How to Make it Through Sinus Season – 2015 Update

Dr. Katz

 

In addition to the instructions below which will help you with keeping your sinuses healthy throughout the winter, this year’s update has some encouraging news from the conventional medical community. Mold or fungus will grow any place that has access to nutrients and moisture. Our sinuses, by design, are moist, and normal mucus contains carbohydrates. It should be no surprise that among the 300,000 species of mold/fungus, there should be many that could inhabit the sinuses. However the conventional definition for fungal sinusitis has five components which include the erosion and destruction of the facial bones. This definition is becoming more liberalized such that fungal sinusitis is being recognized more and more in otherwise healthy people (fungal infections in immunocompromised people has been long-established).

 

With freezing temperatures, four feet of snow on the ground, and relative humidity in the teens, it is time to revisit some time-tested suggestions to limit sinus inflammation, which interferes with quality sleep and health. Failure to get adequate amounts of sleep underlie numerous medical conditions, including hypertension, heart disease, sudden cardiac death, stroke, and resistance to infection.  It is that time of year again, so your local experts – Drs Katz and Nadelberg – have some suggestions.

 

Why are you Miserable?

Your sinuses need moisture; when your sinuses have insufficient moisture, the mucus becomes thick, acidic and sticky and cannot drain.  The sinus membranes can crack and create opportunities for infection. The cold outside air has very low humidity, especially when the temperature is below freezing.  When indoor air is warmed, the relative humidity declines as well.  This applies to all forms of heating – radiator, geothermal, electric, coal, oil, wood stove, or pellet – not just forced hot air. Most furnace humidifiers will only achieve a relative humidity of 30 to 35%, and less on the coldest days. Sinuses need more moisture. Here is your survival guide:

 

Drink Fluids. 

The more fluids one drinks, the thinner and less irritating the mucus becomes.  However, several organs, such as kidneys, heart, and gastrointestinal tract, have a higher priority for fluids you consume.  So while drinking fluids is helpful, it must be augmented with humidification, which adds fluid locally to the sinuses.

 

Humidification

The one spot in which you spend the most time is sleeping in bed.  Night time moisture content drops as outside temperatures decline, so the best payback on humidification is to humidify the area where you sleep.  Desktop humidifiers, for all their inconvenience of frequent refilling, are a great solution.  The best location is near the head of your bed, as the amount of humidity in the air will decrease dramatically each foot further from where you place the humidifier.  Alternatively, you can get a room sized humidifier for the bedroom.  These larger devices require more frequent maintenance in terms of cleaning, filing with water, or replacement filters, but they do work.

 

Nasal Saline

During the day, you can humidify your sinuses with nasal saline.  It comes in small squeeze bottles and can be found at pharmacies.  It produces a fine mist that you can inhale one nostril at a time.  To penetrate your sinuses deeply, you need to bend your head backward.  Some people even lie on a bed with their head over the edge and spray the mist gently, letting gravity help it penetrate.  This is a reversal of everything you learned about keeping water from going up your nose while swimming, but I assure you it can be learned.  For those of you, who keep your head up right, bring along a paper towel or tissue as you will find yourself blowing your nose after the saline.

 

Clean Air

We close our windows, block the drafts from our doors, and seal in any pollutants in the house for the winter. Allergens, dust, and even noxious gases such as nitric oxide all increase inside our houses while pollutants and allergens outside fall to near zero. There are simple filtration units that go under the acronym HEPA (High Efficiency Particle) which contains a box, fan, and a sophisticated paper filter that removes even pollen. The filter paper turns gray as it becomes occluded and must be changed for the device to work, so buy several filters at a time. Most people should concentrate on keeping the bedroom air clean (it’s where one spends the most time). The strategy is to keep the bedroom door closed and leave the filter on all day and night. Pets are basically large dust balls and the more you groom them and keep them out of the bedroom (and off the bed!), the better.

 

Scarves

The lungs exhale about a pint of water a day. A scarf is a great way to get the moisture of exhaled air into the sinuses when walking outdoors. The high collar on a winter parka or shell functions the same way, by directing the moist air from the lungs up towards the nostrils.

 

Steam Where You Can Find It

Steaming up the shower is a great way to moisturize your sinuses (and possibly frizz your hair).  A useful trick is to find moisture in places besides the bathroom and the kitchen.  A lot of older office buildings have hot water systems that will generate steam in a bathroom sink, and many newer office buildings have hot water and ice water outlets in the coffee areas. If you are careful, using two or three paper cups to insulate the hot water from your fingers, a cup of coffee can become brief sinus treatment.

 

Neti Pots

For those of you for whom all the above maneuvers have failed, and you are treating two or three sinus infections per winter, you should read up on Neti Pots.  This is a device made to pour a solution of saline and bicarbonate in your sinuses on one side of your face at a time, and have the solution come out on the opposite side (and sometimes some gets swallowed).  If you have difficulties with nasal saline coming up your nose, the Neti Pots will either be a true challenge or impossible to adapt.  However, there are numerous well-controlled studies in which Neti Pots reduced sinus symptoms and sinus infections, as well as allergies.  I do not endorse them for everyone, but this note would be incomplete without their mention.  For those of you interested in pursuing this further, they can be ordered on the Internet, with instructions, from merchandisers such as Amazon.com

 

If all else fails, and you develop facial tenderness, fever, and drainage becomes foul, you may need a call to the doctor for antibiotics, steroid nasal sprays, and some rest.

 

James Katz MD

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