Oral Thrush - off topic

[akaipop3ps]

Hi mod, if not appropriate then please delete.

My wife suddenly developed oral thrush perhaps from the inhaler she used for her breathing.

Anybody with experience with oral thrush, Nystatin is not helping.

thanks,

Akai

[noahware]

I'm actually picking up a scrip of nystatin today myself... I've had thrush for a few weeks now but a doc only identified it for me last Friday, and unfortunately the scrip got mixed up. So in the meantime I've been trying colloidal silver, which does not seem to be doing much. (It is only a 10ppm solution and I don't think I'm using it often enough or long enough, if it even works at such a low concentration.)

I have not made any of the anti-candida dietary adjustments that some suggest (no sugars, carbs, etc.) but have been eating a lot of yogurt and kefir. Probiotics are supposed to help. I'm not sure how its impacting your wife, but my tongue feels like it would when you burn it with a hot liquid... makes eating and drinking no fun.

I've read the nystatin can take up to a few weeks to work... how long has she been using it?

A bit more about silver...

frontiersin.org/articles/10...

ami-journals.onlinelibrary....

[akaipop3ps in reply to noahware]

thank you for your reply, my wife has been using it for 10-11 days now. Initially felt better for couple of days but no progress since. Burning sensation in the mouth. We don’t know what caused it but Cleveland Clinic mentioned steroid inhaler as one of the causes. She was using it at night for a week prior but we don’t really know. She happened to see her dentist 11 days ago and was prescribed Nystatin. I encouraged her to see an MD but she wanted to wait. I went through Reddit and realized that this thing can be hard to treat and can last a long time.

Please keep me posted on your progress.

Thx.

[noahware in reply to akaipop3ps]

Interesting about the steroids... I was just on a two-week course of high-dose dexamethasone, even though not inhaled maybe that was a factor.

Just wondering... is your wife taking the liquid solution, and how long is she keeping the nystatin in her mouth?

[akaipop3ps in reply to noahware]

About 30 seconds.

[noahware in reply to akaipop3ps]

I'm no expert, but I suspect it may be more effective if held in the mouth longer. My instructions read, "keep the liquid in your mouth for as long as possible." In searching online, I did find info that suggested "at least 30 seconds."

I also found this, from multiple sources: "The longer the medicine is in contact with the site of infection the better." There is obviously a huge potential gulf between "as long as possible" and "30 seconds." But I can find nothing that indicates how long this "long" might be, for optimal results. A minute? An hour?

When I bought the colloidal silver from the local herbalist, she suggested trying to keep it in my mouth for at least five minutes, which I did. (She also suggested I swallow the stuff, which I did NOT do!) So as disgusting as I find this nystatin liquid, compared to the very soothing silver solution, I have been keeping it in my mouth for up to five minutes or more with each dose. Perhaps your wife could extend her swishing and gargling time a bit, and see if that makes a difference?

[noahware in reply to akaipop3ps]

Just to update, it's been a week on nystatin and it seems to be working... my tongue is still prickly but no longer painful when I eat citrus or have a sip of wine. Throat is still sore, however... and very dry mouth at night, which may not even be the thrush?

I have been holding the 4x daily doses in the mouth for about five minutes before swallowing (and only swallowing about half, as I am dosing a slight bit higher an amount than prescribed). Is your wife making progress?

[akaipop3ps in reply to noahware]

I am glad it is working for you, it unfortunately, hasn't solved my wife's issue, it has gotten better but still there (2 1/2 weeks). Yesterday, we went to urgent care and got prescribed Fluconazole tablet 50 mg, one pill for seven days and also clotrimazole Troche 10mg, five times a day instead of Nystatin. Her condition improved the first couple of days but then stalled.

I tried to get her in to see a contagious disease specialist, must have made 10 calls to different ones but unable to get her an appointment, most asked for a referral from her primary care physician, unfortunately it was her dentist who treated her (Nystatin) when it started so we had to go to the urgent care so we could get new medication. The two new meds are pretty much standard stuff like what "dentalwin" mentioned in his response below.

We will wait for couple of days and see if there is any improvement or we will have to seriously beg to see a contagious disease specialist.

[noahware in reply to akaipop3ps]

Good luck -- hope the new meds do the trick.

[akaipop3ps in reply to noahware]

Hi, how is your condition doing?

My wife has seen improvement but it’s still there, the white sheen on her tongue is still there, the burning sensation comes and goes.

Will try to get her to see a infectious disease specialist as soon as possible.

[noahware in reply to akaipop3ps]

Well, the thrush seems to have resolved but it became the least of the worries... I began experiencing some numbness, tingling and burning in the lip, tongue and jaw (all on the left side) that got progressively worsening last week, along with worsening of preexisting headache and earache (also on left side). Gabapentin and oxycodone gave same relief.

Over the weekend, speech became impaired and eye drooped, as if I was having a stroke (but my wife, an RN and stroke victim, knew I was not). Called the MO first thing Mon am, and he also knew it wasn't a stroke... it was bone mets impinging on nerves.

Got an MRI in the ER (where of course they had to first confirm it was not a stroke) and am starting radiation to the mets tomorrow! Also just started high-dose dex again, and sure hope the thrush doesn't return, because no way I will be able to swish or gargle that stuff given the lopsided state of my mouth.

How's your wife doing?

[akaipop3ps in reply to noahware]

sorry to hear that, wishing you the best.

My wife is still dealing with her oral thrush. We think the two tables of Fluconazole was not enough. Under medicated. We saw an internist today and she said it should have been one tablet a day for two weeks instead of 2 tablets for two weeks.

[noahware in reply to akaipop3ps]

Oh boy, one tab a day vs. one a week is a big diff. At this stage of the game and with the state of our care system, I am tempted to double-check even the docs I most trust.

I've heard for some, this thing can be tough to tackle. But heck, until a month ago I never even knew "oral thrush" existed.

You learn a lot of new stuff as you go into old age... unfortunately a lot of it is not good stuff!

Best of luck to you guys.

[dentaltwin]

While I did prescribe nystatin in my (dental) practice, I more frequently prescribed clotrimazole pastilles. Two weeks on nystatin should be enough to get a response. I'm assuming your wife's inhaler includes a corticosteroid? These are most closely linked to oral candida infections. If it does not, your wife may want to have routine blood work done just to make sure the thrush isn't caused by something else. Also, if your wife wears any kind of denture or oral appliance you should paint the surface with the nystatin, or she could be re-infecting herself.

[akaipop3ps]

Thank you Dentalwin, she was using Flonase (Fluticasone Proponate - Glucocoticoid 50 mcg) for about a week.

Should she be taking clotrimazole with nystatin together?

thx.

[spw1]

My husband developed it after the chemo; the chemo did nothing to the cancer. The thrush was resolved quite a bit by a combination of nystatin and fluconazole for a week.

[akaipop3ps]

Thank you spw1

[noahware]

I have taken to having about five different kinds of yogurt and kefir in the fridge. (Apparently, most kefir has far more different active cultures than yogurt. And Icelandic stuff has strains not found in US yogurts.)

Do you know, are there specific prebiotics or probiotics just for thrush? I have also hear that cutting back on sugars/carbs may help... having a hard time with that right now.

[noahware]

As long as the yogurt is full fat, I enjoy it plain without sugar... but sometimes add a bit of maple syrup.

BAT on hold for now... will be posting on that soon!