Sinusitis
Sinusitis
16 Infection Fighters
During the day, your head is so pumped with pressure that you feel like the Snoopy balloon in the Macy's Thanksgiving Day Parade. Later, when you try to sleep, it's as if you've sprung a slow leak. All night long, the drip, drip of nasal fluid trickles down your throat and sends you into coughing spasms. Your spouse is not amused.
Welcome to the nightmare of sinusitis, a condition in which the sinus cavities around your eyes and nose are infected, producing pressure, pain, and gobs of yellow or green mucus. How did you and 30 to 50 million other people get this stuffiness?
To understand that, you first have to understand what your sinuses do when they're working right. Scientists believe the sinuses around your nose act like small air-quality control centers. It's their job to warm, moisten, purify, and generally condition the air you breathe before it hits your lungs. Entering bacteria gets trapped and filtered out by mucus and minute nasal hairs called cilia.
This little air-flow system may gum up, however, if something impedes the cilia, if a cold clogs the sinus openings, or if an allergen swells the sinus linings. Then air gets trapped, pressure builds, the mucus stagnates, and bacteria breed. Infection sets in and you have a whopping case of sinusitis. If you get clogged up too many times, you may wind up with a permanent thickening of the sinus membranes and a chronic "stuffy doze."
Before you get to that point, here's what the doctors say you can do to unstuff your sinuses, reduce pain and pressure, and get the air flowing freely.
Change Your Habits, Not Your Address If your sinus symptoms kick up when the blossoms start to bud, you may feel like packing up for the Sahara desert or some other dry climate. Such a move, however, won't cure your sinusitis. "If you are allergy prone," says Stanley N. Farb, M.D., "your sensitivities will follow you wherever you go and sinusitis will reappear." In other words, you may eventually develop an allergy to desert dust. Or, if you move to a humid climate like Miami, you may develop a sensitivity to mold. The solution? Control your exposure to allergens where you now live. (For some ideas on how to do it, see Allergies on page 7.) |
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Get all steamed up. "Humidity is the key to keeping the cilia working, the mucus flowing, and the sinuses drained," says Stanley N. Farb, M.D., chief of otolaryngology at Montgomery and Sacred Heart hospitals in Norristown, Pennsylvania. Twice a day, stand in a shower hot enough to fog up the mirror. Or lean over a pan full of steaming water with a towel draped over your head, creating a steam tent. Inhale the vapors as they waft up toward your nostrils.
Get a snootful at work. If stuffiness hits during the day when you're at work or on the run, get a cup of hot coffee, tea, or soup, cup your hands over the top of the mug, and sniff, suggests Howard M. Druce, M.D., assistant professor of internal medicine and director of the Nasal and Paranasal Sinus Physiology Lab at St. Louis University of Medicine. It won't work as well as a steam bath, but it will provide some relief.
MEDICAL ALERT
When Self-Treatment Isn't Enough If you've tried self-treatment for three or four days and still have sinus pain, pressure, and stuffiness, you need to see a doctor to help clear up the infection and drain your sinuses, advises Terence M. Davidson, M.D. "Otherwise, your sinuses could abscess into your eye, or worse, into your brain." You may need to take antibiotics or, if your symptoms persist, undergo surgery to break up the blockage. A sinus specialist can also perform x-rays and help you discover what's causing your congestion, be it a virus, an obstruction like polyps, allergies, or a sensitivity to medications such as birth control pills or aspirin. |
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Humidify your home. Running a cold-mist machine in your bedroom will keep your nasal and sinus passages from drying out, says Bruce Jafek, M.D., a professor and chairman of Otolaryngology/Head and Neck Surgery at the University of Colorado Health Sciences Center School of Medicine. Just make sure you clean it once a week so fungus can't set up shop.
Bathe your nostrils daily. To flush out stale nasal secretions, Dr. Jafek suggests using a commercial saline product or mixing 1 teaspoon of table salt with 2 cups of warm water and a pinch of baking soda. Pour it into a shot glass, tilt your head back, close one nostril with your thumb, and sniff the solution with the open nostril. Then blow your nose gently. Repeat on the other side.
Drink to your heart's content. Drinking extra liquids—both hot and cold—throughout the day, Dr. Farb says, thins out the mucus and keeps it flowing. Sipping hot teas made with herbs such as fenugreek, fennel, anise, or sage may help move mucus even more.
Blow one nostril at a time. This will help prevent pressure buildup in the ears, which can send bacteria further back into the sinus passages, Dr. Farb says.
Forget your manners. Go ahead and sniffle. It turns out, says Dr. Farb, that sniffling is also a good way to drain the sinuses and escort stale secretions down the throat.
Unstuff yourself with decongestant tablets. The best over-the-counter medication to dry up sinuses is single-action tablets that contain only decongestants, such as Sudafed, says Dr. Farb. Decongestants constrict the blood vessels, put air through the nose, and alleviate pressure. You should avoid products containing antihistamines if you are stuffed up from an infection, says Dr. Farb. "They work by drying nasal secretions and may plug you up more."
The Alternate Route
Order It Spicy The way to find sinus relief may be through your stomach—by eating foods containing certain spices and condiments, says Howard M. Druce, M.D. Here's what he recommends. Garlic. This pungent herb contains the same chemical found in a drug given to make mucus less sticky, says Dr. Druce. Horseradish. This pungent root is another good mucus mover because it contains a chemical similar to one found in decongestants, he says. The bottled variety will work fine. Cajun spice. You probably can't go wrong if you order Cajon food. These spicy dishes are made with cayenne peppers, little red tongue torches that contain capsaicin, a substance that can stimulate the nerve fibers and may act as a natural nasal decongestant. But not every fiery food that makes your eyes water or nose run will burst through your sinus blockage. "Not every spice contains chemicals that work directly on the sinuses," explains Dr. Druce. In other words, eating them may make your nose drip and do nothing to drain your sinuses. And that could only compound your problem. |
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Use nasal sprays sparingly. Nose drops are fine to use in a pinch, but frequent use could actually prolong the condition or even make it worse, warns Terence M. Davidson, M.D., an assistant professor of head and neck surgery and director of the Nasal Dysfunction Clinic at the University of California Medical Center in San Diego. It's what the specialists call the rebound effect.
"What happens is that, initially, the sprays shrink your nasal linings," explains Dr. Davidson. "But then the mucosa reacts by swelling even more than before, creating a vicious cycle of use. It can take weeks for the swelling to finally subside after you stop using the sprays."
Walk to clear your head. Exercise, says Dr. Farb, may bring blessed relief because it releases adrenaline, which constricts the blood vessels, thereby possibly reducing swelling in the sinuses.
Press here for pain relief. Rubbing your sore sinuses brings a fresh blood supply to the area and soothing relief, suggests Dr. Jafek. Press your thumbs firmly on both sides of your nose and hold for 15 to 30 seconds. Repeat.
Wash your pain away. Applying moist heat over tender sinuses, Dr. Druce says, is an easy way to wash away sinus pain. Apply a warm washcloth over your eyes and cheekbones and leave it there until you feel the pain subside. It may take only a few minutes.
PANEL OF ADVISERS
Terence M. Davidson, M.D., is an assistant professor of head and neck surgery and director of the Nasal Dysfunction Clinic at the University of California Medical Center in San Diego.
Howard M. Druce, M.D., is an assistant professor of internal medicine and director of the Nasal and Paranasal Sinus Physiology Lab at St. Louis University School of Medicine in Missouri.
Stanley N. Farb, M.D., is chief of otolaryngology at Montgomery and Sacred Heart hospitals in Norristown, Pennsylvania. Dr. Farb is also author of The Ear, Nose, and Throat Book: A Doctor's Guide to Better Health.
Bruce Jafek, M.D., is a professor and chairman of the Department of Otolaryngology/Head and Neck Surgery at the University of Colorado Health Sciences Center School of Medicine in Denver. He is also chairman of the Paranasal Sinus Disease Committee of the American Academy of Otolaryngology/Head and Neck Surgery.
