Sinus Problem

[robblok]

I have a blocked nose during the day or night. Either one side or both sides of the nose. I think it has happened because i used too much nose spray in the past. I have stopped this completely now. Been a few weeks now and it does not seem to clear completely did get better.

The nose is either bloked on one side or half blocked and a free other side or both sides half blocked. Sometimes one side full blocked (changes sides)

It has been like this for a few months now and i start to get anoyed.

- Tried antibiotics a pharmacy gave me (claron claritromycin)

- Nasolin (anty histamine

- Nasal rinsing with saline

Recently did a blood test white bloodcel count normal but at the low end (no infections)

I read online a bit about my problem and think that my only option is steroid nasal spray. I am willing to go to a hospital to get either that or pseudo ephedrine (the stuff you cant get at a pharmacy anymore). Question is steroid nasal spray available in Thailand and at hospitals.

[chiang mai]

Perhaps consider an x-ray to see if the sinus is truly blocked and to what extent, and/or, a short and painless exam of the sinus using a scope to see what's going on, both are inexpensive procedures.

[robblok]

Perhaps consider an x-ray to see if the sinus is truly blocked and to what extent, and/or, a short and painless exam of the sinus using a scope to see what's going on, both are inexpensive procedures.

Thing is they are not really blocked.. one day one side is clogged the other day the other side. Its not really the sinus but the nose itself. The membrane in the nose (that is what the nose spray works on shrinking it)

[meatboy]

my mrs suffered badly in the uk and since we have moved to los she have used many nasal sprays with not good results however she managed to get some clarityne* loratadine which helped a lot.168bht for 10tabs.imported by schering-plough bkk.manu.in indonesia.

[zzdocxx]

There's an idea Rob, MB is suggesting an antihistamine.

Have you tried that yet?

[pistachios]

I've had a clogged sinus for 2 months now. That's super annoying. I must use a box of kleenex a day.

When you say it isn't a sinus issue, well it's hard to say because what is piling up in the sinus ends up eventually clogging the nose.

Doctor after 3rd visit thinks it's a bacterial infection that resist to standard antibiotics.

So right now he's giving me stronger antibiotics by daily shots, with anti-inflamm and anti-histamin on the side. Let's hope he's right this time.

He also advised to sleep without aircon or with aircon+humidifier. Saying dry air from the aircon is making the nasal secretion thicker and harder to expel.

I've also read on internet that some kind of device "neti pot" can be used to rince sinus. He says he should be very useful but I haven't found it in a pharmacy yet. Another option is to use a syringe to throw some saline solution up there but somehow i'm a bit reluctant do try it.

I think you should check with a doctor instead of trying various automedication. If you have an infection it's not going away with just a nasal spray.

[robblok]

There's an idea Rob, MB is suggesting an antihistamine.

Have you tried that yet?

Yes i tried it.. noted it in my first post.

[robblok]

I've had a clogged sinus for 2 months now. That's super annoying. I must use a box of kleenex a day.

When you say it isn't a sinus issue, well it's hard to say because what is piling up in the sinus ends up eventually clogging the nose.

Doctor after 3rd visit thinks it's a bacterial infection that resist to standard antibiotics.

So right now he's giving me stronger antibiotics by daily shots, with anti-inflamm and anti-histamin on the side. Let's hope he's right this time.

He also advised to sleep without aircon or with aircon+humidifier. Saying dry air from the aircon is making the nasal secretion thicker and harder to expel.

I've also read on internet that some kind of device "neti pot" can be used to rince sinus. He says he should be very useful but I haven't found it in a pharmacy yet. Another option is to use a syringe to throw some saline solution up there but somehow i'm a bit reluctant do try it.

I think you should check with a doctor instead of trying various automedication. If you have an infection it's not going away with just a nasal spray.

Thing is i dont have a runny nose. Just a clogged nose because of a swollen membrane. ALso i had blood tests done and i have no infection (white bloodcell count confirms this)

I did no self medicating.. i went to a pharmacy and described the problem. They came up with the medication. Now after studying on the internet i found out that i problably have a problem with the nose membrane or however its called because i have used too much nose spray in the past.

So before going to a doctor to get the heavier meds (steroid nose spray) i want to know what is available.

[cmsally]

I've had this off and on now for the past two years so have tried pretty much everything. First went the antibiotic route and got worse, so gave that up. Tried the antihistamines also made it worse. Got lots of exercise and regular sleep with always hot shower before bed - big improvement. But schedule not always flexible and stress makes it worse.

The blocked nose feature which shifts from side to side is your turbinates swelling, this they do alternately throughout the day. If it feels blocked, chances are they are already a bit swollen to start with . Exercise (has to be hard enough to get the heart rate up) will shrink the turbinates, hence after a bit of exercise you'll probably find some "stuff" churning around in the system- sinuses and throat.

Aside from exercise I have hit mine with a regimen of all kinds of things including sinus rinse, chinese medicine, exercise, eucalyptus oil, olbas oil, vicks, yoga breathing exercises and accupressure.

I can now say that it is about 50% better. Basically it probably took years to get like this and it will take a few to correct it. But I very rarely get a blocked nose now even one side and very rarely get rhinitis which I was at one stage getting often.

I did just over a year ago get a ct scan to see what was structurally going on and I have one enlarged middle turbinate and one much smaller than usual sinus ostia (same side). Whether this will correct itself I don't know but I do feel much better than I did about 1-2 years ago.

PS I have also used the steroid nasal sprays but use as needed. Doctors always say you need to use it every day to get results, but I find I use it maybe a couple of days every 2 weeks. I have gone 2-3 months without it, so don't believe anyone when they say you have to use it for the rest of your life unless you have surgery.

Edited June 29, 2012 by cmsally

[bluesmanwarrior]

I feel for you folks. I have lived a life of sinus hell since my youth. Allergies + deviated septum. I spend many hours a day lying on my left side, to drain the right sinus and get the pressure relieved. It is very difficult to keep open.

Have tried everything you have probably heard of for sinus remedy. There is a very skilled doctor at Bumrumgrad who diagnosed my deviated septum via CT scans and more. This was after failure in the US by incompetent physician I was stuck with. Hopefully I can someday afford the surgery I need to free me from this hell. Although I am losing hope in treating the horrible allergies I suffer from.

I keep trying Nasonex on and off. Expensive. I think it doesn't help much, but I seem a bit worse when not on it. Lately been getting temporary results from using too much Nasol I get cheap at the pharmacy. It is either that, or the feeling my eyeballs might pop out from the pressure. Thankfully, my legitimate prescription for stimulants (methylphenidate for ADHD/narcolepsy) has the side effect of vasoconstriction/decongestion, so I do not need pseudoephredrine anymore. Sudafed makes my heart race, without the benefits to my neurochemical imbalance. Yuk.

I do recommend sinus washing. Neti pots are good, but something that uses pressure is better. I have a large syringe with special bulb on the end I use. Use unrefined salt, baking soda, and purified water. Warm a cup of water (8oz/237ml) in the microwave, add either 1/4tsp(1.25ml) salt for isotonic solution. Or, I use 1/2tsp(2.5ml) for hypertonic solution. Hypertonic to hopefully kill bacteria and draw water out of the tissues - reducing swelling. I use about 1.25ml baking soda ("a pinch" is what most sinus wash recipes call for) - this buffers the pH and helps break up mucus. You can wash without the baking soda. But I find it makes it much more pleasant.

The other miracle ingredient for sinus wash is something I cannot find here in Thailand. It will kill a sinus infection more quickly than antibiotics, and more safely. It is XYLITOL, which you can see here in sugar free gums and toothpastes. I buy it cheap in bulk in the US. It is actually much safer than other artificial sweeteners, and tastes better in your coffee. It will kill bacteria in the sinus just as easily as it does in the mouth. I have found that when I add equal amount of xylitol as salt in my sinus wash - infection usually gone within a day. I really need some right now for current sinus problems. If anybody reading this knows where I can get granular xylitol in bulk, please respond.

Anyway, just wanted to share what I have learned in case it helps somebody.

[robblok]

I've had this off and on now for the past two years so have tried pretty much everything. First went the antibiotic route and got worse, so gave that up. Tried the antihistamines also made it worse. Got lots of exercise and regular sleep with always hot shower before bed - big improvement. But schedule not always flexible and stress makes it worse.

The blocked nose feature which shifts from side to side is your turbinates swelling, this they do alternately throughout the day. If it feels blocked, chances are they are already a bit swollen to start with . Exercise (has to be hard enough to get the heart rate up) will shrink the turbinates, hence after a bit of exercise you'll probably find some "stuff" churning around in the system- sinuses and throat.

Aside from exercise I have hit mine with a regimen of all kinds of things including sinus rinse, chinese medicine, exercise, eucalyptus oil, olbas oil, vicks, yoga breathing exercises and accupressure.

I can now say that it is about 50% better. Basically it probably took years to get like this and it will take a few to correct it. But I very rarely get a blocked nose now even one side and very rarely get rhinitis which I was at one stage getting often.

I did just over a year ago get a ct scan to see what was structurally going on and I have one enlarged middle turbinate and one much smaller than usual sinus ostia (same side). Whether this will correct itself I don't know but I do feel much better than I did about 1-2 years ago.

PS I have also used the steroid nasal sprays but use as needed. Doctors always say you need to use it every day to get results, but I find I use it maybe a couple of days every 2 weeks. I have gone 2-3 months without it, so don't believe anyone when they say you have to use it for the rest of your life unless you have surgery.

What you are talking about is exactly what i have. I also went the same way you did. I just read up on it and they were talking steroid nose sprays. I have no problem going to the Dr to get it.

Most days only one tube is partially blocked (was worse before). I do exercise a lot and hard too. It might help im not sure.

[meatboy]

why i mentioned clarityne was this had a good name in the uk.and was always more expensive than others she found it by chance at the pharmacy end of home fresh in the mall in korat.

[cmsally]

I have tried 3 nasal steroid sprays - Rhinocort , absolute crap didn't work at all.

Flixonase - works best for me

Nasonex - got it when Flix. out of stock but bit of a funny reaction with it and in some climates seems to make it worse.

I use the Flixonase when I feel like I might be getting an allergic reaction, sometimes daily for a few days but might not use it again for a month or more.

I have been to 3 ENT doctors and a heap of general ones. Not really much help other than explaining what kind of surgery would correct the structural problem.

I do pretty much have a theory as to how it happened (started with tooth infection) but the questions remains can it be totally reversed. Numerous doctors told me allergies , but couldn't explain why mostly on one side.

Basically my theory is infection leads to scar tissue or maybe swelling partly closing sinus ostia , therefore bad drainage putting you in a cycle of infection and basically allergic to all the gunk in your own sinuses. I feel I have greatly cleared them out but questions remains as to whether drainage will go back to normal (ie ostia open up permanently)

[robblok]

@cmsally

Are those nasal steroids on prescription or do normal pharmacies have them too.

[cmsally]

@cmsally

Are those nasal steroids on prescription or do normal pharmacies have them too.

You can find them in any good pharmacy. Flixonase is quite expensive but lasts me a couple of months or more.

You might want to try using as prescribed to begin with until you notice a fair bit of improvement then cutting down after that. I had to use in conjunction with sinus irrigation to get any decent results to begin with.

[steveb]

One thing I would recommend is turbinate reduction. It takes about 20 minutes and they use some sort of low frequency to burn and reduce the air passage,It is painless and recovery takes a week or so of having to breath through your nose while it heals.It does help and will take you off the nasal spray but it will grow back in a year or two so it's not a permanent relief, but does help. Rabvatte (not sure for spelling) at Victory Monument is excellent for ENT and low cost but it is a Government hospital so you must have a lot of patience.

[steveb]

Sorry. It doesn't reduce the air passage rather it increases the air passage for better breathing

[Tolley]

It all depends what the origin of the sinus problem is?

If it is from a cold or infection the best way is the saline solution. Forget about antibiotics and steroids sprays they can cause other unwanted problems and are not necessary.

Further to this if you can swim in the ocean everyday for a week or two i guarantee your sinus problems will clear up.

Mega doses of good quality high potent garlic work well for sinus problems also horseradish.

Sinus problem can be from allergies too like especially dairy, wheat, and yeast.

I get painful sinus problems from drinking beer sometimes.In these cases you need to look your diet.

And sinus problems can be from environment like exposure to moulds etc

Edited June 30, 2012 by Tolley

[robblok]

I think its the air passage and i think the origin is using nose spray too much in the past.

No antibiotics now because blood test show i have no infection

Anti histamine does not work

The other user who described it had exactly the same as me. Steveb too.. its not the sinus but the nose membrame or passage that is swollen. Strange is that one day my left side is blocked (not with stuff just swollen passage) and the other day its reversed.. sometimes they are both open or both blocked, in general 1 passage is open.

I use saline every day 2 times, nothing else at the moment. But almost nothing comes out. Its just a swelling not stuff blocking it.

So i really think i should go for the steriod spray or the procedure steveb describes.

[CrazyKid]

Sinus problems yes. I had 3 cat scans over as many years and the doctor kept proscribing antibiotics, stronger and stronger. I did some research and suggested this to my doctor Fluconazole nasal spray in the treatment of allergic fungal sinusitis. He told me to try it. In 3 days my problem was gone. During monsoon season I keep it handy.

[mommysboy]

Sinus problems yes. I had 3 cat scans over as many years and the doctor kept proscribing antibiotics, stronger and stronger. I did some research and suggested this to my doctor Fluconazole nasal spray in the treatment of allergic fungal sinusitis. He told me to try it. In 3 days my problem was gone. During monsoon season I keep it handy.

I had similar moderate problems for many years.

1.Nasal rinsing with salt and bicarbonate of soda has been a real blessing. You have toi be diligent maybe 3-4 times a day.

2. Beconase. Only spray I tried that really worked.

3. Fluconazole sounds interesting, never tried it, certainly a lot of mold/fungus knocking around.

Otrivin is good once in a while, but all other decongestants are more trouble than they are worth, given saline solution gives so much better results.

Good luck.

[mommysboy]

I think its the air passage and i think the origin is using nose spray too much in the past.

No antibiotics now because blood test show i have no infection

Anti histamine does not work

The other user who described it had exactly the same as me. Steveb too.. its not the sinus but the nose membrame or passage that is swollen. Strange is that one day my left side is blocked (not with stuff just swollen passage) and the other day its reversed.. sometimes they are both open or both blocked, in general 1 passage is open.

I use saline every day 2 times, nothing else at the moment. But almost nothing comes out. Its just a swelling not stuff blocking it.

So i really think i should go for the steriod spray or the procedure steveb describes.

I don't know exactly how but it's part of the natural rythm for one side to be more open/blocked than the other.

From what you say the problem is nasal irritation/swelling and this can only really be overcome by identifying what is causing the problem and then mitigating it usually through avoidance.

If you live in a city, chances are your problem is caused by smog.

I'm really surprised you aren't getting relief from nasal rinsing, consider using a stroinger solution and/or bicarb of soda.

You should not need any medical procedure for something like this which does not appear to be structural because the nostrils are clear at times.

[Chris Lawrence]

Suffered with nasal problems all my life. Have had two operations with little relief.

I agree with the nasal washes. To be affective the washes must enter at or about a 90degree angle, so you need to tip head to the side to get this affect. Specialist advised this. You can buy the nasal wash bottle and prepared salt solution at the chemist.

Recently had drops to defuse allergies. Taken over 12 months they have helped. I got these from a specialist who tested me for allergies. Allergies will interfere with nasal passages, swelling them up.

A lot of my stuffy nasal problems associated with alergies. Unfortunatly the low steriod base sprays don't work on me or the tablets. Be careful using over the counter sprays as if used for more than a few days can actually make the problem a lot worse. Use the OTC sprays as a last resort for a day or two, and then not for a week or more if you have too.

Sometimes I have to wash nasal passages out 1-3 times a day/night.

Accupunture may also offer relief, if you get a good one.

Years ago a Doctor gave me a steriod injection; had great relief for about 3 months. Doctors today don't like this form of relief as there is little in way of studies done on this.

A blocked nose that is a chronic problem is one of the most frustrating and annoying health issues one can have. It affects breathing and recovery. I had one doctor say just breath thru your mouth? he just didn't understand. Try and stick to some of the most practical suggestions; if something works stick to it. Many of the medical operations I would suggest view with caution or ask a lot of questions.

Swimming also has given me relief. Better if you can swim in the ocean water then pool water.

Try and keep treatments simple. One can spend a lot of money with little affect on this problem.

Good luck

[zkjnxzkcuwf]

Hi there,

I'd like to offer some info about my own experience since I've had sinus problems for over 10 years. I now have it mostly under control because of my research and efforts over the years.

The nasal decongestant sprays (e.g., xylometazoline or oxymetazoline HCl) often cause rebound congestion, hence I do not use them much at all. For serious blockage, I use a systemic decongestant such as phenylephrine (weaker - my preference) or pseudoephedrine (stronger). The systemic decongestants do not normally cause me significant rebound congestion but I still only use them for short periods of time.

The nasal glucocortisteroid sprays e.g., Nasonex (momentasone furotate), Flixonase (fluticasone furoate), budesonide, flunisolide, or triamcinolone acetonide all work on congestion for me, but sometimes they may not work if I have a lot of congestion. They are helpful for me and have an effect within 3 - 4 days. Tilting my head over the back of the bed for about 5 minutes helps the steroids get deeper into my sinuses.

A much more potent steroid is betamethasone sodium phosphate (Betnesol). This steroid certainly blows my sinuses wide open after a few days use. It comes in drops that can be instilled in the nose (again, I tilt my head over the bed for a few minutes to ensure the drops penetrate deeply). The problem is obtaining them in Bangkok. I have yet to find them here but perhaps Bumrungrad may have them.

What has really stablised my sinus problem is Western Herbal Medicine in the form of herbal tinctures containing a blend of effective western herbs. I use this when I need it, but I have to order it from abroad. For dry sinuses, which can often occur, Plantain and Eyebright compound has been particularly effective for me.

If you need to know more about the herbal stuff, please PM me and I will respond.

Nasal irrigation with saline regularly is also helpful.

Ylang ylang essential oil is something I also use from time to time.

Incidentally, my sinus problems mostly during damp, rainy weather.

Max

[cmsally]

http://www.yogaindailylife.org/knowledge/yoga-and-health/expert-view-pranayama-breathing-exercises-in-light-of-contemporary-science

A little bedtime reading on pranayamas which is my latest quest to see if I can reshape my inner workings with breathing exercises. I have found one exercise which is alternate nasal breathing with holding breath in between quite useful.

I see a few others have mentioned damp weather as the worst. Same for me July and August my worst time.

[mommysboy]

http://www.yogaindailylife.org/knowledge/yoga-and-health/expert-view-pranayama-breathing-exercises-in-light-of-contemporary-science

A little bedtime reading on pranayamas which is my latest quest to see if I can reshape my inner workings with breathing exercises. I have found one exercise which is alternate nasal breathing with holding breath in between quite useful.

I see a few others have mentioned damp weather as the worst. Same for me July and August my worst time.

Oh yes the weather, I've got a successful regime for all else but when the weather turns, it's like a 100% seizing up for me, and can lead to a great deal of pain.

Just keep rinsing, resting and munching painkillers I guess.

What is the best painkiller for sinus pain, anyone know?

[TallGuyJohninBKK]

To the OP and other posters...

I've had sinus problems for many years, had a couple of sinus surgeries and learned a lot about taking care of my sinuses myself, since most doctors are pretty clueless on sinus problems... That said...

The OP really needs to consult with a good sinus doc here in Thailand. There are lots of ENTs around, but having the title doesn't mean they know what they're doing. The one good competent sinus doc I've found thru the years is Dr. Pasakorn at BNH Hospital in BKK. I'd highly recommend him as someone who will actually try to get to the cause of your problem, rather than just handing out misc. antiobiotics like so many other docs do.

I've never heard of checking for sinus infections thru blood tests. The normal, accepted way is to do a sinus culture of the mucus from your nose, assuming you have that. You can either blow some out for the doctor, or he/she can use a culture swab to go up inside your nose and get a sample.

There are several different kinds of common sinus bacteria, and many different kinds of antibiotics. In addition, some bacteria may be resistant to certain kinds of antibiotics, based on a person's past history of antibiotic use. So if someone has a sinus infection, the only way to do the correct treatment is to do a sinus culture, identify the bacteria involved and its sensitivity/resistance to antibiotics, and then prescribe the correct choice.

That said, having a chronically congested nose doesn't automatically mean one has a sinus infection. There can be a variety of other causes, including anatomic ones, allergies, etc. Even green mucus doesn't necessarily indicate a bacteria infection, as green mucus can result from both bacterial infections and viral infections.

In terms of self treatment, using a facial steamer with a bit of eucalyptus oil added is a good way to help drain one's sinuses of congestion. I do that along with following that up with saline rinsing of my sinuses. You can use a Water-Pik type electronic unit with a special tip for sinuses that pulses its water flow, or use a specially tipped syringe for that purpose, or the Neti Pot approach for a more gentle flow. Be aware, lately, in another thread here, someone posted about a report from the U.S. about some people contracting a rare and serious infection from saline rinsing with water. So the advice was to use distilled or boiled water for that purpose.

Xylitol is a artificial sweetener that studies have shown has the ability to inhibit bacterial growth. I've used and tried it in the past. But it didn't seem particularly helpful in terms of cleaning out my sinus congestion. That said, it is available in bulk 5 kg bags from a importer/supplier in BKK out beyond the On Nut area... I've purchased from them several times in the past and they pretty much only speak Thai. Call and order a day or two ahead, and then go to pick up from their office. But I can't find my past invoices here at home right now. I think I found them originally from another post re Xylitol here on ThaiVisa.

What I have found to be much more effective in helping clear my sinuses is a liquid product that I haven't found available anywhere in Thailand, so I ship it over from the U.S. in 16 oz. bottles. It's called Alkalol. The company and many users recommend using it as an additive to saline rinsing. But I've found it works better for me by using the Alkalol solution in its undiluted form, laying down on my bed with my head hanging off the edge face up, and then using a pair of 3 ml syringes without needle to squirt that amount of Alkalol solution into my sinuses where it stays by gravity and soaks into my sinuses... Wait 10 to 15 minutes and then go to the bathroom to blow the solution out of my nose. That has really worked great for me.

The various nasal sprays are another treatment method... But their use has various limitations and drawbacks. And whether they're going to be effective and useful at all depends on the root cause of the OP's problem. And that's what brings me back to the original and overriding suggestion to consult with a competent sinus doc for a correct diagnosis of the problem in the OP's case.

[robblok]

Ok update,

I keep on rinsing with salt water (bought in the farmacy), i also use Nasonex now for 3 days. I see improvements. Now one side is always full open en other side sometimes full sometimes partial and sometimes blocked. But mostly open half. So i will see how it goes if i continue this way. I am not using otrivin anymore. I really think that over use of this has caused the problem.

I read that it could give your own body problems with regulating the swelling in the nose membrame.

I don't think i got a sinus problem but a problem with the nose membrame being swollen too much. I think its irritated.

[cmsally]

Ok update,

I keep on rinsing with salt water (bought in the farmacy), i also use Nasonex now for 3 days. I see improvements. Now one side is always full open en other side sometimes full sometimes partial and sometimes blocked. But mostly open half. So i will see how it goes if i continue this way. I am not using otrivin anymore. I really think that over use of this has caused the problem.

I read that it could give your own body problems with regulating the swelling in the nose membrame.

I don't think i got a sinus problem but a problem with the nose membrame being swollen too much. I think its irritated.

I think it sounds more like a turbinate problem. These apparently can swell a great deal. Otrivin is a kind of decongestant which can play havoc if you take them a lot. I haven't used them apart from when the problem started and I knew almost nothing about it.

It sounds like the half open side is the problem side, that's just my opinion from my experience.

In the last couple of months my sinuses have improved greatly, the only new things I've done being pranayamas and olbas oil.

Its not the same as eucalyptus which I've used before. For me olbas oil really whacks it out and widens things for easier nose breathing. The breathing exercises also help a lot.

[robblok]

Just bought that oil on ebay with an steamer. Will see how that is going to work. Anyway there is improvement.

I agree with your turbinate problem, its hard for me to discuss medical stuff in English. My normal English is good enough but i don't use medical terms that much in general. I do know them in my own language but.

Its certainly the Otrivin that caused this. So im staying away from it.