Sinusitis so bad it is killing me! (incapacitating in flight!)

[TexasFlyer]

I hate to write all this, but I have nowhere else to turn. I usually can use OTC products to kick this (nasal spray, sinus rinse, and decongestants). But this has caused me to miss a lot of work (2nd week off line right now and getting worried about my job reliability!).

I finally went to a doc for this because I had the worse headache ever and I can not describe the pain of a knife in my head and eyes! Yet, the doc did not seem not to care about this reoccurring issue that has got to this bad now (this time a serious sinus infection). Gave me a few shots in the hip a week ago and antibitics and sent me on my way. But I still feel awful!!!!

This will be long, but bare with me. Hoping someone has advice for me because I am out of options and really need to know what to do! Hate to post this here, but feel I have nowhere else to turn.

Here is what happens 3 to 4 times a year and it puts me down for like 2 weeks. And this time, it took an emergency trip to the urgent care to see that doc in the middle of a trip block since this always incapacitates me.

Over time my sinus get clogged. So far clogged that even a sinus rinse does not get the stuff out that is in my head. It seems to be a slow process that takes many weeks and I really do not realize it until the day it hits the limit and incapacitates me. It happens out of nowhere. Always while flying. And always in the manner I am going to describe here. And this happens with no warning, on a random trip leg and then it is all over!

1) ON CLIMB OUT: I get dizzy. I get dry sweats. I get nauseous. I hear mucus moving in ears. I feel pressure in my head. I can not function. I can not do my job. I am incapacitated. I let the Capt know I am feeling ill and he takes over for the rest of climb out as both PF and PNF.
2) LEVEL OFF AT ALTITUDE: After a few minutes I tend to fairly rapidly start to feel better. I then take my job back as PF or PNF. As quick as I got sick, I get better! Usually in cruise I just have pressure in my head I can still feel at this point but really not much else of an issue. But this feeling is false, as the descent is going to hurt very badly.
3) DESCENT: Simply all hell breaks lose. Completely incapacitated again so Capt is now once again single pilot. Happens pretty quickly upon initiating descent. But different symptoms, the worse! I end up with ear hissing and mucus moving again. I also end up with a headache and ear ache and top of nose ache and top of throat ache. These aches I can not even describe other than feeling like being stabbed by a sharp knife. The pain is absolutely awful. And then my eyes feel the same like a knife stabbing and pushing them from the inside out. IT IS AWFUL.
4) LANDING: Usually on approach, as quick as all this pain happened. It is gone! It goes away. But this is only temporary since if I do another leg, now every time I fly this process will reoccur until I go load up on meds for like 2 weeks. But it is only a temp fix since within 10 to 12 weeks, the whole thing happens again and again and again with no warning!!!!

This is clearly a safety issue and health issue and at this point I am crying for help. I have no clue what to do or who to go see. And this current time is so bad I am about ready to go to the ER tomorrow due to the following:
1) I have had a severe headache for the 7th day now. So this is my second trip I just called out sick for.
2) For 7 days now I have filled up several bags full of mucus so thick it is pretty much a solid mucus (not liquid). And the mucus is dark yellow and green and completely coated in various colors of bright to dark red from blood. I cough this out. I blow this out.
3) For about 3 days now my eyes seep of sticky mucus.
4) For 2 days now I have a very tight chest and constant chest pain right in the middle (feels like heart burn and pressure, but lower than where I would get such).
5) When I blow my nose or cough, I can not describe how much my head and chest hurts. My head hurts with that sharp knidge edge pain even with or without touching it and that pain sometimes goes to my ears and throat and top of nose as well (more so on right side of head versus left for some reason).
6) I sometimes get chills and my heart races from time to time for no reason and a slight fever comes and goes.

All this the same crap I been dealing with for a couple years, but this time 100 times worse!!!! And the shots and antibiotics the clinic gave me appear to have not worked.

I will kick this mess I have going on right now. But I need to know what to do and who to see and how to get this resolved. I can not be putting my crew and passengers at risk with this ongoing condition that is now getting very severe!

 

[TexasFlyer]

Oh. And a little more short history I likely should add since I never seen anyone describe their sinus issue as bad as I have. Plus it will save all the basic advice I seen in prior threads.

My AME was working with me on this for about 2 years as we had many conversations about each time this happened.

Due to my symptoms at first he thought it sounded like dehydration with just a simple head cold. Well over months of drinking enough water on the flight deck to float away and taking various OTC meds, that theory went bust.

He then agreed it is severe sinusitis, although he seemed a little surprised by the extreme symptoms. For about the last 6 months I been doing a daily sinus rinse. Every day goop would just plop out of my nose. I felt this was working since stuff would come out that I could not blow out. But clearly the sinus rinse also was not the solution. So no OTC meds, sprays, or sinus rinse has helped.

I wish Dr Black was here to call today since he would likely advise what to do next. He knew the verbal history of what I been dealing with as he was always just a phone call away. But unfortunately I need a new AME since Dr Black passed away. And I hate to start the whole history over with someone who may not take this seriously.

I will be moving to St Pete FL in May. Anyone know a good AME and a good doctor that is willing to work closely with me on this?

 

[RetiredATLATC]

I don't have any suggestions, but just wanted to say how sorry I am that this is happening to you.

 

[JordanD]

Sorry if you mentioned it, but has maybe something like a deviated septum or sinus surgery been brought up?

 

[TexasFlyer]

Sorry if you mentioned it, but has maybe something like a deviated septum or sinus surgery been brought up?

My prior AME did mention if this trend keeps going to get in to see a ENT Specialist and get an MRI or CT. I think a CT but can't remember. He was of course going to recommend one after the next flair up (which is now upon me).

Since I need a new AME I feel lost in the process. I just hate to have to start the whole communication history over again. It took almost 2 years of conversation to get to this point in the failed process of determining a solution. But it is clear, all home remedy is unsuccessful. So this would have now been the time to seek serious medical attention at the specialist level.

Hoping to find an AME and ENT and MD that can all work together to resolve this since at this point I have concerns for my ability to exercise my duties on the flight deck when these attacks happen. And the real issue. The way this sneaks up on me. In a week or two I will be back on the line flying again. Feeling great. Doing back flips and running and biking like a normal person with no issues. Just for one day again with zero warning during a flight for me to be incapacitated again.

I have now tracked it down to a serious ongoing problem. But how to solve this? Can I keep flying? How do I know when it is okay to fly? How can this be fixed so I can continue flying safely? Or can this not be fixed so I lose my medical since in the current condition is unsafe/ unstable in its' current state? Very frustrated and quite concerned.

 

[Dphoenix]

You definitely need to see an ENT. There is surgery and other options available. In the mean time, obviously don't fly with this is happening.

 

[TexasFlyer]

I almost feel like this is one of those weird issues. Like glasses. Eye exam comes back 20/25 and 20/30. Eye doc says you fine. They fight you about making glasses because they laugh saying no need. Then you explain you need 20/20 in each eye corrected for your career. Eventually they make the glasses, but still they don't fully get it.

In this case, I feel it is much the same as the glasses issue. It is like I go to a doc and they say, "Oh. Sinusitis. Take this and spray that and sprits this and here is a shot in the hip for good luck. See ya and if it flairs up again just come on back. again. You be fine."

But they do not listen or hear what I am saying about how it affects my job as a pilot. And this concerns me. It is like they do not take it seriously. But now I see how serious this has become and action needs taken. I refuse to jeopardize the safety of a flight, so I need a good team to track me and help with this and advise if I am fit to fly (although that part may be impossible since when I can do back flips down the jetway and run 5 miles without a struggle and breathe clearly no one would doubt my fitness to fly; as this is how healthy I feel until that bad moment)

At this point I am determined to get it resolved because I can not describe how awful things went last week for me on the flight deck mid trip and how I got stuck in a hotel and went to the Urgent Care in a random city as I felt like my head was going to explode. And kudos to the LaQunita in Huntsville as they really took care of me and transported me to the Doc and Rx seeing how sick I was! That is one of our lower end hotels, but the staff there is absolutely wonderful. I need to send them flowers for the lobby!

 

[zx6rrider]

Something you might try is going to a chiropractor. I know they have mixed reviews but my wife was having sinus issues about a year ago and the ENT dr told her it was just sinusitis and nothing he could do. She started going to a chiropractor who worked on getting her neck all straightened up so things would drain properly and felt a lot better. If she feels a sinus issue coming on she will go back and so far has not had any major issues like she had before.

 

[TexasFlyer]

Something you might try is going to a chiropractor. I know they have mixed reviews but my wife was having sinus issues about a year ago and the ENT dr told her it was just sinusitis and nothing he could do. She started going to a chiropractor who worked on getting her neck all straightened up so things would drain properly and felt a lot better. If she feels a sinus issue coming on she will go back and so far has not had any major issues like she had before.

Have not thought of this. And at this point I will try hours handing upside down on the Teeter if someone told me it might work.

I am on my med insurance website now trying to figure out how to go about finding a ENT and MD. Also need to find an AME too. Will start with the AME next week just to introduce myself and see if he knows a good ENT that works with pilots. So lots of research to do. Since moving to St Pete in May, I will just get one down there and make an appointment for about 60 days from now with all the providers. Makes no sense to get someone local and have to switch to a new one in 2 months. This gives me time to research who the best in the business is. Especially if one has worked with pilots before as that would be great. Trying to navigate this insurance process with a headache is possibly causing a secondary headache.

 

[Gonzo]

First welcome to St. Pete, what part of the city are you moving to? There are a ton of us in the area.

I know you asked about a AME, but I think you need to also have a local ENT. Dr. Lanza is the best, you should try to set something up now for May.
I know this might seem like a crazy question, what kind of plane do you fly and how many legs do you fly a day?

 

[TexasFlyer]

First welcome to St. Pete, what part of the city are you moving to? There are a ton of us in the area.

I know you asked about a AME, but I think you need to also have a local ENT. Dr. Lanza is the best, you should try to set something up now for May.
I know this might seem like a crazy question, what kind of plane do you fly and how many legs do you fly a day?

THANK YOU! I will be living on Madeira Beach (next to John Pass). Looking forward to cruising on my e-bike and soaking in some sun.

I will look into Dr Lanza tomorrow and get that set up for May. And just looked, he is in network and says accepting new patients

CRJ's. 4 trip blocks a months. Usually 4 legs a day most days, with sometimes 2 or 3 or 5 legs mixed in each trip.

 

[Gonzo]

CRJ's. 4 trip blocks a months. Usually 4 legs a day most days, with sometimes 2 or 3 or 5 legs mixed in each trip.

Call me crazy but the CRJ might be making you sick. I had major sinusitis issues when I was flying the CRJ, once every 3-4 months I was very sick to the point that I ended up sick for two months over it once. Now after 3 years of flying 76, the only time I have had issues was a month that I did 10 DHs on CRJs.

 

[TexasFlyer]

Call me crazy but the CRJ might be making you sick. I had major sinusitis issues when I was flying the CRJ, once every 3-4 months I was very sick to the point that I ended up sick for two months over it once. Now after 3 years of flying 76, the only time I have had issues was a month that I did 10 DHs on CRJs.

Funny you say this. Although not sure how to correlate this.
* I flew Citations and Caravans and flight instructed 2009 to 2013 on contract, never had an issue.
*** I flew CRJs in 2013 to 2014. During that time I was having some mild issues with this sinus stuff.
* I left and in 2014 flew a King Air, just fine. No issues. And thank god since this condition single pilot would possibly be deadly.
* In late 2014 to late 2016 I went to fly new E175 as a bird. Never had an issue. Pretty sure never had a sick call there in almost 2 years!
*** Late 2016 I return to the CRJ at my old employer. A little over a year on the line these issues are back. Every few months I am getting sicker and sicker each time this occurs again. I am confused how sudden this stuff comes on with no warning.

Hate to think like this as the coincidence is there. Not sure how to correlate all this.
* On E175 I did 1 to 2 legs a day. Coast to coast and Canada and Mexico. New bird without all the rapid climbs and descends daily.
* Same with the King Air and Citations and Caravans since those jobs I flew 1 to 3 times a week max and were out and backs.
* Where right now on the CRJ again I am constantly up and down 4 times a day and that is not jiving with my body chemistry.

All just theory. Dr Lanza is a good first step in moving on now to more of a technical solution. So I will get him lined up along with a good AME. Thanks for referring him. Sinus and Nasal Institute of Florida appears to be a step in the right direction.

 

[SlumTodd_Millionaire]

I had these kinds of problems for years. Finally went to the ENT and had a CT scan done a few years ago. Turns out I had a deviated septum, incredibly tiny pathways to my sinus cavities, scar tissue built up from years of infections, and a few polops. He did sinus surgery on me, and it was life changing. I really can’t describe for you how much it improved my life. I never realized it, but there wasn’t a single day of my life prior to surgery that I was breathing normally. I never knew any better because it was all I had ever known, but my best day pre-surgery was worse than my worst day with a cold now. Don’t walk, run to the ENT. Get it fixed. You’ll be grounded for about six weeks after surgery, but the recovery is easy. Do it!

 

[TexasFlyer]

I had these kinds of problems for years. Finally went to the ENT and had a CT scan done a few years ago. Turns out I had a deviated septum, incredibly tiny pathways to my sinus cavities, scar tissue built up from years of infections, and a few polops. He did sinus surgery on me, and it was life changing. I really can’t describe for you how much it improved my life. I never realized it, but there wasn’t a single day of my life prior to surgery that I was breathing normally. I never knew any better because it was all I had ever known, but my best day pre-surgery was worse than my worst day with a cold now. Don’t walk, run to the ENT. Get it fixed. You’ll be grounded for about six weeks after surgery, but the recovery is easy. Do it!

Thank you. This is hopeful.

I am afraid of surgeries, but I also can not continue in this profession as a pilot with this issue since it has become apparent the unpredictability of when these episodes happen are the biggest concern. If I knew when I was feeling poorly, I could just not fly. But there is no warning, and that is concerning.

So if surgery is required, it is what it is. I really have no choice right now. Hope if this is the case, I have results like yours. And I suppose I will learn something about short or long term medical/ disability benefits and how they work. All this is new to me.

 

[JordanD]

Thank you. This is hopeful.

I am afraid of surgeries, but I also can not continue in this profession as a pilot with this issue since it has become apparent the unpredictability of when these episodes happen are the biggest concern. If I knew when I was feeling poorly, I could just not fly. But there is no warning, and that is concerning.

So if surgery is required, it is what it is. I really have no choice right now. Hope if this is the case, I have results like yours. And I suppose I will learn something about short or long term medical/ disability benefits and how they work. All this is new to me.

As far as I know, there's plenty of people that have had sinus surgery and have no issues with a medical. Flying with blocked sinuses all the time on the other hand is really rolling the dice on doing serious, permanent damage that can ruin your career.

 

[Cessnaflyer]

Get the surgery done! I know someone that didn't and ruined their career because of it.

 

[TexasFlyer]

Just took my last Z PAC antibiotic. Now day 11 since this began. Nose slightly better as mostly mucus and not blood, and the blood that is present seems more dried dark red than fresh runny. Headache still there (sharp pains behind eyes and around right temple and on top of head if touched). Going back to urgent care in about an hour again since infection seems to not be gone given these symptoms.

I could not get into Dr Lanza. He is only taking referrals from MD's and I do not have an MD referral since my insurance is a PPO and I do not have a MD that knows him to refer me to him. But, his partner who he trained is taking new patients. So I will see her. Hope she is as good as him! Appointment is set for May 7. Will try to get in sooner if possible. But at least this is a step in right direction with the ENT Specialist.

Now just need a good AME in St Pete area. I can Google around, but always appreciate referrals if anyone has experience with a good one that helps on a personal level with aviation health and is just not a medical certificate mill. I assume it is a good idea for my new AME to understand what is going on and advise accordingly and be informed with details from the ENT since this affects my duties.

 

[TexasFlyer]

Found this. This is a bit concerning since my assumption is that my condition is affected by barometric pressure (assuming this is what is meant by the cabin pressure changes since I never once fell this ill while my feet are on the ground).


Guide for Aviation Medical Examiners
Decision Considerations - Aerospace Medical Dispositions
Item 27. Sinuses
The following lists the most common conditions of aeromedical significance, and course of action that should be taken by the examiner as defined by the protocol and disposition in the table. Medical certificates must not be issued to an applicant with medical conditions that require deferral, or for any condition not listed that may result in sudden or subtle incapacitation without consulting the AMCD or the RFS. Medical documentation must be submitted for any condition in order to support an issuance of an airman medical certificate.

Acute or Chronic

Disease/Condition Class Evaluation Data Disposition
Sinusitis, intermittent use of topical or non-sedating medication. All Class. Document medication, dose and absence of side effects. Responds to treatment without any side effects - Issue

Severe, requiring continuous use of medication or effected by barometric changes. All Class. Submit all pertinent medical information and current status report. Requires FAA Decision

 

[deadstick]

Don’t sweat it. It is what it is. You have a problem that needs to be fixed. Find a SENIOR AME — start there — who has been going around the block since Orville and Wilbur soloed. That doc might be able guide you to not only the right ENT, but also through the labyrinth that is the FAA.

The last thing you want to do is get sideways with 61.53. Good luck.