r/nonallergicrhinitis

p.s i know this is a lot to help a stranger, but please help me out, im literally dying because of this, i don’t sleep much maybe 2-3 hours per day if lucky
I’d even award $25 for taking your time

My nasal obstruction is very variable. When I’m upright and NOT taking tadalafil, my nose can actually be pretty clear. My main problem is that my turbinates swell and block my nose when I lie down with and without medications, and tadalafil/PDE5 inhibitors make them swell enough that I can feel congested even while standing.
My ENT has confirmed turbinate swelling(No medications on day of exam), and I’m scheduled for RF reduction.
My concern is: if I happen to be more congested than usual on the day of surgery (because I took tadalafil, allergies, lying down, etc.), could the turbinates look substantially larger than their normal baseline? Could that result in the surgeon reducing more tissue than would actually be appropriate for my normal, non-congested state?
I also have a failed root canal/infection on my upper-left first molar (#14). My dentist says there is an abscess/infection around it, and I’m considering extraction about a week after the RF. I’m wondering if the dental infection could be contributing to my left-sided nasal/sinus inflammation.

So my questions are:

1. ⁠Does the amount of turbinate swelling on the day of RF affect how much tissue is actually reduced?
2. ⁠Is RF normally performed conservatively enough that temporary congestion wouldn’t matter much?
3. ⁠Has anyone had RF turbinate reduction when their turbinate size fluctuated significantly depending on position/allergies/medications?
4. ⁠Would you personally ask the ENT to be especially conservative in this situation?
5. ⁠Could treating an upper molar infection afterward reduce nasal/turbinate inflammation enough that the combination could leave the turbinate functionally too small?

I have been struggling since July - it started out as a dry cough and slight sore throat, nothing too crazy.

After 2 weeks of that, it progressed into a very mucousy cough which reminded me of the one time I had COVID in January 2022 so I assumed I was battling a long case of COVID. About a week after that came the nasal symptoms and I was not only coughing up yellow mucous, I was also blowing it out of my nose. I did Neti Pot nasal rinses twice per day along with Mucinex FastMax and Flonase which helped. By about a month in to all this, I lost my sense of taste and smell. Mid-August, I visited my family medicine doctor and he put me on a round of Augmentin (one week) and some medication that was supposed to suppress my cough (can’t remember the name). None of that worked. After symptoms only got worse, I went back to the same doctor after 2 weeks (end of August) and he said he was “stumped” but suggested I visit an ENT and try another round of the same antibiotics. I waited another 2 weeks to get seen by an ENT. In the meantime, I discovered Zyrtec D which helped me a lot for a couple of weeks and then it kindof tapered off. Somewhere in this frame of time, my nasal congestion went away and I was really just coughing up the mucous now, but still couldn’t taste or smell.

Finally got in with the ENT. He examined me and said there was “puss” present in the far back of my left sinus cavity and took a sample and sent it off to the lab, hoping that it might be bacterial so that we could actually treat it. In the meantime, he put me on a 2-week, 2 pill per day dose of Augmentin. Waited a week to get labs results back and they didn’t show anything unfortunately. Antibiotics didn’t help either. He also prescribed prednisone, which didn’t help either. He recommended a CT scan of my sinuses to rule out cysts or a deviated septum. That’s scheduled for October 12. The biggest part for me is that the ENT said that if this is just post-viral chronic sinusitis (which is his best guess at this point), my sense of smell/taste my never come back, or it may take up to a year to come back. Has anyone ever experienced this?? Right now, every morning starts with some pretty gnarly coughing where I have to cough up little bits of yellow mucous and then by around 11am that subsides and then it’s just a feeling of pressure throughout my sinuses all day (not really pain, oddly enough, which is what I remembered a sinus infection feeling like) and no taste or smell which is the most frustrating part. Help!! Would love to know if anyone has tips for what to do going forward- I am absolutely miserable!! Oh - one last thing, in the last few days I’ve tried Nasonex and rubbing Castor Oil on the insides of my nostrils. But not sure any of that is doing anything because I don’t really have much nasal congestion overall, just inflammation and the chest cough with mucous. Looking into red light therapy for my sinuses - ANYTHING to help me at this point I’m desperate!