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The Great Sinus Situation of 2018

Oh, my lungs hurt? It’s the methotrexate. My ribs are inflamed? It’s the rheumatoid arthritis. My tongue is sore? That’s just the Sjogren’s. Your head is completely congested? That’s just your unrelated sinusitis.

Complications of rheumatoid arthritis: Everything seems connected to it

It’s hard to believe sometimes (because everything is always connected to my autoimmune condition) but I did have health concerns prior to it! Around the age of 16, I presented with an acute sinus infection that never went away. I was soon diagnosed with chronic sinusitis. I became one of the lucky few whose sinuses never drained properly after a runny nose.

My junior year of high school was especially bad. Every single one of my sinuses filled up and remained full for weeks to months. I missed school because of the intense pain, light sensitivity, and constant pressure.

I was too young for surgery so I got by on antibiotics and steroids for months at a time. Eventually, I was able to have the balloon dilation to open the sinuses and nasal passages, a slight scraping and some other procedures which I don’t remember. And they fixed the problem.

For the first time, (in what felt like forever) I wasn’t congested, I could breathe properly, I was not in pain and my nose didn’t drip! It was magic. (Okay, it was science, but to me – WOW).

An immune system weakened by RA treatments

When I was diagnosed and started the immunosuppressant medications, mostly Orencia, my sinus infections came back full force. If I was lucky, I only felt pressure in my head for a few days before the issue corrected itself (with a little help from steaming, blowing my nose constantly and avoiding allergy triggers). If I was unlucky, I got the gamut of symptoms and took antibiotics.

Over the last eight years, I’ve been relatively lucky only relying on antibiotics but starting this Fall 2018 I ran into a problem. I began to feel constant pressure in my head. My nose dripped continuously and occasionally I’d get the acute infection. Initially, I thought I’d just take the antibiotics but they didn’t help. It wasn’t until my balance was affected (and I was sick of being sick) that I saw a new doctor.

I had a CT scan (and met my yearly deductible at the same time – even for me 7 days into the new year is a record). I have an acute infection and it turns out a slightly deviated septum. It is almost completely straight which on its own wouldn’t be an issue except the turbinate bones are inflamed and the left one is pushing against my septum. This is causing a mild blockage that is impeding my breathing and draining abilities. Adding a tiny bit of fuel to the fire is my nasal cartilage is weak and collapses every time I breathe.

Well, I guess it wasn’t just my chronic sinusitis. I just don’t have the anatomy to keep myself healthy!

I am on antibiotics and a steroid nasal spray. I irrigate my sinuses twice a day. I am all set to have a balloon dilation. Later (sooner, rather than), I hope to get the septum repaired, along with treating the turbinate bones and adding a little support to the cartilage.

Managing instead of curing

Maybe a clear head is in sight! My doctor agreed this might all help for the short term, but, given my Rheumatoid Disease I am looking at managing the problem instead of just curing it.

Do you have any health concerns that were not in connection with your RA? Let me know in the comments!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • Karen Morgan
    12 months ago

    I have also had a long history of stuffy noses. I don’t think anyone ever thought it was sinuses, but after I discovered a diet called To Quiet Inflammation, and tried an elimination diet for about a week or 10 days. I learned that wheat causes my nose to plug up big time. If I avoid eating wheat all the time my breathing is very clear and no problems. It may not be a help, but you might try eliminating all the usual culprits for food sensitivities for a week or 10 days and see what it does for your nose.


  • glynus
    12 months ago

    Before my RA diagnosis, I blamed all of my aches and pains and tiredness on my congenital blood condition. I was hospitalized a couple of times with hemolytic crises so it was easy to figure that was the cause of everything. Then I got the RA news at the same time I found out that I have “significant” scoliosis (and a bunch of other spinal issues that I can’t / don’t want to remember) and have actually shrunk 4 inches in the last 8 – 10 years.
    I’ve quit trying to figure out why I hurt…

  • suef
    12 months ago

    Comment for Monica,
    Have you ever been tested for CVID: common variable immune deficiency?
    I have RA as a result of my poor immune system. The infusions I receive reduce the number of sinus and respiratory infections as well as help my RA symptoms. Many people with CVID have an associated autoimmune disease. Sometimes RA or others.
    If you are interested in checking it out check the immune deficiency foundation website. There is a lot of information on primary immune deficiency, CVID being one of them.

  • Monica Y. Sengupta moderator author
    12 months ago

    Hey @suef! Thanks for commenting on my article! I have not been tested for CVID since (aside from the chronic sinusitis) I was very healthy. I will bring up to my rheumatologist, though, because now I am quite immuno-compromised!

    Thank you for advice! All the best, Monica

  • suef
    12 months ago

    Hi Monica, here is a link re the basics of the disease. I can send an article re bloodwork require for screening if you like.

  • Lawrence 'rick' Phillips moderator
    12 months ago

    I always say that if A causes B and B causes C than it follows that 1 follows d and 100 follows Q. See its all inter connected, if only in a really odd way.

    Damn it I hate RD stuff.

  • Monica Y. Sengupta moderator author
    12 months ago

    Ah, you forget X occasionally visits and brings his other variable friends to the party! They get drunk and confused and then leave the place in worse condition than before…

  • Daniel Malito moderator
    12 months ago

    @mysengupta Everything is connected! (X-files theme music) lol Seriously , though, I think it all is connected, I get sick during the winter too. My nose runs so much that people must think I’ve sprung a leak. Keep on keepin’ on, DPM

  • Monica Y. Sengupta moderator author
    12 months ago

    When I got the first surgery done (at the time it was done with full anesthesia) my nose stopped ripping completely!! Yes, I am a science person, but this was actually magic. I didn’t remember the last time my nose was dry (except for the few times it’s dry, itchy and bloody from the Sjogren’s).

    I was told the Orencia supresses the part of the immune system that fights sinus infections. I guess its a little ‘risk vs. risk’ at its finest!

    Thanks for commenting, Daniel!

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