Patient's Query
Hello doctor,
I am a 38-year-old female with a normal BMI and I am a non-smoker. I have been diagnosed with chronic sinusitis with polyps for 14 years, managed with nasal steroid drops and antihistamines. I have no allergies; all allergy tests came back negative, and I do not have asthma.
Sometimes, I experience exacerbations that make me anxious. For example, there are episodes where my sinuses feel very puffy (without mucus), and it feels like I am breathing through a narrow, hard straw. The back of my nasopharynx also feels tight. It gives the impression that my entire respiratory tract is affected, but when I pinch my nose and breathe through my mouth, I can still get air, and there is no change in my peak flow (I bought a peak flow meter just to check). These episodes of inflammation typically last between 30 minutes to an hour.
When I am only on steroid sprays (which are not as effective as drops), my symptoms behave like an allergy causing sneezing, a runny nose, and severe congestion. However, I have not identified a specific trigger, although there seems to be a slight correlation with rainy weather. My main issue, which may sound trivial, is that these episodes trigger anxiety. While I have not been diagnosed with asthma, there is a family history, as my dad developed asthma and nasal polyps. At the moment, only my sinuses are involved, but I fear that my lower airway will also become inflamed during episodes.
I have never fully understood my condition. I have been diagnosed with chronic rhinosinusitis with nasal polyps but was told I do not need surgery since there was only minimal thickening. Yet, despite medication, I continue to experience these episodes of acute inflammation, which cause anxiety.
Please help.
Thank you.
Hello,
Welcome to icliniq.com.
I can understand your concern.
According to your statement, you are experiencing chronic sinusitis along with nasal polyps, and any inflammation, triggers your anxiety. Recent studies have revealed that patients suffering from chronic sinusitis are more likely to experience anxiety and depression, with over 50 percent of them affected compared to those without this condition. Other studies have indicated that while sinusitis may not directly cause asthma, patients with sinusitis are more susceptible to developing lower respiratory airway diseases such as asthma, COPD (chronic obstructive pulmonary disease), and bronchiectasis in the long term.
It is a fact that any type of chronic disease in our body may trigger or contribute to the development of anxiety and depression. It is important to avoid anxiety triggers, as they may exacerbate your current condition. You can consider taking anxiolytics to reduce your anxiety, but only after consulting with your physician.
Hope I have clarified your queries.
Thank you.
Patient's Query
Thanks for your reply doctor,
I do need to reduce my anxiety. I believe it is because I can constantly feel inflammation in my sinuses, serving as a constant reminder of my condition. My primary concern is that I do not fully understand my condition. I have no allergies, yet antihistamines help and my condition consistently behaves like an allergy. This raises questions about what is truly happening. Despite taking medication, these exacerbations of inflammation, which can last for up to two hours, seem to have no identifiable trigger and are not allergy-related. Therefore, I am unsure about the root cause or what else I can do to prevent them.
Please help.
Hello,
Welcome back to icliniq.com.
I can sense your mental condition. As I have already mentioned, any kind of chronic disease, such as sinusitis, can trigger or lead to the development of anxiety and depression. You can implement various measures or techniques to alleviate your condition. For instance, try to avoid overthinking about your illness, and engage in relaxation techniques such as relaxation exercises and simple breathing exercises like deep breaths, holding the breath, and exhaling.
Additionally, practice muscle relaxation to release tension, consider distracting yourself by traveling or going outside, incorporate regular aerobic exercise into your routine, enjoy the fresh air in nature, spend quality time with family and friends, share your feelings with loved ones, challenge negative thoughts, engage in competitive or challenging activities, dance, listen to music, avoid strong drinks like coffee or alcohol, consider medication, maintain a regular balanced diet with plenty of water and green leafy vegetables, establish regular sleep patterns, and practice yoga, among other methods.
Patients with sinusitis and nasal polyps can lead a normal life like others if they can overcome their overthinking or anxiety about their condition. There are millions of people worldwide suffering from sinusitis and nasal polyps who lead peaceful lives. As previously mentioned, you can consider taking some anxiolytic medications to reduce your anxiety after consulting your physician. Additionally, consulting with a psychologist and spending time with them can be very helpful for you.
Above all, it is essential to avoid overthinking or becoming anxious about your disease condition at any cost to lead a normal, peaceful life.
Take care. In case of any further queries, please ask me.
Thank you.
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