I've Been Working In Kubul, Afghanistan (altitude 5,900 Ft) For

Posted on Wed, 17 Jun 2020

Question: I've been working in Kubul, Afghanistan (altitude 5,900 ft) for three months now. I'm currently being treated for sinus congestion, sinus pain, sleep apnea and bloody nasal discharge. I've been prescribed antbiotics, histamines, antibacterial and decongestant medications during my treatment here. So far all treatments have been nonproductive. Is this altitude related?

Answered by Dr. Dr. Naveen Kumar Nanjasetty (1 hour later)

Brief Answer:
Sinus barotrauma and Allergic Nasal Condition

Detailed Answer:
Hi

Thanks for posting the query

After going through the history I am of the opinion that you could be having 2 issues, first the sinus barotruama due to high altitude and secondly, allergic nasal condition.

1. At high altitude there is inflammation being caused due to the negative pressure gradient, between the sinus cavity and the surrounding ambient environment. This leads to constant headache, nasal block and nasal bleed.

2. Presence of allergens in the atmosphere can also induce similar set of symptoms.

My suggestions to you are:
1. Drink frequent sips of warm water
2. Do steam inhalation 2-3 times a day for a week
3. Use intranasal corticosteroid nasal spray such as Fluticasone or Mometasone to reduce the inflammation of the sinuses and headache.
4. Use normal saline nasal spray as frequently as possible to keep the nasal mucosa moist, reduce the dryness of the nose, clear the secretions and stop the bleeding.
5. Avoid staying/sleeping in front of the fan.
6. Change the pillow cover every night before going to the bed.

With the above measures you should get better. Revert back to me if you have any follow up queries.

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dr. Naveen Kumar Nanjasetty (7 hours later)

Thank you for your response. I have never had a prior history of allergies and only noticed sinus congestion when I am flying and around cold weather. Air conditioned rooms also trigger congestion. I have been using a room humidifier and a nebulizer for about two months now whith no improvement. I believe this condition may be solely altitude induced. Is there a procedure to correct it?

Follow up: Dr. Dr. Naveen Kumar Nanjasetty (9 minutes later)

Should I return to my home (367 ft altitude) to seek more specialized care since the treatment here in Afghanistan is not producing results?

Answered by Dr. Dr. Naveen Kumar Nanjasetty (2 hours later)

Brief Answer:
Nasal congestion on exposure to cold and air conditioner is due to allergy

Detailed Answer:
Hi

Thanks for writing back

1. The symptoms of nasal congestion in a cold weather of A/C rooms itself is an indication of nasal allergy. Humidifiers are of little benefit only. They help in keeping the nasal mucosa moist and reduce the nasal bleed, but, the nasal congestion may not improve.

2. Even though, the symptoms are more related to the high altitude there is definitely some allergy component associated with it. As I mentioned in my earlier response, use of the intranasal steroid spray would help in alleviating the symptoms. I would suggest you to use spray religiously, and you would see some progress.

3. If you do not get better with the above mentioned medications, it would be wiser to return home and get the complete check up done.

Hope this clarifies your doubts. Wish you good health.

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar