dcypherzzz, This is lengthy, but, I hope it helps in some way for you.

I can so relate. This has been the hardest summer, going into fall, I have
ever had with allergies. I am pretty much on the same meds you are, except for Advair, Benadryl and Gauifenesin. I take NAC 500 mg supplement by Thorne (I only take 1/2 as this can be too drying to my eyes) for the drainage and Children's Zyrtec liquid in the a.m. & in the p.m. I also take Thorne Quercitin and Vitamin C & D for my immune system. I am ultra sensitive to meds so I have to do baby doses in everything.

Please ask your doctor before going on anything I mention.

I drink a cup of hot Lemon Ginger tea before I got to bed at night as this helps with the drainage. You could add local honey in it if you like as that is supposed to help with allergies. Celestial Seasonings and Bigelow is good. This also helps your immune system. I know, one more thing to do right?

Is the head of your bed elevated to help with reflux? Do you eat heavy after 6 p.m.?
I try and not eat after 6 p.m. except an apple or Skinny Pop Popcorn to keep reflux down.
I use Gaviscon cherry flavored tablets for breakthrough reflux and they are wonderful per
my primary doctor's office. You can use these even if you are on Protonix. Ask your doctor
before trying please.

I do find that allergy increase makes the GERDS worse and so dose having asthma. They tend
to both get flared up at the same time. Do you hear yourself wheezing? Then you possibly
have asthma. Normally, you hear asthma wheezing when you lie down. A Pulmonologist
can definitely diagnose this for you.

I use Flonase & Azalastine spray. I irrigate my sinuses twice a day with the NeilMed Sinus rinse which comes with saline packets and use Distilled water. I had a CT scan done with my ENT and he said my sinuses look good. Some folks I know that are not allergy prone are being
bothered this year with sneezing and drainage.

If I sit outside on these pretty days, I get a sinus infection. It's been a vicious cycle. I have
hardly been outside for more than 5 minutes since spring due to how it affects me with
asthma, allergies, sinus infection & headaches. The pollen was horrific this spring.

I am on a Nebulizer daily (Albuterol) and a rescue inhaler (Albuterol) as needed.

Here's what I think it is. Our air is different this year outside. So many natural disasters
all around us, floods, hurricanes, fires, etc., I do believe a lot of this stuff gets in the air and
those of us who are allergic to things are more sensitive to the outdoors. I believe
it gets into our homes as well. Also, we had a lot of rain this summer and high humidity which breeds mold outside more than usual. Even my cat has developed allergies and asthma
this year and is on medication.

Do you have an air purifier in your home? If not, I would invest in a good one. I can tell a huge difference in the air quality in our home since we bought one. We keep a clean house, but, this year, it has become dustier.

Have you been allergy tested with a blood test to see if you have developed new allergies? I just had that done at my Pulmonologist's office.

I will also ask this, have you had COVID? My allergies & upper respiratories issues got worse after having COVID twice. I am more prone to sinus infections, asthma & asthmatic bronchitis & pheumonia since COVID. I was diagnosed with Long Covid.

You said you live near farming....do you think that could be the culprit?

Praying for you right now to get relief. I understand how miserable this can be. Blessings & Prayers.....

@dcypherzzz I sympathize with the allergies. I have allergic asthma, and occasionally, I get a sinus infection that spreads to my lungs. It causes excess phlegm. What I notice when it's an infection is my resting heart rate goes up a little bit, and I usually get a sore throat from post nasal drip. Sometimes my sinuses hurt too. I've heard that it may be something like a staff infection. What helps me is to use Mupiroicin in each nostril for several days at bedtime when this happens. It's just a pea size amount and I put it as high in my nose as possible. This came from a preventative treatment before I had surgery directed by the doctor. It worked well to fix the lung issues and my doctor lets me have this to keep on hand. When I treat this, usually the next day has a lot of clearing of phlegm and it makes me think I'm getting sick, but a half a day of that, and I'm back to normal. I thin the mucus too with generic Mucinex.

I have issues near farming and harvesting that puts a lot of dust in the air. That could be a source of bacterial lung infection. I also use HEPA filters inside my home and wear a mask or respirator outside when the air is dirty or smoky from distant wild fires.