Clearing Frontal Sinus Tips And Surgery Info.

[mommysboy]

I have a significant nasal problem when in Bangkok and a mild problem in town generally. A nasal steroid and mask has helped greatly, but one of my frontal sinus (above the left eye) seems to get blocked very easily and leads to significant nauseating pain albeit for short periods of time. There does not appear to be any infection and after a few hours I sneeze a few times and the problem tends to ease.

Any tips (I already use saline wash, hot showers, etc). Would drinking lots of water really help? I tend to run dry a lot, would this affect my nose?

And is there any surgical remedy eg, widening of ostium that anybody has experience of.

I really need air con in BKK, but can I mitigate it's drying effects?

Sorry for so many questions

[Samuian]

I have a significant nasal problem when in Bangkok and a mild problem in town generally. A nasal steroid and mask has helped greatly, but one of my frontal sinus (above the left eye) seems to get blocked very easily and leads to significant nauseating pain albeit for short periods of time. There does not appear to be any infection and after a few hours I sneeze a few times and the problem tends to ease.

Any tips (I already use saline wash, hot showers, etc). Would drinking lots of water really help? I tend to run dry a lot, would this affect my nose?

And is there any surgical remedy eg, widening of ostium that anybody has experience of.

For these questions get advice from a specialist!

I really need air con in BKK, but can I mitigate it's drying effects? Yes, use an humidifier!

Sorry for so many questions

[MMR]

Have you consulted a professional?

If not, I'd say that should be you first move.

There are plenty of well qualified ENT specialists here in Bangkok.

As far as drinking lots of water goes... This is just good practice.

[mommysboy]

Have you consulted a professional?

If not, I'd say that should be you first move.

There are plenty of well qualified ENT specialists here in Bangkok.

As far as drinking lots of water goes... This is just good practice.

Yes, I have had quite a bit of treatment regarding non allergic rhinitis, which is compounded by a deviated septum and narrow nasal passages. The effect is I tend to get blocked up more than others in a place like BKK. It's a non issue out of town. Treatment has been successful and I feel much healthier, but I'm left with this nagging and at times very painful blocked frontal sinus, thankfully outbreaks are short lived.

That was why I wanted to discuss tips.

It's a toss up whether surgery is necessary as I'm perfectly ok out of town.

But if its a simple procedure to widen the ostium I wondered if anybody could advise.

To be honest, the 2 answers so far have been discouraging, and seek to do better for others.

[MMR]

Have you consulted a professional?

If not, I'd say that should be you first move.

There are plenty of well qualified ENT specialists here in Bangkok.

As far as drinking lots of water goes... This is just good practice.

Yes, I have had quite a bit of treatment regarding non allergic rhinitis, which is compounded by a deviated septum and narrow nasal passages. The effect is I tend to get blocked up more than others in a place like BKK. It's a non issue out of town. Treatment has been successful and I feel much healthier, but I'm left with this nagging and at times very painful blocked frontal sinus, thankfully outbreaks are short lived.

That was why I wanted to discuss tips.

It's a toss up whether surgery is necessary as I'm perfectly ok out of town.

But if its a simple procedure to widen the ostium I wondered if anybody could advise.

To be honest, the 2 answers so far have been discouraging, and seek to do better for others.

Well, I suppose the question is... How much are you in town and how much does it hurt?

Costs for correcting a nasal septum (deviated septum) will be between $1000 and $2000 depending on where you go.

Edited November 6, 2008 by MMR

[mommysboy]

Have you consulted a professional?

If not, I'd say that should be you first move.

There are plenty of well qualified ENT specialists here in Bangkok.

As far as drinking lots of water goes... This is just good practice.

Yes, I have had quite a bit of treatment regarding non allergic rhinitis, which is compounded by a deviated septum and narrow nasal passages. The effect is I tend to get blocked up more than others in a place like BKK. It's a non issue out of town. Treatment has been successful and I feel much healthier, but I'm left with this nagging and at times very painful blocked frontal sinus, thankfully outbreaks are short lived.

That was why I wanted to discuss tips.

It's a toss up whether surgery is necessary as I'm perfectly ok out of town.

But if its a simple procedure to widen the ostium I wondered if anybody could advise.

To be honest, the 2 answers so far have been discouraging, and seek to do better for others.

Well, I suppose the question is... How much are you in town and how much does it hurt?

Costs for correcting a nasal septum (deviated septum) will be between $1000 and $2000 depending on where you go.

I live in BKK but am working my way out at long last. some time ago in the UK I was advised against an operation, but I don't know this is becoming a tad painful.

[Chris Lawrence]

I suppose the other question is 'does surgery work'. I have had two operations 1985/1996 on nasal passages for similar problem, and although relief is obtained, it never lasts. Medicated nasal sprays stopped working along time ago.

I understand the issue MB is talking about.

For drying out, I was experiencing this at night in my mouth? Not sure if this is the same as MB, but I have recently got a C-PAP machine for snoring problem/sleep apnea. This seems to have stopped the drying mouth. Still need to do the saline wash with the nose/this is still drying out.

Another problem for me is in a city I just suffer with the pollution; life is better in a country location for the nose.

Good topic.

[jfchandler]

To the OP, I'd offer my advice as something of a non-medical sinus expert, having fought this problem for the past five years and through three sinus surgeries in the U.S.... What fun....

Re sinus surgery, these days, with the advent of laser and/or endoscopic (meaning they do it inside your nose, as opposed to the old style of cutting an incision to get in) procedures, it's a pretty easy, non-major procedure. For each of the sinus surgeries I had in the U.S., they were all outpatient -- go in the in morning, have the procedure, and go home that afternoon. No complications, no serious after effects, even though all three were under full anesthesia (they put me out completely).

I had similar symptoms, significant deviated septum on one side and blocked/clogged up sinuses leading to repeat and unresolved sinus infections. The first surgery (the most substantial of the three because it involved making the most substantial physical changes inside my nose) solved the deviated septum, and I could breath clearly thru that side of my nose for the first time in my life.

That also involved them placing special cotton tubes up into my sinuses for a week or so during the healing time, which later were removed (pulled out...gently). That part probably was the worst of the whole experience, 5 minutes of uncomfortable wincing in the doctor's chair... But in the end, that surgery didn't do enough in cleaning out the upper reaches of my sinuses, so I had to go back a year and two later for additional work.

I don't know if they use the technology here, but in the U.S. they now have what they call computer-guided surgery. That involved going for a CT scan just prior to surgery, where they take imagery of your sinuses aligned with a special headset. They you go for surgery, and the surgeon uses the headset and CT imagery to guide the surgery as a means of being very precise in what areas they do.

About moisture, yes...absolutely, it's VERY important to keep your sinuses well moisturized. There are many ways to do that. One thing I do that works really well is as follows: go to the ladies section of a department or drug store, and get one of those (like Conair brand) electric facial steaming units (really just a small basin for boiling water to create steam and then a plastic tube/cone to fit over your nose and mouth or face area). Use that for 10 or 15 minutes, breathing in deeply thru your nose. Even better if you add 4 or 5 drops of some pure oil like eucalyptus, which helps clear any congestion.

A low-tech way to accomplish the same thing is to pour boiling water into a large pot or bowl, and then cover your head and the bowl with a towel, to keep the steam contained. But the electric unit is much nicer, and can just sit on the table in front of you while your do other things, as oppose to sitting for 10-15 minutes with a towel over your head. Likewise, especially in the hot and air conditioned climate here, drinking a lot of good, clean fluids (water, green tea, etc.) is important.

In terms of air con, one thing you could also consider is getting an electric humidifier and running it in your closed bedroom at night while you sleep. I've never done that, because of all the issues about keeping those units clean and sanitary, and filters and such. But I gather, these days, the manufacturers are getting much better about producing units that really are more low-maintenance than in the past.

Although I didn't have any sinus surgery in Thailand, I did run into one BKK sinus doc who does those surgeries at BNH Hospital on Convent Road near Silom with whom I have been particularly impressed.... He's really knowledgeable, considered, and a good diagnostician... If you want more info, just PM me.

[jfchandler]

ConAir personal steamer...good for keeping sinuses moisturized...

[mommysboy]

wow! Chris and JF. Thanks so much. There's a lot to take in and and I'll be reading and rereading.

[Chris Lawrence]

How is your nose after the operations JF?

Another thing I have used is a teapot with warm salt water. Over a basin tip head to one side and then pour the water thru the teapot into the high side nostril, water comes out the low side nostril and vice-a-versa. Then blow the nose, cleans the nose out very well. I use a 'Fess' bottle and there packet of salt/bicarb, which is similar to the teapot process.

JF's description of the operation to the nose sounds quite updated. My process, I had about 5 metres of cotton stuck up each nostril. I remember it coming out and thinking when is it going to stop.

[jfchandler]

How is your nose after the operations JF?

Another thing I have used is a teapot with warm salt water. Over a basin tip head to one side and then pour the water thru the teapot into the high side nostril, water comes out the low side nostril and vice-a-versa. Then blow the nose, cleans the nose out very well. I use a 'Fess' bottle and there packet of salt/bicarb, which is similar to the teapot process.

JF's description of the operation to the nose sounds quite updated. My process, I had about 5 metres of cotton stuck up each nostril. I remember it coming out and thinking when is it going to stop.

About the surgery outcome, certainly the original surgery to correct the deviated septum did exactly what was intended -- corrected an anatomical flaw that I'd had for my whole life as best as I know -- that being a totally blocked sinus on one side due to a curvature inside my nose.

What the original surgery didn't adequately do was clear out the upper sinuses of all the accumulated junk that was clogging them up inside. Upon the second surgery about a year later with a different doctor, he showed me afterward a photo of all the "stuff" he had pulled out of my sinuses, and it was quite a tidy pile of mucus, etc...

As far as the general outcome is concerned, I think surgery is a clear call for cases of significantly deviated septum. To the best of my knowledge and understanding, nothing else except surgery is going to remedy that particular problem -- as was the case in my instance.

For other things, I think the longer term outcome on sinus surgery is mixed. Usually, it's SOMETHING that is causing the problem in your sinuses.... allergies, hereditary stuff, physically small sinus openings, or whatever. The surgery will open your sinuses and change the physical layout. But it won't necessarily solve allergies or other things that may be causing your problem. Surgery to open and clear the sinus cavities may make drainage more effective and efficient.

But it also disrupts the interior sinus tisssue and at least temporarily (maybe permanently) damages the muscosal lining of your sinuses. For things other than deviated septums or polyps or other anatomical corrections, I'd say sinus surgery would generally be considered the last resort -- after all other kinds of treatments have failed.

In my case, I had the surgeries, and while I felt better, I still didn't feel good and healthy. At one point, in the aftermath, a sinus doc suggested I go for a comprehensive round of allergy tests, which I'd had as a kid, and which showed I was allergic to dust, cat dander, weeds, etc etc. as I already knew.. But when I actually had the new tests as an adult, those showed I also had developed significant food allergies to wheat, barley malt, soy, and some other things -- of which I had no idea at the time.

In the ultimate irony for me, one of my sinus docs in Los Angeles had been telling me to avoid milk products because supposedly those contribute to sinus congestion. To this day, I can't figure whether that is a scientifically proven fact or not. But based on that advice, I'd been drinking and using soy milk instead for a couple of years, and feeling miserable all the while. And it turned out, based on allergy tests, that soy was one of the thing I had become most allergic to. And as soon as I ceased eating anything soy, a lot of my symptoms, including rashes on my skin, went away.

So overall, it was only after I then modified my diet to avoid those things I had tested allergic to that much -- but not all -- of the sinus symptoms began to lessen. To this day, I'm not entirely sure, but I believe the MANY repeated rounds of antibiotic treatments I had in the prior years trying to resolve sinus infections led to an overgrowth of something called candida, a kind of yeast that can cause serious food and other allergies. And frankly, western doctors are pretty clueless about this entire topic.

Having fought my way thru this over the past five years, I've of the opinion that most sinus doctors are pretty worthless. They most often only have two answers -- either prescribe antiobiotics in an attempt to cure the problem, or suggest you have sinus surgery -- which may or may not resolve your problem as mentioned above. Far to few seem to take any time or interest to get to the bottom of what actually is CAUSING the problem. And if they don't do that, then, chances are they're also not finding a solution.

Having gone thru it all, I think each person needs to take responsibility for their own health, and not just listen and accept the standard advice you will hear from doctors. If they recommend something, ask WHY they are recommending that. And how do they know that will solve your problem. And do they really know what is causing your problem. And if they say they do, ask, on what basis to they claim to know. Or are they just guessing.... Only by doing that are you likely going to have a good result.

[jfchandler]

About the subject of sinus irrigation, that seems to be one of the most universally accepted and recommended things to do...for anyone with sinus problems. And indeed, there are many ways of trying to accomplish that task. Generally, two or three times a day is recommended, usually using about 16 oz. or two cups of hot/warm water, with an added teaspoon of non-iodized salt and a pinch of baking soda mixed in.

The technique I have found to work best for me is one I found in the U.S....that involves using a standard electronic Water Pik device used for cleaning your teeth, combined with a different irrigator tip called a "Grossan" tip named after the sinus doc who invented it (a guy I still see in Los Angeles. (If anyone's interested, just do a Google search under Grossan and you'll find out about it). Basically, it's just like a Water Pik tip except it has a larger, rubber cone at the end designed to fit into the opening of one nostril.

You put the saline solution in the Water Pik device basin, place the tip of the irrigator up against your one side or your nose, and turn it on. The Water Pik machine then shoots the saline solution up into your sinuses on one side and then it naturally drains out on the other open side. Supposedly, the vibrating/pulsing action of the Water Pik unit does a better job of washing out the gunk from the inside of your sinuses. And having tried many different methods, I personally have found this to be true. Nothing else works as well for me.

No pain, no discomfort, it's actually something I've come to enjoy, and I know it helps keep my sinuses clear, because I can see the stuff that washes out in the water when I let it drain into a bucket on the floor below where I am sitting when I do this.

[Chris Lawrence]

Thanks JF. I relate to what you have described.

Regards

Chris

[mommysboy]

Well maybe it's just a break in the clouds, but this is the third time I have got out of Bangkok and found my nasal problems reurn to a normal level, I say normal because it appears to me nearly all my family and friends seem to sneeze, have runny noses, or puffy eyes to one extent or another, and actually at the moment I am the least affected.

I still want to avoid that hellish experience of a blocked frontal sinus, which for me seems just being unfortunate enough to have narrow openings. But I'm very much in agreement about surgery not necessarily being the right option.

[Lost in LOS]

anyone know where to get a water pic and the sinus attachment in pattaya or thailand? had one in america but left it there because of the 110/220 issue. should have brought it here

[jfchandler]

I haven't seen one here yet, but haven't really been looking, since I brought mine (actually two, one to use and one as a reserve model just in case) from the U.S.

I simply use it/them with a small 300 baht, 100 watt capacity 110/220 voltage converter... Works fine.. no problems..

I'll take a look around when shopping and see if I spot any here, but I'm not optimistic based on the things I've typically seen in the stores here.

Alternatives would be to retrieve your one from the States, or order one and have it shipped here. I always used to buy my Water Pik units at Target stores, usually for around $30-$40. The model I use with the separately purchased Grossan tip is the WP-60W. Very durable and long-wearing...

[jfchandler]

A little checking produced some surprises....

WaterPik apparently has an official distributor in Thailand.... it seems...

Thailand

Distributor Name CONICE ELECTRONIC CO LTD

Telephone No. 662 277 6912

Address NO.4 SOI VIBHAVADI RANGSIT 2; JUNCTION 2,

DIN-DANG, BANGKOK 10400, THAILAND

http://www.waterpik.com/distributors/inter...onal-users.html

Also, I see some other potential resources for this...

http://www.dentajoy.com/waterpik.asp

http://astore.amazon.com/waterpik-ultra-dental-water-jet-20

http://cgi.ebay.com/BRAND-NEW-WATERPIK-ULT...%3A1|240%3A1318

http://www.allergybegone.com/waterpik-wp-6...-water-jet.html

All this from a Google search... You can follow these above, or look more for yourself.