Post Surgical Nasal Sinus Dysfunction/ENS

So sorry for your pain and suffering. I have a minor problem with my nose such that when I talk for awhile, as teachers must do, my nose gets completely blocked and I can’t get any air in through the nose. It takes several hours to unblock. I was going to see an ENT doctor about this but after having read your testimonial I have changed my mind. Thank you for your advice.

@willows
I’m glad you have found this helpful.
I don’t discount that what you experience can feel irritating and cause frustration.

I will never discourage anyone from seeing a provider. But before you do, you have to well equipt with many many questions that you would never think to ask, which are extremely important.

As with any body part, throughout life, it changes as we change. The nose is a VERY powerful organ. People forget that it is an entire organ system connected to your respiratory and pulmonary system. It’s always best to work with your natural physiology than to change, alter, remove body parts of an organ.

Rather than see an ENT, I would recommend working with someone who can help address congestion in your nose and why it happens while you are talking.
This can be for multiple reasons, increase in blood pressure, heart rate etc…
Congestion is not a bad thing, it is an autonomic response. Some people feel it more than others is all. Typically congestion that happens with eating or talking is vasomotor rhinitis. Overly sensitive nerves in this area. People with vasomotor rhinitis also tend to have sensitive ears. Sensitivity is nothing to get surgery for. There are many ways to work with this NON medical doctor related.

There is also a New York Times best seller book out called;
Breath: The New Science of a Lost Art

It explains a lot about this important function and what all goes into its entirety.

At any time you feel frustrated and as you state by this minor problem, choose the opposite approach and recognize how much this area works for you non stop without issues.

Rick, thank you for sharing this. You are so right of course. ENT are a bundle of medical negligence and medical trauma.
More awareness needs to get out regarding ENS. I did not even consent to my surgery, he said he would "drain" a mucus retention cyst but now, believe it was just a tiny bit of inflammation that sat in an expanded lower sinus dip in my maxillary sinus, he butchered me, removed my entire sinus wall, cut out my nasolacrimal duct and valve which backs fluid and air into a very painful eye. I have extensive nerve damage. He out-fractured then cut out my turbinate's, and lied about it all....for months, till i had scans done. Yes, it destroyed me and I have no idea why i left to live this way. I went to so many people for help, yes, they all protect each other. I had to travel out of town to learn what happened and its to late for law suit.

@emptynose

Have you been able to find any relief from any different modalities to cope?

When you walk quickly or move fast can your nasal cavity handle the quick rushes of inspired air?

I do appreciate you sharing your experience, although I know it’s traumatizing to re-tell. But these are very true and real and will only be repeated by patients. An ENT will never share these situations with anyone.

Mucous retentions cysts are very common in the Maxillary sinuses. Often sitting on the floor of the maxillary sinus. These are common findings in about 60% of the population. Those especially who have had allergies at one point in life. The only way most people would ever even know they had them is by getting a CT scan. Once that CT scan is in hand, an ENT can chose to review that honestly or use it as an opportunity to present it as something abnormal and to be removed.
This happens all of the time.

I too went to multiple ENTs post surgery to get answers. I finally found one willing to be honest. I asked him whom he would recommend who could possibly help…
His reply “I can’t recommend anyone because I would never trust anyone to touch my nose” from an ENT himself.

John, I have a deviated septum that, after surgery years ago, was different but no better. I consulted with a few ENT surgeons and studied 'second surgery studies and the caution from surgeons that I could possibly be no better off with another surgery. (The first surgery left me with less cartilage, ergo less structural material.)

One of the best surgeons I could find, who advised against surgery, started offering the Vivaer radio-frequency protocol a few years later. I had that and it increased breathing comfort significantly with no cosmetic difference and no further loss of cartilage.

Hello all - here is an interesting blog courtesy of @nrd1 who has chosen to take a break from posting, but shared privately with me. It's about phantom nasal pain and some of you may find it worth a read:

- - https://www.healthrising.org/blog/2019/10/14/phantom-nasal-congestion-chronic-fatigue-fibromyalgia/

Phantom pain and sensory issues that remain long after surgery has been correctly performed and the healing time has been met, ties in with Central Sensitization Syndrome. Dr. Sletten from the Mayo Pain Rehabilitation Center describes CSS in this video:

- https://www.youtube.com/watch?v=vJNhdnSK3WQ

I experienced an upregulation of my central nervous system and peripheral sensory input after having corneal and cataract surgeries. My surgeries were a success visually, however I began having unexplained, increased sensory issues in my eyes.

I hope this info has been helpful, and may be food for thought for some of your situations. Thanks to @nrd1 for sharing the blog. Have a great day everyone and keep your chins up. 😊

Hi John,

I have been considering septoplasty, but would like to try the Mayo Clinic proprietary nasal spray. How does one procure it? Thanks!

Hi @danye1, The 3 ingredients are Mometasone to reduce inflammation, Ipratropium to reduce nasal drainage and Diphenhydramine which is an antihistamine to help reduce nasal drainage. The product description on my prescription is MOMET 0.033% – IPRA 0.02% – DIPH 0.02%. I think an ENT doctor may be able to write an RX so that you can get it from a Mayo Clinic Pharmacy but you may want to talk with your doctor and/or give the Mayo Pharmacy a call. Here's the Mail Order phone information:
Phone: 507-284-4041, 800-445-6326
Mon – Fri 7:30 am – 6 pm
Sat – 8 am – noon
Closed Sundays and Holidays

Does your ENT think that part of your problem with the congestion may be related to rhinosinusitis. Since using the proprietary nasal spray along with a twice daily nasal rinse, I've switched to using the SinuSonic Sinus Therapy - https://sinusonic.com/. Each device lasts about 6 months and is about the same as paying for the twice daily nasal rinse supplies. I was surprised at how well it has worked for me. Here's a study that I found on the device prior to buying one. I've used one for a couple of years now and it has pretty much cleared my congestion as long as I use it once or twice a day. I normally just use it before going to bed.
-- A novel device combining acoustic vibration with oscillating expiratory pressure for the treatment of nasal congestion:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7317541/

What was his name? Can you expand on your Positive Vivaer experience? Not alot to read. Most negative.

@nrd1 - I would just like to say that ENT surgery can in some cases absolutely change your breathing and how you are feeling. In fact, that may be the entire purpose of the surgery. Similar to sleep apnea, treatment for any kind of disordered breathing can have surprising and far-reaching impact. Beyond the obvious impacts on sleep, sports, mental clarity, and energy, sleep apnea has been linked to depression, and sinus inflammation has been linked to anxiety. No one knows at this point what the relationships are exactly, and hypotheses range from some kind of physical, emotional, or epigenetic trauma causing the apnea or sinus inflammatory disorder, or the other way around: the apnea or sinus disorder causing a depression or anxiety perhaps due to lack of proper oxygen supply or negative polyvagal stimulous. Knowing the root cause may not be possible, but surgery can improve breathing at minimum, and sometimes does much more.

In my case I had two extra sinuses, which where inside two of the normal eight sinuses we all have. Being filled by additional sinuses rendered those two "normal" sinuses useless, and the "extras" didn't have a normal drainage pathway. This means I functionally only had six sinuses, when eight is normal. My remaining six sinuses that were doing all the work were misshapen with convoluted hooks and loops that prevented sinus drainage in several locations. All of my turbinates were huge... extra enlarged from years of chronic inflamation. Instead of looking like a potato chip, they looked like small avocados. My turbinates and sinus walls were touching all over the place (normally air flows around the turbinate, inside the sinus). This caused mucus to cling and not drain even where there were no hooks physically catching mucus.

I was getting sinus infections after every cold, and was choking and gagging on thick mucus for about half the year. I was completely convinced this meant allergies. Allergies are a complex area, and I cast I wide net spending a ton of money and a few years seeing several different specialists and getting a wide variety of tests. In the end, it was determined that I was not having an allergic response, but that for some reason I had heightened sensitivity. I was also tested for several bacterial and viral causes, before I finally, finally got an MRI and we found my sinuses looked like Dr. Seuess constructed them!

Prior to my surgery, I was very familiar with trying to remove irritants from my diet, air purifiers, saline rinses, steroids, and when things advanced to infection, antibiotics and systemic steroids. A few hours post opp, even with my sinuses packed, I was breathing better than when I went in. My surgeon said it was a miracle I didn't have more than one infection every year or two, and it showed how brilliant I was at doing sinus rinses, because most people with the same sinuses would have been in for surgery much sooner.

I completely agree surgery is risky, and the medical industry is fraught with problems. I am sure there are people getting surgery that don't need it in some cases, or cases where the risks can outweigh the benefits. For others, it is absolutely lifechanging. Basically I think what you are saying can be true in some cases, but not all.

If you have signifincantly malformed sinuses, I recommend filling your sinus cavity with the saline rinse, and then tipping your head back, rolling it around, and swinging it between your legs before letting it out, gargling, and blowing. Then use your nasal steroids a half hour later.