaches are common indicators of mycotoxin poisoning in the sinuses and usually subside after acute treatment with antifungal medications during sinus surgery. Keep in mind, this is still before mycotoxin testing results are revealed by the lab.

Why aren’t more ENT surgeons taking this effectual approach?

Addressing mold and fungi and their role in Chronic Sinusitis remains controversial. To that end, most, if not all ENTs, will “clean out” sinuses, remove nasal polyps, and prescribe medicine for bacterial infections.  In the event a “fungal ball” is identified, they will remove it; however, the use of antifungal medicines during and after surgery is rare. Thus, the return of a fungal infection inevitable.

It wasn’t until September 1999, where the Mayo Clinic published a study of 210 patients with chronic sinusitis, 96% tested positive for fungi in their mucous, that the causal relationship between fungus and sinusitis were formally acknowledged. 40 different kinds of fungi were discovered, an average of 2.7 types of fungi per patient.  In a subset of 101 patients who had surgery to remove nasal polyps, the researchers found eosinophils (a type of white blood cell activated by the body’s immune system) in the nasal tissue and mucus of 96% of the patients. But, even after this study was widely published and acknowledged by the medical community, why hasn’t the treatment approach to Chronic Sinusitis changed? Why is Dr. Dennis’s strategy still so unique?

Dr. Dennis’ practice for years has had a skewed population as patients come to him to address fungal sinusitis and mold illness. Because of his experience over the past four decades caring for patients with fungal infections, he has some tools that other physicians do not have and acquired wisdom to identify patient conditions.

Most important is his practical recognition of the sensitivity  of the olfactory nerves  and the fact that the sinuses are microns from the brain.

Amphotericin B is a well-known, potent antifungal medication. When given intravenously, it is well known for its severe and potentially lethal side effects.  It is poorly absorbed and not a candidate for oral treatment; however, the Mayo Clinic and other physicians have popularized the use of amphotericin B in nasal lavages during surgery for chronic fungal sinusitis and the use in nasal drops as maintenance therapy. Because of the significantly lower dose and “topical use” in the sinuses with patients with fungal sinusitis, it is very effective and lacks in serious side effects as it is not absorbed and metabolized by the body. This methodology was described in this article coauthored by Dr. Dennis and the late Jack Thrasher, Must See Article on Mycotoxin Poisoning.

So why is this important for you?  If you have severe neurological symptoms, you may continue to suffer for many years until mycotoxins are identified and treated by your physicians.  The average length of suffering from a more recent article I read on mycotoxin poisoning in sinusitis was SEVEN years (Chronic Illness Associated with Mold and Mycotoxins: Is Naso-Sinus Fungal Biofilm the Culprit? Toxins, June 2014 By Brewer, Thrasher, Hooper)

Finding doctors to treat mold-related illnesses is hard enough.  Finding an ENT that embraces these practices is much harder.  Why is that?  Well, I was able to find numerous studies to determine if amphotericin B is effective in treating Chronic Sinusitis.  Unfortunately, many of these studies were focused on  general populations with chronic sinusitis without a pre-determination that it was fungus that caused the sinus infection.  These studies are not likely to yield successful outcomes because they include patients that are predetermined to fail. I do not understand why certain medical innovations are so slow to adopt and meet resistance. I do not think there are any arguments that fully justify the resistance to change occurs often in medicine.  Why is it that   adoption of new ideas can take decades?

Medicine is one of the modern sciences that is very slow to change. The Ear Nose and Throat community has been aware of fungal sinusitis; however, the specialty has resisted the recognition of the prevalence of the fungal role in chronic sinusitis for many years. Encouragingly, during very recent times, more and more articles on fungal sinusitis have been accepted and published in peer review journals.  Still, finding a physician that treats fungal sinusitis AND that will utilize amphotericin B if needed in procedures and maintenance therapy is going to be a challenge for sufferers.  Until the medical community shifts its approach, the burden to find the right doctor still lies on the patient.  Diligently knowing your symptoms coupled with careful review of practice websites, physician bios, and even calling the office are all good practices.  Otherwise, you may find yourself with numerous doctor’s visits and surgeries.

Take Ulcers for Example

During my career, I had the opportunity to witness the evolution of ulcer treatment.  The specialty was Gastrointerology.  Treated by surgery in the late 70s and 80s, several successful medications populated the top of the annual Top Selling Pharmaceutical for decades.  Tagamet, Zantac, Prilosec, Nexium were all blockbuster drugs and led the pharma industry in sales up until the early 2000s.  But in 1982, Two Australian Physicians identified the link of bacteria, h-pylori to ulcers and published their findings.  Very slow acceptance by the GI community occurred and NIH recognized the link in 1994. Even after he CDC launched an awareness campaign for h-pylori in 1997, adoption remained astonishingly slow. The use of proton pump inhibitors remained a dominant practice. In 2005, Drs. Barry J. Marshall and J. Robin Warren won the Nobel Prize for Physiology (Medicine) for this discovery. Today, antibiotic therapy to treat ulcers is the “new normal” .  Past “treatments” are now “symptomatic relief” for sale without prescriptions (OTC). That is 28 years of my observation for complete recognition of new science.

Discussion

I see a real challenge for patients suffering from mold and mycotoxin poisoning.  It is tragic to see patients who are completely debilitated and have lost physical control of extremities and experience brain fog, dizziness, and memory issues.  If the patient has lived in a water-damaged home or building and if (and only if) mycotoxin poisoning in the sinuses is the cause, there is only one way to help the patient get well: remove the mycotoxins from the sinuses.  The human body’s ability to fully metabolize these potent neurotoxins is limited.

In most cases, when Dr. Dennis’s specimens from the surgeries are sent off to the lab to identify if mycotoxins exist in the patients’ sinuses, the toxin is, indeed, present and when removed, the patients’ symptoms subside.  I have heard and read countless testimonials where lives have been changed for the better by this practice.  In some cases, decades of illness and “big bags” of failed medications tried are revealed by patients.

I have a genuine concern that the ENT community’s ability to adapt to change can have an enormous impact on millions of patients with severe neurological symptoms and illness.  Just this year, numerous cities like Houston were leveled by hurricanes, which will undeniably yield mold and mycotoxin poisoning that will be epidemic for years.

Hurricane Harvey Impacts

It is almost assured that people have returned to water damaged homes.  Complete mold remediation of a completely flooded home is nearly impossible. Much of the literature on mycotoxin poisoning I have read  centers around patients who have lived in “Water Damaged Homes”.  Let’s hope patients and ENT physicians do their research and do what they can to see the alternatives.  If you are reading this article, you know that we all do not have 28 years to wait. In August, the “CDC had its first Fungal Awareness Week” suggesting to patients that if chronic symptoms do not get better,” talk to your doctor about the possibility of a fungal infection”

I can only make a general recommendation to patients to do their research, ask questions, and make suggestions.  I’m sure there are a handful of ENT’s who treat mycotoxins in the sinuses in every geography.  I do not know who they all are!  If you find them, please share these important doctor’s names with the community.

For questions, comments or to share your story, I can be reached at cesarcollado@icloud.com.

Cesar Collado is a former pharmaceutical R&D executive, venture capitalist, and seasoned strategy consultant in biotechnology and technology industries in general. He currently works as an advisor to multiple technology start-ups and advises several companies that provide healthcare and other services for environmental illness.

 

 

About the Author:

Cesar Collado is a former pharmaceutical R&D executive, venture capitalist, and seasoned strategy consultant in biotechnology and technology industries in general. He currently works as an advisor to multiple technology start-ups and advises several companies that provide healthcare and other services for environmental illness. Read More

8 Comments

  1. Linda March 29, 2018 at 6:09 pm - Reply

    Cesar. I have suffered from severe sinus issues for years. Was on antibiotics for three years straight. I have a polyp in my nasal cavity, have dealt with mold remediation, tick borne illness, thyroid cancer…..i cannot find an ENT in the Ohio/Michigan area who can help me. My Neuroquant MRI revealed a score of 5 for mold toxicity. Can you provide any suggestions on who can help from here?

    • Cesar Collado March 30, 2018 at 4:24 am - Reply

      Hi Linda,

      Since you have multiple disease states and I am not a physician, I have a question and a few suggestions.

      1. Have you tested your hoe for mold. I’m suggesting mold plate tests (several across your home) because they will give you a black/white yes/no whether there is significant mold problem. I would do just the visual test. You can always order the lab tests to determine what molds and if they produce mycotoxins. This information is valuable when finding an ENT.

      2. I would consider fogging your home with EC3 mold solution. It is all natural and safe and you can fog everything in your home. What is really most important is to see if you feel better when the fungal count in your air is diminished drastically. This is a diagnostic a physician cannot do. When your home is making you sick, it is also preventing you from healing.

      3. Since your sinuses multiple times a day. Clearing the mold and mucous allows your body to heal. Otherwise, your immune system is out of whack all the time when you are home.

      4. Search your area for ENTs who perform surgery for fungal sinusitis.(Not Chronic Allergic Fungal sinusitis). These surgeons regularly remove fungal balls from sinuses. I would call the office to see if they will lavage sinuses with amphoteracin B and whether they will use amphotericin B nose drops or nebulizer to dress the fungi over time.. This medication is very toxic when used systemically but is not absorbed if used topically in the sinuses. Some physicians will use other anti-fungals by IV. I only have seen the results from when Dr. Dennis performs this surgery with amphoteracin B and is is remarkable to see patients feel better for the first time in a long period (up to decades)

      5. You can ask your doctor to test urine for mycotoxins. Real Time Labs. Realtimelab.com can also send you a test as well.

      You ask a difficult question because not many ENTs do this. There is some literature which considers ample B controversial, but that is for across all chronic sinusitis cases and not severe fungal growth in the sinuses.

      Print this article and send it to them to see what their reaction is. https://www.elynsgroup.com/article/surgical-and-medical-management-of-sinus-mucosal-and-systemic-mycotoxicosis

      Good luck and you have my email. I wish I could find a way to help patients convince ENTs. Physicians often do not respond well to being questioned on how they perform care on a patient. If I have been sick for years, I believe I would have nothing to lose by being assertive. Ohio and Michigan is a big geography so search locally or medical centers first.

      Cesar

  2. Anelisa March 19, 2018 at 3:06 pm - Reply

    Dear Cesar, I live in Dubai and the UK and have struggled to find a solution to fungal sinus infection since c 1994, not helped by two lots of sinus surgery, several treatments, low sugar diets etc. Only long courses of diflucan clear the symptoms and allow my body to feel fully well/normal. Diflucan is too strong to take repeatedly, for the long doses needed. Are you able to supply the specific information on the sinus rinses – i.e. brand etc so that we can try to source them? I imagine that you cant recommend personal use without medical approval, but at least I could take the information to a doctor, and use it under medical supervision.
    Many thanks,

    Anelisa.

    • Cesar Collado March 19, 2018 at 7:42 pm - Reply

      Thank you for the comment. I am not a physician but no harm in recommending rinsing your sinuses with a nasal wash system 2x per day. Adding Citridrops will help with removing the mold. Keeping the sinuses clean is similar to keeping a flesh would clean. It prevents infection.

      The anti fungal that I mention is amphoteracin B.It must be prescribed by a physician. the surgeons will use it while inside clearing out the sinuses. It can also be used with a nebulizer. The “magic” drops as a patient tell me are drops made in a compound pharmacy for the physician. The drops include Amphoteracin B, Lidocane, and triamcinolone, a steroid. these are taken upside down to reach the frontal forehead sinuses.

      good luck with your physician!

  3. Tracy Price March 14, 2018 at 8:04 pm - Reply

    Cesar. If you are ever able to develop a list of doctors, ENT or otherwise, that actually know how to treat mold related illness, I sincerely hope you will share with this community. I use Dr. Dennis for any ENT treatments, but it is a 10 hour day to make a visit to his office. The doctor that helped me discover that mold in my workplace was my health issue and the repeated cause of sinus infections, no longer practices for this. I now use the Center for Occupational and Environmental Medicine in Charleston, SC, but would like an option for second opinions.

    • Cesar Collado March 15, 2018 at 1:06 am - Reply

      Thank you Tracy for your comment. You touched on a very difficult task in finding the right Doctor. That is the reason why I write so much on the topic. It requires sleuthing to find mold doctors. You can search for Naturopathic Doctors, Integrative Medicine, Environmental Illness. There are a number of associations that refer; however, you still have to go to their site and potentially call. Finding an ENT that treats fungus and toxins from fungus with anti-fungal medications is a significant challenge! I will gladly like to hear about them.

      I can only recommend physicians and naturopathic doctors I know or follow. To that end, Dr. Dennis and Dr. Kimberly Williford are the two in Atlanta. Here is a list ( http://www.presenting.net/sbs/molddoctors.html) that I have been able to do some due diligence. I believe you will find a practice with a solid website featuring environmental illness treatment that is within an hour of you.

      If you are satisfied with the North Charleston group, let me know. I am not opposed to gathering references from this site to make a list available for readers. For now, I can only personally vouch for these two professionals.

  4. Merritt March 14, 2018 at 3:50 am - Reply

    Thank you! Also, wondering about similar treatments for the respiratory system. I live in the San Francisco Bay Area. Any recommendations of ENTs here?

    • Cesar Collado March 14, 2018 at 4:31 pm - Reply

      Thanks for your comment. Respiratory issues are probable. The post nasal drip is swallowed and can lead to infection in the bronchial areas. Rinsing sinuses remains critical even if it is in the chest. Gargling and drinking with citridrops also helps.

      I cannot speak to San Francisco. I urge you to do the search, research, and call the offices to make sure you find a “friendly.”

Leave A Comment