Chronic Sinusitis

Hi everybody.

I’m after some advice/insight from anybody who suffers chronic sinusitis. I’ve been a sufferer for some years but this year it’s more-or-less destroyed any momentum I’ve built up. I have a deviated septum which leads to ongoing infection in my right side. The symptoms blow up ever 4-6 weeks, causing fever, headaches and general sickness. I explain it to folks as like tonsillitis for the face - people seem to think it’s all snot and sniffles and it really isn’t.
My daily routine is to use antihistamines and sinus rinses as a preventative measure, and I have a steroid nasal spray from my GP which works well (and is legit for competition - I checked). When it flares up I generally stop all training and let it clear, but recently that’s required antibiotics.
I’m getting really fed up. When healthy, this year has been a breakthrough year for me. However I’ve not been able to capitalise on it thanks to the ongoing issues.
I know the long term solution is likely to be a surgically-applied router…but before it comes to that I’d love to hear other people’s experience and advice so that maybe I can minimise the disruption to my training, lessen the occurrences and prevent needing surgery.

Thanks all.
Thom.

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I was in the same boat. My first years of High School were plagued by constant sinus infections.

In my Junior year I had sinus surgery where they went in and corrected my septum (which they counted something like 5 distinct breaks) and got rid of all the gunk in my sinus cavities. The surgery sucked, I had gauze shoved in my nose for a week, and they even gave me a pamphlet warning me about sneezing. After the surgery I wasn’t able to lift anything more than 10lbs for like a month. It was hell, but it was also one of the best things I had done.

I still have sinus problems, and probably will for the rest of my life, but they’ve been reduced by at least 75%. It was a life changer.

My recommendation is to talk with an ENT and if they recommend surgery, go for it, it completely changed my life for the better. I think Chad talked on the podcast about having these same issues and was planning on (or had) a similar procedure.

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ENT and fellow cyclist here. First, sinus surgery has significantly improved. I use no packing and allow patients to return to normal activity in 2 weeks. Ultimately this will probably be your best intervention. Second, make sure you’re seeing an ENT. Too commonly patients are misdiagnosed with sinusitis and prescribed unnecessary antibiotics. In the meantime, irrigate your nose twice a day with saline using a Neti-Pot or Neil-Med sinus rinse (my personal favorite). Nasal steroid applied twice a day after the irrigation. A nasal antihistamine has been very successful in my practice. An oral decongestant can help but be careful with regards to blood pressure, irregular heartbeat and inability to sleep. Best of luck.

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Thank you both. It’s good to hear there are options. I use a Neil-med sinus rinse when it flares up, but am patchy with both that and the antihistamine when it’s not active. Guess I need to be more consistent to keep it at bay.

Yeah, definitely get a referral to an ENT. I was just going to chime in with the same advice as @ebehrens My partner is an ENT, and her first advice is pretty much always consistent nasal irrigation. I find doing a sinus rinse right before training is a big help when I’m congested. I basically rinse, and then get on the bike.

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TY. I’m in the middle of a flare up right now and feel really washed out. Achy, sore, no energy and achy sinuses. I guess I can use it as an opportunity to establish a rinsing routine.

Based on your good advice, I’ve been out today and got an extra Neil-Med kit for work. I’m going to start rinsing daily. I’ve also booked to see my doctor to get a referral to an ENT with a view to more investigation and some surgery. This is the last batch of imaging. To my untrained eye, my septum looks like it could use some straightening out. Hopefully I’m a good candidate for surgery.

Hi Thom,

I had chronic sinusitis for a few years, I’d get crazy sinus infections that would leave me with flu-like symptoms for weeks at a time. Went through 2 sinus surgeries and after the second I saw a bit of relief but would still get infections that would wipe me out.

I tried all home remedies, 2-3x daily sinus rinse, trying to improve my gut biome with fermented foods, sinus rinsing with all kind of concoctions, you name it I tried it with no success. I’ll add that I never saw any relief from antibiotics!

I had a buddy suggest that I go off all dairy as for some it creates a state of chronic inflammation, and I do love my dairy! Well I went off dairy 2 years ago and I have only had 2 minor bouts of sinusitis in the past 2 years.

Purely anecdotal but I am convinced this has been that answer to my getting past chronic sinusitis.

There is a lot of information out there about dairy product intake and chronic inflammation. Worth a try before you go under the knife!

Also talk to your ENT doc about using Pulmicort nebuamp in your Sinus rinse when you get flare-ups.

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Hi

Like the people above I too have/had similar issues.

I used to get completely blocked up and end up with sinuses full of mucous (it shows on x-rays). Eventually after another bout I went to the doc who sent me for x-rays and asked me “when did you break your nose?”
Didn’t know I had but my septum was bent at 90 degrees.

Anyway to cut to the chase I had surgery to correct the septum and open up the sinus passages so they drain a lot better, all done through the nostrils. I battled with my nose being blocked for some time and couldn’t blow it properly for what felt like months but it didn’t affect my cycling.

That was over 15 years ago, I’ve never had a sinus infection since!

I do still use steroid spray chronically and decongestants as needed but as the ENT said some people just have an allergic nose, hayfever sucks!

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Reviving an old thread, but I personally found it worthwhile to read through others’ experiences and tips here, so adding my own.

Also a sufferer of sinus issues for the last few years. They got worse when my kids started attending daycare and/or when I picked up cycling. After testing for allergies (none), adding daily neti-pot “nose showers” to my routine, and trying antihistamine I was forwarded to an ENT. It turns out I broke my nose in the past but never knew about it. So I underwent surgery (1.5 years ago) where they corrected my septum, which helped a bit, esp. in terms of breathing functionality.

However, every cold still turns into a sinus infection. I have the feeling that one my cavities isn’t draining properly, so now talking to my local physician again to explore other surgical options.

You have described my history perfectly. I would talk to your primary care physician about adding budesnoide (a steroid) to your daily nasal lavage. Use a squirt bottle instead of a pot. Use it every day, not just when you a feel a cold coming on. It has been life changing for me, and now as a physician, I have learned that it’s the recommended regimen for chronic sinusitis (and I’ve had success with my patients).

(standard disclaimer not to take what a rando says on the Internet as medical advice blah blah blah but ask your PCP about it)

Been meaning to make a post on my recent sinusitis status. Had a 2nd surgery last year, blah blah blah.

I did the bidesonide rinse briefly postop but soon my ent put me on xhance. It’s basically Flonase with an expensive applicator to get it deep into the sinus cavities. It’s not covered by my insurance but is still cheaper than my out of pocket for bidesonide (unless/until I hit my oop-max)

Aside from that, what I’ve discovered is that coffee is a serious aggrevator for me. I’ve had to give up coffee, for which I’m really broken up about. It takes about a week off if it to make an obvious difference, and it continued to improve for a few weeks. I’m not saying coffee is anyone elses problem, but even silly dietary stuff can be a factor and its not super obvious.

Oh, and I came across astepro, a recently approved allergy spray. It helps with my environmental allergies better than zyrtec.