Runner with sinusitis and fatigue concerned with post op fitness

Resolved question:
I am a very, very active, top 1% finisher for age group, runner (was at least). I am a 32 YO Male, married, no kids. 2 dogs, living in Southern California area, and traveling regularly to Northern CA and AZ. I run everywhere I go, so presumed exposure to anything prevalent outdoors.

In Dec. of 2012, I was hiking in the mountains when I began having shortness of breath. After hiking, I slept 12 hours and awoke coughing up fluid. Thinking it was edema, I drove to the hospital where they diagnosed severe Pneumonia. I was treated IV Levaquin for 2 days, and sent home with a 5 day supply. I recovered fine, and aside from tendonitis I was asymptomatic for months. I went on in May 2013 to finish top-3 (age group) at a half-marathon, so lung capacity and all else was apparently normal.

In July, after returning from Baja Mexico (Cabo), I started exhibiting signs of fatigue, dry eyes, mild fever (<100), and chills. I went to a doctor where they performed an X-Ray, and did a CBC w/ diff. X-ray indicated equivocal diagnosis of Pneumonia, basically just a small infiltrate, I was given a z-pack (single), and sent home. I was also tested (on instinct) for Lyme disease, which later came back positive. I was sent to an infectious disease specialist who scoffed and said no way. We later sent a blood sample to Mayo, for a Western Blot which indicated I only had 2 of the 5 antibodies for Lyme, thus confirming her suspicion that my Lyme test was a false positive. At this point, I had been treated 14 days with doxycyline, my fever was gone after a couple days, but the fatigue was persistent. I also had a substantially elevated Heart rate during "easy" runs where my heart rate monitor indicated that I was at 10 BPM higher than average pre-illness.

After two-bouts of pneumonia, I was sent to a pulmonologist who did some kind of diagnostic test on my lungs of with and without albuterol. Albuterol showed some improvement in function. She then looked at my nose, and within one minute said... oh, you have a sinus infection. She put me on Nasonex, and gave me albuterol. She also gave me a 21 day supply of Augmentin.

After 8 days, I was no better and in fact had started to go downhill in terms of fatigue, congestion, and general malaise. She said the antibiotic should have worked in 3-4 days and decided to then go with Levaquin. After 5 days I had severe bi-later tendon pain in my achilles and she was nervous enough to switch me over to another medication.

At this point, I was given nasally aspirated Tobramycin and Vancomycin that were compounded from a pharmacy. I was to administer 1 dose of each twice daily. This stuff was not well tolerated by my nose. At this point, I started developing severe congestion after administration, as well as substantial bleeding from the irritation in my nasal cavity. I was also using a nasal saline rinse, w/ distilled water 3-4 times daily. After 7 days, I was significantly worse than before, and was referred to to an otolaryntologist. Before I could get in to see him, she put me on Clyndamycin in the off chance it was an anaerobic bacterial infection, which after a 10-day regiment had no impact.

The ENT did a visual with a scope into my nose, and noted it was severely irritated but not surprising given the number of medication and nasal treatments I was doing. He gave me Patanase in case it was hay-fever related, and diagnosed Reactive Airway Disorder as a bi-product of a chronic sinus infection. He went through my list of failed medications and recommended that we try Doxy again. I said... no deal. At this point, I had been on antibiotics for 6 weeks, and although I was taking probiotics did not want to subject my body to the host of problems from long-term antibiotic administration. His next recommendation is surgery, specifically a endoscopic ethmoidectomy with middle meatal antroscopy. I am very nervous about this surgery, as I do not know physiologically what the honeycomb on the sinus cavities does for my fitness, and if I will alter some capability long-term, and ruin my running career?

I have been off of all medications excepting Nasonex now for 1 month. Most of the irritation is gone, no more bleeding, no more green eosinophilic discharge, but the main, original symptoms remain. I still have crazy fatigue, and my heart rate is still really high and I am short of breath anytime I do any activity like jogging, going up a multi-flight staircase, etc. I really want some other diagnostic tests but all CT scans have confirmed low-grade sinus infection. Also, neither doctor independently believes it's fungal because of the nature of the images. That being said, does anyone have any experience with this? Anyone have experience with exercise post-op?

How is the recovery from surgery? I am really freaked out, and running is my happiness my life, pretty much what I need to be me. Thanks again for the time, I know this is long, but it's taken a while to get here.

Submitted: 4 Days
Category: ENT Specialist

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