Oh, So My Sinusitis Is Chronic: Life Lessons from Patient Portals

While looking through my patient portal, I noticed that in 2014 my sinusitis was diagnosed as “chronic”. Ummm… I barely knew I had sinusitis since at the visit that followed the ENT indicated that one, my nose looked good and there was no indication. Looking back, they did recommend that an oral steroid would be helpful. However, I only remember this being in the context that I may need to intermittently treat my sinusitis but largely thought it is under control. I guess I was wrong about that one.

In hindsight, I should have treated it like asthma, the presence of inflammation would be indicated that it would need to be treated. I am not sure why I never correlated that my nasal steroids should have been treated the same way as my asthma controller. Oops, I got that one so wrong. In some ways, it was like having a cold.

The part of this story that has me floored in why did I find out from a “Portal” instead of from physician about the status of my sinusitis. Was there really an ebb and flow to figuring this out? If they knew, they should have informed me or at least checked for understanding that I knew what meant.

What is chronic sinusitis?

Chronic sinusitis is described as sinuses being inflamed and swollen for at least 12 weeks despite treatment attempts.1 It may also be known as chronic rhinosinusitis, it may start as an infection, be related to growths in the sinuses (nasal polyps) or by a dedicated septum.2 I wasn’t really aware that I had anything beyond the infection.

Chronic sinusitis symptoms include:

  • Thick discolored discharge or post nasal drainage
  • Nasal obstruction or congestion
  • Pain or tenderness around your eyes, nose, cheeks, or forehead
  • Reduced sense of taste in adults or cough in children1

Connection between chronic sinusitis and asthma?

There is thought to be a correlation between chronic sinusitis and asthma, some patients have both, some have one, but not the other. There are thoughts that the airway should be viewed as one continuum from the nasal passages to the alveoli - the "United Airway concept". It is thought that the mucosa of the upper and lower airways are constantly exposed to triggers and inflammation may be triggered by a system response that is caused by nasal obstruction. Huang et al found a link that asthma stability is closely linked to chronic rhinosinusitis stability. When chronic rhinosinusitis is stable, essentially asthma is as well.3

I am not sure that I have ever noticed the correlation, then again, I also didn't know that my sinusitis was chronic. I do know that when nasal congestion is controlled that I do indeed breathe better. Even little things that can improve your breathing are worth having under control. I am making a pledge to take more interest in my sinusitis.

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