Chronic nasal congestion

[nasalcongestion22]

Hi everyone,

For starters, sorry for the really long post. I've just joined Medhelp to seek advice for my horrible nasal congestion that's persisted for more than 4 years. About 4 years ago, I noticed I started to have one-sided nasal congestion whenever I was sitting or laying down. When I turn to the other side, the congestion will shift to the other nostril. I'm a mouth-breather when sleeping because I can only partially breathe through my nose. About 2 years ago, I had a horrible cold that lasted a month and since then, my breathing has worsened. I've been prescribed Nasonex, fluticasone corticosteroid spray (ENT told me not to continue it though) which only helped during the day and have also tried every sinus pill and capsule possible. I often get headaches around my eyebrows, eyes and nose bridge which take hours to relieve. I've seen 3 doctors and 2 (allergist and ENT) specialists in the last 3 years - I'm currently seeing an ENT who has looked at all my medical history and even took a bunch of x-rays and endoscopies of my sinuses and septum, but in May he said that they were totally fine and that surgery may not be an option for my condition. He advised me to use a neti pot twice a day, but that isn't really helping much - the congestion just comes back after a few minutes. I've read up on many medical forums and websites and I seriously think I have enlarged turbinates and/or a deviated septum. If I put my finger up one nostril, I can't go up more than about a 1/4 inch because the turbinates on the side are sticking out so far against the septum. The inside of my nose has always been very red and at times looks swollen. This nasal congestion has completely taken over my life. All I think about during the day is "Will I be able to breathe normally?" I can't go on vacations because I fear not being able to breathe on the airplane, it's very hard to sit still in college lectures because my nose gets congested easily and sometimes In the winter I even sleep with a vaporizer during winter months. Anyone have some suggestions for treatment or could have a diagnosis?

Thanks!

[mklarson]

I would definitely push to get a turbinate reduction done if possible.  I had it done years ago and it helped with my chronic congestion. Qnasl appears to be available in Canada so I would check in to it.  As to why it is happening...the list is long and it will become a trial and error trek to find any answers.

  Best of luck

[nasalcongestion22]

Hi mklarson,

Yes, I think I'll return to my ENT and ask about getting a turbinate reduction. I'm in Canada, so not sure if that Qnasl spray is available here yet for prescription. I do already sleep with 2 or 3 pillows and I've actually elevated the front of my mattress so I'm lying on sort of an angle. I had an allergy test done in October 2014 where they tested me for about 40 things and everything came up negative, so they ruled out any allergy issues for me. I'm actually still puzzled as to why my congestion will return even after using my Neti-pot? Is this usual with enlarged turbinates/deviated septum that the swelling would return after irrigation?

Thank you for your reply!

[mklarson]

Ok, let's go over your questions/symptoms one at a time.
First, you MAY have enlarged turbinates which can be reduced by a procedure that can be done at an out patient facility by an ENT.
Second, there is a newer medication to treat the inflammation and congestion called  "Qnasl" (in the USA). It uses a pressurized canister to push the active drug up nasal passages and into the sinus cavities. All all of the other nasal sprays are only inhaled pass the tubinates to the back of the throat completely bypassing the sinuses. The sinuses are where the mucus is formed, so it is far more effective to use something that will reach the real target of the problem. You need to try and clear the nose/sinuses as best possible before using the Qnasl for best results (this is where the Neti-pot would fit in). It will burn a bit when you spray it in your nose as it is going to reach the inflamed sinuses but it will quickly subside. Here is a website that has a coupon to help with the cost: http://qnasl.com/savings.aspx  
As for the headaches at your eyebrows, eyes, bridge of the nose... those are classic areas of pain for sinus headaches. See the following chart for their location:  http://www.sinus-wellness.com/images/sinus_diagram_sept11-290px.jpg   When the sinuses are inflamed, they will press on the very areas you mentioned.

A couple of others thoughts... Elevate the head of your bed by two or three inches so that your head is higher than the rest of your body ( Just using a pillow will not give you the same benefit, you need to do both). This will help with your congestion at night when you lay down. Next avoid your triggers that may contribute to your congestion. Things to check are your soap (both body soap and laundry soap)...Avoid ones that contain perfumes and run an extra rinse cycle to ensure that all of the soap is out of your clothes and sheets.  Try to keep track of days when your congestion is worse and try to tie it to something that was different that day (food, house, animals, etc.) it takes a bit of detective work but it will pay off in the end.

  Best of luck.