ALL ABOUT SINUSITIS
ONLY YOUR NOSE KNOWS
Nonstop and never-ending. I've even had two sinus surgeries, yet nothing has worked to end my suffering. I feel miserable about 90 percent of the time, whether from a sore throat, postnasal drip, or congestion. The days I have no congestion, my head usually hurts. I can't win.
—Beth, age forty-one
I live in the hot and humid South, which makes my sinuses feel swollen all the time. I also have pollen allergies. While I take prescription antihistamines to deal with the allergies, my sinuses stay inflamed and congested. When I complain because of headaches or earache from sinus fluid, my family says, "It's all in your head!" And they're right. It is in my head. If I didn't have sinusitis, I'd be healthy.
—Bob, age thirty-four
It's not unusual for those around you to think your sinus symptoms are in your head. After all, chances are that you look perfectly healthy. Outwardly no one around you can see the misery you feel. But you know differently. You know how sinus misery—the ongoing pain, swelling, congestion, and postnasal drip—keeps you from fully enjoying life.
No one needs to tell you what a struggle it is to deal with lack of sleep at night and the resulting inability to concentrate during the day. You also know how the medicines taken to control these symptoms leave you nervous, fatigued, spaced-out, or just downright crabby.
Forty-nine-year-old Judith lived with the persistent suffering of sinusitis most of her life, along with the resultant irritability from lack of good sleep. She had tried all the medications—from over-the-counter decongestants and antihistamines to the newer nondrowsy prescription antihistamines to nose drops, nasal sprays, antibiotics, and even steroid nasal inhalers. Nevertheless, none really worked to end her sinus problems.
"While they mask the symptoms for a few days, all it takes is a change of weather or a blast of someone's cigarette smoke at my office to send me into a sinus tizzy," Judith said. "Then it may take weeks to get rid of the resulting infection."
WHAT IS SINUSITUS?
Sinusitis is inflammation of the facial cavities around your nose—those above the eyes (frontal), behind the nose (sphenoids), on either side of the top of the nose (ethmoid), and beneath the eyes in the cheek area (maxillary). They produce mucus, which drains through the ostia (small openings) in your nose. If the sinus cavities get clogged with mucus and the openings are blocked, infection and pain can result.
When conditions are "healthy," it means that the mucus in your sinuses is pushed out of the nose by cilia. (Cilia are tiny hairs that beat or wave rhythmically to carry anything on their surface in the direction of their motion out of the respiratory tract.) This mucus provides a highway for the good white cells produced by your body to reach any invading bad bacteria. It also cleans the air you breathe, moistens your sinuses, then slides down the back of your throat to your stomach, where acid destroys the mucus and trapped bacteria.
Fig. 1.1. The Sinuses
1. The frontal sinuses lie above your nose and just above your eyes behind your forehead.
2. The maxillary sinuses are cavities located inside each cheekbone. They are the largest of the sinuses.
3. The ethmoids are filled with tiny air pockets and are between your eyes.
4. The sphenoids lie deep in your skull, behind the ethmoids.
When conditions are not healthy, you get sinusitis. This happens when your cilia slow down or stop working properly. Or sinusitis can occur when there is an anatomical blockage, and the stagnant mucus becomes infected.
How Prevalent Is Sinusitis?
Chronic sinusitis is the most prevalent "adult disease" in the United States, with more than 38 million sufferers. Noxious smoke and deleterious fumes and chemicals work to bring on sinusitis. With an increase in population along with this increase in pollution and drug-resistant bacteria, the number of people who suffer with sinus problems continues to skyrocket.
Symptoms of Sinusitis
From coughing all night because of the continuous, thick postnasal drip running down the back of your throat to a throbbing earache because of trapped fluid to the excruciating pain of pounding headaches to chronic hoarseness from clearing your throat repeatedly, sinus discomfort is all too familiar to millions.
Besides suffering from headache pain and pressure, postnasal drip, and congestion, people experience other problems with sinus disease. You may have achiness and fatigue, fever, ear pain, or a throat so swollen that eating or breathing is difficult. Or your teeth may hurt, making you think you have dental problems. Thirty-seven-year-old Raymond went to two different dentists seeking relief for throbbing upper molars. "About three of my molars started hurting after I got over a horrible head cold," he said. "At first it was a dull ache, but after a few days, my whole jaw was throbbing, my head was pounding, and I had a fever."
After agreeing that his teeth were perfectly healthy, the second dentist referred him to an ear, nose, and throat doctor (ENT). The ENT diagnosed Raymond with an acute sinus infection and started him on antibiotics and a decongestant.
Fortunately for Raymond, the dentist referred him to the specialist, and he got an accurate diagnosis and treatment; within a week his pain had subsided. Sadly, in some situations, people go for months thinking they have a "bad tooth" or "tension or migraine" headaches, when, in fact, they are suffering from sinusitis. It can also happen the other way around: an infected upper tooth can sometimes lead to a sinus infection.
The Sinusitis/Asthma Link
Not only can your sinuses affect tissue in your teeth, face, and jaw, causing excruciating pain, but they can also trigger an all-out asthma attack. Did you know that more than 50 percent of all asthmatics also suffer from chronic sinusitis at some point, which can make asthma symptoms flare up and worsen?
Chronic sinusitis—that is, sinusitis that goes untreated for weeks or months—can sometimes damage the nasal membranes or structure, requiring corrective surgery to regain function. Left untreated, sinusitis may lead to meningitis, an infection of the brain that can cause brain damage. In some rare cases, a blood clot forms in veins around the sinuses (cavernous sinus thrombosis), which can affect the brain like a stroke.
If you have any signs or symptoms of sinusitis, talk with your doctor to be sure no other problems are present. Sinus disease is serious and should certainly not be taken lightly.
The Untold Cost
Not only does sinusitis cause you great physical suffering, but it is an expensive and chronic illness, resulting in more than 16 million visits to doctors' offices annually for treatment. Remember Raymond? He had not met his insurance deductible, so his diagnosis of sinusitis cost more than $500 out-of-pocket (for dentists, the ENT, and the medication). Add to this unexpected cost the three days of work with pay that he lost. Combined with expensive treatments, the cost of personal suffering is great not only for patients but also for their families, friends, employers, and coworkers.
Another cost of sinusitis is the stress it causes—for example, all the anxiety and worry about "Will I ever feel better?" Over a period of time, this and other stressors arising from persistent sinus infections can result in depression and other emotional reactions that further limit your ability to deal effectively with life. Many sinus sufferers cannot exercise outdoors because of pollen or dust allergies. Some sinus sufferers cannot enjoy a day at the beach because of high humidity or a mountain hike because of cold, damp air. Still others are just too fatigued to move around much because they ache all over from low-grade infection or the medication they take zaps any energy or motivation to exercise. This inability to enjoy life and exercise can lead to feelings of malaise or depression—feelings that only add to your lethargic state of mind and body. When you don't move around, the chances are that your stress and anxiety level will just increase even more. Depression can result if certain medications are used to help with sinus symptoms.
The High Cost of Personal Suffering
What do you feel when you notice your sinuses becoming inflamed or irritated? Other than the standard symptoms of headache, pressure, swelling, congestion, and postnasal drip, there are more serious personal repercussions experienced by millions of sinus sufferers every day of their lives. Here are some examples:
nI dread getting up each day knowing that I have to live with this chronic and annoying problem.
nI don't want to talk to anyone—even my family members—when I have sinus headaches.
nI feel muscle aches and pains throughout my body most of the time.
nI run a low-grade fever periodically from my chronic sinusitis.
nMy sinus problems affect my work performance and my relationship with colleagues.
nI feel fatigue or tiredness that does not go away even after several large cups of caffeinated coffee.
nI feel in a low mood, which does not lift even as I get on with my daily activities.
nI have felt depressed enough to get antidepressants from my doctor.
nI feel irritable and impatient, and have mood swings from the medications I take and from the constant headaches.
nI often have difficulty being with a large group, as my medications make me feel jittery and nervous.
nThe medications I take make it difficult for me to concentrate in school or at work.
nI am unable to recall useful information after being up all night with a sinus headache and feel "foggy" sometimes.
So you've felt the fatigue, fogginess, and irritability that sinus disease can cause. Maybe you have lived with a plugged-up nose and annoying postnasal drip for years. You've read the self-help books, and your doctor has prescribed the latest medications. You've even gone on-line searching for breakthrough treatments. Yet you still suffer and are looking for answers, a possible cure.
Before we share answers in this book, let's address what a "sinus cure" means. A cure is defined as partial or complete relief of symptoms. Therefore, after years of research, interviews, and personal and professional experience, we wrote this book to share "cures" from the top health-care specialists and patients—cures that really work.
Although medical research has yet to find a definitive cure to end sinusitis permanently, the treatments and medications described in this book will work in most cases to greatly reduce or end your sinus problems. The conventional and alternative modalities we discuss are effective, and most of them have no side effects. We'll offer you, the reader, a seven-step plan—it's safe, easy, and comprehensive—to put you on the road to relieving yourself of sinus problems and complications once and for all. NASAL IRRIGATION: RECOMMENDED BY ENTs WORLDWIDE!
We'd like to point out right here, right now, one incredibly important preventive measure you can take to eliminate sinus difficulties. Nasal irrigation with saline solution (see chapter 6) is one method of controlling sinus symptoms—and possibly curing mild infections—that you can easily do at home. Nasal irrigation is not a new discovery; yet more and more ENTs worldwide are recommending it for patients with chronic sinus or other respiratory diseases. Why? Because it is natural and effective, can be done any time you feel congested, and usually works, providing immediate relief.
In fact, one of the best tools for such irrigation is the Pulsatile Nasal Irrigator (fully described in chapter 6). This device was developed by Dr. Murray Grossan, the medical editor of this book. The nasal irrigator is easy to use and convenient, and according to thousands of users worldwide, helps to alleviate thick mucus buildup and prevent infections.
By connecting the irrigator to a Water Pik dental cleansing device, you can clean out your sinuses with a saline solution in the privacy of your home anytime you have problems with thick mucus, postnasal drip, or beginning infections. Most sinus sufferers choose to make this kind of cleansing a daily routine, just like brushing their teeth or bathing.
Done daily, nasal irrigation helps keep sinuses clear of bacteria-laden mucus and encourages the cilia to function normally. As explained on page 22, when the cilia are slow or damaged, you live with the result: a buildup of thick mucus that cannot drain properly and subsequent infection. You also get the resulting inflammation, pain, low-grade fever, and overall misery.
Many clinical studies have been done on the positive benefits of sinus irrigation. Medical research reported in Otolaryngology concluded that saline irrigation has many benefits, the principal ones being that it:
nAugments mucociliary flow
nLiquefies tenacious mucus
nSoothes irritated tissues
nRemoves crusts and foreign microbodies
nAugments tissue repair
nReduces forceful nose-blowing
"Improves olfaction? What does that have to do with my sinuses?" Olfaction refers to your sense of smell—and olfactory cells are found in a tiny piece of tissue high up in your nose. They connect directly to your brain and let you distinguish the fragrance of homemade bread, baby powder, and freshly brewed coffee—that is, when you can breathe through your nose!
Along with olfactory cells are your gustatory cells. These refer to your sense of taste and belong to your chemical sensing system (chemosensation). They are mixed with saliva and are clustered in the taste buds of your throat and mouth. Because of these cells, you can discern whether you are eating chocolate icing, sardines, or feta cheese—definitely important differences!
If you've suffered with a series of respiratory infections or have chronic, ongoing sinusitis, you know how your sense of smell and taste are affected. Each time you get an infection, these senses are the first to shut down. Your sense of smell may be shut down because of stagnant, odorous nasal bacteria. It is usually restored when the nose is cleared by pulsatile nasal irrigation and the cilia return to good health.
Improves Allergic Rhinitis
Not only does saline irrigation help improve sinusitis, but all forms of allergic rhinitis benefit from this natural treatment. Recent studies in the Journal of Allergy and Clinical Immunology revealed that pulsatile irrigation using Dr. Grossan's attachment works for allergy relief by removing the IgE—the primary antibody that is produced in great quantities during an allergic reaction—so that the pollen doesn't cause symptoms.
Drs. José and Javier Subiza, in their clinical immunologic studies of allergic response, tested a sample of people with grass-pollen allergies. During the pollen season, the sample population who performed pulsatile irrigation daily were checked for allergic response factors in the nose and in the blood, and they were checked for inflammation in the nose. The patients who irrigated showed a significant reduction in the allergic factors of IgE in the nose and blood, along with a reduction in inflammation. The observations show that the pollen had been washed out of the nose, actually preventing the allergic response. These patients could reduce or even stop their allergy medication!
Reduces Cold Symptoms
Irrigation also has been shown in clinical studies to reduce symptoms of the common cold. How? The nose produces a substance called ICAM-1, a product that is the gateway for the common cold virus to enter your body. By daily sinus irrigation during cold season, the pulsation removes much of the ICAM-1, thereby leaving no entrance pathway for the common cold virus.
Keeps Asthma Symptoms at Bay
For those who fight the complications of sinusitis with asthma symptoms, pulsatile nasal irrigation is proved to offer a positive benefit to those with asthma—without the deleterious side effects of current asthma medications. After conducting studies on children with sinusitis and asthma (reported in the Pediatric Infectious Disease Journal), researchers concluded that sinus secretions can contaminate the tracheobronchial tree, causing infection and bronchospasm. Nasal irrigation often helped remove the offending secretions before asthma was experienced.
In another study researchers concluded that removing mucus and pus from the sinuses using simple saline irrigation can significantly speed healing and prevent the spread of infection from the sinuses to the lungs. So they recommended that patients remove bacteria-laden mucus daily, at home, for optimum benefit.
Heals Sore Throats
You know how good a soothing, warm drink feels when your throat is dry and irritated? Well, irrigation has also been found to help throat infections or the swollen, sore throat associated with postnasal drip. Saline irrigation of the throat speeds healing by increasing blood flow to the area, encouraging lymphatic drainage, and removing bacteria on the surface and in the crypts (tiny holes in the tonsils). For those who have undergone sinus surgery endoscopically, saline nasal irrigation is highly recommended to promote mucus flow and to restore cilia function.
Pulsatile nasal irrigation and other natural treatments can give amazing, soothing relief to sinus sufferers without the side effects of strong medications— and the benefit of clearing the stagnant mucus out of the nose is great. While the most common side effect of pulsatile nasal irrigation reported so far is burning or irritation—and this is very infrequent—keep in mind that this side effect also occurs in patients who do not use pulsatile nasal irrigation.
After you read chapter 6, talk to your doctor about this natural alternative to sinus treatment.
MORE NATURAL CURES FOR SINUSITIS?
Beyond nasal irrigation, there are even more natural and effective medical treatments to control sinus symptoms or even end sinusitis. One alternative method is taking papaya enzyme tablets buccally (held inside the mouth between the inside of your cheek and the gum), four times daily, to reduce inflammation and liquefy mucus (see page 189). Another is sipping hot tea to help keep cilia moving naturally or avoiding iced drinks, which can actually damage cilia, causing them to stop functioning altogether (see pages 22—23). An effective medical treatment is the steroid nasal spray or inhaler, which can help shrink swollen sinus passages, promoting drainage (see pages 228—229). The steroid spray or inhaled medications have few side effects.
Sinus sufferers from around the world share their "best" natural treatments in chapters 7 to 10. These methods, used in conjunction with effective breakthrough medicines, discussed in chapter 11, can offer dramatic improvement in your sinus symptoms and quality of life—without the side effects of drowsiness, stomach upset, or nervousness caused by the older sinus drugs.
HOW THE SINUS CURE CAN TRULY HELP YOU
You may object, "Ending my sinus pain and congestion can't be as easy as keeping my nasal passages irrigated or taking an herb!" Well, you may be correct. It may not be that easy for your situation, depending on your specific problem. You may have an anatomical problem, such as a deviated septum or nasal polyps, that requires more aggressive treatment.
The only way to know what can really work to end your sinus problems is to talk with your doctor and seek a medical diagnosis. Once you understand the causes of your particular sinus problem—and the causes differ from person to person—know which treatments are likely to be effective, and which probably will not work well, you can begin to manage this problem just as you do other areas of your life. And you can still use our seven-step plan to improve your specific situation even further.
For example, while you are checking on natural therapies for sinusitis, ask your doctor about the new nasal steroid inhalers that reduce inflammation, as well as other safe and effective medications to reduce congestion. Using the inhaled medicine—along with healing foods, natural supplements, increased exercise, and sounder sleep—can help you to heal your sinuses, boost your immune function, and keep infection at bay.
YOUR SINUS CURE GOAL
Sinusitis is an extremely common problem that many doctors believe is incurable. Fortunately we are presenting conventional and complementary remedies in this book that may prove them wrong! Your goal should be to gain control over all sinus symptoms—inflammation, headache, pressure, swelling, congestion, and postnasal drip—so you can get around and do the activities you wish without thinking about your sinuses. No matter whether your sinus problems are mild, moderate, or severe—acute or chronic—you can regain control if you follow the advice in this book.
Who has time for sinus pain or pressure, much less the ongoing symptoms of cough and congestion?! Certainly not you or millions of other sinusitis sufferers! Read this book: learn about the most effective treatments available and breakthrough medications that can end your sinus problems, and make sinusitis a problem of your past.
Excerpted from The Sinus Cure by Debra Fulghum Bruce, Ph.D., and Murray Grossan, M.D.. Copyright © 2001 by Debra Fulghum Bruce and Murray Grossan, M.D.. Excerpted by permission of Ballantine Books, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.