I want to set off a mucus-removing themonuclear device in my sinuses.
October 7, 2014 10:24 AM   Subscribe

For the longest time (read: years) I've been congested. My sinuses are stuffed up and there's this unpleasant backflow of mucus in my throat. It's not fun. How can I unplug my sinuses? Details inside!

Sometime ago, I went to an ENT doctor and he told me that because where I was living had dry air (very true), my sinuses were dried out and if I rinse them out, my congestion would go away. I did rinse them out, for awhile, but it was kind of unpleasant and I kept getting nosebleeds, so I stopped.

I have recently moved to a place with more humid air. However, still with the stuffiness. Is there a medicine that can unblock my sinuses for good? I'm thinking if I can get them unblocked, then maybe they will stay that way because of the more humid air.

So, AskMe, what is your go-to solution for unblocking stuffy sinuses? YANMD, etc. Thanks!
posted by Fister Roboto to Health & Fitness (29 answers total) 10 users marked this as a favorite
Your sinuses are little bony caves in your skull that are lined with tissue so congestion can come from three causes:
1 - too much mucus
2 - irritated, swollen tissue
3 - small or oddly-shaped sinuses

Rinsing out your sinuses helps with #1, decongestants like Sudafed help with #2. Dry air can irritate your sinuses leading to both #1 and #2.
If this is still a problem now that you live somewhere with moist air then your ENT wasn't entirely correct. I'd suggest seeing another ENT and let them know how long this has been going on so they can properly figure out which of these issues is causing your congestion.
posted by arrmatie at 10:33 AM on October 7, 2014 [3 favorites]

Have you been tested for allergies? I had chronic sinusitis until I got rid of the allergens in my environment.

Additionally, did your ENT order a CT scan to determine if you have polyps, deviated septum or other physical blockages that can cause a stuffy nose or chronic sinus infections?
posted by joan_holloway at 10:34 AM on October 7, 2014 [4 favorites]

Hi, sinus issues, my nemesis.

1. You may be in a more humid environment, but it may still not be humid enough. I live in New York - which is certainly not a desert - but I still have bad dry-air issues in winter. I got a cheap vaporizer from the drug store (it ran me only about $14) and I have that running in my room every night in winter, and that's worked wonders at keeping the air moist enough to keep my sinuses partly happy.

2. You may also want to check with your doctor about whether you may have allergies, especially since you're now in a new environment. I have some that cropped up as I got older, and I've been able to keep them pretty much at bay with the generic version of Claratin and with Nasalcrom; both of which are available over the counter.
posted by EmpressCallipygos at 10:34 AM on October 7, 2014

Chiming in for allergies here, too.

I used to be you. Thought it was just my life and my crap sinuses and that was what I had to deal with. Then I went to an allergist, discovered I was allergic to almost absolutely every single thing, went on claritin and singulair, and now can use both of my nostrils at the same time.

Definitely make a trip to an allergist for a scratch test if you haven't before.
posted by phunniemee at 10:39 AM on October 7, 2014 [1 favorite]

Yes, nthing allergies and humidity. After years of not knowing I had serious dust allergies, I've found a happy way to breathe by using flonase daily and also using a humidifier in the winter. Best of luck!
posted by brackish.line at 10:46 AM on October 7, 2014

Afrin will clear you up, but you can develop dependency to it. So if you are suffering right now, then go for it, but don't use it for more than a couple days.

Beyond that, get saline spray and use it all the time, take a zyrtec once a day in the morning

Go see an allergist and have them put you on a regimen.
posted by OuttaHere at 10:52 AM on October 7, 2014

Check into the Butyeko Method. It's a way of retraining yourself to breathe designed for asthmatics but that is very useful for anyone who has trouble consistently nose breathing. You can take a class or buy a DVD (eBay for savings), it's very simple and effective. You need to sort out allergies etc too
posted by fshgrl at 10:53 AM on October 7, 2014 [2 favorites]

Two sprays of Nasocort in each nostril + a Zyrtec and a Benadryl every night. Saline sprays in the morning. Godsends, all around.
posted by Hermione Granger at 11:09 AM on October 7, 2014

For medical reasons, my husband has to irrigate his nasal passages, like, 5 times a day, to keep them moist. He uses high-quality isotonic saline packets (from NielMed), not just water or even worse table salt. Even store-brand packets cause him bad irritation.

He also uses a humidifier pointed right at his head at night, which definitely helps things stay moist.

I do agree that you should talk to another ENT and perhaps an allergist to figure out why you're still blocked up. If you want immediate relief then Afrin nasal spray is the big hitter, but you can only use it for about 3 days. There is also Nasacort nasal spray that you can use long-term if your stuffiness is due to allergies.
posted by muddgirl at 11:12 AM on October 7, 2014 [2 favorites]

I'd also like to note that in questions like this, as you can see, you will get 800 different suggestions for decongestant cocktails. What will work for you is going to vary depending on what your allergies are and how you react to them. For instance, Zyrtec has never ever worked for me.

This is just to say that it's going to be less expensive and less frustrating for you to go to an allergist right off the bat and get recommendations for drugs that are targeted to your actual problems than it will be for you to snort half the CVS aisle trying to find what works.
posted by phunniemee at 11:17 AM on October 7, 2014 [3 favorites]

I should have added that no one should use a saline nasal irrigation 5 times a day unless under doctor's orders. It can cause other side effects such as sinus and ear infections.
posted by muddgirl at 11:22 AM on October 7, 2014 [1 favorite]

ENT specialists like to treat allergy symptoms with as many possible therapies at once as you'll tolerate. These include, but are not limited to:
  • Decongestants like pseudoephedrine or phenylephrine (US brand names Sudafed and Contac, among others)
  • Antihistamines like cetirizine, fexofenadine, or loratidine (US brand names Zyrtec, Allegra, and Claritin, respectively);
  • Corticosteroids which I won't even try to name here, but of which Nasacort is one.
You can get all the popular antihistamines over the counter, but most of the useful steroids are prescription only, so you should still see a doctor before self-medicating. Also the steroids can cause nosebleeds (and interfere with blood clotting, meaning those nosebleeds just don't stop once they start), and decongestants and antihistamines can mess with your ability to sleep. So yeah, Nth-ing the recommendation to see an allergy specialist and get on a drug cocktail that works for you.
posted by fedward at 11:47 AM on October 7, 2014

Have you tried an elimination diet? Dairy can sometimes cause excess mucus. It's worth a try.

Also, seconding NeilMed. Follow their instructions to the letter.
posted by janey47 at 11:56 AM on October 7, 2014

I have terrible sinuses and have been congested for years too. I knew it was allergies, but only got tested last month. Yes, it was miserable going off of all of the antihistamines in order to do the scratch testing. But it was well worth it to find out that the fun new asthma attacks and previous unrelenting congestion were being caused by dust mites.

A combination of singulair, allegra, and astepro (antihistamine nasal spray) has worked wonders. The astepro has made it possible for me to not have to take zyrtec, which makes me very stupid, so I am happy. Some people like me can't tolerate any steroid nasal sprays, so it was nice to finally have an alternative.

Nasal irrigation can be good, but for me it just seems to cause nice pockets of trapped water that encourage sinus and ear infections. Even if I use baby shampoo or betadine. Which I don't recommend.
posted by monopas at 12:03 PM on October 7, 2014

When someone combines the words "nuclear" and "sinuses" in a sentence, my mind jumps immediately to SinusBuster (at work, so I can't check the link). Available in some pharmacies, OR....

The actual, active ingredient (once you get past the woo-woo "immunity-building natural oils") is capsaicin. At my calculations based on web data, something around 100,000-1M SCU; IOW, hotter than Durkee's/Siracha by a lot. When I can't find sinusbuster, but NEED to clear my sinuses, I take the hottest hot sauce I can find, and snort a drop up one nostril, and then (as soon as I recover) the other.

Your sinuses will open and drain and be empty. Fast.

Also, your nose will hurt a lot for a short while, then subside into a throbbing numbness.

And you'll probably smell vinegar, because it's in most hot sauces.
posted by IAmBroom at 12:09 PM on October 7, 2014

Claritin for allergies, Sudafed for congestion, add in some ibuprofen for inflammation and some neti-pot use for acute mucous clearing (or in the evening when you shouldn't take sudafed).

happy breathing!
posted by entropone at 12:18 PM on October 7, 2014

Do you still have your tonsils? Getting mine removed was the only thing that stopped my sinusitis.
posted by The corpse in the library at 12:41 PM on October 7, 2014

If my sinuses are really giving me trouble eating a spoonful of wasabi usually takes care of it.
posted by yohko at 1:15 PM on October 7, 2014

These are all good suggestions. I would recommend, first, going to a new ENT (since you now live in another area, this will be a good idea and a great place to start).

That being said, if your sinuses are filled with mucus, an OTC method that will actually be good for your sinuses is to irrigate them. Muddgirl recommended NeilMed. I would second that. This is what I use and it's easy. It comes with premixed packets of saline solution. Use distilled water, not tap water. I heat it for about 20 seconds in the microwave so it's slightly warm. Bend over the sink when you do it so it doesn't go down your throat. And, after I have done both sinuses I gently blow my nose. Now, this will take some time to get your sinuses working well again. So stick with it.

I also do not use the exhaust fan when taking a shower when I have sinus problems. The steam is good for them.

But, again, go see an ENT so you can find out the underlying issue and, hopefully, a regimen that will help you.
posted by Taken Outtacontext at 1:43 PM on October 7, 2014

Don't bother to try phenylephrine (mentioned above). Unlike pseudoephedrine, phenylephrine is known to be ineffective.
posted by artistic verisimilitude at 1:59 PM on October 7, 2014 [5 favorites]

For when it's really bad, I got a nebulizer/steam inhaler. Helps a lot.
posted by Gotanda at 2:41 PM on October 7, 2014

Guaifenesin can help dry out your mucus. If this does anything for you, you will need to drink lots of water and consume a little extra salt. I highly recommend you consume some good quality salt (NOT table salt), like kosher, canning/pickling or sea salt. Mucus is mostly water and salt.
posted by Michele in California at 3:25 PM on October 7, 2014

Eliminate Dairy. It took me three days to clear out my stuffed sinuses. Opera singers avoid dairy for this reason.
posted by Coffeetyme at 4:24 PM on October 7, 2014

I would advise strongly against Afrin. When people say it's addictive, it doesn't quite convey the misery. What it means is, for a few days it works great. Then it starts to burn horribly every time you use it, but you have to keep using it, because the alternative is your sinuses locking up tighter than Fort Knox. Locking up an order of magnitude tighter than they were when you started looking for relief. After a couple of days, using Afrin burns, and breathing after using Afrin burns, and burns badly. And then the really fun part is, it works for less time every time you use it, until eventually you're getting maybe a few hours of relief... and after that, it just stops working altogether. The only way to breathe again at that point is to sit there in misery gasping through your mouth for around 24-48 hours until the effects wear off.

It's not like blasting your sinuses clear once and for all. It's like blasting them clear and then filling them with concrete.

Flonase and allegra and a humidifier do the trick for me most of the time; when things are really bad, I'll sometimes use Zicam nasal spray, but I dilute it by half with distilled water.
posted by kythuen at 7:35 PM on October 7, 2014

I had a chronic sinus infection for close to three years, and badly wanted to avoid sinus surgery because I'm a singer. My ENT concurred ("going into your sinuses is like taking a dremel tool to a cello," he said) and prescribed something that was apparently the new hotness at the time: antibiotics and steroids, mixed with saline in a nasal irrigation bottle and applied that way. Like the NeilMed irrigation devices linked above. I figured it was worth a shot, dutifully lavaged my sinuses with mupirocin and budesonide twice daily for three months, and it solved the problem. I still use the budesonide occasionally if I have a cold starting and a gig coming up, but it's nothing like it used to be.
posted by KathrynT at 9:26 PM on October 7, 2014

To answer your first question, there used to be a drug available in North America named Drixtab that was basically the type of tactical weapon for sinuses you are looking for. Unfortunately, it also caused hemorrhagic strokes in a lot of users. Because of this and its potential use in meth labs, it had been pretty much banned worldwide. Drugs containing the active ingredient Phenylpropanolamine are still available in a few countries other other names, but may be hard to get a prescription for since the medical risks should outweigh the benefits for most people.

For your second question, as others have mentioned, there are a lot of choices and you will have to find the combination that works for you. I would also recommend consulting a doctor to help supervise this, especially considering the nosebleeds from the nasal rinses your ENT recommended. They may have warranted a follow up visit to the ENT.
posted by Yorrick at 10:22 PM on October 7, 2014

Lifetime sinus sufferer here. I find that daily use of Nasonex is the most effective.
posted by gillianr at 10:30 PM on October 7, 2014

Unlike pseudoephedrine, phenylephrine is known to be ineffective.
Ha. I thought it was just me. If I need a decongestant I take pseudoephedrine (and go through the legal hassle required to buy it) but it makes me agitated and sweaty if I take it too long, plus it inhibits my already poor ability to fall asleep. Since its side effects are so self-limiting, I usually just suffer unless my sinuses are completely blocked.
posted by fedward at 8:45 AM on October 8, 2014

Coffeetyme: Eliminate Dairy. It took me three days to clear out my stuffed sinuses. Opera singers avoid dairy for this reason.
Opera singer avoid dairy due to their superstitious belief in the completely discredited claim that milk products increase or thicken saliva, and affect the voice.

You may well have a dairy allergy; so may the OP, by coincidence; but barring that, eliminating dairy will simply make chai lattes far less interesting (and ice cream impossible).
posted by IAmBroom at 10:29 AM on October 8, 2014 [1 favorite]

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