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Nasal inflammation, congestion, pain......but only late in the day?

I have a 25 year history of nasal and sinus problems.  Seen dozens of ENT’s and I’ve had my symptoms relatively under control until about 1 year ago.  The usual process is that i catch a cold and it takes a long time to go away.  Usually it is not an actual sinus infection (CT scans are clear, no colored mucous, no facial pain) but the best i can describe it is that my nose stays irritated, blocked, congested ..... just feels crappy for a month or 2.  My treatment plan includes the usual .... steam, nasal irrigation, nasal gels, nasal oils, humidifiers, tons of water and tea, no dairy and ocassionally an antibiotic and oral steroids.  This is how I’ve managed to keep things under control.  Had septoplasty and turbinate reduction about 17 years ago and maybe there was some relief but really not sure (surgery screwed up my septum, now ive got a septal spur and small hole in septum....in other words, the doc screwed it up).  Had cosmetic rhinoplasty about 30 years ago and even though I can’t really prove it, I’m convinced that this was the initial cause of all my nose and sinus issues.

Anyway, I’m now going on 4 months since I caught a ‘normal’ cold and I’ve tried my usual remedies.  Here’s where this gets really weird and I don’t remember this ever happening to me until this last go around......I am totally fine until early afternoon.  The mornings I think to myself ‘wow - I feel pretty good’.  I can breath through my nose, its not overly dry or irritated and I feel pretty good.  Then at about 3pm my nose goes CRAZY!  It gets so swollen that i actually get dizzy and have to lay down.  Sometimes I’ll pop a sudafed or 2 but that messes with my already high blood pressure.  Sometimes a breathe rite strip will help a bit, sometimes not.  Sometimes a nasal irrigation will help, sometimes not.  The only small relief I get is if I lie down in a cool room, pop a sudafed and spray some Afrin (I’m trying to keep that to a minimum).  Again, the really unusual part about this is that i am fine until the afternoon.  I’ve been through all the allergy tests, I’ve tried all sorts of dietary modifications, tried budesonide nasal rinse, flonase, azelastine, cingulair, magnesium supplements and any food that Google tells me is ‘anti inflammatory’, i try to eat.  There is no correlation with the weather, no correlation to where i sleep (traveling to hotels, staying home).  I’ve had extensive bloodwork and nothing obvious going on there.  I’ve had some skin problems with my hands and long story short, I was sent to a Rheumatologist for more extensive bloodwork which all came back OK.  I was hoping to find some link here but apparently there is none (or at least not one they could find now).

My CT scan is clear and I don’t have all the classic sinus infection symptoms other than my nose.  After 25 years of dealing with this, I thought I had it under control.  If I could stay healthy 10 months of the year, I could live with it.   But this time is very different.  Just doesn’t seem to be getting better.  

I’m seeing a pretty good ENT but he seems to be out of ideas.  I’m starting Prednisone tomorrow and I’ll see if that does anything.  I’d rather avoid another surgery since that seems to make things worse and doesn’t actually get to the root of the problem anyway.  My countless hours of Google searching brings me from Vasomotor Rhinitis to life threatening diseases.  It’s probably a long shot but if anyone else has similar symptoms or suggestions, I would love to hear it.  Thank you.
1 Responses
20812580 tn?1519201022
Question could it be a lotion or shampoo or someone that's around you at that time that could be wearing something your allergic too. Have you tried benadryl? I take small amounts for the same kind of odd flair ups.  You will debunk it, it could be just the fact your up and not lying down... me, I use the teeter hang up and that after time drains and can be more useful than medicine. That's really all I can think of other than a food sensitivity not showing on the allergy tests. Hope this helps. I know the struggle. Good luck and much love jo
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