Sinus Problem

[TallGuyJohninBKK]

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.

Overuse of various kinds of nasal sprays can cause what's called the "bounceback" effect, where using them for too long actually causes your congestion to worsen. That's part of the reason why a lot of the sprays are only recommended for short-term, not chronic use.

But more broadly, you really don't want to be choosing and using these things on your own, or on the recommendation of some Thai pharmacist, who likely has little or no real knowledge of the details of such sinus issues. As I said above, go and find a competent sinus doc who can evaluate your problem and recommend the appropriate treatment.

BTW, I should add, for home-based self treatment, I've found that using a two-step process of steaming following by rinsing/cleaning works best.

When I wake up in the morning, I have congestion/mucus in my nose... But it's relatively thick, not runny. So steaming first helps loosen things up and allows me to successfully blow my nose to remove some of the mucus and begin to clear my sinuses.

But then, once it's loosened up, a following up Akalol soaking or saline rinsing does a much better job of thoroughly cleaning my sinuses... vs. just rinsing only without steaming first.

That's a regimen I perform twice daily...once in the morning upon waking and once at night before sleeping.

Edited July 5, 2012 by TallGuyJohninBKK

[tinfoilhat]

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.

going to a pharmacy and buying whatever they recommend is the very definition of self medicating

[saengsureeya]

Great, I'm not the only one.

For me it started 2 years ago and since then I keep my air-ways clear by using Otrivin.

Sometimes 2 times per day, but at least once a day (before bed-time).

All posts are valuable; a lot of solutions, but also a lot of different problems as well as causes.

I suppose that a visit to the doctor won't do no harm.

[cmsally]

A visit to the doctor is always advised. But the doctors literally were no help other than confirming it was all sinus related and looking at the CT results. The doctors loaded me up with anti biotics which made me worse and decongestants. It was only after multiple visits I got the nasal steroid and it was an option for me to get the CT scan which I took. After all that it was really get the surgery one recommended, although on a second opinion another ENT said not to hurry and get my allergies sorted out (what allergies? I don't know) first.

So that's when I started to do all the research and bombard it myself, but you are right best to check that it is not something more serious first. But if you are suffering from sinusitis a lot of it is a self help route.

Don't discount the self help method because in 2 years I have 90% recovered from what was a debilitating illness. I had all kinds of symptoms for a while that even put me in hospital twice.

[TallGuyJohninBKK]

CMS, I agree with your comment above to a certain extent. There are A LOT of ENT doctors in Thailand and elsewhere who are simply terrible at properly assessing and treating sinus problems. They don't bother to get to the real cause of the problem. Just hand out misc. antibiotics and decongestants off their standard list, and out you go. That's just poor medicine.

On the other hand, there are at least some good sinus docs, and one I recommended above, who know what they're doing and will advise the proper and best treatment based on the real circumstances at hand after performing the correct diagnostic tests/procedures.

The issue is not whether or not to seek the guidance of a good sinus doctor. That's without debate. The issue is to FIND a good sinus doc to guide your treatment among all the lousy ones out there.

Some/many things the sinus sufferer can do on their own and at home, as we've discussed above. But some things require the involvement of a good sinus doctor, and one of those is getting the proper and correct diagnosis of a person's actual problems.

That's not something you or I or some Thai pharmacist is likely able or qualified to do.

[mommysboy]

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.

I don't think you should be using nasolin either, same problem.

Instead, try beconase altogether much safer but it takes a few days to kick in.

Personally, I also use sodium bicarbonate (bicarb) with the saline solution, for me it makes a difference.

How are you rinsing your nose?

[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.

I don't think you should be using nasolin either, same problem.

Instead, try beconase altogether much safer but it takes a few days to kick in.

Personally, I also use sodium bicarbonate (bicarb) with the saline solution, for me it makes a difference.

How are you rinsing your nose?

Nasolin is totally different its a steriod nose spray it does not work the same way at all. I dont even feel Nasolin shrink my nose membrane, while with Otrivin it certainly does and comes back with a vengance.

I use saline (bought at a pharmacy) so its not contaminated heard bad things about bugs getting in the brain and such. I just put saline in one nostirl and blow it out the other. Holding it there first for a while.

[cmsally]

To get a decent sinus rinse you have to get a fair amount of saline going through. If you can't get a neti pot , there are the sinus rinse kits which you can find in pharmacies (only abroad as far as I have found). They have a special bottle provided. I got mine in Boots in the UK.

If you are without either, then you can improvise and use a tomato ketchup bottle ( I mean the plastic squeezy refillable ones - not the glass Heinz kind!!!!). They work just as well and cost only a few baht.

Then just look up what you need to do on Youtube!

[TallGuyJohninBKK]

There are a variety of methods available for sinus rinsing that provide a stronger water flow than a Neti Pot... And I prefer those..

One is to use a regular Water Pik dental rinsing electronic device coupled with a special tip made with a rubber end that's designed to fit into one nostril. Turn on the Water Pik, adjust the water flow setting, and the stream flows up through one side and down and out the other side of your sinus. Water Pik doesn't sell the sinus tips, but they're available separately online thru Amazon and elsewhere. Just have to make sure the Water Pik model you get is one that's compatible with the sinus tips.

Similar to the description above re the plastic ketchup bottles, an outfit in the U.S. by the name of NeilMed makes and sells sinus rinse squeeze bottles that likewise have a special tip designed to seal with one nostril. No electricity required, just squeeze to push the water flow. Between the two, I like the Water Pik approach better. NeilMed also makes and sells a variety of related products, including premixed salt and baking soda packets to mix with your water solution.

Some of the various sinus docs I've dealt with like the Water Pik approach because it provides a pulsing/pulsating stream of water, instead of just an flat flow... And the former is supposed to be good for your sinuses and more helpful in flushing out gunk. You do have to be careful, though, not to set the water power too high, or it will end up pushing the sinus rinse water into your ear canals (eustachean tubes) and that can cause problems including potential ear infections.

I also ordered from Amazon lately, but haven't used yet, a product called "Nasaline" (not Nasolin) that is like a big syringe with (again) a soft tip at the end designed to fit your nostril. In this product, you're just pushing the syringe plunger to push the water up into your sinuses... No electricity required. But the product claims to produce a swirling motion with the water flow...

At home, where everything is settled and easy, I'd always opt for using the electric Water Pik device for sinus rinsing. But when I travel and don't want to carry about the Water Pik unit and a power converter for Thai electricity, I'll carry along something like the NeilMed rinse bottle or something similar.

[jellydog]

Any updates on finding distilled water in BKK ? Or "dimineralized" water ? I use a Neilmed product for rinsing and I need the right water to do it safely. I just arrived in BKK and the constant AC seems to be responsible for the congestion.

Thanks for any ideas.

[mommysboy]

I had this problem for a number of years and it intensified when I started to live in Bangkok. I concur it is much more than just a stuffy nose and in my case caused terrible sinus headaches, and an intolerable jabbing pain above the eye.

Causes range from hay fever, air conditioning, the weather, immediate chemicals, and of course the blasted pollution. Sporting activities, such as swimming and diving can be a problem too, and even just exercise itself as you put strain on the upper respiratory tract system.

Just from my own experience, the 'near cure' for me was nasal rinsing using a saline solution with bicarb. I do this at least twice a day. I need not be wierd or elaborate. I tilt my head back and squirt the saline up each nostril using one of those rubber bulbs colloqually known as a bogey snatcher, and then blow through the other side. I mix and keep the saline solution in a standard beaker with a top of course. A standard ration is about a teaspoon of salt, a teaspoon of bicarb, and 1 pint of water. You'll notice immediate benefits, but the beauty is you get clearer and clearer over time. It must be done as a mater of routine and diligence.

If the cause is natural allergens, eg, pollen, a non drowsy anti-histamine is worthwhile, eg, zyrtec, loratidine.

Beconase is the only nasal spray my doctor in UK would prescribe. And it works quite well for a while, but is a temporary solution.

Avoidance is an obvious if somewhat unwelcome option.

Give the rinsing a go, don't delay!

[mommysboy]

Any updates on finding distilled water in BKK ? Or "dimineralized" water ? I use a Neilmed product for rinsing and I need the right water to do it safely. I just arrived in BKK and the constant AC seems to be responsible for the congestion.

Thanks for any ideas.

Can't you use the water from the many water dispensing machines often found outside apartment blocks and convenience stores?

[jellydog]

Any updates on finding distilled water in BKK ? Or "dimineralized" water ? I use a Neilmed product for rinsing and I need the right water to do it safely. I just arrived in BKK and the constant AC seems to be responsible for the congestion.

Thanks for any ideas.

Can't you use the water from the many water dispensing machines often found outside apartment blocks and convenience stores?

Maybe so. I had no idea chasing down distilled water was going to be such an adventure. Today I struck out at medical supply stores. One says they never have it and the other "out of stock". I've become used to the Neilmed product, but it looks like I may have to improvise, as you have done. Off to Chaing Mai soon and maybe some distilled water thereabouts.

[David006]

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

Agree 100%...convinced it is the farm environment... ie allergy to something ..pollen etc or maybe even fresh air...?

Often get, what I call a head full of mud and consequent slight giddiness... usually at night...antihistamines seem to work .

Had the beer problem too for about two years ...fricking terrible ache back of neck and ear/temple..would go away with nasal spray.(Otrivin) .not had it for a long while now though.

The bit about ocean air/swimming is certainly true..when we take a break on Phuket ...no issues not even the usual tinnitus!

Found that resort pools exacerbate it!

[ray35ty]

i think you may have a deviated nasal septum. look in the mirror underneath your nose. Do nose nostril wholes look the same. you may need an xray to confirm

[TallGuyJohninBKK]

Can't you use the water from the many water dispensing machines often found outside apartment blocks and convenience stores?

The water dispensing machines in building and on the street corners are NOT a good option for sinus rinsing water...

They often aren't even good options for drinking water, since the filtering systems often are not maintained or poorly maintained.

There was a news article posted here recently on water quality tests from these kinds of units in Thailand, and the results were pretty bad.

Better to stick to the saline solutions that can be found (sometimes) via pharmacies.

BTW, I'm not sure anyone SHOULD be using distilled water for sinus rinsing... As I recall it, the sinus doctors recommend against that, because it tends to pull minerals out of your sinuses, which isn't necessarily a good thing. Pre-prepared saline solutions or home boiled water with non-iodized salt and a bit of baking soda added probably would be better.

Edited January 5, 2013 by TallGuyJohninBKK

[robblok]

I am back, my sinus problem never really cleared. I went to an ent, i got antibiotics, that did not help. They gave me serveral kinds of nasal steriods, also did not help. Anti histamine, in the end it did get a bit less but never really cleared.

Then i went on a holliday to the south of thailand and swimming every day and it cleared, but now back in Bangkok the problem is back too. I might have gotten alergic to my dogs or something like that. Its now bad again and i bought some anti histamine.

I have a machine to help me with nasal rinsing (electronic pumping device). I hope i can get it under control a bit.

[TallGuyJohninBKK]

Sounds like you should for starters get checked by an allergist for environmental allergy sensitivities.

The improvement while in the south could have been due to environmental factors...but it also could have been due to sea water (saline water) getting regularly into your sinuses.

Allergy testing would help identify or rule out causes. But either way, two of the best remedies I've found for sinus problems are:

1. steaming for 10-15 mins. with a capful of water and several drops of eucalyptus oil, using something like a ConAir facial steamer.

2. soaking each sinus cavity for 10-15 mins. with 3 cc or so of 100% Alkalol solution, by laying on your back on the bed with your head down. Alkalol (avail in the U.S.) does wonders for clearing mucus out of your sinuses.

Make sure your air con unit filters at home are regularly cleaned and kept clean. Try to keep your home as dust-free as possible.

Get an assessment from a knowledgeable sinus doc (not just a do nothing doc who hands out antibiotics for everything) as to whether you have any structural problems with your sinuses that might be contributing to/causing your problems.

[canman]

@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.

Flixonase works for me as well. It is, I guess expensive by Thai standards but I can tell you it costs twice as much in Singapore or Australia. I always stock up when I visit Thailand. Another similar steroid spray is beconase, available in Australia but could not find it in Thailand. I think it is a differant steroid used in the two but I find them both equally effective. I suffered horribly from a sudden onset sinus problem about 12 years ago and simply could not function without a daily double shot of beconase. After a couple years I tapered the dosage off and was fine for several years. Recently I have started to suffer again so now on the flixonase and find that one shot every other day seems to work.

[mommysboy]

I am back, my sinus problem never really cleared. I went to an ent, i got antibiotics, that did not help. They gave me serveral kinds of nasal steriods, also did not help. Anti histamine, in the end it did get a bit less but never really cleared.

Then i went on a holliday to the south of thailand and swimming every day and it cleared, but now back in Bangkok the problem is back too. I might have gotten alergic to my dogs or something like that. Its now bad again and i bought some anti histamine.

I have a machine to help me with nasal rinsing (electronic pumping device). I hope i can get it under control a bit.

The dogs!!!

Logically, it is surely the air pollution, and possibly the air conditioning within your apartment/room.

If it is a borderline problem, and it sound like it is, because you don't have any problems under normal conditions, then simple rinsing 3 or 4 times a day will help, as will limiting your exposure to the outside air. Don't expect instant results from the rinsing, but over a period of time the results are profound.

I also where a light hat in bed and draw it over my nose if the air conditioner is particularly harsh.

You may also benefit from eye drops, to keep your tear ducts nice and clear.

And if you need painkillers then consider Ponstan which seems to do the trick for me.

[JDGRUEN]

OP - your nasal passage membrane lining is inflamed... it swells up and blocks your breathing - as you are well aware.

Try Pseudoephed ... http://www.prescriptiondrug-info.com/topics/pseudoephed/ ... if you can get it. It comes in long acting 12 hour caplets and gives great relief. Pseudooephed is not a cure... but will give great relief pending a more effective and different remedy. True Ephedrine (if available) works well ... but there can be side effects.

Unless you have a yellowish thick exudate running out your nose ... you most likely do not have an infection.

Use warm saline irrigation up your nose... Use the kind of saline that comes in a big plastic bottle normally used in contact lens / eye care. Clean and use an old nasal spay bottle for this ... works great. Some excess saline will drain out - so be prepared for this.

Hot water wet towel soaks of the nasal and sinus area should help.

Beconase is a steroid nasal spray that will help greatly and may lead to a cure or nearly so.

There are generic brands of Beconase - less expensive.

[robblok]

Yes, JDGRUEN, my nasal passage membrane lining is inflamed. I have seen it on the camera the Dr put in my nose and on the stills it produced. She told me the same. She had given me nasal steriods and i think pseudoephed. The problem is this is an OTC medicine and the Drs are real reluctant to hand it out. I am trying to get my hands on it but it is hard. All because of that stupid war on drugs a perfectly good medicine is not available.

[JDGRUEN]

Yes, JDGRUEN, my nasal passage membrane lining is inflamed. I have seen it on the camera the Dr put in my nose and on the stills it produced. She told me the same. She had given me nasal steriods and i think pseudoephed. The problem is this is an OTC medicine and the Drs are real reluctant to hand it out. I am trying to get my hands on it but it is hard. All because of that stupid war on drugs a perfectly good medicine is not available.

So Pseudoephed is not really available in Thailand... it is - but it isn't because doctors are reluctant... Wow! Pseudoephed is available over the counter in the USA ... You do have to pick up a product card for it - take it to the Pharmacy counter / desk and ask for it. Then show a photo ID and it is entered into a computer... Pseudoephed (as you probably know) is a primary ingredient in making Methamphetamine... thus the reason for control. Pseudoephed in and of itself is a harmless and useful drug.

You might try to find some Ephedra. Ephedra usually refers to the plant Ephedra sinica. E. sinica, known in Chinese as ma huang, has been used in traditional Chinese medicine for 5,000 years for the treatment of asthma and hay fever, as well as for the common cold. This herbal remedy may be available in a Chinese herbal medicine shop in Thailand.

Don't be scared off by negative posts about Ephedra. Ephedra was over used and abused as a diet drug in the USA... so basically it was banned six years ago for use in most everything. The FDA is noted for over reaction

If you find some herbal Ephedra - take it in moderation and you will be fine. I took Ephedra years ago when it was available - for the same problem you have...

Do the other things I recommend - hot moist towel compresses on your nose and sinus area. Plus saline irrigation from a nasal spray bottle. And try to get a prescription for Beconase or a generic version of Beconase.

Edited January 12, 2013 by JDGRUEN

[TallGuyJohninBKK]

The question you're not addressing above is what's CAUSING your nasal passages to become "inflamed".

While trying to treat the symptoms is certainly appropriate, you might be well served to also try to get at what's causing your symptoms.

[robblok]

Yes, JDGRUEN, my nasal passage membrane lining is inflamed. I have seen it on the camera the Dr put in my nose and on the stills it produced. She told me the same. She had given me nasal steriods and i think pseudoephed. The problem is this is an OTC medicine and the Drs are real reluctant to hand it out. I am trying to get my hands on it but it is hard. All because of that stupid war on drugs a perfectly good medicine is not available.

So Pseudoephed is not really available in Thailand... it is - but it isn't because doctors are reluctant... Wow! Pseudoephed is available over the counter in the USA ... You do have to pick up a product card for it - take it to the Pharmacy counter / desk and ask for it. Then show a photo ID and it is entered into a computer... Pseudoephed (as you probably know) is a primary ingredient in making Methamphetamine... thus the reason for control. Pseudoephed in and of itself is a harmless and useful drug.

You might try to find some Ephedra. Ephedra usually refers to the plant Ephedra sinica. E. sinica, known in Chinese as ma huang, has been used in traditional Chinese medicine for 5,000 years for the treatment of asthma and hay fever, as well as for the common cold. This herbal remedy may be available in a Chinese herbal medicine shop in Thailand.

Don't be scared off by negative posts about Ephedra. Ephedra was over used and abused as a diet drug in the USA... so basically it was banned six years ago for use in most everything. The FDA is noted for over reaction

If you find some herbal Ephedra - take it in moderation and you will be fine. I took Ephedra years ago when it was available - for the same problem you have...

Do the other things I recommend - hot moist towel compresses on your nose and sinus area. Plus saline irrigation from a nasal spray bottle. And try to get a prescription for Beconase or a generic version of Beconase.

I am crazy about training, i have taken Ephedra and herbal Ephedra in the past. I am pretty sure that i can get it if i want. I can also get the Pseudoephed from Belgium if i want too.

[robblok]

The question you're not addressing above is what's CAUSING your nasal passages to become "inflamed".

While trying to treat the symptoms is certainly appropriate, you might be well served to also try to get at what's causing your symptoms.

I hear you as it dissapeard in the south of Thailand (almost completely) i think its Bangkok or my dogs, i cant change either. My aircons are serviced every couple of months and i clean the other filters myself.

[TallGuyJohninBKK]

As I mentioned above, getting allergy tested for environmental things would be a prudent step, and the results would help you identify what's causing your problems, assuming they're allergies, or conversely, tell you they're not caused by allergies. That also would help inform what the best medications and home/life changes would be to combat your symptoms.

I've had allergy panels done here in Thailand, and it wasn't particularly expensive, though that obviously would vary based on what hospital ENT department you choose. The testing I had done here was via blood test, though in the U.S. previously the allergist used the skin pricks method.

Right now, it seems you're guessing and presuming... And that's not the way to direct your treatment.

Edited January 12, 2013 by TallGuyJohninBKK

[robblok]

As I mentioned above, getting allergy tested for environmental things would be a prudent step, and the results would help you identify what's causing your problems, assuming they're allergies, or conversely, tell you they're not caused by allergies. That also would help inform what the best medications and home/life changes would be to combat your symptoms.

I've had allergy panels done here in Thailand, and it wasn't particularly expensive, though that obviously would vary based on what hospital ENT department you choose. The testing I had done here was via blood test, though in the U.S. previously the allergist used the skin pricks method.

Right now, it seems you're guessing and presuming... And that's not the way to direct your treatment.

I have to agree with you on this one, i am always doing test for training (blood) so why not test this too. Next month when my workload is less i will get tests done.

[mommysboy]

Allergy testing is cheap in Bangkok, and it would be an indicator. If you had a definitive allergy you'd probably be aware of it by now.

But am I missing something ?, you have gone from an area with good air quality, to an area with bad. Assuming all else is more or less equal, how can it be anything other than non allergic rhinitis? especially as this problem is so prevalent in Bangkok.

If so, there isn't a magic bullet cure but the condition can be greatly relieved as outlined by many.

I used to do a lot of exercise, but noticed that the symptom worsened afterwards, and came to the unhappy conclusion that more training meant taking in more irritating toxins. So you might get a bit of relief by cutting back. According to the latest studies short bursts of exercise over shorter time frames appear to be far more beneficial anyway.

[TallGuyJohninBKK]

Assuming all else is more or less equal...

Again more assuming... How about instead having people get tested to find out for certain???

I went back today and reviewed my allergy test results from Phyathai II hospital last year...

They did, based on a blood test, one whole set of sensitivities based on food items, things like egg, wheat, soy, shellfish, glutamates... Things that people eat regularly, and also things that many people have allergies to, without ever knowing it.

They also did a separate panel of sensitivities for inhaled environmental things, like various trees, grasses, dust mites, cockroach, dogs, cats, birds, mold, candida, and others.

I had extremely high sensitivity to cats and some sensitivity to dust mites, which typically are present in mattresses and bedding.

BTW, given the dusty environment in Bangkok, I find it useful to clean my own removable bedroom air con filters once a month... apart from the unit cleanings that I hire locals to do. I could wait longer, of course, but it's a pretty simple and easy thing to do and helps minimize potential problems, especially considering the number of hours each day people spend sleeping.

Edited January 12, 2013 by TallGuyJohninBKK