I feel your pain, 12%

by Yule Heibel on September 20, 2003

If you could have one question answered, what would it be?

In my case it would depend entirely on my sinuses. If I could have an answer to anything today, I would like to know what the point of sinuses really is. There are theories, certainly — I especially like the theory that it lightens bone mass: that if your skull, which has to be large enough to accomodate your big fat brain, were solid bone, it would be too heavy for you to hold up. Thunk. It’s certainly the case that in the midst of sinusitis, one’s head feels so heavy and sad that one would like to lie it down and die.

But why are there sinus cavities, really? Did you know that you have these cavities not only under and over your eyes, but above your ears (the sphenoids)? Popular literature typically leaves these little fuckers out, showing only the massive ones on your face; but the sphenoids are killer. For surgeons to clean them, they have to thread tools under and behind your eyeballs. No matter where they are, fill ’em with warm mucous and they’re the ideal breeding ground for bacterial and viral infection.

What’s the link to being environmentally connected and having chronic sinusitus? Excess mucous triggered by allergens, susceptibility or exposure to viruses and bacteria: boom. Some of the worst sinusitises I’ve had were in summer. Chlorine absolutely sets it off, too: no swimming pools or filthy, chlorine-doused hot-tubs for me. Latex and alkyd paint, too. Industrial solvents. Anything, it sometimes seems!

How come folk humour implies a connection between the size of one’s nose and a man’s genital endowment? The bigger the nose, the bigger the … In German, the saying is, “An der Nase eines Mannes erkennst Du seinen Johannes,” the name “John” serving as stand-in for dick. Freud’s erstwhile colleague Ernst Fliess developed an elaborate if whacky theory about blocked noses and their relation to sexuality, which Freud took on board to a certain extent and for a certain (limited) time. But what if there is a nose-sex connection? What if there’s a sinus-sex connection? Dr. Horowitz, my Mass. MD, knew of another theory about sinuses: that they helped modulate our speaking voices, allowing the voice to resonate and echo appropriately, and perhaps even modulating how we hear (viz. sphenoids). Think Creole Love Call, I suppose; and we all know that it’s very lovely to fall in love with your lover’s voice. I have a very nice voice. My husband has a big nose. But I still get sinusitis from time to time.

What’s the connection between the nose, the sinus cavities, their chronic inflammation, and depression? And the eyes, whose socket-muscles seem connected to the tidal flow of inflamed matter above or below and beyond? And the neurons in the brain, whose morphology has to be shaped by pain as much as by pleasure? Chronic anything is extremely depressing, but sinusitis seems to have special relationship to mood, and sinuses, once sensitised, have a special relationship to environment (allergy alert! bing!bing!bing!). It’s been my experience that stuffy noses do not have to accompany sinus inflammation. What’s that all about? Stuffy nose? Fergit about it. Right now, my nose is as clear as Puss in Boots’s boot polish, but I can feel the inflammation ringing my eyes and the region over my ears. Screw the pussy, buck the ass; I almost never have a stuffy nose (thank you, Dr. Fliess), but often wish I could unscrew my head. And swallowing that post-nasal drip is a drag.

These are the variations of a question I would ask on some days, with the hope of finally fixing the problem, for myself and for the millions of people afflicted. Some estimates say 37million people suffer from sinusitis in the US. Let’s downscale to 30mil; downplay the population to 250mil., that makes 12% by conservative estimate. To the world’s 12%, wherever you are, believe me when I say I feel your pain.


Joel September 21, 2003 at 2:34 am

There are three reasons why a particular feature exists in the body:

1.) It does something helpful that helps us survive better.
2.) It is a relic of something useful that our ancestors used to have (e.g. the tail)
3.) It evolved for no particular reason and it continues to exist in us because it is does not result in our being killed off before we have a chance to reproduce.

Take your pick!

Joel September 21, 2003 at 11:15 am

Are you going to change the name of your blog to Yule’s Post-Nasal Drip Studio for the time being?

I’ve responded at greater length on my weblog.

Yule Heibel September 21, 2003 at 2:21 pm

It’s drippy enough without being designated as such?, no, that’s too self-deprecating. How about, I’d have to call it YH’s Totally Inflamed? Well, I’ll leave it as is; like a migraine, it’s just as mysteriously going away as it came….

jr September 21, 2003 at 8:53 pm

My sinus problems stopped with the removal of a tooth with roots so long they had entered the sinus cavity. I no longer feel the pain, but I feel your pain.

Yule Heibel September 21, 2003 at 10:11 pm

Gah, that extraction, even with anaesthesia, must have felt …um, exquisite? Glad to hear it took care of your sinus problem, though. (And I should note that I don’t have sinusitis nearly as often or as severely these days as I did about 4-to-5/6/7 years ago; I can fend off an attack better these days — knock on wood — but it lurks, lurks, lurks in the background always, nasty beast.)

desperate September 28, 2003 at 11:33 pm

Interesting comments. My husband has terrible pain on a regular basis from sinusitis. It seems to inflame his bones and they press on his trigeminal nerve and cause horrific migraines (which go right to the back of his eyes– I thought was interesting because I had never heard of the cavities behind the eyes until I read them in your post). The pain is bad and he has been suffering for many years to no avail….no one seems to know what to do. Two surgeries that were suppose to help….now the newer doctors say there has been too much “traffic” in the sinus area and could have made it worse…..it can’t filter our the bacteria on its own and, thus the sinuses are always infected and thus, he always has head pain. Any thoughts on whether a move to a dryer climate would be helpful….we are desperate and are ready to do anything. Thanks

Yule Heibel September 29, 2003 at 12:45 am

You know, sinusitus can be so depressing. I hope your husband’s outlook hasn’t been completely degraded by this nasty chronic disease. Re. surgery: I don’t have much faith in it, since the sinusitis often seems to come back anyway, and your husband’s story confirms how surgery doesn’t necessarily solve the problem. (I chickened out of surgery because, after finally getting an MRI scan, I learned that my sphenoids were the most infected, and those have to be accessed via the eyeball sockets. Permanent double vision or possible blindness weren’t risks I was ready to incur, no matter how small the chances. And n.b., the sphenoids aren’t behind your eyes, but over your ears; same general geography, though.) But the doctor who diagnosed my pictures and sinus cavities did prescribe a medicine that really helped me: Zephrex LA (“long-acting”) 120 — and I do not mean the over-the-counter varieties of guaifenisen and pseudoephedrine in combination. I’m referring to Sanofi Lab‘s version. I basically took it on a daily basis for years. Note that for me the generic version did *not* work as well as the ‘brand’ did, and maybe this indicates that it was all psychological on my part, or that there really is something in the Sanofi version that the others lack. But what the medication did was to make the stuff flow, which it wasn’t doing before. I was sucking (kosher and/or sea) salt water up my nose 3x per day, and it did no good because you can’t get the water into the sphenoids (duh — I mean, how would you get it out?). The Zephrex got in there and liquified all this glue, which meant that after several months I could get my immune system to have half a chance to fight off the bacteria. (Some decongestants dry your sinuses up, which is really bad: then the glue turns to cement; you want the stuff to flow, to be liquified, and to move out.) (And re. Zephrex: guess what?, I moved to Canada in June 2002, and it’s a banned substance here. Man, I don’t care if the stuff kills, as long as it helps me kick the sinusitis….) Anyway, several things saved me: I took the Zephrex religiously for years; I nearly died of pneumonia in ’98 and required *brand new* (1 week old, no bugs had yet developed resistance to it) antibiotics administered intravenously over a period of days, which not only knocked out the pneumonia, but also the sinusitus; I felt so good after nearly kicking the bucket that my fighting spirit — which had been crushed by the miserable chronic sinusitus — came back and I was able to change my lifestyle (lose the depressing teaching job, focus on what’s important, or at least start to think calmly about what might be important), which has been the biggest factor in helping me to stay healthy.

Long and short of it: if your husband hasn’t tried a really, really good decongestant (and I can’t say anything bad about Sanofi’s Zephrex LA 120), I would suggest that he try this route. (The brand is expensive, the generic less so, but as I said, I didn’t find it as effective. My insurance refused to pay for the brand after a while, so I paid out of pocket — nearly $100 for 60 tablets.) I don’t think the climate change will really help, unless it’s a question of lifting your spirits by moving to a climate you like better. Me, I hate filthy cold weather, so Victoria, BC is ten times better than Boston; I also can’t stand hot & humid weather, and again: ditto. But I was fine and sinusitis-free for several years in the Boston area, after starting the Zephrex meds and having that really bad pneumonia, so it’s not just a question of climate. I also tried to figure out if it was allergies, and again, I can’t say there was one thing that triggered it. (Many people would freak here, for eg., because it’s leaf-mold paradise…!) Chronic sinusitus is a combination-disease, an opportunistic disease related to environment and psyche, but once it’s there and has taken on its own nasty morphology, it’s beyond life-style tinkering: you need really good medical help. By all means, do the head-shrinking and lifestyle adjustments and all that holistic stuff, but basically, once it’s there, it’s a nasty little monster that needs the shit kicked out of it. Did you know that if you have it long enough — for years — it actually affects (deforms) the bones in your skull? We are talking nasty nasty disease. Try the meds if you haven’t. And good luck.

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