Thanks for posting this. I've experienced something similar. My nasal passages have almost always been swollen since I was 11-12. Most ENTs I'd seen over the last 15-20 years have completely failed to provide me with relief. Earlier in 2018 I visited an ENT who noted that my turbinates were "absolutely massive" and the rest of the nasal passage was swollen.

Sometimes the swelling would affect the rest of my airway and I'd feel like I couldn't take even a moderately deep breath. I'd be rushed to the ER but the doctors couldn't find anything other than an elevated heart rate (and some immediately went to their go-to diagnosis of it being stress or a panic attack). After going through that about 10 times, I got a good doctor who told me: "oh dear, you're actually choking." But then, things like hereditary angioedema were ruled out, and the cause remained elusive. I later discovered I could control my symptoms with diet.

I'm now looking into having somnoplasty to reduce the size of my turbinates, but it's unclear whether doing so will simply shift the problem to another narrow point of my swollen nasal passage.

I appear to have lost some kind of cosmic lottery because I also have severe digestive issues and must follow a very strict diet (which also reduces the airway swelling). As you touched upon, it is very hard to accept that you spent most of your life not being able to be yourself. I know I spent most of mine in a subdued fight or flight mode due to the chronic strain on my basic bodily functions. It's been a cruel existence thus far and I can't wait for the day I can rid myself of this torture definitively (my plan for fixing my problems is getting closer to fruition and I've had some success with some of the measures I've tried).

Same thing with me! After going to ENTs for 5 years they all told me “nasal steroid sprays, antihistamines, nasal deviation”. The nasal steroids sprays and antihistamines never worked, so I thought surgery is the only option. I did an MRI of my brain for another reason, and there I go with the scan to the ENT, turns out I have huge turbinate swelling and no nasal deviation. I need to try more meds now before going in for surgery (turbinate reduction surgery).

You might be interested in somnoplasty, it seems less invasive than traditional surgery, although I have yet to complete my research on it. It's usually done for soft palate reduction in order to remedy some forms of sleep apnea, but it can also be used for turbinate reduction. Somnoplasty uses radiofrequency to reshape soft tissues.

I've had an ENT surgeon explain some of the normal/traditional surgical methods of doing turbinate reduction, and it seems to be fairly complex; some methods preserve or reconstruct the underlying bone structure which may be needed for the turbinates to function correctly, while others just do a straight reduction and don't consider the final composition of what remains of the turbinates. I'm trying to find out how somnoplasty relates to this.

I will check it out and do some research on it. I am giving antihistamines and nasal steroid sprays a final try, along with testosterone replacement therapy. Found out I am hypogonadic, and hormonal issues also cause turbinate hypertrophy. If none of these work I will do a surgery.

Let us know how your situation works out

Have you ever lived in or spent extended time in a different climate? I've had many of the same problems and two surgeries. Things were definitely worse in the humid polluted swamp I used to live in...

Yes, you're probably right about that being a trigger. Unfortunately moving is not an option right now.

When I said “modified septoplasty”, turbinate reduction was the modification. In addition to the collapse, they were very large.

I’m curious how often these kinds of symptoms are caused by an undiagnosed chronic viral infection.

I'm pretty sure i've had a chronic sinus infection for a few years now. When I was a kid I was told I had narrow sinuses...I used to get ear infections pretty much any time i got sick. I find they don't drain properly. It always feels like there's liquid on one side. I can tell days it's worse, the area below my ear and jaw are warm to the touch and hurt to press.

It comes and goes. The breathe right strips mentioned by another commenter helps. I find it feels more clear the next day after using them.

But i've found the biggest thing that helps is paying attention to.my stress and the way I hold the muscles in my face. I find making a concious effort to takes some time to do some deep breathing and focus on relaxing the muscles around my eyes and my jaw really helps. A few days of keeping up with that and I findy breathing and pain and such go away.

I also find it to.be a good way to gauge my stress levels. When the sinus infection cones back and stays for a bit. I know i've been slacking with being mindful and letting stress get on top of me.

Sleep makes a huge difference. Insufficient sleep compromises the immune system. Sleep deprivation also causes increased anxiety.

It may even be a post-viral syndrome, which is virtually impossible to detect.

Sometimes it is air pollution irritating the nose, when I went to Copenhagen, I said it was the first time I was able to breath in a decade, while I was smoking at 3 am outside my hotel,Bella Sky .

I had a similar problem. When I was younger, I suffered an accident (I fell, and a metal piece entered my left nostril) which caused an abnormal formation on the inside after it healed. I lived many years having trouble to breathe correctly because of that blockage. Eventually, a doctor discovered the problem, and I had surgery. The difference it makes, being able to breathe correctly, is incredible.

I am curious why it is so important to breath through nose during aerobic exercises? I succeeded very well in different high intensive kinds of sport like boxing and sprint running, and always breathed using mouth..

The general technique is to inhale through the nose, exhale through the mouth; if you breathe through the mouth, you'll breathe in a lot of unfiltered, cold / dry air, which you'll end up feeling in your windpipe all the way down to your lungs. The nose filters and pre-warms the air you breathe in.

I googled 'running breathing nose or mouth' and read articles on first page, and general consensus is that you can't take enough oxygen during intensive exercises by inhaling through nose only..

On a similar note, my mother was recently diagnosed with Silent Sinus Syndrome [0].

She had been having vision issues for a while, and it surprised her whenever they figured out it was due to the collapse of her sinus cavity.

[0]: https://en.wikipedia.org/wiki/Silent_sinus_syndrome

Thanks for sharing.

I've gone through not one but two turbinate reduction surgeries myself. One when I was young and another several years ago. Alas, my quality of breathing now is still pretty abysmal. It's just gotten to the point where I've come to accept having to breathe through just one nostril all the time, as much as a nuisance it is. Frustrating to have spent all that energy and funds to land back at square one.

Also went and tried CPAP for a while, which didn't really help me with breathing for restful sleep.

Where I notice this most is probably during heavy exercise. Having to breathe through the mouth during intense aerobic exercise makes me hit my limit much faster.

I've had two turbinate reductions, a UPPP, and balloon sinuplasty, and I still don't feel right about my nasal breathing. Dr's have pretty much given up at this point.

The strips eventually ruin my skin, or don't stick through the night (they come off and eventually stick to my foot, or my cats...). So I finally turned to "nose cones". The ones on Amazon and the local pharmacies are barely passable, so I did the unthinkable in this day and age and ordered some "Max Air Nose Cones" directly from the manufacturer. Don't want to seem a link shill, so Google/Duck, or just find it as the domain name is the product name. I use the Max Air for exercise (clear) and the Sinus (beige, a bit more stiff) for sleep.

Still not a perfect solution, but cheaper, reusable (still on first set), and less skin irritation than other solutions.

Can you dilate your nostrils? I just did a test in front of the mirror, if I breathe in hard my nostrils collapse slightly, I can feel the breath in getting more difficult. But if I dilate my nostrils at the same time, the effect is almost completely negated.

It looks like the nostril dilation muscles evolved for this purpose (keep the airways open) but they don't always get triggered automatically.

I can, but presurgery it still wouldn’t prevent the collapse.

I wore the strips everywhere, all day, for two years. People looked at me as if I got out of my house wearing pajamas :D

It's normal for the nostrils to suck in somewhat when inhaling....right? If not maybe I should see an ENT or try those strips.

I do find myself yawning a lot, when it feels like I haven't had enough air. However, I've never had any trouble sprinting or doing athletic activity.

So I just tested it and find that I use the muscles of the nose to keep it open - so this doesn't happen. If I don't they do suck in and breathing is harder. It's also possible to open them more than normal for even better breathing.

It is. The degree to which they were doing it was the problem. I couldn’t even try to force them to stay open and they would completely seal the airway.

I’d definitely try the strips if you’re curious though. Really simple and effective.

Could you explain how you got your breathing fixed permanently?

Probably surgery

What was the problem and how did it get diagnosed and fixed?

I'm curious if you eat dairy, soy, and/or bananas? They're all very high mucous producing foods and can impact breathing significantly. I suppose after surgery removing such foods may or may not show improvement/alleviate things more.

Not sure the science is conclusive on this. Also, breathing well probably helps your body to eliminate mucous. Speaking from a yogi's perspective.

I'm not sure I've seen a properly conducted research study to give a solid enough answer either; can read some of my reasoning in my last comment - https://news.ycombinator.com/item?id=18960189

I've been practicing yoga for more than 10 years, a lot of Bikram hot yoga - so I feel you regarding the differences on energy level and at least how the heat and increased flow of air can help free up and clear the sinuses, and why long ago I gave up dairy, soy, and bananas - as I'd notice the decreased ability to breath and likewise my sleep would become worse - I believe because there'd be less ease of breathing while asleep.

Makes intuitive sense to me too but:

- You might have an especially strong reaction to those foods, i.e. they produce more mucous in _you_

- You might have engaged in other mucous-reducing habits around the same time e.g. drinking more water or practicing yoga. Hard to identify a root cause in a study of one.

I do. Nothing significant but I don’t avoid those at all.

If you're into experimenting it may be worth doing so for a week or two to see if there's even further improvement in sleep/breathing; you first have to remove the potential agitant and then let the body recover.

Getting a Neti pot (use distilled or previously boiled water only, along with adding a proper amount of non-iodized salt - Google search will give the answer) and trying that out to help clear the sinuses with warm water seems to help a lot of people as well.

It’s not really an issue anymore, but I’ll keep it in mind.