Thick yellow post nasal drip, why?

One quick question for you: would a CT scan or an in-office nose scope show if that connection you mentioned is correct?

If the person is looking for it-
They would use an angled scope for endoscopy, not a rigid scope.

And if they are looking for it they can sometimes point it out on a scan.

You would need both for confirmation.

And yes, many general community ENTs, whom see someone seeking a second opinion after an original surgery do not want to “deal” with patient complaints, post surgery from a surgery they are not responsible for.

It takes A LOT of their time and is completely different than taking on a patient of their own that has an issue.
They are also very hesitant to comment on any surgery performed by a fellow colleague. Too much liability issues these days. Unfortunately this is behind the scenes, unspoken agreements.
So it’s hard to trust if someone is truly assessing you or just wants to say you’re good and send you out-just the way these days.

Most teaching institutions have a lead Rhinologist whom focus on Revision surgeries, weather you would need one or not, they are the best at assessing because they know what to look for and are willing to take on someone else’s patient post surgery.

If you have selected these ENTs yourself without knowing what they specialize in, that’s fine- but most likely they accept your appointment, look at your history 5 minutes before walking in the room with you, and give you an “all looks good to me” just because they don’t have the time nor willingness.

I am being very direct-this is just the way it is.

So, if you are unsure if you have met with an ENT whom dedicates 80% of their practice to revision, I would look there.

There is a reason there is a revision specialist in almost every area- this surgeries are not the best and are the most grey area operations performed on the body.

What were your original presenting symptoms for surgery to begin with?

Thanks, I appreciate all the info, it’s very helpful.

Original symptoms were sinus pressure, fever, bad breath, malaise, sometimes pain. Antibiotics always made me feel better, but symptoms would return 10 days after finishing a course of antibiotics.

@303wendy-

You’re welcome.

Something else to consider is that opening of the sinuses for some people can cause drying out of mucous/mucous membranes.

This can cause some odd sensations in people as the tissue is supposed to adapt to the new air that it has been introduced to.

If you have experienced, dry eyes, different type of pain that you did not experience pre surgery this “might” also be the case-

Something to discuss w/ the ENT doing your PRP.

If pre surgery you had did not have a bunch of mucous you were draining out or having to clear, yet had more of an inflamed/dryer feeling already, this can alter that in a way.

Some people whom have allergies are also just naturally more prone to thicker/dryer mucous & mucosa.

Doesn’t mean there is anything wrong with that, it just is.

Some people confuse allergy issues with infection and perhaps the antibiotics that you felt worked for you at the time, were lowering the overall inflammatory load, which is what antibiotics do, aside from just the bacterial component.

Again-we can change the structures which is what ENTs do, but the body is still going to do what it is doing from the inside out.

Also to add on to my last reply,

Were you ever on long term topical treatment before surgery?

I wasn’t. Wishing they suggested I try that.

@303wendy—

I understand this- and I really feel for you that you have gone through this.

There are many unknowns in the ENT world, especially they way they diagnose and recommend “elective” surgeries.

This isn’t to say that people don’t benefit in certain situations, but all boxes have to be checked and serious trials of therapy before ever moving someone forward for surgery. And even still surgery is only for better access of medical therapy into the sinuses. It’s not a stand alone surgical treatment.

Do you have the constant yellow mucous daily and just an overall general feeling of being unwell?

Also-keep in mind often times loss of smell is not due to any blockage or nerve issue but rather inflammation in that area.
With your ENT wanting to inject PRP in this area of the olfactory tissue is he suspecting nerve/tissue loss?

I would also be curious to ask this ENT if indeed a FULL complete FESS was done.
Or just partial areas of the ethmoid air cells.
Do you know if yours was indeed full?

Sorry for all the questions-just trying to help.

Hi, I actually had a doctor say that I was just breathing differently and had to get used to it. It's much different than that. I've been ill for 2 years, with fever. My illness was so intense that for the 3 months following surgery I was bedridden, unable to walk more than a few steps around the house. My husband had to learn to cook, shop, do laundry, clean, take care of the dog, etc. I lost half my hair and was euthyroid sick. I've had a fever every day since my surgery and feel the kind of sick you feel when you have any respiratory infection - malaise, exhaustion, achy, altered appetite, etc. So I don't believe it's just a simple matter of feeling air in my nose differently (no shade to you, but shade intended toward the ENT who dismissed my symptoms).

I've had allergies all my life, and never had this amount of thick mucus (nor was it ever colored) go down my throat. In fact, allergies make my nose a watery type of runny. My allergies have always produced itchy eyes, nose and throat, sneezing, and watery runny nose. Allergies never made me feel sick. Nothing like what's happening now.

I don't believe it's empty nose syndrome, as I have no issue feeling air going through my nose, and it feels like the normal temperature as always. While a doctor was trying to help me figure out what's been going on, we discovered that I have a milder form of cystic fibrosis, and that can cause thick mucus, but since I've had CF since birth that wouldn't be the main cause (otherwise my mucus would always have been thickly going down the back of my throat).

The mucus is constant, and I feel sick. It's not just feeling a bunch of symptoms, it's feeling sick -- which I'm finding is hard to describe to people, they just want a list of symptoms.

My sense of smell comes back nearly all the way on antibiotics/antifungals.

I think mine was full? But the last ENT said the surgeon didn't mess with the frontal sinuses.

I'm very thankful for all your questions! And your interest in helping.

@303wendy -

I completely understand what you are saying. And I want you to know that, so you feel heard.
I know what you are trying to explain in the terms of sick feeling, and I wish there was an ENT who could explain what inflammation of the sinuses can cause. I as well had NO clue, because I never had true and real “sinusitis” pre surgery.
My sinuses knew what to do on their own even in an inflammed or allergic state, so I never felt “sick” except for how any other person would feel with a common cold for a few days.

I’m assuming you feel as if you have the sensation of a permanent sore throat, but in your face?

This might be long, but I will explain how this was explained to me by multiple ENTs. This is not googled and I’m not coming up with random diagnoses that will lead you down random paths.

I know in one of your previous posts you stated a year ago your CT was clear?

I believe you feel better on the anti fungal/antibiotics and your smell comes back because it is reducing the inflammatory load for a little while.

The frontal sinus outflow track follows a convoluted pathway and has so many variants from person to person.
By working on the sinuses below, this can tork the natural track that all sinuses follow, leading to a back up in a “funnel” so to speak-if this happens everything above can stay inflamed. Not saying this is your situation, but just something to have someone consider to look at.

Some people can really suffer if their anterior ethmoids/frontal sinuses were not addressing in the original surgery as this can “narrow” the funnel so to speak for drainage pathway.

This can can keep someone in a chronic inflamed state, not by way of infection but because working on the lower half caused upstream narrowing, inflammation and scarring.

If spacers were not used in the middle meatus and ethmoid cavity post surgery this can also cause scarring off of original openings. Causing different pathways of mucous trying to secrete and therefore causing new onset of inflammation.

On CT there is no way to distinguish, why you are experiencing inflammation.
Someone would really have to know what to look for.

The way you describe how you were bed ridden for 3 months leads me to think that while you were in the healing process, however you were healing was causing new inflammation, pressure, scars, and more narrowing. This can put new pressure on nerves that you never felt before, hence the head pain, and Trigeminal neuralgia type pain.

I would assume that before surgery although you might have had some sinus infections were they pretty self limiting, although you did use medication?

It was also explained to me, that people who suffer from allergies have poorer outcomes with these surgeries, because the skin barrier is naturally sensitive. So we will always have that type of skin barrier, but throughout life it develops a “callus” so to speak due to adaptations. And over time you become less sensitive.

People who have success are those who have true and real sinus infections due to anatomical blockages.

Pre surgery did you ever have mucous draining issues as far as constant nose blowing of thick stuff or having to cough back mucous?

Often times, sinus infections are due to allergies as well, and if you never tried anything topical with your allergy shots, that could have addressed some allergic inflammation. Many people get pain, pressure and congestion that are purely from allergy and not infection at all.

I think what you are experiencing is an entirely new inflammatory load from the alterations to your sinuses that were made.

The constant yellow draining mucous is an indicator of unhealthy inflamed sinuses.
Why that area is draining like that needs to be assessed as a POST surgical patient.

A PCP/FP will only address this as an “infection” and give you more antibiotics.

Unfortunately once a post surgical patient it is almost impossible to get help, as you normally would in your natural pre-op physiologic state.

For whatever reason, it’s hard to say, but there is a stuck inflammatory state occurring and if this started the way you described it, I don’t think the sinuses healed properly.

I know this frustration- and I also know the frustration of being told it’s “just inflammation”. It’s not true type of inflammation you had pre-surgery.

I will just encourage you to speak with an ENT who is well equipt to assess the outcome of FESS surgeries and perhaps can come up with a new set of eyes to look at your scan.

Having ongoing inflammation in your face and head is very distressing to all the systems from the neck up.
Vestibular, Vision, Smell, Taste and overall well being.

Also- if you were a very active person before this lien you mentioned, something tells me you did not fall into the category of “chronic Rhinosinusitis” which is categorized as ongoing unrelenting symptoms for 3 months or more. Did you have a long history with your ENT?

It is not the same as inflammation in a joint.