Sinuses and Travel

I feel your husband's pain. My sinus issues are aggravated by the different pollens, dust, and air pollution encountered when I travel. I always prepare for worst case scenario. It's not fool proof, but these are things that have helped me in the past:

• put a thin coat of Neosporin or Vaseline inside my nose on long flights. This seems to keep things from drying out too much and aggravating allergy symptoms on arrival.
• take an allergy med every day - I choose Zyrtec because it works on indoor and outdoor allergens.
• use an allergy nasal spray daily - Flonase or the generic equivalent (it's not a steroid - correction per Grace, not a prescription steroid)
• use a Neilmed sinus irrigator every day (it's like a neti pot, but plastic bottle) every day. Note this only works if you're sure the water is safe, so I won't be doing this on my upcoming trip to Turkey
• bring prescription strength Sudafed and antibiotics if something does go awry. My doc will prescribe a small quantity for this purpose.

Best of luck!

I have had this happen when I started up the international travel after a 1.5 year break due to Covid constraints.

Obviously, talk with the physician which you’ve likely done. For me, not catching up on sleep once at the destination is a trigger. Zicam if I feel anything off at all, I take it immediately. I have found Sudafed is the best OTC medication for my symptoms. I bring it along; the type with Pseudoephedrine works best for me, but it is on the list of drugs not allowed into some countries like Japan, so I often bring Sudafed PE.

After one international and 2 domestic trips with sinus infections, I am back to pre-covid norms of healthy respiratory system. 3 international and several domestic flight later, I’ve been fine. I hope your husband finds the same “adjustment”.

Good luck! Interested in what others have to say.

CL, Flonase is indeed a steroid, a synthetic corticosteroid that decreases inflammation.

You do not want to take allergy meds for sinuses because they can often dry out the sinuses, making the problem worse.

I have to take allergy meds from Spring to the first frost and my sinuses are always worse because of the allergy meds. So, I often take Sudafed in addition to my allergy meds.

You want the Sudafed that you get from the pharmacist (EDITED: It's not prescription, but you need to show ID as they limit how much you can purchase). This is the only thing that helps my sinuses, and it works quick. I just take half the dose (1 pill, instead of the recommended 2 pills).

The Sudafed available from behind the counter (i.e. handed over by pharmacist after showing ID and signing register) is the type with pseudoephedrine - a banned substance in Japan and New Zealand, perhaps other countries.

I know I had it legally in France and England a year ago when I needed it. I always check each country's laws. In practice, a small package probably wouldn't be picked up in my purse at immigration, but I am not going to risk it!!

I deal with intense ear pain while flying, but it's usually when we are descending to land. If there is a second consecutive flight, that one is always worse. The worst ever was the second leg (after landing on a glacier) of a flightseeing tour in Alaska.

I've tried the Earplanes (they don't seem to help much). I chomp on gum when we are landing (I think that is a little helpful). On our last trip to Europe I used Flonase and Zytec, and that eased some of the discomfort. When we fly on Saturday, I am going to add a Tylenol to the mix.

FWIW, I thought I was always dealing with yearly sinus infections, but since I have started using Flonase/Zytec more regularly at home, I haven't been treated for a sinus infection since 2019.

I went to an Otorhinolarygologist who specializes in endoscopic surgery. (Many people point out that if you ask a surgeon for an opinion, he's likely to recommend surgery ... In this case, he was strongly recommended by a doctor I'd had for a long time.) My surgery, 30 years ago, changed my life, for the better. I continue to rinse my sinuses daily. I had two more old-fashioned sinus surgeries before that, with only temporary improvement. I recommend that you do not get medical advice from unknown people like me on the internet, however.

In fairness, one of the doctors in my Internist's group commented that 1/3 of people who get sinus surgery say it was good, 1/3 say it was useless, and 1/3 say it made things worse.

I would also point out that a doctor whose practice is based on the endoscope has dramatically higher billing prices than a doctor who has a round mirror on a band around his head. (1950's Otorhinolarygology ... !) Everything that happens in his office is outpatient "surgery", which can be billed differently in our unsatisfactory American healthcare system.

Thanks all. We have just 7 weeks until our next trip and determined that his sinuses play nice this time!

I agree with him consulting with an ENT but....

I also agree with CL on using a nasal irrigator. I use a neti pot every day at home but use the plastic squeeze bottle from Neil Med when I travel. I use the pre-mixed salt packets and I've added 1/8 tsp of baby shampoo to the mix. This is apparently something that ENTs have been using for years to combat stubborn sinus infections. The baby shampoo destroys the outer coating of the bacteria or virus and prevents replication. He'd want to consult with the ENT to see if this would be appropriate for him.

I am careful about the water I use. I usually use bottled water as I can tolerate room temp water no matter how cool, lol. In some places you might be able to get distilled water at a pharmacy.

Your husband might want to ask his doctor for an antibiotic prescription to fill and take traveling just in case, since it seems to be a recurring problem. Having a bottle of decongestant spray like Afrin or Neo-Synephrine on the plane can be used to alleviate sinus pressure quickly, especially tilting the head over and dribbling it down the nostril to open up the eustachian tubes. But as the labels warn, it shouldn't be used for more than a couple of days (rebound congestion). It's good to have a backup treatment plan if your everyday regimen fails.

CL, don't mean to nitpick, but Flonase is available on prescription and OTC. Not many insurance companies cover it any longer, but some plans do. Cheaper to buy it OTC if insurance won't cover it.

Flonase is available on prescription and OTC.,

Yes, mine is a prescription. It was prescribed when I had an undiagnosed case of anaplasmosis, so it didn't help that situation, but I have found it very useful for reducing my sinus issues.

I'm pretty sure a doctor once told me to drink plenty of water since I seemed prone to sinus headaches. I don't know whether that would help prevent sinus infections.

@mnannie - I used to have the ear pain but read (probably on this forum) to take one Sudafed (the behind-the-counter kind) an hour before landing. When I remember to do that, I have no ear pain.

Thank you, Janet!

Yes Mary…I have had enough sinus flare-ups, congestion and infections following flights I finally saw an ENT Dr. She recommended Flonase Semi-mist spray before and after flight. It’s OTC. I used it and had no issues with transAtlantic flights this summer. It’s soooo frustrating when you need to recover from jet lag while coughing your head off all night! Best wishes.

Sorry to hear about your husband's sinus ailments when he travels! I traveled for business for many, many years, and would literally have up to six sinus infections a year. What I discovered was that when I was staying in a hotel room with a wall unit air-conditioner/heater, I could always count on a sinus issue. So, I opened up the unit in my room on one trip, and could see that the filter had probably never been cleaned. I removed the filter and washed it out in the bathtub, and even the quality of my sleep improved because I wasn't breathing in all of the trapped dust, molds and mildew (all of which I'm highly allergic to). After that, I did the same in each different hotel, or if opening the unit wasn't possible, I would soak a towel and put it over the unit to filter the unit and add some humidity to the room. Somewhere along the line, I also learned that consuming local honey, in tea, on toast, etc, would help me build up an immunity to pollens in the area that I might have never been exposed to before. Knock wood, I haven't had a sinus infection in years, basically because I've learned what my triggers are, and try to avoid them as much as possible. Not sure if any of this will be helpful to you, but I'm a person who avoids using antibiotics and OTC drugs whenever possible.
Best of luck on your upcoming trip!!

Thanks for the ideas everyone.

justsweetjs, I'm starting to think the hotel AC played a big part. In our first hotel the windows opened and there was no AC. Our second hotel was when his symptoms started and there the windows didn't open and we had the AC on as it was stuffy without. I'm about to start checking my upcoming hotels to see if the windows open.

I agree with many of the other comments but I want to add another. Mucinex- most people think of it for chest congestion but it thins all mucus so it also works on sinus congestion as well. Since I started adding this to my repertoire it has decreased my need for Sudafed. I would caution to test the dosage- the "normal" dose of 1200mg makes me nauseous and I have heard the same from others. 600mg tablets are made but harder to find. For me 600mg still works well but without the nausea. It tastes ghastly so have water ready!

Thanks for all the tips.
I’ve had sinusitis for years.
I only started having it after the surgeon that did my jaw surgery in conjunction with dental work told me when I woke up: ”By the way, I took a few “pounds” of polyps out of your nasal and sinus cavities while I was operating on your jaw”.
Thanks, buddy.
Years later, still suffering.
I always keep Flonase at hand all year, as I find it’s the best nasal spray for me; but I’ll bookmark this thread for when I next fly.

Hope you are all breathing easy.

Here is another vote for Musinex. A nurse recommended it to me years ago after constant sinus issues every time I travelled. I also was prescribed Azelastine for ear/sinus issues, which is more effective for me than OTC nasal spray. So the trio of Musinex/Azelastine/Loratadine works for me. Have a great trip!

Mary, good luck with the windows versus air conditioner hunt! I will say, I truly enjoy a smaller accommodation (typically the ones where you aren't forced to use the air-conditioner) such as a B&B or a family run inn. I'm certain it's because I always sleep better!
I hope that your husband's issues are an easy fix such as that. With all of the issues I had in my younger days, I never even considered surgery for my sinuses, mainly because I have friends who have had serious complications. Best of luck, I hope everything turns out well!

Mary, I hope that you'll let us know how your husband makes out this time! I'm hoping that you'll have had a wonderful trip!

I’m going to throw out a crazy suggestion, but it affects me. What about his pillow? If he’s used to sleeping a certain way, but some of the pillows aren’t allowing him to sleep normally, it might affect him. I get sinus headaches, and my size of pillow affects me.

And I agree about your air conditioning comment. I always open windows, instead, when that’s an option.

I have had a lot of sinus infections in the past. The last few years not so many. What really helps me is to drink a LOT of water. I feel best when I drink a gallon a day. Not saying everyone should drink that much and I often don't. However, it has helped me so much when I fly, esp. long overnight flights. Before liquid restrictions on flights I often carried a gallon jug of water on overnight flights. More than once a flight attendant commented on how wise that was. Now I just purchase a big bottle of water after passing through security. Being well hydrated has really helped my sinuses feel more comfortable. I don't know if being that hydrated is why I have so few sinus infections lately, but I'm not discounting it either.

Traveler Girl

Yikes, well that sounds miserable, so I really hope some of these suggestions work! BTW, I had a problem in Tokyo with a major hotel window not opening, I went to the front desk & someone came up and unlocked the window. Agreed about the pillow, I would go a step further & suggest he take his own, or at least an allergen-proof cover so he could change the cover on the pillow? (I'm planning this for our next trip, as long as we remember to take those covers with us when we leave.)

Just adding a note about what kind of water to use in sinus rinses - ONLY distilled water or water that's been boiled for 5 minutes, and rinse the bottle out with boiled water frequently. There are directions on the packaging about the importance of not using bottled or tap water. And reading this I've just learned I should replace the bottle every 3 months, which I've not been doing. https://www.neilmed.com/usa/neti-pot-water-quality/

Do not use tap or faucet water for dissolving the mixture unless it has been previously boiled for five minutes or more as boiling sterilizes the water. Other choices are distilled, micro-filtered (through 0.2 micron), commercially bottled or, as mentioned earlier, previously boiled water at lukewarm or body temperature. You can store boiled water in a clean container for seven days or more if refrigerated. Do not use non-chlorinated or non-ultra (0.2 micron) filtered well water unless it is boiled and then cooled to lukewarm or body temperature.

Just an FYI that recent studies have concluded that Sudafed does not work. Ditto with other OTC products with pseudoephedrine. I'll try to find the link to the NPR report.

Just an FYI that recent studies have concluded that Sudafed does not
work. Ditto with other OTC products with pseudoephedrine.

cbrochu30, you’re confusing pseudoephedrine with phenylephrine. It is the OTC meds containing phenylephrine that are being pulled from some shelves.

https://www.fda.gov/drugs/drug-safety-and-availability/fda-clarifies-results-recent-advisory-committee-meeting-oral-phenylephrine

Thanks for the correction :).

Thanks for the concern everyone. We're in the middle of our first night in Spain (Toledo). It's 2am and we're both wide awake because we couldn't hold out and both knocked out before 8pm. 😒

I told my sleepy jetlagged husband that a bunch of people on the RS site are following his sinuses on this trip. The look on his face was priceless, then a curt "go back to sleep, honey." 🤣

I've booked rooms with windows that open on this trip so fingers crossed. 🤞 I like the idea of bringing our own hypoallergenic pillowcase for next time...

OMG, Mary! I'm still chuckling at the thought of the look on your husband's face!

Haha, justsweetjs, he was not amused (unlike us). Day 2 and he's still ok despite it being extremely windy today. 🤞

OMG...your poor husband. On BostonPhil's thread there was talk about being in a Premier Inn "cult"...so maybe we need to start a sinus cult too, hahaha!!

Happy sniffing!

xxoo from your cultish forum friends, hahaha!!

Buenos Días Mary,
I’ve been following along because I too suffer from sinus issues. I’ve had sinus endoscopic surgery + I use Flonase daily.
When in Europe, where I can’t bring my own pillow, I take one of the hand towels (much to my husband’s chagrin) and place it over my pillow. I hate the thought of just a thin pillowcase separating my nose/head from the dander of others before me.
Also, we always shower before going to bed on our trips, hopefully ridding ourselves of any outside pollutants.
I’ve avoided sinus infections on our trips, but on our last trip I started getting post-nasal drip (tested for COVID-negative); drank lots of water + herbal teas. Suspected might be mold in some of our rooms.
Upon returning home, I did the NeilMed nasal rinse nightly. After a few days, I was back to normal.

Pam, I'm now imagining a RS branded tshirt "Keep on Sniffin'" Instead of the Eiffel Tower one of the letters is a neti pot.

Carol, I totally get that. You reminded me of a Jim Gaffigan bit https://youtube.com/shorts/yh7EWYUM12M?feature=shared

"Pam, I'm now imagining a RS branded tshirt "Keep on Sniffin'" Instead of the Eiffel Tower one of the letters is a neti pot"

Oh Mary!!!! That is hilarious!!

Mary, too funny about the Jim Gaffigan video. Yep, that's us...sharing one hand towel in the bathroom because I claim one as soon as we get to the room.
And...we always appreciate Jim's humor whenever he appears on CBS Sunday Morning.

My little rug rats brought home a bug from daycare that caused me to spend a month in the hospital and two years to get rid of the drug resistant bacteria causing my sinus infection. I fought having surgery for eight years but gave in after one sinus infection after another. I can’t remember what my ENT had me take whenever I flew. It was a pill and Flonase.
What does his doctor suggest?

Mary, laughing at the Jim Gaffigan video! I remember the conversation on the forum that washcloths aren’t provided because they’re “personal washing “. But then I see a hand towel hanging next to the Italian bidet…. ; )

This creepy stalker is also closely following your husband's sinuses! It's been a few days more since your last update ... how're they doing? 🤞

Btw as I was typing this comment up, I told my husband the story of your husband's face finding out about us and this thread and my husband had the same reaction. They can get their own shirts just the two of them, party poopers.

Hannah, LOL! We just had breakfast here in Seville and I told him "the rick steves people are wondering how your sinuses are doing..." He paused mid-bite and sniffed, then kept eating. He's using saline multiple times a day and no AC so far. I'm not superstitious usually but don't want to jinx it. 🤞

But then I see a hand towel hanging next to the Italian bidet…. ; )

Everything about bidets bother me. I try not to look at it. Once a hotel had hand towels sitting on the rim of it (well, obviously not hand towels, but..)

What does his doctor suggest?

Meds, which tend to make it worse for some reason.

GP's will always try to treat sinus infections with quasi benign anti-biotics. These will (sometimes) knock back the symptoms temporarily and for long enough to make you think you have overcome it. My experience was that after another air travel, the infection would return and often significantly worse than before. Some physicians would then either attempt to re-treat the infection with the same medication and a stronger dosage or possibly move up to a more powerful antibiotic, and often in a moderate dosage. In my case, my infection developed a resistance to all of the available drugs in part due to the reluctance of the physicians to go for the kill from the onset. I struggled with continuous travel related infections for years. The pain was often totally unbearable and especially if the flight cabins were not maintaining consistent air pressure.
There is no over the counter or prescription drug or home remedy that can cure this problem. You could use a pressure washer in your sinus and it would not stop the problem. Home remedies are a waste of time.
I had three surgeries over a 25 year period that eventually cured this for me. The first two were traditional hammer, chisel and knife affairs that corrected a deviated nasal septum. The first one was dreadful and took nearly a year to recover from. I stopped having problems for several years. Eventually the passages blocked again (broken nose) and the problems returned. Again, the physicians played their games with antibiotics. My sinus infection were virtually continuous as a result. Another surgery followed and again, traditional hammer, chisel and knife. This time I went nearly 10 years before the return of the issues. This time I went to a different surgeon and he used what has proven to be the best approach to corrective surgery, laser. Here the surgery was brief, relatively painless, recovery was very quick (weeks, not months or years) and the result has been over 20 years without a single sinus problem...not one. During the time when I suffered from this, I was a road warrior and travelled millions of miles, often in total agony. My years of travel following laser surgery and beyond have been a total blessing. I can breath. I am unaffected by sinus problems, even when my allergies are acting up (damned pine pollen!).
If you have this problem, deal with it as a serious issue and see a specialist. Don't get your advice from me or the internet. Consult with an expert. You can (as I did) suffer from this for years and hundreds of agonizing flights if you don't deal with this problem properly. And yes, surgeons do like to operate. If you learn that surgery is what you need, seek out the best surgeon you can find and get it done without delay. It can be life changing.

Mary that is an excellent and jinx-free update!

Arrived in Granada today and there's noticeably more pollution than in previous cities. He's feeling drainage and throat irritation, which are usually the first signs. ☹️ ☹️☹️

NOOoooooooo!!!!! 😩

Oh, Mary and Mary's husband. I'm so freaking bummed by this news. I'm so sorry.

Mack, thank you. I read your reply to my husband as he now has yet another sinus infection. He's already requested an appointment with a new ENT doctor for when we get back. Hoping they can offer better solutions than previous ones.

Darn it!! I was so hoping he'd win the battle this time! Let him know that there are many of us who are sympathizing with him. 🤧 I'm just on the tail end of the first one I've had since before covid started.

Mary, not sure you husband would want to try this on a trip but I have been using a neti pot for years. When I travel I use the Neil-Med squeeze bottle for irrigation. According to the internet (so you know it must be true), some ENT docs recommend adding 1/2 teaspoon of Johnson's Baby Shampoo to the saline mixture.

https://www.nysinuscenter.com/2015/08/baby-shampoo-for-your-sinuses/

Of course he'd want to run this by his new ENT doc as well.

I'm totally invested; if husband's willing for us to know even more of his medical journey, then please do continue to post updates after more ENT appointments!

Seeing another doctor is a wise next move. Just remember, these folks are wired to minimize treatment. Minimalistic treatment only prolongs the agony by offering the illusion of progress. That illusory progress will be followed by yet another sinus infection.
Chronic sinus problems do not solve themselves.
A tanker car of saline solution will not cure anything. You could inject it with a turkey baster, pressure washer, neti pot, what have you, the result will be the same, nada.

A pharmacist in Madrid gave him this which seemed to help enough that he could at least continue sightseeing. https://www.aboca.com/product/fitonasal-concentrated-spray/

I'm assuming that was an over the counter medicine in Madrid? Good to know, should I ever run into issues while in Spain.

Yes, OTC.