u/Kreios_IX

I posted this on the ENS subreddit the other day, and thought I'd see if any other folks might have some suggestions over here:

Hey, first time poster here and I'd love some advice.

So, I was historically a mouth breather my entire life, up until Sept 2022, which I had a septorhinoplasty (also had submucosal resection with lateral out-fracture). My septum was extremely deviated and one side of my nose was more or less entirely blocked prior to surgery.

My nose was very large and the surgeons felt that my dorsal hump was pinched at the top, further impeding my breathing. So, they ultimately shaved the hump down and used the excess cartilage to create a sort of make-shift breathe right strip. They also used grafts to strengthen the tip of my nose, as I also had nasal valve collapse on the left side. Additionally, as mentioned earlier, my septum was extremely deviated, so they moved it pretty far over to the left. Surgery was long, but went well and my QOL improved tremendously for about a year and a half.

Spring 2024 comes around and I catch COVID for the first time. After a few weeks, I recover and I went outside to weed-eat my backyard (I had just had a large tree cut down a few days prior). Shortly after starting, I clipped a large piece of mulch, which flew up and hit me pretty hard on the bridge of my nose.

After this, I noticed that where there used to be two little bumps inside my nostril (from the graft at the tip), was now a fairly large, rectangular piece of the graft that sticks out a bit. Also, though perhaps it was always this way, I noticed a small spiky bit of cartilage at the base of my right nostril (presumably where my septum used to connect).

Either way, not long after, I develop an issue where I feel a constant, and I mean absolutely constant sense of pressure/squeezing/clamping sensation at the bridge of my nose (right over the nasal bone). It never, ever stops, though it's notably worse when I bend over and when I'm lying down and turn my head side to side.

I eventually see both of my surgeons, whom do nasal endoscopies on me and find nothing of note. I then see a neurologist for months, though he ultimately has no ideas as to what could be the cause.

After trying gabapentin (900mg nightly) for months, I discontinue use as it didn't help. I also end up trying astepro, budesonide saline mix (2x a day for months), and ipratropium (does help with the chronic runny nose, but not the congestion or constant pressure).

I go back to my ENT and he orders a facial CT. It's normal besides the fact that my right turbinate is hypertrophied (may be inconsequential). I see him in office again and he scopes me once more. He notes that my right turbinate is quite swollen, and nearly touching my septum. He suggests we repeat the submucosal resection with lateral out-fracture, but notes he's not certain that it will be a permanent solution. He added that it's very uncommon for him to need to do the surgery more than once, and that I had some type of white, frothy substance in my nose (it didn't look like mucus). He suggested that I may have some type of autonomic issue, as my nose very frequently drips, too (much worse with eating and temp change).

After this, I try 10, then 20mg nortriptyline for 2-3 months, but it doesn't help. I realize, however, that's a low dose, but the GI side effects were just too difficult to deal with, at least for me.

This brings me to current day: I feel like I've nearly exhausted my options, yet I still don't even know exactly what's wrong with me. I don't know if it's some type of post-viral autonomic issue that or possibly a physical injury that resulted in some kind of nerve damage. I've read more and more about ENS, and I do take it very seriously. I don't want to have to get this surgery again, but I feel I'm running out of options.

Based on what you all know, does this sound like more of a nerve issue or an autonomic/vascular issue? The only other plan I have right now is to try an SNRI like cymbalta, but that's about all.

Again, this sensation around my nose is legitimately unrelenting. It's been 2 years of constant clothes-pin like pressure, and I'm just very, very sick of dealing with it.

Any advice or info? Also, apologies for the long post, but I wanted to be thorough with my story-- thanks for reading.

I forgot to mention, I also ended up having a brain MRI via neurology, and that was normal as well. Also, I probably should've mentioned: my right turbinate is indeed swollen much of the time and I'm very often congested on that side of my nose, even now.

Another note at the end here: my ENT surgeon did mention that he's able to do posterior nasal nerve neurectomy (intra-op division of the posterior nasal nerves). He also noted that he here's microdebrider for SMR.

Also, even when I take afrin and iptratropium, while the runny nose and congestion improve, the constant pressure on the bridge of my nose is still present-- it's just not as intense.

Sorry for the very, very long post, but it's been a long two years-- with that said, any thoughts?

I posted a week or so ago for the first time and got some helpful feedback, so thought I’d follow up and ask for some more advice.

Basically, I had a septorhinoplasty back in September 2022 to resolve chronic breathing issues I’d had my whole life. My dorsal hump was notably shaved down and the excess cartilage was used to create something of a permanent make-shift breathe-right strip in the middle of my nose. I previously had nasal valve collapse, so it resolved that issue. They also put in some grafts to give the tip of my nose more structure. I also had a septoplasty (I had a very deviated septum) and a submucosal resection with lateral out-fracture.

The surgery was a success after the splints were taken out a week later. I more or less felt “normal” for about a year and a half. Fast forward to around spring 2024, and I catch COVID for the first time. A few weeks afterwards, I start developing a constant, severe headache on the left side of my head. A month or two later and it goes away, but I then develop a constant (legitimately 24/7) sense of squeezing/pressure (not painful) on the bridge of my nose. Additionally, my nose would run frequently, particularly when I ate and with temp change.

It’s been 2 years and this feeling has not gone away. I’ve seen 5 ENTs and had 4 nasal endoscopies as well as a brain mri and facial CT. The only thing noted was that my nasal passages are still a bit narrow (they were prior to surgery too) and my right inferior turbinate was hypertrophied.

I’ve tried numerous nasal sprays and so far, Ipratropium is the only thing that’s helped. It’s dried my nose out to the point to where it hardly leaks at all. Subsequent, the pressure has decreased quite a bit.

However, my right inferior turbinate is still frequently hypertrophied and I’m often congested.

I’ve been using a budesonide/saline mixture for a couple months, but I’ve felt little change. Afrin obviously helps, but I avoid it as much as I can. Astepro did nothing. When I use breathe right strips, I feel almost normal. It’s by far the most relief I get (along with the Ipratropium).

With all that said, besides the Ipratropium, is there any way to deal with this safely, long term? My surgeon suggested a repeat submucosal resection with lateral out-fracture, but admitted that I likely have some type of autonomic issue that may cause my turbinates to re-swell anyway.

I’m getting a consultation for a RhinAer procedure this week, but I’m not sold on it yet either.

I’ve read extensively on ENS and I want to avoid it at all costs. I’m trying to exhaust all my options before I consider surgery, but I just want relief.

TL;DR: what’s the ENS risk factor of SMR and RhinAer? Are their OTC/natural methods that may yield a similar, safer result for severe, chronic vasomotor rhinitis and turbinate hypertrophy?

I'm a very active seller and often have around 200 items for sale at any given time. I've been selling on marketplace with this inventory amount for about 5-6 years with no issue.

Over the last month or two, however, I've had a significant drop-off in views and messages. The reason I suspect something has changed is that my items are no longer searchable by other people. I've had numerous friends and family search my exact titles (very specific model numbers, etc) and none of my items are visible.

I tried listing a few things on my wife's account and when I had people search up those same items, they popped right up and the views were much higher in a brief period of time.

My profile says it has an active marketplace account, so I don't know what's going on or how to fix the issue.

Any ideas?

Hey, first time poster here and I'd love some advice.

So, I was historically a mouth breather my entire life, up until Sept 2022, which I had a septorhinoplasty (also had submucosal resection with lateral out-fracture). My septum was extremely deviated and one side of my nose was more or less entirely blocked prior to surgery.

My nose was very large and the surgeons felt that my dorsal hump was pinched at the top, further impeding my breathing. So, they ultimately shaved the hump down and used the excess cartilage to create a sort of make-shift breathe right strip. They also used grafts to strengthen the tip of my nose, as I also had nasal valve collapse on the left side. Additionally, as mentioned earlier, my septum was extremely deviated, so they moved it pretty far over to the left. Surgery was long, but went well and my QOL improved tremendously for about a year and a half.

Spring 2024 comes around and I catch COVID for the first time. After a few weeks, I recover and I went outside to weed-eat my backyard (I had just had a large tree cut down a few days prior). Shortly after starting, I clipped a large piece of mulch, which flew up and hit me pretty hard on the bridge of my nose.

After this, I noticed that where there used to be two little bumps inside my nostril (from the graft at the tip), was now a fairly large, rectangular piece of the graft that sticks out a bit. Also, though perhaps it was always this way, I noticed a small spiky bit of cartilage at the base of my right nostril (presumably where my septum used to connect).

Either way, not long after, I develop an issue where I feel a constant, and I mean absolutely constant sense of pressure/squeezing/clamping sensation at the bridge of my nose (right over the nasal bone). It never, ever stops, though it's notably worse when I bend over and when I'm lying down and turn my head side to side.

I eventually see both of my surgeons, whom do nasal endoscopies on me and find nothing of note. I then see a neurologist for months, though he ultimately has no ideas as to what could be the cause.

After trying gabapentin (900mg nightly) for months, I discontinue use as it didn't help. I also end up trying astepro, budesonide saline mix (2x a day for months), and ipratropium (to be fair, I only tried for a day or so, as the dry mouth was unbearable-- felt like I was choking to death).

I go back to my ENT and he orders a facial CT. It's normal besides the fact that my right turbinate is hypertrophied (may be inconsequential). I see him in office again and he scopes me once more. He notes that my right turbinate is quite swollen, and nearly touching my septum. He suggests we repeat the submucosal resection with lateral out-fracture, but notes he's not certain that it will be a permanent solution. He added that it's very uncommon for him to need to do the surgery more than once, and that I had some type of white, frothy substance in my nose (it didn't look like mucus). He suggested that I may have some type of autonomic issue, as my nose very frequently drips, too (much worse with eating and temp change).

After this, I try 10, then 20mg nortriptyline for 2-3 months, but it doesn't help. I realize, however, that's a low dose, but the GI side effects were just too difficult to deal with, at least for me.

This brings me to current day: I feel like I've nearly exhausted my options, yet I still don't even know exactly what's wrong with me. I don't know if it's some type of post-viral autonomic issue that or possibly a physical injury that resulted in some kind of nerve damage. I've read more and more about ENS, and I do take it very seriously. I don't want to have to get this surgery again, but I feel I'm running out of options.

Based on what you all know, does this sound like more of a nerve issue or an autonomic/vascular issue? The only other plan I have right now is to try an SNRI like cymbalta, but that's about all.

Again, this sensation around my nose is legitimately unrelenting. It's been 2 years of constant clothes-pin like pressure, and I'm just very, very sick of dealing with it.

Any advice or info? Also, apologies for the long post, but I wanted to be thorough with my story-- thanks for reading.

I forgot to mention, I also ended up having a brain MRI via neurology, and that was normal as well. Also, I probably should've mentioned: my right turbinate is indeed swollen much of the time and I'm very often congested on that side of my nose, even now.