Sinus Problems-just Curious

[friday7]

I was just wondering how many of you have sinus issues?

I know a lot of people with POTS have dizziness and it's probably related to blood pressure. Although I do get lightheaded when my BP is too low . My BP is pretty good now but I still feel lightheaded and dizzy most of the time, or rather just off balance. The thing is I have had one ear infection after another for the past two years. And when it' s not an infection I just get fluid in my ears. I am supposed to have tubes put in..yet again. But it only partly solves the problem. I think maybe it has to do with constant inflammation of the Eustachian tubes. I've tried all kinds of meds for sinus and allergies but nothing seems to help.

I'm just wondering if other people hear have chronic sinus issues or inner ear problems and if they are related to the POTS at all.

Sue

[erikainorlando]

My nose is stuffy and runs we thought it was allergy but it is not.... I thought this would all be part of my diagnosis last year...but it was a dead end!! Finally, after the POTS diagnosis my ENT told me my wild fluctuations in BP and HR can cause the tiny blood vessels in mthe nose to be irritated mimicing allergies. Someone else here probably has a better explaination..and I am paraphrasing!!

Erika

[friday7]

My nose is stuffy and runs we thought it was allergy but it is not.... I thought this would all be part of my diagnosis last year...but it was a dead end!! Finally, after the POTS diagnosis my ENT told me my wild fluctuations in BP and HR can cause the tiny blood vessels in mthe nose to be irritated mimicing allergies. Someone else here probably has a better explaination..and I am paraphrasing!!

Erika

Hmm that's interesting..mimicking allergies? Did he say if anything can be done to help you with this?

I'd like to hear more about this if anyone can elaborate..

Sue

[firewatcher]

Vasomotor Rhinitis.

It is an ANS issue where there is too much blood in the nose. I can cause recurrent sinus infections, ear infections and pain. I have this. I have made vast improvements for many years using a neti pot (nasal saline irrigation--not as nasty as it sounds ) and recently with a nasal steroid spray. My ears always pop, flying is painful and sometimes my ear canals actually swell. Every MRI/CT scan I've had shows some sinus thickening indicative of an infection, but without the fevers and nasal goo. They just swell and block. I use my neti pot at least once a day and 4-5 times if I feel like I am getting a cold: salt shrinks my nasal passages and is a wonderful, cheap, side effect free decongestant. I still get symptoms, but if I control my POTS, they are not as bad.

from American Family Physicians:

Vasomotor rhinitis is characterized by prominent symptoms of nasal obstruction, rhinorrhea, and congestion. These symptoms are excessive at times and are exacerbated by certain odors (e.g., perfumes, cigarette smoke, paint fumes, inks); alcohol; spicy foods; emotions; and environmental factors such as temperature, barometric pressure changes, and bright lights. Patients with vasomotor rhinitis are further divided into two subgroups: "runners," who demonstrate "wet" rhinorrhea; and "dry" patients, who exhibit nasal obstruction and airflow resistance with minimal rhinorrhea. Many studies have attempted to clarify the pathogenic mechanisms for these subgroups. Current theories include increased cholinergic glandular secretory activity (for runners), and nociceptive neurons with heightened sensitivity to usually innocent stimuli (for dry patients). These theories have not been adequately proven. The vasomotor nasal effects of emotion and sexual arousal also may be caused by autonomic stimulation. In one small study, researchers concluded that autonomic system dysfunction is significant in patients with vasomotor rhinitis. Possible compounding factors included previous nasal trauma and extraesophageal manifestations of gastroesophageal reflux disease.

[kayjay]

yes to ear infections, sinus infections and allergies- MOLD, dust, pollen.

When I have allergy problems I feel much worse. I get ear infections if I get a cold or upper resp. problem.

I think Black Mold exposure when I was pregnant may have triggered my dysautonomia problems.

Rinsing my sinuses with Neil med sinus rinse helps me prevent problems.

I don't know if you can link these .... sinus problems are really common (depending on where you live) but interesting thought.

[erikainorlando]

I just want to add that I never had an allergy etc until I had that virus last fall. Then my nose started to run and I felt awful!! So for me there is definately a coorelation between getting POTS and this vasomotor rhinitis. When I am very POTS my nose runs more than other times. That is my story...furthermore....went to ENT and Allergist after Allergist and no one had a clue...no sinus meds ever helped and neither did any of the allergy meds...I just kind of deal with it. Compared to the other POTS stuff it is so insignificaant for me.

Erika

[erikainorlando]

Firewatcher -

I saw the article you quoted...thank you!! Now...I can't really get it..if vasomotor rhinitis is caused by the swelling of the blood vessels in the nose..how does this relate to POTS...My cardiologist and you talk about the inadequate constriction of blood vessels in returning blood back to the heart..am I reaching here?

Thanks,

Erika

[scarfgirl]

What Erika said....can you explain the vasomotor rhinitis connection? I'm not quite getting it.

@friday7 - I sometimes think that my POTS wouldn't be a disabling condition for me if it weren't for my sinuses. Every relapse I have is triggered by sinus problems. My quality of life improved greatly after sinus surgery, but I still have a ways to go.

[firewatcher]

Like POTS, vasomotor rhinitis is an autonomic dysfunction. POTS can be worsened by allergies/histamine, but vasomotor rhinitis is only seen with dysautonomias. If you've tried all the "allergy stuff" and still have sinus/ear issues, it may be vasomotor rhinitis and not allergens that are the cause. Basically, yes, the blood is pooling in your nose and causing the linings to swell, cutting off the passages that allow your sinuses to drain.....causing recurrent sinus infections. If you can control your allergies, then your POTS will be better (due to histamine.) But if you have no allergies and have POTS, you can get sinus problems just from the autonomic dysfunction of POTS. Then you can also have BOTH vasomotor rhinitis AND allergies which is a double whammy.

With vasomotor rhinitis you can't control the blood flow, but you can relieve some of the symptoms with topical decongestants/steroids (salt water/rhinocort, etc.---basically compression for your nose.) The recurrent sinus/ear infections are the real medical issue. Always having a low-grade infection in your face taxes the immune system and just makes you feel crummy.

Is that any clearer?

Edited November 27, 2009 by firewatcher

[erikainorlando]

Yes...Thank you!

[Guest tearose]

Yes to sinus problems.

I always have tissues on me. I was told I had allergic rhinitis. I don't treat it, I manage it.

I am use to sniffling, not sensing smells at all or normally and sometimes being over sensitive to them.

[firewatcher]

Yes to sinus problems.

I always have tissues on me. I was told I had allergic rhinitis. I don't treat it, I manage it.

I am use to sniffling, not sensing smells at all or normally and sometimes being over sensitive to them.

You could have both. If allergy meds don't work, then according to their diagnosis flow-chart (I know, I'm a nerd!) you'd have Vasomotor Rhinitis. The best thing I've had to treat it is the Neti Pot/Rhinocort combo. I used to get sick every year, from Ragweed season till spring (odd since spring has more pollens) but it was a continuous sinus infection brought on by the Ragweed and perpetuated by the VM rhinitis. Since being on the Rhinocort, I have had one sinus infection free winter and am hoping to have another!