zonk Wrote:I have been noticing nasal congestion and stuffiness during the day , recently i had a check up with the ENT doctor he examined my nose with the camera and told me that there is a slightly left septum deviation and swollen inferior turbinates . He said that it is not uncommon to get reactive swelling of the nasal lining due to CPAP therapy and the nasal obstruction is a combination of septal deviation and a vaso-motor reaction secondary to CPAP use .

Diagnosis : CPAP/Vaso-Motor Rhinitis .

He put me on a trial of Nasonex and suggest if it prove ineffective then turbinate reduction and perhaps septal correction might help .

Beside using Nasonex which is quite expensive i also use Neilmed sinus rinse ( squeeze bottle ) , it is helping but not all the time , the thought of the operation scaring me , anyone been through this ...Please Help

HeadGear Wrote:As you know, zonk, I have been through this very thing. There is a generic version of Nasonex, called Beclomethasone which is considerably less expensive. I have used both it and Nasonex. Although better than nothing, I found neither worked well enough to eliminate the stuffiness.

One ENT (in the big city) felt that my septum deviation to the right was a significant obstruction, as was swelling of the turbinates - surgery was scheduled. A second opinion, (small town ENT,) scoffed at that finding and I agreed to continuing treatment with Nasonex. (I really did not want surgery and I feared that it would interfere with my CPAP during healing.) A year or so later, after lots of my complaining about stuffiness, the latter ENT relented and performed a reduction of the turbinates, by radiofrequency surgery, while I remained in his offfice and under local anaesthetic. Healing was mostly pain free, took about a month but had no adverse impact on continuing with CPAP. The easing of the stuffiness was quite remarkable! Some four years later, I do get occasional stuffiness due to allergens, colds, GERD, or CPAP, but nothing like before. My impression is that the turbinates are regenerating over time, but I will have to ask to confirm that.

Do try the NeilMed NasoGel which I reviewed here. In my opinion, it is more effective than Nasonex, without the risks of hormone use!

zonk Wrote:Thanks HG for the response , it is assuring to know that healing from turbinate reduction is pain free , for the time being i find Nasonex is helping but i,m getting headaches whenever i use it .

I have no luck so far finding the gel spray but i,ll inquire from the company on monday where to get it from .

HeadGear Wrote:The NasoGel is not a spray but a gel substance. It comes in a tube or an injection bottle. I prefer the bottle. If you use the tube, a Q-tip is required to apply the product a ways up the nose! You can google the NeilMed website for detail and dealer location. (Sorry, can't post the link - them's the rules!)

zonk Wrote:Looking at Neilmed website the nasogel comes in drip free gel spray and gel tube as you said , i have got the tube but have not used so far but i.ll start using it see if it help .

NasoGel Moisturizer is a drug-free saline based water soluble nasal gel formulated with sodium hyaluronate to provide nasal moisture.
NasoGel Moisturizer helps to alleviate dryness caused by:
Dry Air
CPAP machines
Oxygen therapy
Sinusitis
Allergies
Common Cold

zonk Wrote:What i find helping sometimes is heating the bedroom before going to sleep .

HeadGear Wrote:It's funny how a simple thing as being stuffed up suddenly becomes a big deal when on CPAP therapy! We may get hypersensitive and hyper vigilant about this problem because it is such a desperate situation for us. Sometimes, the "cause" is just random bad luck! So many other causes, if you consult google regarding rhinitis!

zonk Wrote:I have read quite a bit about Rhinitis and recently i have posted Nasal Breathing Videos series in For/Sale Commercial Posts .

HeadGear Wrote:He mentioned Astelin for treatment of non-allergic rhinitis. Looked into that?

Ltmedic66 Wrote:I use asteline spray. It is available as a generic (I believe the name brand is Astapro) and is somewhat inexpensive. It works great for me.

zonk Wrote:I don,t know what is going on , last few days felt fine without using anything not even sinus rinse .

I,m not sure if having Septoplasty and turbinate reduction would help in the long term as it might not resolve the problem completely so may be it is better to do the simple things like nasal washes and as one get older surgery shoud be the last option ?

HeadGear Wrote:Yes, I agree that it is better to do the simple and least intrusive things first. It is a matter of individual tolerance for the dysfunction. So, if and when, you get fed up, then look at the surgical options.

zonk Wrote:From what i gather that the recovery from the septal correction surgery is slow and painful and might have some complications :

Bleeding
Collection of blood within the septum , may need drainage
Septal perforation
Infection
Re-dislocation of the septum
Failure to improve the nasal airways

The turbinate reduction might be less invasive but still might have some complications :

Bleeding and nasal crusting
Nasal stuffiness and discomfort
Failure to improve breathing
Infection
Complication of general anaesthesia

I might don,t get any of the complications but can not be sure and at the same time my doctor think it might improve my compliance with cpap .

I think you summed up well " It is a matter of individual tolerance for the dysfunction " .

johnomg Wrote:Hi All,

Very recently I was talking to (who I think was) a Ward Pharmacist and mentioned I was using Spray-Tish to help clear my nose at night.

They recommended I use Flo Xylo-Pos which they said is preservative free and better for long term use than the Spray-Tish.

They did say it might be hard to find and does not need a prescription, I haven't looked into it yet but thought I would mention it.

Cheers
John