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Ask Dr. Gott 12/12
Unsanitary conditions cause chronic sinus infections
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    DEAR DR. GOTT: My 54-year-old sister, who weighs more than 300 pounds, has constant sinus infections. She doesn't have any pets and lives alone in a 5-year-old house full of newspapers, plastic bags and other items she plans to recycle but never gets around to. Her entire house is cluttered several feet deep. I think her chronic sinus infections may be related to this accumulation. She gets upset when anyone offers to help with the recycling and rarely lets anyone take any of it. Could these living conditions be the cause of her sinus trouble? I love her dearly but don't know what to do.
    DEAR READER: Your sister may have chronic sinus drainage due to sensitivity to environmental factors, such as mold or dust, that are the consequences of her poor living conditions. There are two things that need to be addressed. First, she needs to see an ear-nose-and-throat specialist for testing to be sure that her infections are not caused by polyps or other blockages.
    Second, from your brief description, I believe your sister is suffering from compulsive hoarding syndrome. This invovles excessively collecting items (newspapers, magazines, etc.) that have little or no value coupled with an inability to discard them. Compulsive hoarders often believe that the items they collect will be needed or have value in the future. They may also worry about not having these items on hand or believe if they don't save these items, they are being wasteful. Some compulsive hoarders may even keep items such as empty food cans or wrappers and other trash. Occasionally, a hoarder will keep animals, which often leads to extremely unsanitary conditions and health problems, not only for the person but for the animals, as well.
    There is no known cause for compulsive hoarding, but it is thought to be connected to obsessive-compulsive disorder. Treatment is often difficult because the hoarders do not see their behavior as a problem. They often fail to see the dangers of hoarding, such as fire hazards, unsanitary living conditions and even the possibility of being buried by falling piles of junk. When a hoarder realizes there is a problem, there are two treatment options. The most common is psychotherapy, which allows the person to explore the reasons and emotions associated with his or her hoarding. The second treatment option is medication. Selective serotonin reuptake inhibitors (SSRIs) are the most common, but results are mixed. Studies are still being conducted concerning which medications are the most effective.
    Contact the Obsessive-Compulsive Foundation (203-401-2070 or for more information on ways to help your sister. I also recommend that you sit down with her, armed with your information, and explain your concerns. She needs to know that you care about her, her safety and her health. If she chooses not to listen, then you know you have given it your best try. You can offer your sister help and support, but whether she takes it or not is up to her. She will at least know that you are there should she decide to take the necessary steps toward recovery. I wish you the best of luck. Let me know how this turns out.

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