Nasal congestion - suggestions welcomed

Ears, nose and throat
1

Hi

For many years my nose has been a mix of runny and too dry at times, but didn't affect me and I didn't think anything of it.  I'm in the UK, now 72 and for the past few years this has been getting steadily worse, with my nose feeling blocked up to the point where it is affecting my breathing.  I smoke but my lungs seem to be fine, however I don't seem to be able to get enough air through my nose, which gives me problems when I walk and climb stairs.  I can do it, but I have to stop and catch my breath.  I'm now putting on weight because I'm not getting exercise.

Recently I've seen two GPs. The first one looked up my nose and said I had some nasal polyps but the main problem was the narrow airway.  He gave me an Avamys (steroidal?) nasal spray which I used for 2 months but it didn't have any effect.  

The second GP said the first one wouldn't have been able to see any polyps I had because they would be too far up!  He gave me anti-histamines on the off-chance that swelling in my nose is an allergic reaction, and they seem to have had some effect on drying up the phlegm dripping down the back of my throat causing a tickly cough - but haven't led to any opening of the airway.  He also gave me Flixonase Nasule Drops which I haven't started using yet, but even if they are effective I can only use them for 12 - 16 weeks.  

If this stuff doesn't work he will refer me to an ENT specialist - but he also said it was quite possible there would be nothing that could be done!  I can't believe that!  We can give people body part transplants, even a face transplant - but we can't do anything about a blocked nose which is affecting my breathing!  I have read of someone with similar problems who finally had their swollen labinates reduced with laser treatment, which resolved the problem.  But the second GP wasn't at all keen on this.  He insisted that consultants don't like using laser treatment, that hardly anyone does it now, etc.  I know surgery is possible on polyps, but it sounds pretty major and I don't fancy it.

Does anyone have a similar condition? How is the diagnosis done - camera up the nose?  Have you had any treatment that worked?  Anyone had laser treatment?  Did it work?  Any information from your experience would be much appreciated.

2

Hi

Well, I understand you completely, I had gone through the same prretty much the same. I'm sooo fed up with DRs ignorance and for every nasal problem giving the easiest solution, steroid sray like awamys, yes I have used it too, along with a other doezens, none workded for me!, or antihistamines. They only work if you have runny nose, not blocked nose!

About the polyps, you probably woldn need a CT scan, I don't understand why any of your GPs send you to get it done. ENT wouldn't even bother to see you without a CT. ENT will put a little camera up your nose, to check for anything like polyps or deviated septum. It doesn't hurt at all, not to worry about it!

If you have a polyps surgery could help, discuss it with ENT, not a GP.

You could also have an enlarged turbanates, this can be diagnosed with CT / camera up the nose. I had middle turbinate reduction, but for me it didn't work at all! So I would be extremely caution for any turbinectomy, in some / few cases it can lead to  ENS, google it up, horrible uncurable, irreversible disease!

There's another wau to fix enlarged turbinates, it's called cauterisation, there are different names for it, (your referring it as laser) but basically they burning part of the turbinates. I was thinking about it done, but at the end I didn't. I read that it's a better and safer way that the full surgery. But I don't really know much about it, it's just something to consider for enlarged turbinates problems

Deviated septum might also cause blocked nose, but if you have blockage on both sides, it might be something else.

What the most likley possibility, that you have allergies / sensitivity to pollen, dust, fungus, mold. You could get an allergy test done, it;s also very easy, quick, doesn't hurt. It won't tell you 100% , as they just doing tests for the most common ones, not for everything, but it will be a good start to find out what's causing your problem. Nasal steroid sprays can be effective for seasonal allergies, but chronic ones, very unlikely. Constant use of steroid sprays can also damage the lining of the nose.

You can certainly give a try for natural therapies / treatments,

The most common one is saline rinse, you can make the saline solution at home or buy it at any chemist. Cheap! Regular use helps a lot of people suffering from allergies.

Changing diet, something to try, no milk, dairy. (goodle allergies and diet / milk)

For me the only and only thing which helped is miving very far away from my home - I used to live in a hot tropical climate, and had blocked nose 24/7.

Everybody is different, there is no treatment fitting everyone. Unfortunately as the doctors / Pharmaceutical companies do not provide much help, you can just start experimenting which treatment works for you. I hope one eventually will!

And you absolutely right, I'm thinking exactly the same, we are in the 21st century, we can give people brand new hearts, brain surgeries, transpalnts, etc, but can't fix a block nose. Isn't it amazing? What I think, is that they don't put any money into research because if it could be fixed who would buy nasal sprays, antihistamines etc?! 

Hope you find a cure, good luck!

 

3

Hi care4health

Many thanks for taking the time and trouble to write a detailed reply.  I think I've read adverse stuff in the past about prolonged use of nasal sprays, so I've steered clear of the proprietory ones from chemists.  I have been using an Olbas inhaler recently which is mostly menthol and peppermint.  Usually one side of my nose is blocked when I use it, but it's rarely the same side twice, so I figure that rules out deviated septum, and suggests swollen turbinates.  There could also be polyps of course; I guess I'll find out about that when I get referred to ENT.

In the meantime I'll follow up the allergy route, and thanks for the suggestion of an allergy test, which I'll suggest next time I see a dr.

I'm determined to try to get some improvement on this.  Not sure if I'll find a cure though.  I would love to, but I may have to accept that this is going to continue to affect me to some extent.  However I'm determined to find some way to get it under control enough for me to keep doing what I want to do.

Thanks for your thoughts on laser treatment, which are very useful.Hope things go well with you.

All the best   Terry

 

4

One more thing I thought about, humidity or dry air could also cause nasal congestion. Depends which one your are sensitive to. Could be both.If the air is too dry you can try a humidifier or if it's very humid, maybe a dehumidifier, but those one are quite expensive and not very effective. 

If you don't want to use nasal sprays, you can occasinally use Pseudoephedrine tablets during the daytime (no good if you have heart problem or high blood pressure)