I am a 47 year old female who used to be above average in health. I was an avid runner, running an average of 3 to 4 miles every other day. I lifted weights and was very seldom sick. I eve ran competitively for several years and always did quite well. Looking back on my breathing levels, I know I had always had some difficulty getting my breath after a race because I tended to pant quite heavily, but breathing through both of my nasal passages has never been a significant problem.
In the past two years, my entire physical condition seems to be going "down-hill." I teach school and have been having increasingly difficult times talking. I have almost continuous bouts with losing my voice, sore throat, bloody discharge from my left nasal passage, irritated and full feeling eustachian tubes, sore upper molars on the left side, and excessive stomach acid. I can no longer run because the discharge in my throat becomes so thick and excessive that I almost choke when ever I try any physical activity at that level! I can't even walk outside in the cold or my throat will become even more irriated, and this lasts for days.
All of these problems seems to be related to constant and excessive drainage down the back of my throat. For the past year, I have only had relief starting in June and ending in December. Additionally for the past year, I have been using FLONASE nasal spray (one spray in each nostril am and pm); one tablet of GUAIFEN - a decongestant - am and pm) and most recently, ZANTAC 150 mg am and pm, for the increasing bouts of cramping and stomach pains which occur every afternoon to bedtime. This worked for a good part of this last winter, but now my throat is becoming increasingly irritated and the discharge seems to be thickening.
Two local ENT doctors have examined me and each states that I have a deviated nasal septum on the left side, which is blocking my nasal passage almost 80%. Allergies have been ruled out by a simple blood test one of the doctors performed. Additionally, I have had a CAT scan of the sinus area and no abnormalities were noted.
Both doctors have stated that they believe the best option for me to consider is corrective surgery for my deviated septum; but is there some other options that I have not considered? Will the correction of this deviated septum clear up all of these problems? I would hate to go through a surgical procedure such as this and find that I still have my problems. Also, why would this deviated septum take this long to cause this many problems? I have never had a broken nose and other than the panting I previously described when running, I have never had any significant problems related to breathing difficulties.
Thank you for any help you can give me on this. I am concerned that these physicians are "knife-happy" and really are not giving me any more options to consider.
Reply: ------------------------
Many of the symptoms you have described including the bloody nasal discharge, post-nasal drainage, eustachian tube problems, and dental discomfort could be explained by a significant deviation of the nasal septum. However, it is not likely that all of your symptoms are caused by the septal problem - I would suspect gastroesophageal reflux (GER) as a likely cause for many of the other symptoms. GER can cause many throat and voice symptoms with or without dyspepsia or heartburn. Management ranges from simple measures including head of bed elevation at night and avoidance of meals within an hour of bed to the regular use of prescription medication (Zantac, Axid, Prilosec, Propulsid, Prevacid, etc.). Severe and complicated GER can even warrant surgery in select cases. In any event, I suspect that septoplasty may indeed provide you with some benefit that you would appreciate, but I do not believe it would eliminate all of the bothersome symptoms. I would suggest a good evaluation for GER and, if it is indeed present, maximizing the therapy directed at GER before embarking on septoplasty.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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