Jack Benny once said, “Age is strictly a case of mind over matter. If you don’t mind, it doesn’t matter.” Advancements in science, medicine, and technology means we don’t have to mind our old age. Older patients, though, present certain complications they do have to mind. When dealing with the symptoms of sinusitis, the right treatment is what’s most important for older patients.
If you’re a close follower of our blogs (and we know you are), you’ll remember that sinusitis is the inflammation of the lining of the sinuses. Inflammation is caused by excessive histamine and antigens trying to fight off an infection in your sinus area. This could mean facial pressure, nasal congestion, and postnasal drip in the back of the throat. Headaches, ear aches, bad breath, and loss of smell can also result. A holistic approach is necessary when treating these symptoms in older patients given the complications that can arise.
A Changing Older Body
The simple truth is that a 70-year-old body doesn’t function as well as someone half that age. Older patients may present with lengthened noses, drooping nose tips, and restricted nasal airflow.given the reduced thickness of their cartilage. These normal changes to the human body’s physiology compound the typical sinusitis symptoms in the form of excessive sinus drainage, facial pressure, or nasal obstruction. Primary care physicians (PCPs) will notice that something as simple as clearing mucus from the nose can become less efficient in patients. Corrections to the structure of the nose and sinuses passages can vary between a less invasive balloon sinuplasty or more invasive surgical solution, depending on the severity of the sinusitis symptoms.
Polypharmacy in the Elderly
Older people will commonly have a daily regimen of medication. On a day-to-day basis, this isn’t a problem. But when a doctor is diagnosing and treating a patient, she would like to avoid any adverse drug reactions. As a simple example of how a patient’s polypharmacy can affect treatment, let’s say that we have an elderly patient with a history of osteoporosis. He comes into the office complaining of sinusitis.
OTC Medicine can Counteract
The doctor knows most prescription or over-the-counter nasal sprays use corticosteroids to easily suppress the immune system response in the patient’s sinuses. Though, we know that corticosteroids will activate molecules in his cells that will decrease the amount of usable vitamin D. Since this vitamin is an important contributor to the bone-creation process, having less vitamin D leads to lower levels of bone formation. Less vitamin D will also interfere with a bone’s responsiveness to other bone-fortifying molecules in your body.
The physician will already know that treating osteoporosis involves bisphosphonate therapy, which lowers vitamin D n the body. Thus, adding a vitamin D-reducing nasal spray to the mix will reduce their levels even further, so she’ll probably increase the dosage of our hypothetical patient’s vitamin D supplement.
Multiple medications like this can complicate a simple sinusitis treatment and why a full view of a patient’s health is important when delivering care. The complication doesn’t appear with steroids. If the doctor wants to steer the patient towards an antibiotic, she’ll have to confirm that it’s bacterial and not viral. Sinusitis is typically caused by viruses, so that option might not be available. A decongestant could also work at constricting blood vessels in the sinuses, which would reduce a patient’s symptoms. But if the patient’s osteoporosis is caused by hyperthyroidism, then a decongestant can be taxing on his heart and circulatory system.
Whether it’s structural problems with the nose or sinus cavity or imbalances in a patient’s biochemistry, the quality of life of elderly patients is first and foremost. This is why an integrated approach is always needed to ensure that further health complications aren’t created by sinusitis treatments. If age is strictly a case of mind over matter, then we think that using our mind is what matters most.
Is your nose stuffed-up with seasonal allergies? We’ve got plenty of options for you. Take back your nose (so your goofy uncle can take it away again) by scheduling an appointment with Dr. Pasha and his team. Follow us on Facebook and Pinterest for more updates!