Narrow Nasal Passages - getting desparate

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Dog Slobber
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Narrow Nasal Passages - getting desparate

Post by Dog Slobber » Sun Apr 15, 2018 11:28 am

I am really lost and getting desperate. I'm open to all suggestions.

I have posted before regarding what I believed was a congestion problem, I've discovered that it really isn't so much a congestion issue (as in a lot of congestion is being created) but rather my nasal passages have narrowed (because of swelling) so much that just a little congestion is blocking me up.

I have seen my family doctor a few times now and he has prescribed Flonase which appeared to help a bit for a little while, but has become ineffective. He has made a referral to an ENT, but I have no idea how long that will take and I'm desperate to get some relief until I can see them.

History and things I've tried:
  • ResMed A10 Autosense (8-14cmH20)
  • ResMed N20 Nasal Mask
  • Started therapy Feb 8 - First two weeks went very well absolutely no issues
  • Nasal passages started to become inflamed and close about Feb 25
  • I originally thought it was a congestion issue and not a narrowing of the passages issue
  • The problem comes a go, but lately it has become much more constant and just not going away.
  • It seems when the nasal passages close just a little bit of congestion soon clumps and blocks me up
  • I've learned that when I do feel some blockage I need to blow my nose very gently otherwise I block my passages instantly
  • Irrigating with saline nasal spray but often makes my passages feel "sticky" contributing to clumping of congstion
  • Neti-Pots, and Net-bottles help a bit but similar to saline sprays shortly after congestion clumping starts again.
  • I have been up and down the humidity setting and but because of the intermittent nature I have had difficulty determining what it should be, I believe that excess humidity might be problematic.
  • My Doctor prescribed Flonase two squirts per Nasal passage per day. It initially helped but things returned again
  • We increased Flonase to 1 squirt per nostril in the morning then 2 squirts in the afternoon.
  • Once again it helped at first but soon reverted back.
  • We switched to Nasonex two squirts per nostril twice a day. Didn't help and further complicated things by causing extreme salivation. I'm back to Flonase.
  • I've tried oral decongestant and they helped the narrow passages but they kept me awake all night
  • Nasal decongestant (Otrivin) worked terrifically! But I'm desperately afraid of becoming addicted and or bounce-back effect. I'm currently on my second night in a row.
    I've been through a box of Breathe Strips

Any suggestions are deeply appreciated.

I'm thinking of ordering a full face mask and shipping over-night.
I don't know how well I will take to a FF mask and mouth breathing. Mask suggestions are welcome.

If you require any other information please ask.

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Pugsy
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Re: Narrow Nasal Passages - getting desparate

Post by Pugsy » Sun Apr 15, 2018 11:41 am

I assume you have tried various humidity levels...
which was worst and which was best?
Off...low, medium,..high????
I may have to RISE but I refuse to SHINE.

rzw
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Re: Narrow Nasal Passages - getting desparate

Post by rzw » Sun Apr 15, 2018 11:47 am

In my experience, a major component at this stage is inflammation.....I have dealt with mild nasal passage problems while on C Pap....sometimes one nostril can just totally close up.....sometimes excessive humidity from the machine can make things worse, along with warmer air.....bottom line, you are going to need to reduce the inflammation......the sprays will be just be temp fixes as you have found, with things really just rebounding, sometimes even more so than before you started the sprays....

The best thing that I have found, that I can without a doubt recommend for inflammation in general, Fish Oil.....EPA and DHA found in the fish oil will greatly help reduce inflammation within the body......I have been using fish oil for several months now, and my nasal inflammation has greatly decreased.....there are many companies out there which are made of 3 different forms.....I have found that a triglyceride form seems to be the easiest to digest in the system....not saying that the other forms won't be beneficial, it just appears from studies that this is the best form.....I would also recommend a liquid form.....They have lemon and orange flavor.....they have done a very good job with natural flavoring over the years, and as long as you keep it in the frig, you will not taste, nor burp fish oil......

Nordic Nautrals is the brand I use.....you can take anywhere from 1 to 2 teaspoons a day....I have found that even at 1 teaspoon a day, that within about 7 days, inflammation reduction is very noticeable.......this is greatly helped with my compliance for cpap treatment.....

You can order on amazon or find in a local heath food store or vitamin shoppe.....I would highly recommend you get a bottle and try for at least 2 weeks....

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Dog Slobber
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Re: Narrow Nasal Passages - getting desparate

Post by Dog Slobber » Sun Apr 15, 2018 12:18 pm

Pugsy wrote:
Sun Apr 15, 2018 11:41 am
I assume you have tried various humidity levels...
which was worst and which was best?
Off...low, medium,..high????
Hi Pugsy,

I have tried various humidity levels, from off to Max.

I believe lower humidity levels are better for me, but in all honesty it has been tough determining this because of the intermittent nature of my experience.

It seems that I have had tougher days after higher humidity and a couple times on higher humidity it is more uncomfortable and I can feel my passages getting sticky.

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Dog Slobber
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Re: Narrow Nasal Passages - getting desparate

Post by Dog Slobber » Sun Apr 15, 2018 12:25 pm

rzw wrote:
Sun Apr 15, 2018 11:47 am
In my experience, a major component at this stage is inflammation.....I have dealt with mild nasal passage problems while on C Pap....sometimes one nostril can just totally close up.....sometimes excessive humidity from the machine can make things worse, along with warmer air.....bottom line, you are going to need to reduce the inflammation......the sprays will be just be temp fixes as you have found, with things really just rebounding, sometimes even more so than before you started the sprays....

The best thing that I have found, that I can without a doubt recommend for inflammation in general, Fish Oil.....EPA and DHA found in the fish oil will greatly help reduce inflammation within the body......I have been using fish oil for several months now, and my nasal inflammation has greatly decreased.....there are many companies out there which are made of 3 different forms.....I have found that a triglyceride form seems to be the easiest to digest in the system....not saying that the other forms won't be beneficial, it just appears from studies that this is the best form.....I would also recommend a liquid form.....They have lemon and orange flavor.....they have done a very good job with natural flavoring over the years, and as long as you keep it in the frig, you will not taste, nor burp fish oil......

Nordic Nautrals is the brand I use.....you can take anywhere from 1 to 2 teaspoons a day....I have found that even at 1 teaspoon a day, that within about 7 days, inflammation reduction is very noticeable.......this is greatly helped with my compliance for cpap treatment.....

You can order on amazon or find in a local heath food store or vitamin shoppe.....I would highly recommend you get a bottle and try for at least 2 weeks....
Thank you very much for this, I will try it.


I'm also particularly interested in people opinions regarding trying FF Masks.

Julie
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Re: Narrow Nasal Passages - getting desparate

Post by Julie » Sun Apr 15, 2018 12:27 pm

I suggested (from personal experience) that you go 100% 'no humidity' at all, but from your note here now it doesn't sound like you've really tried it, or for any length of time. Until you do so and determine that it either works or definitely does not, what's the point of continuing to complain? For me, saline would be bad as it makes passages swell to an extent. Also, are you sure nothing in your bedding causes even a mild, but ongoing allergic reaction? I know you've tried decongestants (which I think are counterproductive) but it might be worth looking into - e.g. even carpetting can cause problems for some.

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Dog Slobber
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Re: Narrow Nasal Passages - getting desparate

Post by Dog Slobber » Sun Apr 15, 2018 12:41 pm

Julie wrote:
Sun Apr 15, 2018 12:27 pm
I suggested (from personal experience) that you go 100% 'no humidity' at all, but from your note here now it doesn't sound like you've really tried it, or for any length of time. Until you do so and determine that it either works or definitely does not, what's the point of continuing to complain? For me, saline would be bad as it makes passages swell to an extent. Also, are you sure nothing in your bedding causes even a mild, but ongoing allergic reaction? I know you've tried decongestants (which I think are counterproductive) but it might be worth looking into - e.g. even carpetting can cause problems for some.
Hi Julie,

I tried 0 (off) for a few days, but still had water in the tank. I'm assuming by 100% "no humidity" you mean turn humidity off and remove the water.

About the bedding. I guess without changing the bedding I can't be 100% sure, however I've been sleeping on the same bed for years, and have never experienced any kind of allergic reaction.

Hose_Head
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Re: Narrow Nasal Passages - getting desparate

Post by Hose_Head » Sun Apr 15, 2018 1:35 pm

I have had similar symptoms for years. I have no definitive answers but a few things you might try:

1) try setting your machine to straight cpap. I've long used a respironics auto pap set at 8 - 12 cm h20 but when I changed to the Resmed Autosense auto, I found that it's algorithm is way too aggressive for me. The result is that it seems confused by nasal decongestion and then bumps up the pressure, and keeps it there. This leads to excessive mask and mouth leaks. Unless you are one of the few who REALLY need to use an auto-pap, I suggest you use straight cpap set at your titrated pressure until you sort out this congestion issue. This will remove one variable to help you isolate the cause of your congestion, reduce leaks, also may show whether you really need to think about a full face mask.

2) Antihistamine nasal decongestant. Try Benedryl tablets. It will make you sleepy so it should only be used overnight. This is not a long term solution but it may help you through a tough night.

3) as others have suggested, reassess your humidity settings. Start with no humidification at all for a few nights or more. If that's not a solution, then try passover mode (water in tank but no heat in the tank), etc. Because your symptoms are intermittent, your trial period at each setting has to be much longer than the intermittent periods of the issue.

4) Have you had a cold? There's a terrible strain of the common cold going around right now. Could it be that lingering effects are the source of your problem?

5) Keep the area around your apap clean and dust free. Check the filter! Over the years that I've found that a dirty filter can be the cause of excessive nasal drip. While you're at it, wash the humidifier tank and rinse out your hose (these are unlikely to be a problem, but you never know).
I'm workin' on it.

jbgilm
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Re: Narrow Nasal Passages - getting desparate

Post by jbgilm » Sun Apr 15, 2018 2:49 pm

A simple possible solution would be to try a nasal dilator such as Breathe-Right strips. When I recently bought a new chin strap it came with 20 free off-brand nasal dilator strips. I never believed they could work, but out of curiosity I put one on. It definitely helped! I was very surprised. I use one each night and it helps hold open my nasal passages. If the trouble is deeper inside your sinuses the strips probably won't help.

Rhodesie
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Re: Narrow Nasal Passages - getting desparate

Post by Rhodesie » Sun Apr 15, 2018 3:10 pm

My husband (APAP user) is in the same situation. We are waiting to see the ENT next month as his nasal passages are blocked (one side blocked 100% and other about 50%). His is 3 weeks into his trial with the Resmed Airsense 10. We tried the nasal mask but wasn't great as he needs to breath thru his mouth most of the time. He is using a full face mask with pretty decent tolerance wearing it. He was also prescribed nasal steroid spray to try and decrease the nasal inflammation.

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ChicagoGranny
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Re: Narrow Nasal Passages - getting desparate

Post by ChicagoGranny » Sun Apr 15, 2018 3:31 pm

Dog Slobber wrote:
Sun Apr 15, 2018 11:28 am
Nasal decongestant (Otrivin) worked terrifically! But I'm desperately afraid of becoming addicted and or bounce-back effect. I'm currently on my second night in a row.
This product is not addictive. However, if you stay on it for several days, you will likely experience rebound congestion when you discontinue it. If you are as desperate as you indicate, I would stay on it until you see an ENT. There are ways to deal with the rebound congestion when the time comes to stop using Otrivin.

What are you doing to speed up the consultation with the ENT? In the States, I would be calling their office, insisting on a timely appointment and getting my name on a cancellation list.

xcountrygal
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Re: Narrow Nasal Passages - getting desparate

Post by xcountrygal » Sun Apr 15, 2018 3:35 pm

Just to add another thought. I had severe congestion after starting apap. For me, higher humidity helped, but also
1. make sure you are drinking plenty of water, especially early in the day
2. Do you think you might have a sensitivity to the preservatives in most saline sprays? I did and switching to something such as Arm & Hammer that used baking soda was very helpful.

Good luck!

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Dog Slobber
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Re: Narrow Nasal Passages - getting desparate

Post by Dog Slobber » Mon Apr 16, 2018 8:02 am

I used Otrivin again last night for the third straight night. as last night I became incredibly plugged up.

I had a good night, but as described I'm very concerned about continued use.
Hose_Head wrote:
Sun Apr 15, 2018 1:35 pm
3) as others have suggested, reassess your humidity settings. Start with no humidification at all for a few nights or more. If that's not a solution, then try passover mode (water in tank but no heat in the tank), etc. Because your symptoms are intermittent, your trial period at each setting has to be much longer than the intermittent periods of the issue.
I set my turned my Humidifier off and removed all the water.

I woke up about 6:00AM to a dry throat and a very dry nose. I took a couple sprays of Saline. I put Water in the tank but left the humidifier off.

This morning my nose feels pretty good. But I'm not sure how much of that is the Otrivin and my nasal issues usually come on in the evening.

Wondering if I should empty the water out again tonight or continue with passover.


rzw wrote:
Sun Apr 15, 2018 11:47 am
The best thing that I have found, that I can without a doubt recommend for inflammation in general, Fish Oil.....EPA and DHA found in the fish oil will greatly help reduce inflammation within the body.
I bought some yesterday, and will be taking two teaspoons twice a day.
jbgilm wrote:
Sun Apr 15, 2018 2:49 pm
A simple possible solution would be to try a nasal dilator such as Breathe-Right strips.
I've been through a box of them thus far.

ChicagoGranny wrote:
Sun Apr 15, 2018 3:31 pm
What are you doing to speed up the consultation with the ENT? In the States, I would be calling their office, insisting on a timely appointment and getting my name on a cancellation list.
I'm still waiting to hear. I don't even know who the ENT is yet.

I am trying to get a hold of my Sleep Clinic doctor hoping she has better access to ENTs.

One of the problems with the Canadian Health Care is system is it can be really difficult to expedite services.
xcountrygal wrote:
Sun Apr 15, 2018 3:35 pm
1. make sure you are drinking plenty of water, especially early in the day
2. Do you think you might have a sensitivity to the preservatives in most saline sprays? I did and switching to something such as Arm & Hammer that used baking soda was very helpful.
I'll increase my water.

I hadn't considered a sensitivity to the preservative within the Saline.

I've been using Salinex and HydroSense. I'll try to make a correlation between using them and nasal responses as well as looking for Arm & Hammer.


I want to thank you all so much for the suggestions, even though I haven't responded to all of them, I'll consider all as I go.

I look forward to any more suggestions and opinion on my responses.

Barbee
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Re: Narrow Nasal Passages - getting desparate

Post by Barbee » Mon Apr 16, 2018 9:02 am

I have a lot of sinus type issues. I use Flonase 2 squirts per nostril per day. I take it right before bedtime. It seems to help more by doing this.
I take Singulair daily.
I alternate weekly on OTC decongestants. I alternate Zyrtec, Allegra, Claritin D. Alternating keeps them from rebounding. None of these 3 keep me awake or give me the shakes.
Even doing all this, i plug up for about 1/2 an hour when I first put my mask on. After 30ish mins, my nasal passages open back up and Im back to normal.

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palerider
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Re: Narrow Nasal Passages - getting desparate

Post by palerider » Mon Apr 16, 2018 9:38 am

Dog Slobber wrote:
Mon Apr 16, 2018 8:02 am
I used Otrivin again last night for the third straight night. as last night I became incredibly plugged up.

I had a good night, but as described I'm very concerned about continued use.
Well, some years ago, a clever ENT told me I could use Afrin (oxymetazoline hydrochloride) for an extended period, (weeks...) if I only used it at night. Afrin was developed from otrivin back in the 50s or 60s... so the 'only use at night' trick may apply to it too.

The period during the day when you don't use the nasal decongestant lets your nose recover, and keeps you from getting dependent on it so quickly.

If you do become dependent, then stop using it on one side only, and after that side clears up, then stop using it on the other side.

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