@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.

Also-
What did your original surgeon assess after your 7 months of Budesonide rinse?

What was his advice on next steps?