Aspirin Triad Sinusitis (or Aspirin Exacerbated Respiratory Disease) is the combination of aspirin sensitivity, severe chronic sinusitis with polyposis, and asthma. It often manifests in adulthood and can be one of the most difficult-to-manage sinus problems.  Read More. 

By Thomas S. Higgins, MD, MSPH, www.higgins-sinus.com

Okay, the sinus doctor got a sinus infection. And yes, he recovered. And WITHOUT antibiotics.

I tell my patients to try remedies other than antibiotics for the first few days of feeling a sinus infection. Now, there are exceptions: high fever, severe symptoms, a scope examination clearly showing a bacterial infection, etc. However, most early infections are viral or inflammatory, so they do not necessarily require antibiotics.

So, back to my sinus infection. On Friday, I started feeling the congestion. Then came the thick yellow drainage and difficult breathing. By Saturday, I was fatigued, had facial/sinus pressure, and felt warm. I took my temperature: 97.8 degrees Fahrenheit. No fever.

This is the day when many people think that an antibiotic is the answer. I have to say, the thought crossed my mind, but I resisted. I, instead, started “The Dr. Higgins’ Nose & Sinus Relief Routine”:

• Warm soup.
• Humidification.
  
• Nasal decongestant and acetaminophen (sometimes in combination formulas) by mouth every 4-6 hours during the day.
  
• Sedating antihistamine (such as diphenhydramine) and acetaminophen at night just before bedtime.
• Nasal decongestant spray twice a day followed by nasal saline irrigations.
  
• Nasal saline irrigations several times a day, particularly after using the nasal decongestant spray.
  
• Nasal saline spray as needed.
  
• Nasal steroid spray twice a day.
  
• Try to stay upright and be moderately active.
  

The first two days of fatigue were tough, but I could breathe through my nose because of The Routine. I believe allowing myself to breathe served two purposes: (1) It made me feel much more comfortable and (2) It prevented the mucus from getting backed up in my nose, which could prolong or worsen the infection. I started noticing some improvement on days 3 and 4. I started taking the decongestants less often. For the next week, I continued an occasional irrigation to clear thick yellow mucus in the back of my nose. By the end of the week, however, I was off nasal decongestants and irrigations. I felt back to normal, except for a lingering cough, which I knew typically would last on average at least 10 days. I continued the nasal steroid spray until the cough disappeared.

And, aaaahhhhhh. Back to normal. No antibiotics, but aggressive treatment. Now, when I have a true bacterial infection, I do not have to worry that I could have previously created an environment for a resistant bug, and my body will be ready.

Hot off the Presses!

http://onlinelibrary.wiley.com/doi/10.1002/alr.21054/pdf

Impact of tobacco smoke on chronic rhinosinusitis: a review of the literature† Douglas D. Reh MD, Thomas S. Higgins MD, Timothy L. Smith MD, MPH, International Forum of Allergy & Rhinology, Volume 2, Issue 5, pages 362–369, September/October 2012

"There is clear evidence in the literature that cigarette smoke, either through active smoking or passive exposure contributes to chronic sinusitis. Recent prospective studies suggest that active smoking is not a contraindication to sinus surgery, although the impact of smoking volume and long-term smoking after sinus surgery has not been sufficiently evaluated."