I am not sure if I understand your problem, but will say what I am thinking anyway. Usually when there is this kind of congestion, you need a mucolytic (mucus thinner) to relieve it. I have had this problem throughout my respiratory system. I found the most effective way to clear the mucus was to use acetylcysteine by nebulizer. When this medication was on back order and unavailable, I resorted to nebulizing saline. This loosened up the mucus/phlegm instead of thinning it. Although it did not work in the same manner, it was helpful. I think both should work whether or not there is an infection. I am under the care of a pulmonologist.
Since your doctors have not found a way to help you, have you asked if there is a problem in addition to the obstructing mucus?
Thank you for your comments - will keep the nebulizer option in mind.
It is interesting how some of the most successful treatments are the simplest. The congestion was wrecking my sleep and I was choking all the time. Then - acetylcysteine and instant peace.
Re: Constant phlegm / nasopharynx area
I had the feeling something was lodged in my nasopharynx for about a week, but prior to that, I had the thick mucous plugs that I just couldn't seem to either spit up or swallow--for probably a year.
I tried everything, neti pot, antihistamines, throat lozenges, gargling--then came the medications--albuterol inhaler (for asthma like problem that developed), dulera (corticosteroid), topamax (migraines), hydrocortisone (I was given a "magic mouthwash" that had this in it), lidocaine---NOTHING WORKED. In fact, I began having the most horrendous panic attacks in the middle of the night, I was afraid of going to sleep. THAT brings about a vicious cycle all it's own (fatigue).
Turns out, after much distress, ENTs (inner ear infections, tinnitus, esophagitis, constant fluid in my ears, dizziness, migraines, tooth/facial pain, sinusitis, asthma like symptoms, gagging)---lump in my throat, began to have the burning behind my sternum (which felt more like pressure, not burning), absolutely no way to get rid of the mucus plugs I could "feel" in the back of my throat and up into my sinuses---
It's something called "Silent Reflux" or laryngopharyngeal reflux. It is NOT the same as GERD--as GERD is confined to your esophagus--and you have that typical heartburn or knot behind your sternum. What happens is that the acid from your stomach (usually from sleeping flat and having structural/motility problems in your esophagus) is washed up into the back of your throat, into your eustachian tubes, up into your sinuses and even INTO YOUR LUNGS. The epithelium in these passages is VERY DIFFERENT than in your esophagus. You are literally burning the lining off of all of the delicate surfaces in there---and you can damage your ears/hearing permanently by the acid going into your auditory tubes.
Try this and see if anything changes. Put a wedge or a few cases of canned goods under the head of your bed--maybe just put blocks under the feet of the frame at the head--make sure it's up a good 6-8". PILLOWS DO NOT WORK. This is about GRAVITY. Don't get sucked into the "gerd pillows". GET A WEDGE UNDER THE MATTRESS and make an INCLINE.
In the a.m. start on some type of proton pump inhibitor--Prilosec or one of the OTC types. This usually is a 14 day regimen.
Look at your meds. Some effect the tone of the smooth muscle of the esophagus--like topomax does. Get off of them if you can.
Don't eat after 6 p.m.--and if you do, DO NOT LIE DOWN for at least 30 minutes post meal.
Watch your intake of acidic foods--I went no acid completely at first and have been adding small amounts of things I really like--but for the most part--watch the caffeine, tea, citrus fruits, spicy foods.
Until you find out what may have caused the motility or structure problem in your esophagus--remember all of that acid (hydrochloric acid is what resides in your stomach) as well as anything you eat is coming back up when you are horizontal.
The reason you (and I) still feel it in the daytime is because the lining is damaged--reddened, but not infected. You're bathing all of your sinuses, inner ear, lungs and mouth with hydrochloric acid. The mucus is a defense mechanism--your body trying like hell to protect your delicate passages from the acid.
Use your nasal washes if you like, but after the first 2 days of this routine, the fluid in my ears drained (the acid reflux at night literally goes into your eustachian tubes), the back of my throat began to heal, the knot in my chest began to dissipate, no more headache...and I could swallow. NO MORE MUCOUS FORMATION.
Look up the term Laryngopharyngeal Reflux--and you will see that the misdiagnosis is because an ENT doesn't cover that, a GI guy doesn't cover that, a Pulmonologist doesn't cover that. There is actually a new field emerging to deal with this problem.
Have you tried Young Living Essential Oils? Many of these oils act as expectorants to loosen mucous in the nasopharynx. I am using an expectorant blend of these oils in a diffuser to help me dislodge this mucous in the nasopharynx, applying oil under the jawline and spraying the back of my throat for infection in the nasopharynx with Young Living's Thieves Spray plus other applications. I am a Young Living Independent Distributor and would be very glad to help you with this. With a little knowledge of how these Essential Oils work and how to use them, You will be so happy to try them. Sincerely, give them a try. You have nothing to loose. Please write me when you are interested. I would very much like to help.
I think U need to consume hot onion broth. Make it by slowly sautee chopped globe onion in slight amount of oil until they are carmel in color, then simmer in water or chicken broth. Eliminate dairy, eggs, fried foods. your flow should improve, then infectious influenced will dissipate and you will regain balance. Please get well soon. If this starts to make you better, then text me a reply and I'll offer U more.