Chronic sinusitis, flares in pregnancy- Q

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Hi Group, I have a tough nut to crack. 43 yo female has been seeing me for over a year. She initially came in the early weeks of her 2nd pregnancy (1st led to her now 5 yo son). CC was chronic sinusitis that was exacerbated during her last pregnancy and caused her much misery. She feared a repeat and sx's had started to appear at 5 wks of that pg. Unfortunately, she miscarried at 8 weeks. We have spent the year doing *major* dietary changes. She avoids her Carroll test sensitivity and put herself through an elimination diet to precisely assess every sinus flare up as it related to her

diet. I have done undas for dysbiosis, for sinusitis, all flavors of trying to help things move, drain and heal. Amidst all of this she became interested in

fertility so we have also been addressing that, though the focus for at least 10 months was sinus/ gut issues. Her BTG's are as follows: *COP's nightly*Neti pot bid (including nystatin in recent months which alleviates sx's, but does not create lasting abatement)*excellent sleeping and exercise habits*ACV *B complex: 1 capsule/day.*Probiotics: HMF

Replete, 1 teaspoon BID.*Vitamin D: Thorne D3 (5,000 IU)- take 1 pill qod*Rainbow Light Pre-Natal Multi Vitamin*Carlson’s or Nordic

Naturals Encapsulated Cod Liver Oil. 2 caps BID.*Evening

Primrose Oil: 2 caps BID day 15 to menses.*Rotating

seeds*Rotating homeopathic hormone remedies*Pure

Encapsulations Zinc Citrate 30 mg: take 1 capsule 2x/ week.

*1 tbsp powdered turmeric in 1/3-1/2 cup coconut

milk every evening (with dinner)

..... and she is meticulous with these! I was just about to explore treatment of biofilms in her sinuses when she got pregnant (much to my surprise!). She is now 6 weeks along and having an acute flair of sinusitis. She also gets bimonthly acupuncture/ cranio-sacral tx's as we were working on both the fertility and sinusitis from that angle as well. She has had one nasal specific tx after which she reported no major changes in sx's. So, here she is pregnant and fearing the worst sinusitis flare up ever! Her pregnancy is (in my eyes, and hers) a delicate one as all signs pointed toward improbability when it came to conception. I know that there is a natural increase in sinus congestion for many women in pregnancy as the hormones change, so I wonder how much is hormonally induced and how much we can actually do something about.In any case, I am just hoping

for some insight, if anyone has any, as to where to go with this. What sinus tx's do people feel comfortable with in pregnancy (ie essential oil rinses, allicin/ DMSO sprays, etc). All of her infections have been unresponsive to abx and positively respond to anti fungals, but as noted, they never fully resolve. Is there something I am not seeing? Thank you for your insights!Dr. Jeannie Achuff, NDBerkeley, CAOriginsofHealthNaturalMedicine.com