Many thanks for your reply.I moved to Asia and within weeks I began to have URI symptoms. First hospitalised six months later for sinus infection and IV therapy and then my first ENT surgery. In 2015 the fires in Asia which lasted 2 months did not help and I was hospitalised numerous times for IV therapy. I returned home in 2017 and since then I have had 3 additional sinus operations including turbinate and the last one a modified Lothrop. My ENT does not like to do surgery as each time I lose some structure and integrity however the level of infection is severe and the last CT showed the sphenoid completely blocked. I flush twice a day and usually nothing comes out. Since this has all started I have also developed a skin rash requiring a regime of 3 months of histamine blockers, severe rash when I go on a beach vacation, skin abscesses requiring drainage and raynauds. I have seen a rheumatologist, infectious disease specialist, gastroenterologist (to rule out GERD) and an immunologist. Some of my lab tests were abnormal but nothing drastic. I also follow a vegan diet and take probiotics. I was contemplating asking for second ENT opinion but as mentioned my doctor is the one that other ENT refers the severe cases to but perhaps it’s time. It’s a horrible way to live and I try to remain positive buts it’s not easy.