Sinus Problems

[steveb]

Having problems when sleeping at night. I get a blockage in both sides of the nose and wake up not breathing through my nose. Been to many ENT doctors but they seem to have different opinions and difficult to know who to believe. Some say have an operation ,others treat it with different kind of drugs. Anyone have sinus problems and can offer some suggestions?

[ProThaiExpat]

As a life long sufferer of sinus difficulties, including surgery and almost every medication known to man, I may be able to provide you information that may be helpful.

However, more facts need to be provided. From what you have posted, you are describing nose congestion. There are no sinuses in the nose.

Congestion of the nose is a form of rhinitis, for which there are different drugs and surgery than for sinuscitis.

Do you ever have a congested nose during the day?

Do you ever have headaches accompanying the nose congestion?

Is your nose congetion seasonal or weather related?

How do you relieve the nose congestion upon arising?

Do you ever have trouble breathing, especially during exertion?

Do you normally breathe through your mouth often?

Winging it to help you start thinking clinically about your problem, the nasal passages in the nose can be obstructed by cartilage, either because of a congential anomoly or broken noses. Rhinoplasty is the operation to clear the nasal passages in the nose and relatively cheap in Thailand. You can also have the nose reshaped at the same time if your present configuration is not to your liking. Plastic surgeons perform the proceedure best. It is covered by insurance, as the underlying medical condition is being treated. When mine was done the first time is was purely medical. The second time it was cosmetic, but the surgeon used the same medical terminology to have insurance cover a "nose job".

Sinuses are passages in the skull and an entirely different subject, it may be your problem, however, nose congestion at night is rarely caused by sinuses.

You might try the nose tapes that hold the nostrils open wider than normally to see if congestion of the passages is the problem. Sleep apnea is where you stop breathing naturally, which causes your sleep to be interrupted, but that condition doesn't seem to apply to what you have described.

I am happy to discuss further with more information in this thread or you can PM me.

[Ijustwannateach]

^One warning I've heard, though- if you get a nose job at the same time as a septoplasty- there's a slight chance that you could experience a fatal hemmorhage at some time in the future. In other words, you'd spontaneously bleed to death through your nose!

"Steven"

[Thetyim]

I am also a long term sufferer of Rhinitis.

I have been diagnosed as having a deviated septum by the thai quack.

He says the operation has a 50 per cent chance of success.

Do you know how much this sort of op. should cost.

His estimate seemed very expensive to me .

[PvtDick]

A friend of mine has been having sinus problems on and off for the past year; nothing helped, despite seeing lots of doctors.

They finally found the problem after sending him to Chula Hospital for some special type of head X-ray. The problem was a huge tooth abcess that was spreading to his sinuses. Two pulled teeth and one less abcess later, relief.

[Ijustwannateach]

I am also a long term sufferer of Rhinitis.

I have been diagnosed as having a deviated septum by the thai quack.

He says the operation has a 50 per cent chance of success.

Do you know how much this sort of op. should cost.

His estimate seemed very expensive to me .

<{POST_SNAPBACK}>

It *is* very expensive- in the low thousands of dollars, probably. I had one back the states a few years back. It did help, though- I was having 5 sinus infections a year; now I'm down to one every 2-3 years.

"Steven"

[steveb]

I now know that I am not alone with this problem. Is living in Bangkok with pollution make it worse? Also are there any alternative natural medicine out there? Are there side effects of taking medication or using nasal spray on a long term basis? One last question, are the ENT doctors here in Bangkok any good? I have seen so many of them and they all seem to have gone to the same school.

[Explorer]

Got the same problem before but lesser now

maintain some exercise, at least 10 - 20 minutes a day

get some vitamin C - oranges are good and also the vitamin C tablets

avoid drinking with ice, drink warm water or hot drinks

and hopefully all this help as it does to me

Explorer

[Sheryl]

If you're living in Bangkok, that explains it. I had the same problem until I moved away, and so do many people, both Thai and farang.

Buy an air purifier for your apartment, especially your bedroom.

Keep the filter of your a/c clean. If you work somewhwer with A/C, check that filter too.

If you can tolerate it, a mask when out on congested streets is helpful. And do the best you can to stay off the streets at rush hour when the air is thick with exhaust. For same reason, no tuk-tuks or open-window buses.

As for the safety of nasal sprays -- nasdal decongestants are not safe for long term use but antiinflammatory sprays (usually some form of corticosteroid) are OK.

If you haven't yet, try Zyrtec 1 tab at night (available at any pharmacy). Can be taken long-term.

Your problem probably doesn't involve the sinuses unless you have had an Xray shwing fluid levels in the sinus and/or have headaches over the sinus area (forehead/below the eyes) and fever. More likely it is just nasal inflammation due to chronic irritation from the Bkk " air" , or possibly something else you are allergic to, either in your home or workplace. In which case there are only 2 things which can be done:

1) Cure it by getting away from the source of the problem (leave Bkk or identify and avoid the allergen)

2) Treat it symptomatically as described above -- Zyrtec and if necessary anti-inflammatory nasal spray.

There are perfectly finer ENTs in Bangkok, problem is that there isn't much they can do beyond tell you what I just did. Assuming you've had a thorough evaluation (including a good look uop your nose and sinus films) that ruled out strucural problems, no need to search further. If you HAVEN'T had such a work-up then go to the doctor search engines on the web sites for Bumrungrad and Samitivej hospitals and select an ENT who is board certfied in the U.S.

I now know that I am not alone with this problem. Is living in Bangkok with pollution make it worse? Also are there any alternative natural medicine out there? Are there side effects of taking medication or using nasal spray on a long term basis? One last question, are the ENT doctors here in Bangkok any good? I have seen so many of them and they all seem to have gone to the same school.

[frequentatore]

Buy an air purifier for your apartment, especially your bedroom.

I use one. Much better sleeping!

I used to buy Sinutab (from the US) but they don't sell this medication in Thailand anymore...

Explorer also mentioned some vitamin C: I drink a glass of protein (a powder) mixed with some vitamin C in the morning. Got rid of my sinus infections (nasal discharge) and allergies (sneezing) with the air filter and extra proteins.

[haha]

when I first came to bangkok, I remember waking up in the middle of the night experiencing bouts of not being able to breath. after much experimentation, I came to the conclusion that it was due to the smog in the air.

....I know it is the smog because when I go to pattaya, I don't have the breathing problems.

with further experimentation, I found that if I lived near the traffic, then, I needed to live above the 8th floor to avoid getting problems with breathing.

to do your own experiment using yourself as a guinea pig, go to a hotel near the traffic, rent rooms at different floors, and just be aware of breathing problems while you sleep. get a cheap hotel to do the experiment because the rooms won't be air tight.

after much observation, I also found out that there are certain areas in the city where the smog doesn't collect. in these places, you can live on any floor of the building. ...sukhumvit soi 12 is one of those neighborhoods.

everybody is different, so you need to find out how sensitive you are to the smog. instead of the 8th floor, you may need to live in a place higher than that. some people are so strong, they can tolerate any amount of smog. they are lucky.

nowadays, before I go to sleep, I look out my window to see how the smog condition is. ...when the air looks "red", expect the worst. when it is clear, I know I will breath easy that night.

I know. you are asking, "knowing what you know, why do you live in bangkok?" to which I answer, "I like big cities, and the variety of things to do that they offer."

hope this helps...

[Kathe]

If you're living in Bangkok, that explains it. I had the same problem until I moved away, and so do many people, both Thai and farang.

Buy an air purifier for your apartment, especially your bedroom.

Keep the filter of your a/c clean. If you work somewhwer with A/C, check that filter too.

If you can tolerate it, a mask when out on congested streets is helpful. And do the best you can to stay off the streets at rush hour when the air is thick with exhaust. For same reason, no tuk-tuks or open-window buses.

As for the safety of nasal sprays -- nasdal decongestants are not safe for long term use but antiinflammatory sprays (usually some form of corticosteroid) are OK.

If you haven't yet, try Zyrtec 1 tab at night (available at any pharmacy). Can be taken long-term.

Your problem probably doesn't involve the sinuses unless you have had an Xray shwing fluid levels in the sinus and/or have headaches over the sinus area (forehead/below the eyes) and fever. More likely it is just nasal inflammation due to chronic irritation from the Bkk " air" , or possibly something else you are allergic to, either in your home or workplace. In which case there are only 2 things which can be done:

1) Cure it by getting away from the source of the problem (leave Bkk or identify and avoid the allergen)

2) Treat it symptomatically as described above -- Zyrtec and if necessary anti-inflammatory nasal spray.

There are perfectly finer ENTs in Bangkok, problem is that there isn't much they can do beyond tell you what I just did. Assuming you've had a thorough evaluation (including a good look uop your nose and sinus films) that ruled out strucural problems, no need to search further. If you HAVEN'T had such a work-up then go to the doctor search engines on the web sites for Bumrungrad and Samitivej hospitals and select an ENT who is board certfied in the U.S.

I now know that I am not alone with this problem. Is living in Bangkok with pollution make it worse? Also are there any alternative natural medicine out there? Are there side effects of taking medication or using nasal spray on a long term basis? One last question, are the ENT doctors here in Bangkok any good? I have seen so many of them and they all seem to have gone to the same school.

<{POST_SNAPBACK}>

<{POST_SNAPBACK}>

I used to have the same problem, the first years in Europe. Went to many doctors and got many treatments. Thought i had sinus but I got allergy. Understand how terrible it is , when you cant breath. I let all the carpet away and I cant eat too many citrus fruits as Kiwi or oranges. I cant eat Nam Prik or glutamate. If it's worst you can take the Carythyn or Zyrtec. Outside is hot and inside the cool or cold room with AC is dangerous too. Keep yourself warm. Hope you feel better soon !

[bangkokian]

INHALE ESSENTIAL OILs such as rosemary. If you are pregnant or have hi BP, use a relaxing essential oil such as rose and chamomile, or citral and spicy ones for moderate stimulation. A deep inhalation of EO will get enough Eo molecule to your sys.

[Pink Mist]

horseradish and garlic pills if you can get them, a natural remedy and they take about a week to kick in.

[toastwars]

Get rid of the A/C copletely, that will be the main cause

[bangkokian]

Good idea about horseradish--They are in some mustard sauce you can get at the supermarket. My brother takes these really good garlic pills with GMP certificate and all, but they are expensive--better go for real fresh garlic.

[cathyy]

Get rid of the A/C copletely, that will be the main cause

That will work if you never cleaned the filter on the A/C and it's spewing out allergens instead of filtering them out. A better solution is to just clean the filter or even replace it so it will again be cleaning the air.

I'm surprised nobody has mentioned sinus irrigation yet. It works wonders for nasal and sinus problems. It rinses out pollen, dust, fine pollution particles, and snot. I do mine daily, using a special attachment for a Water Pik that slows the water flow. I use bottled water in Thailand, not tap water. The recipe my allergist gave me was 5 grams of sea salt and 2.5 grams of sodium bicarbonate (baking soda) per cup of water. There are also little pots called neti pots you can buy to do sinus irrigation. I used to suffer from chronic allergy-triggered sinus infections, but now I only get one if I forget to irrigate. Google on "sinus irrigation" for all the info you ever wanted!

[PETERTHEEATER]

I too am a long term sufferer of nasal problems. Yes, many problems with obstructed nasal passages are caused by allergic reactions from air pollution, pollens, animal dander and so on.

The condition described may be caused by nasal polyps. These are (usually) benign growths the size of peas which develop on the mucous mebranes inside the nose and, eventually get to a size which restricts or blocks the passage on one or both sides. A sufferer may find that when lying down he gets some relief because gravity causes the polyps to hang back. Breathing in through the nose is usually possible except in really bad cases but, breathing out through the nose the polyps act like a one way valve and air pressure forces them to block the nose.

Treatment is initially by medication in tablet form CORTICOSTEAROIDS which should be taken under doctors prescription, however, this will often only shrink the polyps temporarily in which case surgery (POLYPECTOMY) may be required. This is a general surgical procedure which would need hospitalisation for around 3 days.

If your desparate, try PREDNISOLONE 5mg tablets (ask at your Pharmacy for the local generic equivalent) Read the instruction sheet thoroughly. A typical regime would be 4, 4, 3, 2 & 1 over 5 days. This should shrink them down then use a nasal spray such as BECONASE or FLIXONASE therapautically every day to keep them at bay.

Nasal sprays sold as relief for blocked nose should not be used long term on polyps as they cause rebound, a condition in which the problem gets worse instead of better.

hope this helps

[jaloochapurr]

I have had the same problems. sinus blocked and with head aches.

I have found relief in yoga and inhaleing a salt water combonation through my nose.

first mix a teaspoon of salt water with 8 ounces of water. breath the water salt combination through your nose deeply. at the chinese store at Warut you can find a device to help. after this do deep yoga breathing for at least five munutes.

if really need help with yoga visit the sunshine house on soi 4.

good luck the yoga breaths realy do help

[bangkokian]

Good to be reminded of the saline nasal wash. There's this really unconventional method in which they poke some stick in your nose and get your nose running with pain. I don't think there was any blood, and I suppose it did help me as I never suffer such bad nasal congestion again. I don't think there was any blood, but the pain was excruciating. The guy who did it for me when I was just a kid had some sort of certificate hanging in his house-cum-clinic. He gaurantees the result for life. He said when he passes away, his son will do it on his behalf.

I don't know if he deformed my nose a bit or not, but it still looks o.k., and better than somone I know who had an operation--her nose is noticably deformed. Any way, noone can really gaurantee anything la....

....So better go for the yogic breathing, nasal cleansing, essential oil therapy, steam therapy, infrared therapy and perhaps accupuncture, sauna therapy, and osteopathic manipulation.

Best of Health,

Bangkokian

[daxbr]

Good to be reminded of the saline nasal wash.  There's this really unconventional method in which they poke some stick in your nose and get your nose running with pain. 

(...)

Best of Health,

Bangkokian

<{POST_SNAPBACK}>

There is no reason to go to such extremes. I had the same sinus problem and the following procedure took care of it completely:

- buy saline solution in any drugstore

- buy syringe

- fill syringe with saline and empty it into a nasal cavity

- clean up your nose

- repeat a couple times a day

Pardon me for this nasty description but it works 100%. It was recommended to my by Bumrungrad doctor.

[Rainmon]

I have had sinus problems for 15 years, just started all of a sudden on Sept day in Dallas when i could not stop sneezing. The doctor gave me a steroid cocktail injection which was fantastic and was a temporary fix.

Then it progressed to sinus infections about 3-4 times a year, now after moving to Bangkok and living here for 5 months I've had 2 sinus infections. The last one which i am still fighting now for 2 weeks, causes jaw area swelling as well as the usual face, eye and fore head preasure.

Have tried everything, now I am going back on a daily beconase steroid spray, saline water irrigation, allergy tablets and moving out of Bangkok seems to be the best solution.

Just wondering if anyone else has had the lower face jaw area or upper neck swelling with this condition, I have not had this area swell before so much?

Good to be reminded of the saline nasal wash.  There's this really unconventional method in which they poke some stick in your nose and get your nose running with pain. 

(...)

Best of Health,

Bangkokian

<{POST_SNAPBACK}>

There is no reason to go to such extremes. I had the same sinus problem and the following procedure took care of it completely:

- buy saline solution in any drugstore

- buy syringe

- fill syringe with saline and empty it into a nasal cavity

- clean up your nose

- repeat a couple times a day

Pardon me for this nasty description but it works 100%. It was recommended to my by Bumrungrad doctor.

[FBN]

Good to be reminded of the saline nasal wash. There's this really unconventional method in which they poke some stick in your nose and get your nose running with pain.

(...)

Best of Health,

Bangkokian

There is no reason to go to such extremes. I had the same sinus problem and the following procedure took care of it completely:

- buy saline solution in any drugstore

- buy syringe

- fill syringe with saline and empty it into a nasal cavity

- clean up your nose

- repeat a couple times a day

Pardon me for this nasty description but it works 100%. It was recommended to my by Bumrungrad doctor.

The nose contains some erectile tissue and when this gets congested, a blocked nose results. This is usually posture related. Worse when supine, no problems during the day when upright. There is a condition called "vasomotor rhinitis" which may occur as a result of an allergic condition or long term or overuse of nasal decongestants.

I quoted the "unconventional" method above as it may actually cure this condition as it causes trauma to the erectile tissue with sclerosis and thus prevents it from swelling again. It is recommended though that this procedure be done under proper conditions by sclerosing injection only after appropriate investigation and diagnosis by a qualified ENT..

The saline rinse does work and is useful with sinus problems.

[astral]

I too have had sinus problems, with congestion and infections for the last 55 years.

The various drug and natural cures mentioned may bring you some relief and should be tried.

Particularly the washing with salt water. The pharmacy will have spray cans available, the one I used is named Tonimer.

In my case part of the problem is allergy, so a regular dose of Clarityn helps, available at the pharmacy.

Around 15 years a CT scan showed that I had a deviated Septum so the Dr did a Septoplasty.

There was some improvement but not as much as hoped for.

I struggled on, until last year when a new doctor recommended Functional Endoscopic Sinus Surgery

Basically he went inside and reshaped the passages and openings to the sinuses.

The improvement has been tremendous.

I have regained my sense of smell, my sinuses drain, and I even got through a very bad cold in the nose

without getting an infection.

My insurance company paid, despite Allergic Rhinitis being on the pre-existing conditions.

[mommysboy]

Sheryl writes :

"If you're living in Bangkok, that explains it. I had the same problem until I moved away, and so do many people, both Thai and farang"

And I couldn't agree more.

If you tend not to have such a problem outside Bangkok the likelihood is you do not have much of a problem at all.

I guess I'm a Bangkok pollution veteran of sorts. At one point I suffered quite marked symptoms including painful bouts of blocked sinuses.

So I think this info (much of it gleaned from TV health boards) is pragmatic:

1. Reduce exposure to smog by spending less time 'on the streets' so to speak. Never walk in a built up area for more than 5 minutes without protection.

2. Use a mask - Cheap ones available at bike/motor bike shops and in Lotus for instance (try to get one impregnated with charcoal).

3. Nasal rinsing. I use saline solution available in a squeezy bottle-it's the same stuff that people with contact lenses use.

4. Hot showers- train water on back of head.

5. Ice on sinus areas - can be very relieving for me and even help drain sinuses. Just put a dozen or so ice cubes in a plastic bag. Particular relief points are at the corner of the eyes, just under brow and side of nose. Be careful not to apply to eyeball obviously. Also very good at back of neck and across head if your sinus pressure is causing clenched muscles.

6. 2 hours more rest than you usually have - works wonders.

7. Regular indoor exercise.

8. Light air conditioning only.

9. Beer (not with prescription meds).

Medical solutions:

1. Antibiotics under medical supervision.

2. Nasal steroid under medical supervision. I used nasocort and very good it was too.

3. IMHO anti histamines are next to useless for non allergic rhinitis, but the older style ones may help you to rest.

The ultimate cure is to leave Bangkok

In the provinces my problem goes, despite having a deviated septum and narrow nasal passages. It's not that Bangkok air is so dirty, it's just that there are so many agitating factors.

I decided against surgery.

[Rainmon]

Thanks for your input Sheryl, now if I can find someone to sublet my large studio apt near Thong Lo, I am outa here... Paul

Sheryl writes :

"If you're living in Bangkok, that explains it. I had the same problem until I moved away, and so do many people, both Thai and farang"

And I couldn't agree more.

If you tend not to have such a problem outside Bangkok the likelihood is you do not have much of a problem at all.

I guess I'm a Bangkok pollution veteran of sorts. At one point I suffered quite marked symptoms including painful bouts of blocked sinuses.