What can I do about this constant sinus discomfort?

February 14, 2012 7:12 AM

You are not my doctor, but I won't be able to see him for a few weeks and you might have some helpful sinus-related advice and tips that could really help me out. Long and slightly gross details inside.

So, for over a year now, I've had really bad sinus drainage. It's most days, most of the day. It feels like there's a little ball of filth at the top of my throat, four inches behind my nose, steadily releasing a drip-drip-drip of mucus or snot or bad-tasting gunk or whatever.

Sudafed used to work really well, but not so much anymore. I went to an allergist two months ago, who did the whole "pincushion on your back" thing. He said I'm allergic to the basic stuff that most people are - dust mites, cockroach droppings, etc. - and put me on Singulair and Cetirizine (basically a prescription, very strong version of Zyrtec). Neither one had any effect at all.

He wants me to do the "two years of shots" routine, but my insurance won't cover it so it is absolutely not an option.

The worst of it is the heartburn and stomach discomfort caused by all the drainage, so lately I've been treating those symptoms (pepto, etc.) rather than worrying about how to stop the cause.

Here's the thing: it's been like this for more than a year, with absolutely no regard for the change of seasons. So it's clearly not a "seasonal allergy," and I'm wondering if it's even allergies at all. Neti pot helps a little, as does a really hot bath and a glass of scotch. Any other OTC treatments that you've had look luck with?

posted by jbickers to health & fitness (20 answers total)

I was about to say "steam" when I read you already kind of do that. What about the old traditional steaming method, bowl of steaming hot water, you, towel to cover your head...

I get bad sinus problems too, and if things get really difficult, are stogged up and not dislodging, spicy soup will do it for me every time.

Try this:
1 butternut squash, peeled and cut into 2" dice
1 onion, chopped
a knob of ginger, maybe 1 to 1 1/2 inches long
1 thai chili, chopped
4 cups of vegetable or chicken broth
1 can coconut milk

Sweat the onion in a pot in some butter or olive oil, till translucent. Add in the butternut squash and cook for a couple of minutes. Peel and chop the ginger small and add it and the chili to the squash in the pot. Add the broth, bring to the boil, then reduce the heat and simmer till the squash is tender. Use a stick blender to swizz the whole thing into a smooth soup, or use a food processor. Add in the coconut milk, adjust the seasoning, and serve, garnished with chopped coriander if you like.

It's delish, and will definitely get everything moving upstairs.
posted by LN at 7:21 AM on February 14, 2012 [5 favorites]

Drink some Perrier and Orange Juice. It mostly helps with the sore throat aspect of allergies and sinus problems but I swear it cuts out the gunk in the back of my throat like nothing else. I call it Draino for my throat.

The important part is the Perrier. No other carbonated beverage acts the same way (that I've found.) I mix it with juice purely for the taste. If you can handle it straight, go for it. I usually chose orange juice for the illness-fighting Vitamin C but I've mixed it with other juices and still have the same success.
posted by TooFewShoes at 7:23 AM on February 14, 2012 [1 favorite]

Running a vaporizer at night helped me out a lot with this.
posted by EmpressCallipygos at 7:27 AM on February 14, 2012

Sounds to me like you've got chronic sinusitis.

I had this for years. Any time I'd get a cold, I'd always get a sinus infection, and I never really stopped draining down the back of my throat. It got to the point that I couldn't actually put my head underwater, at all, regardless of whether or not I "had a cold," because it felt like someone was sticking an ice pick in my forehead. It didn't matter how much I blew my nose either: nothing ever came out, regardless of how stuffed-up I was. Steam, sinus irrigation, decongestants, nothing worked.

Then I had my sinuses routed out with a drill.

Turns out I had smaller than average sinus passages and a deviated septum to boot. I'm much better now.

Getting the surgery involved going to an ENT doc. He had me take a CAT scan, which showed a lot of disease up in there. He then put me on like two months of augmentin (he said the real debate was whether 60 or 90 days was the right dosage) and had me take another CAT scan. When the second study showed minimal change, he said it was time to break out the drills.

The surgery was done on an outpatient basis, but it took over a week before I was back to normal. You spend about a week learning how to irrigate your sinuses. Also, I was instructed to avoid picking up anything that weighted more than a gallon of milk, as the increased blood pressure had the potential to rupture the healing scabs. if you are given such an instruction, listen to it. This was right around Christmas, and I was exiled from the kitchen when picking up a fruitcake released caused something up there to shift, releasing a surprising amount of old blood.* Also, afterward they do a few followups which involve sticking a steel spike about six inches long up your nose. They give some anesthetic, but there is no way on God's green earth that this will ever, under any circumstances, be okay. It's an essential part of the process--the spike is actually a little suction tube complete with light and camera--because they gotta make sure there aren't any clots, as the mucus membranes up there will grow right over them, leaving you just as congested as before. It's unpleasant, but it only takes a minute or two.

Still, all in all, it's totally worth it. The surgeon said that he had thought I was a marginal case, but that when he went in there, he found far, far more disease than he had expected, and the passages were narrower than he'd thought. All of that's fixed. Now, when I get a cold, instead of it always resulting in a nasty, multi-week bout of sinusitis, it goes away in a few days or a week like it's supposed to, usually ending with the expulsion of a rather large and unpleasant glob of mucus. But I can actually blow my nose now and get stuff out of there rather than having it never, ever make a difference. I can also swim and do whatever without worrying about it.

*I don't even like fruitcake.
posted by valkyryn at 7:28 AM on February 14, 2012 [7 favorites]

NeilMed Sinus Rinse works wonders. The squeeze bottle is much more effective, in my opinion, than a neti pot.

Have you considered whether the acid reflux is causing the sinus problems, rather than the other way around? GERD can cause/mimic sinusitis.

See both a gastroenterologist and an ENT to get to the root of the problem.
posted by melissasaurus at 7:31 AM on February 14, 2012 [7 favorites]

My #1 recommendation is washing all of your bedding -- really, all of it, including any quilts or mattress pads -- in hot water. (If you can't wash your pillows, either replace them with allergy-specific pillows or at least run a vac over them. I also run the vac over the mattress surface.) The hot water is vital because warm isn't enough to kill dust mites. Some bedding may need to be dry-cleaned (or replaced if you don't feel like dealing with dry-clean only bedding). It's worth it.

Also, do you have any bedding with feathers? Did they test for down/feathers? Because that can also cause allergy symptoms like this.

Overall cleaning can also be helpful, but I'd definitely start with a deep clean on your bedding, especially if you tested as allergic to dust mites.
posted by pie ninja at 7:31 AM on February 14, 2012 [1 favorite]

I had better luck with Flo-Nase than other similar treatments (and I had no luck at all with Zyrtec; plain Benadryl is better for me). Low-tech home help: For the stomach discomfort, sometimes getting some bland carbs (toast, crackers) in there in the morning to "soak up" some of the grossness reduces the stomach upset for the rest of the day. For nighttime stuffiness discomfort, those Breathe-Right strips may help some. Caffeine dries you up a bit and sometimes can give you a boost to get things a little more tolerable. Try sleeping in different propped-up positions to find one where you can keep draining at night -- sometimes I prop my head and torso well-up on a bunch of pillows, normal fashion, and then roll onto my side and keep my face pointed down (so my head is higher than my legs, but my nose can't drain down my throat). I tend to scoot out of it in the night, but my throat isn't as sore in the morning. All of these things just make it a tiny bit more tolerable at home; none of them are as good as effective drugs that get rid of the snot ball.

I don't have anything else super-helpful to say except that I had the same problem, and then I had it clear up some and go back to being periodically acute rather than chronic. I'm sure it will be chronic again in the future. The sore throat is the worst.

STOPPING the drugs and living with it for a while and then starting the drugs again may make the drugs more effective again. I was pregnant so I didn't have a choice on the stopping, and it SUCKED BALLS but sudafed, etc., were more effective again when I was allowed to take them again.

I've considered sinus surgery but valkyryn's description is making me giggle uncomfortably so I think I'll just hope it doesn't get bad again.
posted by Eyebrows McGee at 7:42 AM on February 14, 2012

Still, if you are looking for some temporary, and I stress temporary relief, consider the judicious use of Afrin. You really only want to do this once, maybe twice in a week, at the very most, and probably no more than a few times a month, because it is chemically addictive, in that you'll wind up way, way more congested than you are now if you get hooked on the stuff.

The directions say not to use it more than three days in a row. I've found that's pushing it, especially if you're doing that more than once a month. So a hit here, a hit there, with several days in between, is all I go with. YMMV of course, but be aware that when they say that prolonged use is problematic, they are absolutely, for serious, not kidding.

All of that said, in terms of almost immediate and ridiculously effective alleviation of sinus congestion, shit is freaking magic.
posted by valkyryn at 7:49 AM on February 14, 2012

I had the newfangled minimally invasive sinus surgery, which is like a Ferrari to the Model T surgery valkyryn had. No packing, no probing, no worries.

But that's waaaaaaay down the road. Before you get there, try the whole regime of nasal rinsing (follow the instructions to the letter! Especially about only using sterile water!) and dust mite remediation and Flonase or Rinocort or Veramyst or Nasonex. Also an anti-GERD diet and maybe omeprazole. Post-nasal drip and GERD are mutually reinforcing, per my magical sinus surgeon---one condition exacerbates the other.
posted by Sidhedevil at 7:52 AM on February 14, 2012 [1 favorite]

Along the lines of the spicy soup recommendation above, I often take a cayenne pepper supplement. It gets the pepper into you faster than eating spicy food and still helps clear things out. (It's literally ground up pepper in a capsule -- you can get them at health food stores.)
posted by cranberry_nut at 8:33 AM on February 14, 2012

I'm on a nasal steroid (and the now OTC Allegra) with your symptoms. It helps somewhat, but sinus surgery is definitely something I'm thinking of, especially with the new techniques like balloon sinuplasty and the like.

Another downside of this condition is the damn tonsoliths. Oh, and the constant throat-clearing and coughing when things swell up back there enough that it catches food and you're trying to get it unstuck. Don't eat potatoes when it's bad.

I feel your pain. My wife gets slightly annoyed and thinks I should see another doctor so I don't have sinus problems that drag on for months, but I am not personally sure that there's too much else to do besides surgery, and the surgery seems a bit extreme for something that's basically an annoyance. But there are plenty of satisfied people post-surgery, so what do I know?
posted by RikiTikiTavi at 8:39 AM on February 14, 2012

My solution for managing chronic sinusitis was simply to sip vast amounts of hot water throughout the day. The first mug would have a teaspoon of lemon juice and a teaspoon of honey. The rest of the day, just water. It doesn't make the sinusitis go away, but I felt a lot better, because I had better drainage.
posted by bardophile at 8:41 AM on February 14, 2012

Steroid nasal spray used faithfully daily has changed my life for the better. Get some Nasonex/Flonase/generic. You will probably need a prescription, though.

It's a slow build to results, but you should start seeing some in a few weeks.
posted by vegartanipla at 9:07 AM on February 14, 2012

It definitely sounds like you have chronic sinusitis, which is an infection of the sinuses. That would explain the constant drip of gunk down your throat. Steroid nasal sprays and decongestants are (in theory) great for reducing the swelling but they don't do jack for getting rid of the infection. For that you may need antibiotics and/or a trip to an ENT to see if you have something physical that is causing recurring infection.

Neti pots are great for helping to clear out the gunk and reduce the drip. Again, it won't necessarily flush away the infection, but it can be soothing. You really need to do it multiple times every single day, not just occasionally.
posted by joan_holloway at 9:36 AM on February 14, 2012

When did Sudafed stop working for you? Maybe you're not getting the right kind? The Sudafed that you can get without signing your life away doesn't work for me either, but the kind with pseudoephedrine works well.

In late 2004, Pfizer publicly disclosed its plans to make available a new over-the-counter product, Sudafed PE, which does not include pseudoephedrine. Decongestants with other ingredients were completely converted to phenylephrine later in 2005. Original Sudafed is still offered behind the counter to customers 18 years of age or older upon request, requiring the customer to show ID and sign a sales log next to a record of their name and address.
posted by SuperSquirrel at 9:47 AM on February 14, 2012

I always get sinus infections when I travel by plane, and I carry around little squeeze-bottles of plain saline to snort/blow wads of phlegm throughout the day. Not as thorough as a neti pot, but easier to use in public. I also swear by Mucinex, but I don't know how effective it will be for chronic sinusitis. For the actual snot-blowing, I find it well worth the extra expense to get the fancy soft kleenex with lotion and/or the saline wet nose wipes marketed for children. And always blow nose with mouth open! Pressure forcing mucus into ears=BAD
posted by nicebookrack at 10:01 AM on February 14, 2012 [1 favorite]

Have you thought about acupuncture and/or other TCM (Traditional Chinese Medicine)? Some insurance will cover acupuncture from a licensed provider for a specific ailment. If yours doesn't try google for "community acupuncture placeyoulive." These are often very affordable (the one I go to is $20 a session). I haven't been going long, but already have noticed an improvement in my constant sinus issues. Any reputable place will tell you that this is not INSTEAD of going to an ENT, but rather an approach that may be more useful to you than the neti pot/sudafed combo.
posted by lodie6 at 4:00 PM on February 14, 2012

This is a stretch, but by any chance did these symptoms start after a bad case of food poisoning or a stomach flu? I had a colleague who had symptoms much like you describe, and eventually found that a horrific case of projectile vomiting had lodged a pea in one of her sinus cavities, which proceeded to slowly rot and cause all kinds of horrible, horrible problems. Removal of the pea solved all the problems.
posted by KathrynT at 4:13 PM on February 14, 2012

I had a dreadful chronic sinus infection. I finally kicked it (serious antibiotics and prednisone), and keep things manageable with a) obsessive hydration, b) netipot/NeilMed and steam, c) knowing when it's time to call in and get a short course of antibiotics, which now only happens about once a year. I go to an asthma/allergy practice (even though this isn't technically either) because of their expertise in medical (rather than surgical) treatment of sinus inflammation.

I had considered sinus surgery for my chronic sinusitus...until the arrogant ENT completely dismissed my concerns about commonplace side effects such as loss of smell and/or taste, facial numbness, empty nose syndrome, and the need for repeated surgeries. I know a lot of people who were happy with their surgery for the first year...many of whom found that after a year, they were right back where they started or worse.
posted by desuetude at 9:39 PM on February 14, 2012

I am one of the deviated septum/chronic sinusitis crowd, and the rinsing doesn't work for me. The water gets all stuck up in my sinuses and then I really get a whopper of an infection.

The only thing that has come close to helping is Flonase (generic) and OTC Allegra (even though I'm not allergic to anything) every day. If I eat a lot of dairy products, it's worse. I am considering having the surgery...

You might want to go to an ENT and have them do the x-rays to see if you have any structural problems.
posted by getawaysticks at 6:04 AM on February 15, 2012