Sinusitis

Sinusitis

Make Breathing Easy

When God was handing out noses, most of us probably hoped for something attractive--a stylish Roman or a cute little turned-up version. Who thought about mucus drainage and discharge?

Well, according to Nelson Gantz, M.D., chairman of the Department of Medicine and chief of the Division of Infectious Diseases at the Polyclinic Medical Center in Harrisburg, Pennsylvania, form should follow function. With apologies to God, Dr. Gantz suspects that the reason that sinusitis is a common health problem in the United States is that the sinuses aren't very well designed. "The sinuses should really have better drainage," Dr. Gantz says.

Although sinusitis is a common condition, it isn't as common as the complaints about it would indicate. "People frequently think they have sinusitis when they actually have bad colds, allergies or tension headaches," says Donald Leopold, M.D., associate professor of otolaryngology/head and neck surgery at Johns Hopkins University in Baltimore. Strictly speaking, sinusitis is a bacterial infection that swells the sinuses, causing headache, facial pain and sometimes fever and other symptoms.

The sinuses are eight hollow compartments located behind your cheekbones and eyes, like little bedrooms tucked off the nose's main hallway. No one pays much attention to them until they start to hurt. But then, oh, brother! The symptoms of sinusitis--thick, yellowish-greenish mucus that keeps draining and makes breathing through your nose a battle, severe headache with facial tenderness centered around the cheeks and eyes, a dry cough and sometimes a fever--can make you miserable.

Design defects may be part of the problem, but it takes a catalyst to infect and inflame the sinuses. The common cold is frequently the culprit. Colds cause congestion, which makes it harder for the cilia, tiny hairlike projections that line your nasal cavity, to sweep out germs in the air you breathe. Congestion from a cold or a bout with seasonal allergies flattens the cilia, giving bacteria a chance to accumulate in the nasal passages and infiltrate the sinuses. Only 1 cold in 200 actually develops into sinusitis, but because women catch an average of three or four colds each year, the odds are that most of us will suffer the pain and discomfort of a sinus infection at least once in our lives.

Pregnancy and Other Causes

Except when they're pregnant, women are no more likely than men to have sinusitis. During pregnancy, hormones secreted to thicken the uterus also thicken nasal passages, causing nasal congestion, which in turn can increase the incidence of sinusitis. "Some women say they never want to get pregnant again," says Howard Levine, M.D., director of nasal and sinus surgery at the Mount Sinai Nasal-Sinus Center in Cleveland, "because they have so much trouble breathing that they can hardly sleep or eat."

Sinusitis is seldom the most troublesome symptom that pregnant women face. But when it does develop, especially in conjunction with asthma or allergies, it can make breathing--never a simple task when a fetus is pushing on your ribcage--a major challenge. Physicians may prescribe antibiotics and often recommend steam treatments and other home remedies, but pregnant women should consider avoiding decongestants, which can elevate their blood pressure.

Pregnant women aren't the only ones at special risk for sinus problems. Anyone who has asthma or seasonal allergies is vulnerable, too. People with vasomotor rhinitis, a condition that makes them exceptionally sensitive to airborne pollutants such as perfume and cigarette smoke, are also more apt to develop sinusitis.

Low humidity and polluted air set the scene for all kinds of respiratory problems that could lead to sinusitis, says Stanley Shapshay, M.D., chairman of the Department of Otolaryngology/Head and Neck Surgery at Tufts University School of Medicine and otolaryngologist-in-chief at the New England Medical Center Hospital, both in Boston. "As air quality deteriorates, doctors are seeing much more airway disease," he says.

How to Keep Your Nose Clear

Because an acute attack of sinusitis is such a dreadful experience, anyone who's endured it once wants to avoid future episodes. If prevention is the key, steam is the first line of defense. Taking a hot shower, for example, opens up the sinuses. Decongestants may also be taken at the first sign of cold congestion, because if nasal passages stay blocked long enough, they will inevitably get infected. And although antihistamines may seem like a good idea, they're not. They're great for relieving allergic symptoms, but they dry up mucous membranes and increase congestion.

The best advice, says Dr. Levine, is don't catch cold. "Most colds are spread by hand-to-hand contact," he says, "so it helps to wash your hands frequently." If you manage to get a cold anyway, here are some tips to keep your sinuses from swelling.

Get humid. Invest in a humidifier, says Dr. Levine, but be sure to keep it clean. Humidifiers are great for adding moisture to the air, but they're also great at growing mold and mildew. Using distilled water helps, but you should also clean your humidifier weekly. Empty the tank and scrub it out with a half-cup of household bleach or vinegar mixed with a gallon of water. Rinse well before you use the humidifier again. By the way, it doesn't matter whether you buy a warm-air or cool-air humidifier: It's the water itself that creates the climate for mold and mildew.

Drink chicken soup. "Grandma was right," says Dr. Levine. "The heat from the soup is mucus-thinning, and the garlic is, too." For best results, drink your chicken soup--or any other hot liquid, such as hot tea with lemon, Chinese hot-and-sour soup or even hot water--from a cup so that the steam rises right up into your nasal passages.

Breathe deep. Fragrant herbal steam not only relieves congestion, it also soothes the soul. Place a drop or two of eucalyptus, pine or tea tree pure essential oil (available at health food stores) into a large pot of boiling water. Remove the pot from the heat. Hold a towel over your head and the pot and breathe in deeply for ten minutes. Rosemary Gladstar, an herbalist in East Barre, Vermont, and author of Herbal Healing for Women, recommends doing this two or three times a day, using eucalyptus, sage or pine oil.

Spice up your life. Treat yourself to fiery Mexican, Chinese or Indian food. Horseradish, cayenne, curry, jalapeño and chili seasonings help unblock sinuses. These fiery foods seem to stimulate nasal secretions to loosen up and pour out. Horseradish works particularly well, says Gladstar, who recommends grating it fresh and eating it on toast, with soup or on rice. It's almost painful to eat, she says, but it clears congestion and thereby helps the body fight infection.

Stay moist. "With noses, the big thing is humidity," says Dr. Leopold. "If your nose gets dry, bad things happen." When nasal passages dry out, you're more susceptible to nosebleeds. The mucus blanket thickens, the cilia can't move, and you're more likely to get infections.

There are several alternatives for moisturizing the nose, according to Dr. Leopold. Drink lots of water. Use saline nasal sprays, which are simply purified salt water in spray bottles and are available in drugstores. On drugstore shelves, you can also find moisture creams such as petroleum jelly or Eucerin lotion. Put a little on a cotton-tipped swab and lightly coat your nostrils. Also ask your pharmacist about gel-mist sprays for keeping your nose moist.

Exert pressure. Acupressure works wonders for sinus symptom relief. Traditional Chinese medicine practitioners use pressure points in the web of flesh between the thumb and forefinger to relieve sinus headaches and a point just above the bridge of the nose, between the eyebrows, to relieve congestion, says Harriet Beinfield, a licensed acupuncturist and co-author of Between Heaven and Earth: A Guide to Chinese Medicine. You may also apply pressure to your cheeks (along the ridge of the cheekbones) and temples and along the sides of the nose. Look for tender or sensitive spots in the crease between the nostrils and the cheeks.

When you've found the right spot, you'll know. You may feel a twinge or a tingle. You may feel some relief right away. Press gently but firmly, using your knuckle or fingertip (with a short nail), using a rotating motion in a tight circle. Continue massaging for 30 seconds to five minutes, as you wish. Repeat as often as it feels good, says Beinfield.

Watch what you consume. When you have a sinus infection, avoid coffee, tea, cola and alcoholic beverages, says Dr. Levine. The caffeine in coffee, tea and colas is a diuretic, and alcohol dehydrates you. Stay away from dairy products and chocolate, too; they thicken congestion.