Guidance needed on chronic sinus problems - Sinus Problems Message Board

sanufi · 05-21-2006, 05:47 AM

Hi,

29 year old male from Australia here. I have been having bad sinus issues for 5 months now after an allergy-induced sinus infection. However, I believe I may have been suffering from chronic sinus issues for over 10 years which I left untreated. I have been diagnosed with bad dust mite/house dust/cockroach allergies as well as other lesser allergies.

My symptoms for the past 5 months are:
- Sinus pressure around my head which seems to have gone for now.
- I feel as if air just rushes down my right nose when I breathe.
- I have pain in my right nasal area at the right side of my nose.
- I have ear fullness in my right ear.
- I have PND especially my right side.
- When I irrigate, I can smell a foul odor. What is this? An infection?
- I cannot smell things through my right nose. Probably for years already.
- I have thick white mucous. Again for years. Now there is more.
- My nose is dry and my nose rarely runs.
- I have shortness of breath. Not often.
- Exercise seems to produce more drainage down my throat.
- My nasal passages have become highly sensitive to irritants.

I usually don't have trouble breathing, though one side always seems to block up somewhat. I feel the congestion on my right side is worse and is deeper inside. Weird thing is I can still breathe through my right nostril but it just doesn't "feel" right. I believe this is due to my chronically enlarged right turbinate.

I have been to 2 ENTs, 2-3 months ago but they do not believe I have serious issues and just said I have allergies. I had an endoscopy and CT scan a couple of months back with nothing abnormal. Problem is, I had the CT scan right after the endoscopy, so it probably missed my enlarged turbinates.
It has probably gotten worse since then. Should I ask for an MRI to check whether my turbinates are swollen?

I have been to 2 allergists. Both recommended I start allergy desensitization. Only one suggested a "quick-fix" solution for my problems - which is a sub-mucous resection of my turbinates. However, he said an oral drop desensitization program plus food allergy elimination diet will solve my problems without surgery. I have some doubts about this - though I am willing to try.

I have pretty much done everything possible to reduce my dust exposure at home. Dust-mite covers, laminate floorboards, blinds, air filters, etc. I have been on Rhinocort for 3 months which is not helping. Should I give Nasonex a go?

I have been irrigating with Neilmed sinus rinse for a couple of months. However, I find that it irritates my right nasal passage and causes some pain. Should I continue with the irrigation? It does clear out the mucous somewhat but seems to cause more inflammation. Any ideas on the pain? Allergist believes it's the swollen turbinate touching the nerves.

Would turbinate surgery such as turbinate cautery or sub-mucous resection be helpful? I have heard that it is not a cure since my turbinates will keep swelling. And of course reading horror stories on the Net is not helping.

Do I just wait it out for the next 6 or so months and start the allergy drops now? My GP said the allergic reaction and histamine production can take a year to settle down. I really hope so.

Wow. turned out to be longer that I intended. Hope some people will be able to help me with my questions and offer some advice on what to do next. I'm sick of feeling like this. I've never had any health issues before and this is just dragging me down. Always loved exercising but find it hard due to the constant nasal issues.

Thanks,
Chris

sneezydiva · 05-24-2006, 12:50 PM

You sound a lot like me. I think you have a combination of allergy and sinus issues. I would definitely recommend the allergy desensitization. Even if you were able to get sinus surgey or a turbinite reduction, the allergies are to root cause of your problems, and you won't feel completely better until your allergies are under control.

I had a similar problem as you, foul smelling drainage, even the allergist said it looked infected, but the CT showed no infection. Unlike you, my swollen turbinite was very large and noticable, and that was enough justification for surgery, and we were able to convince the surgeon to clean out the maxilary sinus on that side. He said it was mostly "allergy" mucus as opposed to infected mucus, but it was so old and dried up, it would've have taken forever to come out on its own.

How far apart was your endoscopy and CT scan? It might be worth it to get another CT. Make sure you don't use any nosesprays for at least a week prior.

I had been on allergy shots for almost 2 years before my CT scan, so there was no way my turbinate was going to go down on its own. But it is very possible that desensitization will shrink the swollen turbinates. I know my left one did shrink as a result of the shots.

With my surgery, the surgeon said there was no way it was going to grow back, he actually cut away part of it, I believe. I don't know what a sub-mucus resection is.

Anyway, sorry to be long winded. What I'm trying to say in a nutshell, is regardless of what you do to pursue a sinus/surgical solution, you need the allergy desensitization. If you do that first, you might find you don't need surgery. And if you chose surgery, then your improved allergies will still prevent your sinus problem from recurring.

sanufi · 05-24-2006, 05:28 PM

Thanks sneezydiva,

I had the CT scan about 30 minutes after the endoscopy. Don't really want to do another scan - too much radiation.

OK, looks like allergy desensitization is the way to way to go. Have to figure out whether to do the oral drops or the shots. How soon will the allergy shots start working?

Would it be ok to take antihistamines like Zyrtec and oral decongestants like
Sudafed? Do they help shrink the turbinates? My doctors never recommended them to me for some strange reason. I had to come on to boards like these to find out about them.

Also, should I continue irrigation or stop completely. I find that it just inflames my right turbinate causing pain. Has this ever happened to you? Maybe I should just use saline sprays instead?

Hope you can help me out with my questions. You've been a great help.

Chris

sneezydiva · 05-24-2006, 07:09 PM

It takes about 6 months for the shots to start working. I imagine the drops are similar, but not sure. They aren't widely used in the States for whatever reason.

It's definitely ok to take Zyrtec and Sudaphed to help symptoms. You can take them while getting the desensitization.

What are you irrigating with. Are you using a premade saline solution or packets, or are you making your own? How long have you been irrigating? Inflamed tissue will sting, but as it heals, it usually goes away.

sanufi · 05-24-2006, 09:52 PM

I had been irrigating since March. I haven't irrigated for a few weeks now because I didn't want to inflame the tissues any more. I had been using the Neilmed premade packets.

Tried the Grossan Hydropulse for a few week at the beginning of May but then came down with a stomach bug which made the inflammation worse and produced tons of white mucous which I had never experienced in my life before. Don't know if I want to use it again.

Maybe the tissues are still too inflamed to irrigate.