Thick yellow post nasal drip, why?

Posted by 303wendy @303wendy, Jun 14, 2023

I got severely ill after endoscopic sinus surgery more than 2 years ago — to the point where I was bed-ridden for three months. I lost 1/2 my hair and was euthyroid sick. Antibiotics and anti fungals have always made me feel better (but it’s never fully gotten rid of it), and I’m no longer bed-ridden, but still feel sick and have had daily fevers this whole time (99-101).

My last CT scan more than a year ago looked fine. I still have fever, fatigue, sinus pressure, stabbing headaches, nasal voice and smell loss AND I still
Have thick yellow mucus going down my throat. I have allergies, but have taken shots for 4 years, and no longer have symptoms. We did have a significant mold outbreak at our house when I had the sinus surgery. Any idea what could be the cause of this long illness, and/or some innocent reason for the yellow mucus?

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@303wendy

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.

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

What was his advice on next steps?

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Very interesting. These are all very valid points for me to consider. Two other factors which may be of interest -- 1) we had a significant mold outbreak in our house a few months before surgery until several months after, and 2) not even prednisone gives me the near full relief that medication does (and I'm just guessing, but I think prednisone would be a stronger anti-inflammatory than antibiotics or antifungals).

I am allergic to mold, and my allergist wonders if I had a severe reaction to mold in the house right after surgery.

Good question about chronic rhinosinusitis. I think I did fall into that category, as I had sinus infections that would clear up and return within days of the completion of my antibiotics for about 6 months. I believe my turbinates were quite large, so much so that I couldn't breathe out of one nostril for more than a year. No doubt my allergies didn't help with that.

Maybe of interest is that my allergist added mold antigens to my allergy shots about 10 weeks ago, and since then, my fever is about 1/2 a degree lower on average. I also have more energy and can, on the whole, smell a bit better. So all I can say is that *maybe* mold has something to do with all this, but I can't confirm it.

I also have tested positive for both staph pseudintermedius and staph intermedius with my nasal swabs in 2021. Both did show they were susceptible to normal antibiotics on the culture. I had high hopes someone would take a tissue sample to check for mold, but no one wants to.

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@nrd1

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

What was his advice on next steps?

Jump to this post

The ENT thought I could just go ahead and quit doing the rinses since there was no improvement. In fact, I have often felt worse with nasal rinses.

He had no clue for next steps (this was my second ENT, as my surgeon ENT gave up on me after 6 weeks and referred me to a chronic pain clinic -- the pain is the least of my complaints).

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@303wendy -
I am so sorry to hear this. And I really feel for you.

This is exactly what happened to me. The referral to Neuro or Pain.
I kept telling them, I was not going to take pain medication when I feel this systemically unwell.

I’ve dealt with pain before this was not that kind of pain. Otherwise I could have been able to navigate through that.

When I went for 2nd opinion I was told to do Budesonide rinse/w topical antibiotic. This made me feel worse as well. And I could not continue do to worsening symptoms from rinsing.

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@303wendy

Very interesting. These are all very valid points for me to consider. Two other factors which may be of interest -- 1) we had a significant mold outbreak in our house a few months before surgery until several months after, and 2) not even prednisone gives me the near full relief that medication does (and I'm just guessing, but I think prednisone would be a stronger anti-inflammatory than antibiotics or antifungals).

I am allergic to mold, and my allergist wonders if I had a severe reaction to mold in the house right after surgery.

Good question about chronic rhinosinusitis. I think I did fall into that category, as I had sinus infections that would clear up and return within days of the completion of my antibiotics for about 6 months. I believe my turbinates were quite large, so much so that I couldn't breathe out of one nostril for more than a year. No doubt my allergies didn't help with that.

Maybe of interest is that my allergist added mold antigens to my allergy shots about 10 weeks ago, and since then, my fever is about 1/2 a degree lower on average. I also have more energy and can, on the whole, smell a bit better. So all I can say is that *maybe* mold has something to do with all this, but I can't confirm it.

I also have tested positive for both staph pseudintermedius and staph intermedius with my nasal swabs in 2021. Both did show they were susceptible to normal antibiotics on the culture. I had high hopes someone would take a tissue sample to check for mold, but no one wants to.

Jump to this post

@303wendy-

That is interesting additional info.

People w/ allergies naturally have a weakened epithelium barrier. Doesn’t mean there is anything wrong, just means more sensitive.

Your allergist sounds like they are well equipped to help you in that area of the mold issues if that has been playing a factor.

So many people have mold sensitivities. Was anyone else around you affected?

Either way I’m so sorry you are dealing with this.
I do believe that our nasal/sinus lining is so delicate, even more so in an allergic type person.

One ENT explained it to me like this. Someone with low level but stable Rhinosinusitis has sinus epithelium that has developed a “callus” of defense so to speak. With sinus surgery this callus is removed and new epithelium has to form as brand new and get used to a brand new way to defend. This is why allergic patients just don’t do as well with sinus surgery because the new epithelium sometimes just doesn’t have the capacity to fend off all the new things coming its way.

I know you are tired of explaining “symptoms” but what are the worst symptoms that you are still dealing with today?

Oral prednisone has also done nothing for me either.

Are your nasal passages clear now?

Something else to add in-once you are a post op patient and you mention the word “pain” to a surgeon they assume it’s all neurological. Verbiage becomes very important.

I have learned that they will listen the word “pressure” more seriously than they will the word pain. If you can point to specific areas etc they “sometimes” are more receptive.

Post surgery things become very subjective vs. objective which can be very frustrating.

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@303wendy

The ENT thought I could just go ahead and quit doing the rinses since there was no improvement. In fact, I have often felt worse with nasal rinses.

He had no clue for next steps (this was my second ENT, as my surgeon ENT gave up on me after 6 weeks and referred me to a chronic pain clinic -- the pain is the least of my complaints).

Jump to this post

@303wendy-

You can take a listen to this if too would like.

Migraine- “sinus type” headache.
https://m.youtube.com/watch?v=w6_3Tw9mMSQ
https://m.youtube.com/watch?v=w6_3Tw9mMSQ
This is why I am very against sinus surgery- especially in women.

PCP/ENT do not take the time to navigate through this with thorough history. Every person especially women, should be screened with a Neurologist and educated on migraine type sinus headache before ever moving forward with surgery .

It should truly be a protocol.
I believe people who were wrongly diagnosed due to the autonomic symptoms that present in nasal/sinus area can suffer greatly with the type of pain triggered from throwing off this entire system.

This is why many Neuros are referred patients from ENTs AFTER sinus surgery, which is very backwards.

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@303wendy I hope you have found some answers. I had two surgeries, five weeks apart. After the last one, my throat had a sore spot from the tubes down my throat. Then all the thick bubbly mucus started coming up in my mouth and blowing out my nose. It was constant and seemed never-ending. My PCP sent a referral to ENT. I cannot get in till the end of July. Now last weekend woke up and looked in the mirror. My mouth and tongue are all white. Never in my life, have I seen this. I now have a fungal infection. I am now taking a liquid dose of Nystatin, four times a day for eight days. The mucous and nasal drainage has slowed down. It should be gone in two weeks. We shall see. Now I wonder if you do not a mold infection which can be worse than what I have. Who knows where it came from? I just want it to go away. Stay in touch and let me know what you find out about your discharge and how to get rid of it. I will be thinking about your situation. This is not fun. KLH

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@kilh

@303wendy I hope you have found some answers. I had two surgeries, five weeks apart. After the last one, my throat had a sore spot from the tubes down my throat. Then all the thick bubbly mucus started coming up in my mouth and blowing out my nose. It was constant and seemed never-ending. My PCP sent a referral to ENT. I cannot get in till the end of July. Now last weekend woke up and looked in the mirror. My mouth and tongue are all white. Never in my life, have I seen this. I now have a fungal infection. I am now taking a liquid dose of Nystatin, four times a day for eight days. The mucous and nasal drainage has slowed down. It should be gone in two weeks. We shall see. Now I wonder if you do not a mold infection which can be worse than what I have. Who knows where it came from? I just want it to go away. Stay in touch and let me know what you find out about your discharge and how to get rid of it. I will be thinking about your situation. This is not fun. KLH

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@kilh- if you don’t mind me asking what surgeries did you have?

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@nrd1

@kilh- if you don’t mind me asking what surgeries did you have?

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@nrd1 April 13th posterior rectocele which caused a large rectal prolapse. I could do anything for when standing up it came out. So May 19th had a Robotic Ventral Mesh Rectopexy. I have five little incisions across my abdomen. No lifting, no pushing when going, and changing diet so nothing gets plugged. Lots of liquids, protein shakes, and fiber. Have to be careful so the mesh can bond where it was placed. That will take 2-3 months. I do not want a repeat of the last few months.

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@nrd1

@303wendy -
I am so sorry to hear this. And I really feel for you.

This is exactly what happened to me. The referral to Neuro or Pain.
I kept telling them, I was not going to take pain medication when I feel this systemically unwell.

I’ve dealt with pain before this was not that kind of pain. Otherwise I could have been able to navigate through that.

When I went for 2nd opinion I was told to do Budesonide rinse/w topical antibiotic. This made me feel worse as well. And I could not continue do to worsening symptoms from rinsing.

Jump to this post

So interesting! I feel like you and I fall into a category about which not much is widely known, so docs offer the things they know about. Very unfortunate.

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