Sinus pressure, pain, recurring infections, antibiotics, repeat. Kim Blair of Waterford remembers well suffering through this ongoing scenario for several years - which were worse during the wintertime. Eventually, she was referred to Dr. David Boisoneau, an otolaryngologist with Ear, Nose & Throat Associates of Southeastern Connecticut, she said during a February telephone interview.

After several visits to Boisoneau for sinus infections, she said he saw a pattern and said she was a good candidate for surgery, which she agreed to. After the surgery, which caused her to be uncomfortable for just one day, he informed her there was a lot of thick mucus in her sinuses, which was preventing them from draining properly.

Since sinus surgery 15 years ago, she said her “reward” is she hasn’t had a sinus infection since.

Boisoneau said during a telephone interview that surgery has become much less painful over the last 10 to 15 years, because he and his partners no longer “pack” the sinuses with gauze after repairing deviated septums and opening sinuses - and their results are just as good.

“A pretty significant” issue for Blair, now 64, was that she is allergic to penicillin and sulphur medications. By taking antibiotics frequently, she was concerned that her body would become immune to them - a grim problem if she were ever to become seriously ill.

Boisoneau said Blair’s issues are common.

Sinus infections actually fall into three categories, he said: Acute sinusitis, recurrent acute sinusitis which comes and goes, and chronic sinusitis with symptoms that last more than 12 weeks.

Sinus infections are worse during the winter months, because it’s cold and dry outside and warm and dry inside, said Boisoneau, a Pawcatuck resident.

Our noses and sinuses work overtime during the colder months, since their primary job is to humidify the air that we breathe in, he said. “So by the time it goes down into our lungs, it's heated up to body temperature.”

Describing sinuses as our first line of defense, Boisoneau said they’re a “dark, damp area inside the body that is designed to filter out particles and help prevent the rest of your body from getting infected.”

Oftentimes this is effective with the help of your immune system; the virus is killed and the “inflammation subsides in two or three days and you’re fine,” he said.

A sinus infection occurs when the air-filled pockets in our skulls known as sinuses, located in our foreheads, between and below our eyes and in our cheekbones, become inflamed - whether reacting to an allergy or upper respiratory virus. Sometimes, cold dry air makes the sinuses swell up, Boisoneau said.

When one of these scenarios occurs, exit pathways to the sinuses become blocked, which causes bacteria already living there to have “a little party and start to grow and take over and cause more inflammation and blockage.”

“So what do you get? You get the facial pain, congestion, sneezing and inability to breathe through your nose, the mucus discharge pain in the face and the teeth, and all the classic symptoms” of a sinus infection, at which point antibiotics are often needed,” he said.

Boisoneau agreed that you can sometimes have a sinus infection with congested passageways even though you can breathe through your nose.

Dentists sometimes refer to him patients who come in complaining of tooth pain, even though their teeth look good, he said.

“Pain in the upper teeth is one way to distinguish whether or not you have a little cold or a sinus infection,” he said, explaining tooth roots poking into the sinuses can cause teeth to ache if there is a sinus infection.

Boisoneau said there are definitely more upper respiratory viruses that seem to be infecting more people this year than in prior years. Theories behind that include “a little rebound after coming out of two years of mask wearing. And now that mask rules are more laxed and not as mandated, people are now back to spreading viruses around.”

Now that we're back to being more socially together, Boisoneau predicted “you can expect to get a spike in viruses, and not just Covid. I think everybody's seen that. I know that right around now, as ENT doctors, we're seeing the fallout of these viral infections that occurred around Thanksgiving and Christmas.

“Now it's about four to six weeks after people were acutely sick with these upper-respiratory infections, including Covid, and the ones that didn't clear up are now coming into our office to be seen for sinus infections that have taken root, that aren't going away.”

Admitting he often feels like a detective, he said he doesn’t automatically treat sick patients with antibiotics. He first asks patients who call how long they’ve had their cold/sinus symptoms. If they have just started, he said he often recommends they take over-the-counter medications like decongestants and anti-inflammatories and give it 24 or 48 hours, and if they’re not feeling any better, to call back.

Allergies suspected

About two years ago when Blair began experiencing a lot of pressure again, but this time with a runny nose and itchy eyes, she went back to Boisoneau.

“He said that I didn't have an infection and that I possibly had allergies.” She was then scheduled for skin testing on her arm with an allergy nurse at Boisoneau’s office. The skin test itself was "no big deal and doesn't hurt," Blair said.

Test results showed she was allergic to 58 different allergens. She then began self-administering allergy shots three days weekly. With significant improvement and some residual allergies one year later, Blair decided to stop the allergy shots and just be more diligent about keeping windows closed in the spring to prevent pollen from coming in her home.

Blair said Boisoneau has a phenomenal bedside manner, great sense of humor and is "awesome" at explaining everything. "Diagnostically, he was able to really pinpoint what was happening" and took care of it.

In addition to testing for allergies and operating on sinuses, the surgeons also remove patients’ tonsils and tumors from the thyroid in the throat, and perform ear surgery to restore hearing.

Ear, Nose and Throat Associates of Southeastern Connecticut has offices in Mystic and Waterford and a surgery facility (River Valley Ambulatory Surgery Center) in Norwich. The group is affiliated with Lawrence & Memorial Hospital (Yale New Haven Health) in New London and Backus Hospital in Norwich (Hartford Health Care). For more information, go to entofsect.com.

Doctor’s remedies to prevent sinus infections and allergies:

- Use a humidifier to add moisture to the air and keep dust particles from floating in the air.

-Take a hot shower and breathe in the steam.

-Use a saline nasal spray (more effective if it has a gel in it).

-Periodically change sheets.

-Use a dust cover over comforter (as it’s easier to wash).

-Use air purifiers.

-Vacuum – preferably with a HEPA vacuum to better capture dust and dust mites.

-Follow manufacturers’ instructions for sanitizing appliances and changing filters.

Jan Tormay, a longtime Norwich resident, now lives in Westerly.