marjoriam, I am so sorry. Some thoughts below.

I too have acid reflux & have dealt with sinus issues for years. Mine was different and I had a lot of sinus infections & I have a lot of allergies. I tried a lot of things. Sinus surgery helped, but, it wasn't a cure-all. I can breathe better & I have less sinus infections. I am still headache prone.

Do you think you are grinding your teeth in your sleep or have sleep apnea? They both can cause headaches. Have you ever been diagnosed with migraines? Neurologist?

I was prescribed Protonix 20 mg in the a.m. and 20 Mg of Pepcid AC at night for reflux. If my reflux ramps up, I use Protonix 40 mg and when it calms down, I go back down to 20 mg. It try not to eat anything after 6 p.m. except an apple or popcorn to avoid backup reflux. The head of my bed is elevated, I do not wear a tight belt around my waist and getting off any extra weight helps greatly with reflux. All of this worsens reflux.

Flonase itself is notorious for nosebleeds and a lot of folks that I know simply cannot use it.

Decongestants and antihistamines both can be drying to the sinus cavity.

Personally, I would get a 2nd opinion from another ENT doctor and get an mri done if possible. Did your ENT doctor swab your nose to send to a lab to see if any bacteria or mold was growing in your sinuses?

Praying for relief for you & Happy New Year.