sinus drainage excessive choking and coughing constant..Ent can\t help

My problem has worsened over a 2yr, span.  Never had sinus problems previous to a virus 2yr ago.  Have lupus and Hi BP so limits types of antihistamines that can be used.  Have seen two ENT's and both are baffeled they say I fit the 1-2% of people who they are unable to help.  Saw allergiest and that ruled out allergys (allergies).  I wonder about food allergy so have tried eliminating soy, gluten and of course all dairy.  No help gave a good month try. I'm so clogged on one side that the build up is awful it closes off my throat and get in my chest this is excessive not a normal amount. I have to usre aoral pik to break the bands of fiborius mucus to get it out of my throat and chest.  I get right over the sink head down and am there for at least 45min to 1hr sometimes more. I'm exhausted and my voice is hoarse constantly. I can't believe one head can hold so much fluid .  It's not real thick it's like spit.  Iv'e been using nasal washes and of course all the therapys like flonase, astelin,and take many meds for lupus they all have been checked to see if they are ti\e culprit doc says no.  Is there any help for me out there who do I turn to now ?  What type of Dr might have some advice.  I'm struggeling to live right now I can't even go out it's so bad eating seems to also aggravate doesn't matter what it is.  HELP

[National Jewish]

This is obviously a very difficult problem for you.  It may be related to immune problems.  It may be due to how your body handles and rids itself of infections.  You may consider visiting National Jewish Medical and Research Center.  Here we have a team approach to evaluating your problem and hopefully giving you some solutions.  It may involve a more extensive type of evaluation to see where the problems lie to get to the solutions.

[pe2e]

Hi, I have noticed a build up in the sinuses over the last few months, I was blaming it on my occupation (painter and decorator) but then realised when we visited back home for the weekend that after being there only for about an hour the problem had completely gone. I have put it down completely to living in a city enviroment, pollution and being inland seems to exagerrate symtoms (symptoms), back home is by the sea and the salty water smells so sweet. I just cant wait until we return home next year. I use a facial steamer with a little sea salt and tiny amount of tea tree oil this is very effective.

[imbabsj]

Thanks for the advice I'm open to trying any all things.  Thanks so much.

[star_light294]

could you tell me how to loosen thick phlem that gets caught in the tubes
hugs star

[imbabsj]

You need to ask your dr. to prescribe a solutuin that is made for nasal irrigation or you can make a solution yourself I have found a receipe for this online it said to use 2-3 heaping teaspoons salt and 1 teaspoon baking soda to 1 pint of water.  I also bought a nasal irrigation bottle made by "Salt AIr Sinus Relief"it is called you could look for it in a drug store but I found it in Meijers which is a big store like Wal-Mart etc. Look for it in the area where sinus and cold products are. Salt Air has a web site you could get more info on it.  This really helps me clear that thick gunk out hope you have some luck with this.
Barb

[star_light294]

thank you so much Barb
would it help the chest too
hugs star

[imbabsj]

Well it doesn't really bring stuff up from the chest but there is a product on the market OTC now called Mucinex I use it and it helpes with thinning all the mucus both upper and in your chest.  You do have do yuk it up and cough hard to get the junk out get right over the sink head down and you will have better luck coughing it out.  I use the MucinexDM which helps calm the coughing at night.  Good luck and give it a try.

[daydream26]

Barb,

  I have been having similar problems for almost two years myself (though my symptoms seem less severe that yours).  I developed my condition after contracting the flu, followed by bronchitis.  My doctors were baffled as well.  I saw a general practitioner, an allergist, an ENT, and a pulmonologist, all of them were unable to diagnose me - I've been given everything from asthma medication to drugs for immune deficiencies (none helped).  However, after studying my own symptoms for nearly two years, I was able to diagnose myself, and my family doctor agrees with my findings.

  I have a condition called Vasomotor Rhinitis.  It's not an allergic reaction, it's a reaction to irritants in the air.  It's a form of non-allergic rhinitis.

  You have two of the classic symptoms of this condition, congestion that is worse on one side of the nose, and severe post-nasal drip.  Some of the other symptoms:

- cold, dry air makes it much worse.
- alcohol makes it worse.
- car exhaust makes it worse.
- strong odors make it worse.
- GERD, development of acid reflux disease at the same time as  nasal symptoms.

  If any of these sound familiar, I'd say there's a good chance this is what you have.

  I have been able to find other people with this condition, and most of them say that nasal sprays have not helped, because the spray pump cannot get the medication deep into the sinuses, so you still have terrible drainage.

  Some of the people I have spoken with say that nebulizers have given them their lives back.  Apparently a combination of Astelin, Atrovent, and Rhinocort/Flonase/Nasonex used in a nebulizer can work wonders for this condition.  It is my understanding that the mix of medications is turned into a fine mist that you breathe in through your nose for roughly ten minutes.  I think that the theory is that this method delivers the medication to areas that nasal sprays miss.

  I have not gotten a nebulizer for myself, however, I am currently mixing Astelin, Flonase, and Saline spray (to dilute the mixture - I don't respond well to antihistamines myself).  I also rinse my nose with SinoFresh antiseptic and saline roughly three times a day.

  I still have symptoms, but I've been able to make them bearable, I'm 70% better than I was last year at this time.  You may want to find yourself a new doctor, probably an allergist (should know about the different types of rhinitis, ask people if they know of any good ones) and raise the possibility of vasomotor rhinitis.  Keep going to different doctors, until one of them is truly confident in a diagnosis.  I hope this will help you.  If it is vasomotor rhinitis, it's a nasty condition, but you can get through it.

P.S.  It is extremely difficult to find detailed information about vasomotor rhinitis on the internet.  You can google it, but it will probably turn up sites that list a few sentences at most.  This may be good to look up additional symptoms.  However, the in-depth information can be found in scholarly journals.

[imbabsj]

Hi, Thanks for all the information about  
I'm very intrested inthe use of the nebulizer and mixingVasomotor Rhinitis I too believe that could be the problem.  I have had the tests for gerd even the one where they have you drink stuff and tip your body and watch it go down.  The radiologist told me that was not my problem so I can rule GERD out as the culprit.  I am very intrested in the use of a nebulizer and the mixing of the Astelin, Flonase etc. how do you mix it and then how are you getting it in your sinuses without a nebulizer?  I don't even know what a nebulizer is but I need to find out. It's encouraging that you have had such remarkable results let me know how to use it if you can explain it.

Thanks again
Barb

[daydream26]

Barb,

  I've never seen a nebulizer myself, but I believe that they are primarily for people with asthma.  I think that there are converted versions that people are using for vasomotor rhinitis.  From what I've read, they're just small electric machines that turn medications into aerosols.  A good asthma/allergy specialist could probably find one for you.  Or you could try to google it.

  I have been mixing my medications in an odd way.  I have been fortunate enough to get my hands on a number of Astelin sample packs (from my doctors).  The sample packs contain screw tops, so you can easily pour the medicine out.  

  I unscrew the top (spray pump) off of an old bottle of SinoFresh nasal spray, then soak it in hot water to kill any germs.  I take my Flonase bottle, hold it at a 180 degree angle, sideways, and put the tip inside the empty SinoFresh bottle with it's cap/pump removed.  I spray the Flonase 40 times into the SinoFresh bottle.  Next I pour in a small amount of Astelin from one sample pack (roughly 16 sprays).  I fill the rest of the SinoFresh bottle with a generic saline nasal spray from my grocery store.

  I have to be honest here though, I have no idea if this will work for you - but a similar technique may produce good results.  I calculated this dosing based on my own reactions to the medication.  I calculated that after shaking the bottle and putting 3 sprays into each nostril once a day, I'm getting the equivalent of 0.4 sprays of Astelin in each nostril and 1 spray of Flonase in each nostril.

  I've found a lot of little tricks that seem to help me quite a bit.  I feel strange discussing it, but if any of it can help you, it's worth it, so here's my daily routine...

-When I wake up in the morning, I'm terribly congested, so I immediately go into the bathroom and turn on the shower.  I have one of the removable shower heads, I pull it down and lean over the edge of the bathtub, pointing the shower head at my face and letting warm/hot water contact my nose/sinus area.  I let the water run for roughly three minutes.  I turn off the water, get up and blow my nose, it almost completely clears out.  Next, I put 3 sprays of SinoFresh into each nostril and inhale deeply through my nose (repeatedly) with my head tilted back.  You get a brief nasty feeling as the solution runs down the back of your throat, but it feels great after a minute or two.

-After having coffee/breakfast, I go back to the bathroom and take my "real shower".  This time, when I'm ready to wash my face and hair, I take the shower head and actually point it up towards my nostrils.  I alternate between nostrils, shooting warm water up each one for about 4 seconds, then blowing it out.  I do this between 5 and 6 times for each nostril.  It's not as comfortable as nasal rinses, since it's tap water, but I think that the warmth and pressure have a much greater effect on me than a bottle rinse.  It really gets that nasty stuff out.  

-Once I'm done getting ready, I spray my mixture of astelin/flonase into each nostril 3 times, tilting my head back and inhaling deeply again for about a minute.  I'm sure I don't have to tell you that Astelin tastes less than great, but I think my technique gets it down in there, where I need it.  *And I think that the previous steps of clearing my nose enable this part.

-At this point, when I leave my house, I actually feel 85% normal again.  To keep my nose clear throughout the day, I take about 6 Halls cough drops (usually 2 hours apart).  I can usually go through most of the day feeling somewhat normal.

-I take Prilosec OTC every day for my cough (well, what was a chronic cough at one point).  I realized that I had GERD when I woke up one night coughing up acid a few months ago.

-I also take Advil Cold & Sinus every day (3 doses total, 1 dose every 4-5 hours).  Surprisingly, this has helped me a lot.  The pseudoephedrine helps me with the congestion and the ibuprofen helps the irritation in my nose.  This particular brand doesn't make me feel spacey either, like tylenol sinus.

-Once night time rolls around, my symptoms tend to get worse.  Before bedtime, I do something similar to my "quasi-shower" first thing in the morning.  I go in the bathroom and run warm water over my face for roughly 3 or 4 minutes.  Then I blow my nose and use 2 sprays of SinoFresh in each nostril.

That's about it, not a complete change in lifestyle, but it takes some dedication.  It may time to get better, so try to be patient and don't expect too much too soon.  I felt like giving up at one point too.

You may want to recondsider the possibility of GERD though.  From what I have read, a huge percentage of people with the condition don't even show visible symptoms.  I never thought of it in my case, or that it could be causing my chronic cough, until the night time acid incident.  I've read numerous scholarly journal articles regarding vasomotor rhinitis, and several of them mention research that has produced strong links between VR and GERD.  VR is a pretty complex condition, it looks like the leading theory is that it's actually a nervous system disorder (oddly enough).

[Ptstvsnd]

I am new to this list and have read the comments.  It sounds like I am not alone with my problems.  I developed sinusitus 2 years ago.  

I tried everything and saw many types of MD's and non-traditional therapies.  I was diagnosed with asthma for which I take Advair and Tilade.  I was tested for allergies and allergists said I had no allergies, but my ENT gave me more in depth tests and apparently I do.  But, the allergist said that anyone would test positive if given the types of tests my ENT gave me.  So, I am getting shots but I don't really know if they are doing any good.  I never had allergies prior to this sinus infection nor did I have asthma.

This year the congestion improved I believe because I used nasal sprays consistently. But drainage and excessive saliva became a real problem.  I never understood how I could have so much drainage but my sinuses were infected because they could not drain. My doctors did not seem to see the contradiction in this.  Also, after no antibiotics for a year, my new ENT decided to try a broad spectrum antibiotic once more.  When on the antibiotics I feel GREAT.  Even my air flow improved greatly.  But, after going off them, I return to illness fairly quickly.

Because of that, I finally had sinus surgery as a last resort. I had my surgery July 27th and I am having copius amounts of drainage which started two weeks ago. It is horrible and worse than before the surgery.  The stuff that drains down the back of my throat is real liquidy but a couple times a day it is thick from my nose.  I am interested in the diagnosis mentioned earlier (I don't have the post open right now) and will research that.

I don't believe the surgery worked but I was told it takes 3 weeks to 3 months to know if it worked.  Sure would have been nice to know that up front.  The infection is supposedly gone but I don't feel any better.  I feel the same in town and at our cabin where the air is cleaner.  I am at wits end.  Have any of you had surgery?  

ptstvsnd

[daydream26]

ptstvsnd,

I was considering having sinus surgery, but I never did.  I was convinced that I had chronic sinusitis for almost a year, but that opinion changed a few months ago.  I think that these types of conditions are often misdiagnosed.

In my case, it was the little things that shed light on the culprit.  I had been diagnosed with allergies, then asthma, then sinusitis.  But after months of observing my own symptoms I realized that cumulatively, they did not match any of the conditions I had been diagnosed with.

For example, my nose is now hyper-sensitive to strong smells.  If one of my professors uses dry-erase markers to write on the board, I can smell it within seconds of the cap being removed and I start to sniffle and feel drainage down the back of my throat.  Exercising produces a burning sensation in my nasal passages (no where near my sinuses) along with sniffles and drainage.  Alcohol, even one beer, causes my nose to become so congested I can barely breathe out of it.  Exposure to car exhaust in traffic causes drainage and coughing.  Cold air (this past winter and spring) caused a burning sensation in my nasal passages.

I realized that those things mentioned above (along with others) happened repeatedly.  And more importantly, they aren't really indicative of any of the conditions I was diagnosed with.  I've never heard of allergies, asthma, or sinusitis causing one's nasal passages (closer to the nostrils) to burn when he/she does sit-ups.  I focused on these odd symptoms and found out about vasomotor rhinitis - when I found a list of its common symptoms, it was almost identical to my own observations.  Apparently (when one has this condition) anything that increases bloodflow in the body can cause a burning sensation in the nose and drainage.  

Try to do keep a diary of odd little things like that.  It may be the only way to tell if you were misdiagnosed.

[Ptstvsnd]

Thanks for the tips.  I think I will start a diary. After my surgery, my sense of smell and taste are much improved.  I am finding smells to be more irritating now (lawn mower smells and things like that).  I think we need to diagnose ourselves as much as possible by watching our bodies and learning about illnesses and their symptoms.  Thanks very much for sharing your daily routine.

Pt

[tvkid]

You may need a script from your doctor for the nebulizer.  My doctor insisted that I have one because of the cough I had that would not go away.  She was unsure that I had asthma, but wanting my cough to go away as well.  We have tried everything from albuteral to flonase.  From rescue inhalers to plain cough supressants. Tesselen pearls to Halls!!!!
The cough still remains.  Been 9 weeks now.
BUt I like the flonase thing in the Nebulizer.

You may be able to find a good pocket battery operated Nebulizer from a company called OMRON ( I think that is how you spell it) The one I have is by PARI, and is quite small and easy to use as well.
Type in ( from Google) either one + Nebulizers and see what comes up.  You should be able to find it there.

Maybe if your doctor can get your insurance company to pay for it, mine did.

Good luck and God Bless

kj

[janzibel]

Going on at least 5 yrs now, every morning of my life, right after getting out of bed I have what I would call a 2-phase phlemg problem.  Phase one consists of having this very thick stuff in the back of my throat which is anywhere from a clear, yellow or green substance, sometimes almost rubbery looking.  Once done with this phase, then on to phase 2, which is just regular excessive phlemg, & lots of it, for the next hour or two, phase one goes on for about 45 minutes.  I can't swallow cause it's so thick.  I used to have this problem following a cold, sinusitis, strep throat, right after completing my regimen of antibiotics & it would last for about a week.  I now, as afore mentioned have it everyday.  I've has nose surgery, 2 yrs ago, I've has ct scans to check for chronic sinusitis, they were negative.  My doctors (including my ENT) can't seem to diagnose it.  I've been give flonase, rhinocort & a couple of other similar products, which I used religiously for a month, to no avail.  HELP!  I am at my wits end with this stuff, & I fear that all the coughing (which is quite violent at times) is going to cause me other problems.
Thanks.

[imbabsj]

Oh my gosh thats pretty much what I go through too!  I just had sinus surgery and can see that the problem is not solved.  After the packing was taken out the clots and mucus began .  I know the clots are normal part of healing but the excess mucus is still as bad as before surgery.  Now I don't know how to handle it.  I feel the same way HELP!

[judyk]

HI!I HAVE BEEN SUFFERING WITH SINSUS DRAINAGE AND PHLEM.I TAKE CLARITIN 24 HOUR BUT AROUND 15 HOURS I WAKE UP CHOKING AND COUGHING.I USE NASAL RINSE 2 OR 3 TIMES A DAY WHICH HELPS A LOT.I TAKE NASACORT AND ASTELIN TWICE A DAY.I CAN AT LEAST BREATHE GOOD THROUGH MY NOSE.THERE WERE TIMES I WAS SO CONJESTED I THOUGHT I WOULDNT MAKE IT.I ALSO USE YICKS STEAM INHALER WHEN I FEEL REAL BAD.MY DOCTOR SAID I COULD USE AFRIN IF REALLY CONJESTED BUT ONLY FOR 3 DAYS BELIEVE ME IT WORKS VER VERY GOOD.BUT WAS AFRAID TO USE IT TO FREQUENTLY.I WAS ON ADVAIR BUT I SEEM TO GET A THRUSH MOUTH EVERY 2 WEEKS AND A WHITE COATED TONGUE AND THEN A SORE THROAT SO I QUIT THE ADVAIR.I WAS ON ASAMAX AND ALSO FORADIL WHICH SEMS TO OPEN THE THROAT PASSAGES.I HAVE SPEND 1,200.00 ON ACCUPUNTURE,MY BODY FELT GREAT 12 TREATMENTS WHICH YOU PAY YOURSELF NOT COVERED BY INSURANSE.MY DOCTORS KEEP TELLING ME TO HAVE MY SINSUS DRAINED.I AM VERY SCARED AS I HAD MY SPLEEN AND DIDNT WAKE FOR 6 HOURS SO I AM AFRIAD TO GO.I  AM TAKING ALLERGY SHOTS SINCE SEPTEMBER -05 I HAVENT FELT BETTER YET.I AM RELLY THINKING  ABOUT TRYING SOMES HERBS I AM READING UP ON THEM.CAN ANYONE HELP ME.RIGHT NOW ITS JUST THE COUGHING AND PHLEM THAT HAPPEN 2 TIMES A DAY USUALLY WHEN I AM SLEEPING I HAVE TO GET UP.SO THERFORE I DONT GO TO SLEEP UNTILL 250 SOMETIMES 530 THANK GOODNES I DONT WORK AND MOST OF THE TIME HAVE A LOT OF ENERGY.I WAS ALSO THINKING ABOUT GOING TO A AUTOIMMUNE DOCTOR.ANY HELP I WOULD GLADLY APPRECIATE.I FORGOT TO MENTION I HAVE BEEN ON 5 OR 10 MILLIGRAM OF PREDISONE AND HAVE FELT WONDERFUL BUT MY DOCTOR WONT LET ME STAY ON THAT.ITS A MIRACLE DRUG.ANYONE OF A DRUG SIMILIAR THAT CAN HELP,

[MrSandman]

A related discussion, How to help my wife with chronic sinus problem was started.