What do I have?

[Sean M]

I'm a regular runner and work out alot. About a month ago my nose got clogged. I noticed my-self having trouble sleeping alot. My endurance for running wasn't near what it used to be. Now, I have shortness of breath, and I feel tired alot; also, when I finish running my ears feel clogged. I went to the doctor and he told me it's probably a sinus infection. I am eager to start running again, is there anything that will take my shortness of breath and the other symptoms I described away?

[National Jewish]

Sinusitis is an inflammation of the mucous membranes that line the sinus cavities.  Symptoms can include a headache or pressure in the area of the sinuses, a clogged nose and ears, postnasal drip, cough, sore throat, thick nasal drainage, and feeling tired.  The best way to identify a sinus infection is with a sinus CT scan, although sinus x-rays are a decent alternative.  A sinus CT scan will also identify if any of the openings that drain your sinuses are blocked.  If your symptoms are due to a sinus infection, they will last as long as the inflammation continues.  It is also possible for the infection to inflame the airways of your lungs and this could be the cause of your shortness of breath.

Infections like sinusitis can cause inflammation of the airways of the lungs.  This inflammation can cause shortness of breath.  After the infection is gone, it is possible for the inflammation to linger.  This inflammation can last for several weeks.  Sometimes this inflammation may linger for 3 to 6 months.  Eventually the inflammation will go away, and then the shortness of breath will stop.  This is called reactive airways disease (RAD) and behaves a lot like asthma.  This inflammation often clears more quickly when it is treated with an inhaled steroid medicine that is used to treat asthma.  Your doctor is the best judge of this.

The most common cause of sinusitis is an infection, especially when the mucus is green.  Sinus infections can be difficult to treat since they respond slowly.  When any of the openings that drain your sinuses are blocked it will take longer to clear a sinus infection.  If a viral infection is the cause it’s a matter of time until the sinusitis clears on its own.  When a bacterial infection is the cause you may need to take an antibiotic for at least 3 weeks.  Even after an antibiotic clears the infection, it is possible for the inflammation to linger.  However, inflammation of the sinuses could also be due to an allergy or ongoing exposure to an irritant, such as pollution or smoke.

A decongestant like Sudafed® (pseudoephedrine) can relieve your blocked sinuses by decreasing the swelling so they drain better.  If your symptoms continue, your doctor may recommend a prescription nasal steroid spray.  This can improve sinus drainage by decreasing the inflammation in the nose and openings that drain the sinuses.  This generally provides a more lasting improvement in sinus drainage.  A nasal steroid spray does not provide immediate relief of symptoms.  It may take several weeks of routine use to become effective.

You will need to see your doctor to learn why your symptoms are occurring.  Only then can the best treatment be determined to take your symptoms away.  Please read our Sinusitis MedFact at http://www.nationaljewish.org/medfacts/sinus.html for further information.  An ENT would be the type of specialist to identify if blocked sinuses are causing your symptoms to continue and the best treatment.