I would appreciate to hear about any experiences anyone has had with a long lasting sinus infection. At the beginning of July I started coughing and have never stopped. Its a wet cough, usually hacking up something that is kind of almost in my chest...but not quite. Never felt bad...just an annoying, persistent cough. I have never done anything like this before. First, I went to a doc in the box. They gave me a z-pac and a steroid. Did nothing. Month later went to my regular doctor and saw the PA. She said I probably had bronchitis another antibiotic...nothing. Finally went to my allergist. In my old age I have developed the basic Texas allergies but they never manifested in runny nose sneezing kind of thing so this was all very strange. She sent me to get a chest X-ray and a sinus CT. Xray was fine but the CT analysis said "severe ostiomeatal disease". Allergist has now put me on the "strongest sinus antibiotic" and a steroid for two weeks. She said if that doesn't work, and she was not optimistic that it would, that I would need FESS surgery with an ENT doctor. Sounds awful.

Any insight and or recommendations will be greatly appreciated.

Can you post images from your CT. Preferentially coronal bone windows?

Thanks for asking but I don't really have access to the images. The imaging center did give me a cd. I just now loaded it to post for you but it is apparently not compatible with iMac OS. My allergist is fairly old school, she doesn't have a MyChart or similar capability. Indeed, I just called them and they don't even look at the images either...they just go off the report from the imaging center. Doesn't sound ideal.

Ok, think I have accessed the cd...bunch of acronyms that Lord knows I have no idea...any of these get what you are looking for?

Wow. Those are some full sinuses. I'll defer my opinion to the expert in the room.

Agree with the radiologist. Hard to tell from a CT, but it looks like very chronic stuff, and maybe polyps. The third picture from the bottom is the coronal bone windows. You can post more from that series, but "I get the picture". Allergy testing is useful information, as it likely is playing a part in how you got to the point where you are now. But either it gets better on its own, you live with it (fatigue takes the place of headache very often in chronic cases vs acute), or you have surgery to clear it out. If you have surgery, it helps to know if allergies are prominent in order to prevent recurrence. If you have surgery, or just see an ENT and they can tell that it is indeed nasal polyps, Dupixent and Nucala are alternatives that can provide really impressive relief, particularly if you have other allergic conditions such as asthma, eczema, or eosinophilic eso****itis (TexAgs usually edits this word). They can be solo therapy or used in conjunction with sinus surgery if polyps start to regrow postop. All the best

Ok. I greatly appreciate you taking the time to take a look and to provide feedback. Don't know how I got here. I'm 61 and really have never had any problems…never seemed like I have had any sinus issues in my life.

Just curious, do you take an anti histamine like Zyrtec consistently? What you are allergic to changes throughout your life and how you react can change too. I had no allergies until my late teens and then it hit me like a ton of bricks. I go through periods where my sinuses are fine but my body is just generally itchy so the symptoms aren't always just a runny nose or sneezing. Regardless I'd advise just taking it every day for a couple weeks. The side effects are minimal (might feel drowsy a bit the first few days).

Note I'm not a doctor, just an allergy sufferer.

TMan86 said:

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Ok. I greatly appreciate you taking the time to take a look and to provide feedback. Don't know how I got here. I'm 61 and really have never had any problems…never seemed like I have had any sinus issues in my life.

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No worries. If you post some more of those coronal bone windows, I can get a better idea of the entire picture. Your story is not at all uncommon. It can be like a frog in a pot getting constantly warmer until you can't stand it anymore. It doesn't always happen where people have lifelong symptoms. Also, there are some weird theories that have a decent amount of science behind them about immune system triggering related to parasite and other exposures. But, as we used to say in medical school, the uncommon presentation of a common condition is still more common than a common presentation of an uncommon condition.
Sinus surgery isn't so terrible. And it is done with image guidance now, which makes it much safer than it used to be.
BTW, you also have a bit of fluid in your left mastoid bone. Do you have a lot of ear symptoms?
Edit:
If you see your allergist again, maybe ask them to measure your total IgE and your eosinophil count. Assuming you've got nasal polyps, one of the biological I previously mentioned could be an option if you really wanted to avoid having surgery.

Thanks, MaxPower. I grew up here in Texas and never had any problems until about 12 years ago. Then I started having these strange symptoms. My brow would get a little inflamed but the strange one was my hands and forearms got very sensitive. It literally hurt to play catch with my son. Went to my regular doctor, bunch of tests and nothing. It seemed to occur each year about the time winter started and then would go away. Something told me to go see an allergist. Did the allergy panel and turns out I was now allergic to everything, especially trees, grasses, pets etc. So strange as I never had the typical sinus issues that I related to allergy suffering.

Allergist put me on once a day Allegra. That fixed the brow and sensitivity issue and I was happy for the remaining years until this happened.

Lol…yes, my left ear is completely clogged. So uncomfortable.

Allergist is recommending another panel as it has been a while since I have had the original completed. I will get that and your recommended measurements and go see an ENT. I will discuss all that you have brought up.

Again, thank you very much for your help! Makes me feel better.

TMan86 said:

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Thanks, MaxPower. I grew up here in Texas and never had any problems until about 12 years ago. Then I started having these strange symptoms. My brow would get a little inflamed but the strange one was my hands and forearms got very sensitive. It literally hurt to play catch with my son. Went to my regular doctor, bunch of tests and nothing. It seemed to occur each year about the time winter started and then would go away. Something told me to go see an allergist. Did the allergy panel and turns out I was now allergic to everything, especially trees, grasses, pets etc. So strange as I never had the typical sinus issues that I related to allergy suffering.

Allergist put me on once a day Allegra. That fixed the brow and sensitivity issue and I was happy for the remaining years until this happened.

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Sounds just like the frog in the pot

Based on which ENT you see (old school vs new school) you could start with balloon sinuplasty and ethmoidectomy before going straight to FESS. The newer techniques have come a long way in recent years and the recovery is 10x easier. Also, if you do have chronic allergies and are "allergic to everything," you should start allergen immunotherapy (shots or drops) instead of depending on bandaids like antihistamines and steroids that won't treat the root cause of the problem. If you do the surgery but don't address the chronic inflammation, you'll likely be in line for a revision surgery in a few years. They will also be able to tell if the sinus disease is polyploid in nature after the procedure, in which case biologics are very effective in preventing recurrence, but they are indefinite medications.

I have had a couple sinus surgeries over the years and generally speaking they are pretty easy recoveries with hugely positive results.

I was on shots before when I first had the panel done but after about 16 months I stopped as I never really felt bad or had many symptoms. I know, in hindsight that was a colossal blunder. But, yes, Will certainly strike those up again.

Thank you each for the insight on the surgery options. I don't really have a health advocate and I turn into the biggest weenie when it comes to medical issues. Thank you all!