Sinus Saga and Some Rosacea

I was sick with a cold in May, which turned into a sinus infection (always, my whole life, even after sinus surgery) that was treated the first week of June but has not completely gone away (I usually need multiple rounds of antibiotics and prednisone to get rid of them, that's just how it is for me). I also lost my smell and taste again. I was taking a biologic shot to keep asthma and sinus problems calm for 18 months before moving here, and then I started back up for all of 2025, but this January the asthma office messed up the renewal paperwork to keep me on it for another year, and after two months of me calling back and forth with the specialty pharmacy and the office, the asthma doctor suggested since I hadn't been taking the shot for those two months, I should stay off the shot and see how I do. Well, this is how I do off the shot: sinus infection and multiple rounds of medicine I'd rather avoid. The asthma/allergy doctor has been treating my asthma and sinus problems, but I decided I finally need to get set up with an ENT doctor. 

I found an amazing ENT doctor who had a cancellation this week, and I'm so happy with him. He listened to me and agreed about treatments and talked with me on a different level because of my long history and experience with sinus problems. Then he scoped my nose and showed me pictures of all the nasal polyps that have regrown. He also showed me the active sinus infection. Seeing the proof of polyps and infection validates how bad I've been feeling and why I lost my smell and taste again. My body is so good at making inflammation which wreaks havoc everywhere, ugh. So he's putting me back on Dupixent, and his office is great about staying on top of the paperwork that's needed. They even gave me the first two shots to start while I wait for the specialty pharmacy to start deliveries again. The whole staff was so friendly and helpful. It's an amazing medicine that works well for me, and without it, I can't smell or taste, I get infections, the polyps grow out of control, and I have to take too many medicines to calm things again. The ENT doctor also gave me stronger antibiotics and prednisone to take for a few weeks because this infection didn't go away with a short round. I'll be feeling better soon, phew.

I related too well to all these posters around the room. I have most of these problems:

Also, some days the Rosacea is calm, and some days it flares. Today is a flare day just because. 

But for sure it's been way more controlled thanks to three daily topical medicines I've been using for the past 18 months. Sometimes old pictures like this pop up and I realize it used to be uncontrolled and so painful and itchy and burning. I'm thankful for progress in any of my health troubles.

Snapshots

Leah found a new favorite yogurt.

Living in Minnesota for 20 years made us very familiar with the history (and Gordon Lightfoot's song) of the Edmund Fitzgerald that sank in Lake Superior. We even toured its twin ship in Duluth and visited a boat museum with artifacts they collected from the wreck. This is Dan's new book he's reading:

A little more than four weeks left!! Not only is it the end of his mission, but it's also the end of sending out missionaries from our family. It's another phase of life that will be behind us soon. So many changes in the past few years.

For one of her jobs, Paige was tasked with updating the location of all the sculptures around campus. On a day off, we spent a few hours wandering campus looking for lost sculptures in extremely hot weather. 

This flute-playing sculpture was the hardest but most rewarding sculpture to find. We came upon her in a secluded courtyard very far from the location listed. It's now updated thanks to Paige.

A few migraine days recently.

Almost done reading the Emma M. Lion series of books. I've been reading them slowly so I can enjoy them longer.

We have a mouse problem in our newly landscaped backyard. The mice didn't care about our yard when it was only dirt, but now they like it. They're burrowing under rocks in these three areas of our yard. We keep finding holes and new piles of dirt, and we've caught five mice so far. It's unpleasant, but if we don't take care of them, here in Arizona they become a big problem and cause a lot of damage to yards, houses, and cars. We also don't want snakes following mice into our yard.

Dan and Colby have every other Friday off work, which was today. Paige took this morning off work too, and we all went to the U of A Mirror Lab to see how giant telescope mirrors are made.

Monsoons have begun, and they're fascinating. Yesterday there was a heavy downpour with loud thunder, and then the sun quickly came out.

I have a plane ticket and will be packing Leah up and driving her home soon. This is the cutest picture of Leah with her cousin this week:

I chopped my hair short again. And my stomach still hates me every day. Any progress I was feeling has stopped.

We're getting quotes for a mini split air conditioner in our small garage so we can exercise in there and use it in other ways. It's too hot to keep walking the neighborhood in the summer, and we're out of room inside the house for an exercise spot. A lot of people in Arizona park outside and use their garages for exercise rooms, offices, etc., especially since there are no basements.

Mid June

We watched our nephew's mission homecoming on Zoom. Now Carson's the last missionary in the family still out, and he has six weeks left! 

Leah is finishing up a summer term, learning to test blood in a lab so she can use the results for her thesis, and then at some point I'll fly to Utah, pack up her room and pile boxes in the living room, and drive her home. She's staying in the same apartment but moving to a bigger bedroom with its own bathroom. We won't have to pack her kitchen things, but we will clean out her bedroom and leave it ready for the next person who might move in before we come back. Meanwhile, the girl whose bedroom Leah is moving into has left for the summer but didn't clear out her room, so Leah can't move in yet.

A monsoon happened yesterday, and all the lightning set another mountain on fire across the valley. We could see the new fire begin and then grow bigger. 

Meanwhile, the mountain fire next to us started back up, and by the end of last night a third fire had started somewhere else. Last night we set up a telescope to check on the three mountain fires (that's Colby in the picture). The lightning storms across the valley were amazing to watch too.

We did go back and buy the VW Atlas. I think it's going to be the best choice for us. I don't want to car shop again for another 15 years.

Fire on the Mountain

This was certainly a new experience for us and quite fascinating. A fire started on the mountain this morning. While ground and air crews fought the fire, we watched it grow until they finally got it under control many hours later. There is no more smoke on the mountain now.

Enough Already

There is no end...I fix one thing and another problem always takes its place. I finally got over a stubborn sinus infection. My stomach was amazing for five days but went back to all its problems for two days, and then today it hasn't bothered me yet, so I don't know what to expect next.

There were no same-day doctor appointments available, so off to Urgent Care I went today for new problems...hoarse voice, extremely dry mouth, and painful inflamed sore throat with white spots. A strep test came back negative, so the doctor took a new culture and is treating me for thrush. **Update on 6/13: Three days later, the culture came back negative for thrush. I stopped the medicine. I had a few miserable and uncomfortable days, but I'm finally feeling better now. I don't know what was going on.

Decided

Now my car is making loud noises, so we still have to replace it. We already decided against another Chevrolet Traverse. We've owned a rare one with no major problems that was able to last 15 years and 202,000 miles with the same transmission and engine. I've read enough reviews to convince me another Traverse won't be the same experience. 

Dan and I spent most of Saturday at dealerships, looking again at Honda Pilot, VW Atlas, and Kia Telluride. We also drove a Subaru Ascent this time. 

And then we chose the car we really like and keep coming back to because it hits everything on our want and need list. We put money down to hold it and give us a little longer to think about it and be sure, but we're probably going back tomorrow night to finish paperwork and make it official.

Unless something comes up and changes our mind, this is our new VW Atlas. 

Woohoo!

I've had five amazing days with my stomach! Five! I can't believe it! No problems! 

I don't know if the new medicine suddenly started working more, or if I'm feeling great because a doctor put me on a short burst of prednisone this week for a sinus infection. Or maybe both those medicines together have calmed the inflammation down and relaxed everything.

I am a completely different person when I feel this great. I know I may slide backward again as prednisone wears off, but I really hope this lasts and I keep improving. 

It's Already June?!

We got Carson's travel plans! He and I worked on his college schedule today, and now he's registered for fall classes. We also have a date for his homecoming talk.

Paige finished one paid internship at a museum on campus and began another one at a different museum, where they took this nice picture of her and shared her bio on social media.

It took a few weeks and a lot of prednisone, but Colby's hearing is now back to normal after his car accident. The ENT confirmed he can hear at all decibels again. That's a big relief.

I think we all gave up on car shopping. Colby didn't get enough money from insurance to replace his car with the very same year, make, and mileage. He's not interested in starting another car payment yet. He invested the money the insurance company paid him, and he plans to continue driving our old 2008 Jetta for now.

Dan fixed the headlight problem on our 2011 Traverse, so it's not an emergency anymore to replace that car. We want another 3-row car with enough space for adults in any seat, and we want good towing capability. We've shopped a few new and used cars, all with pros and cons (Kia Telluride, Honda Pilot, VW Atlas).

No change in stomach problems yet. New medicine won't make a difference for a few more weeks or months. 

This is a worthy goal:

Except I should stop taking walks at night, because that's when all the terrifying critters come out and make me want to move far away from Arizona:

To try and love where we live, we jumped in, got involved, met people and joined groups, explored things to do in the area, purposely looked for beauty in this foreign desert, and have tried to turn this house into a home we love and feel comfortable in (the right furniture, art, paint, backyard landscaping, etc.). Now I'm deep-organizing the garages and finishing all the last things inside the house. It took longer than I planned to fully settle in, but I've had busy things and health problems and sometimes no motivation. This August will be our two-year-mark of moving to Arizona and buying our house.

Lastly, we ordered furniture for the yard! It won't come for another month, but it's happening. Arizona heat and sun is relentless, so instead of furniture with fabric cushions that burn, I chose faux-wood-grain Polywood adirondack chairs that are supposed to last 20 years in full sun without fading, warping, or cracking and are heavy enough to stay put through our wind and dust storms and monsoons. They're comfortable and low maintenance. I'm still looking for the right fountain, a firepit table, a little bistro table set, and eventually some plants for the backyard. 

Final Diagnosis and Solution

Tests are done and everything's normal for the most part:

• Gastric emptying
• Two SIBO tests
• Enzymes
• Food allergy bloodwork
• Two ultrasounds
• Colonoscopy
• Endoscopy
• Barium swallow test
• HIDA scan
• Regular bloodwork
• Four throat scopes
• Esophagram
• CT scan

We've found:

• Globus sensation (nerve damage in my throat that made my voice hoarse and caused a feeling like food was stuck; it finally calmed after a year of symptoms)
• GERD
• One gallstone
• One kidney stone
• SIBO (last test showed I'm negative now)
• Small hiatal hernia
• Gastritis (stomach inflammation)
• Vitamin D and B12 deficiencies

We've tried:

• PPIs and H2 blockers to calm GERD
• Five antibiotics in three rounds to calm SIBO
• I'm still taking Vit. D and B12 supplements every day
• Many diet changes and restrictions
• Lifestyle changes (wearing loose clothes, walking after eating, lying on left side to sleep, staying upright for hours after meals, eating small meals, lowering stress, etc).

And still I'm no better; in fact, I feel worse. Extreme symptoms used to happen a few times each week but now happen daily.

After a gastroenterologist fully checks everything else and there are no structural problems, we arrive at a final diagnosis and solution now that all other possibilities are eliminated: Functional Dyspepsia and Visceral Hypersensitivity. My mind learned to tell my body that all food and drink is hurting me, and then no matter what I eat or drink now (safe foods or not), my body responds with pain, immediate bloating, feeling very full, and nausea. Functional Dyspepsia causes real reactions -- it's not "just in my head" -- it's a dysregulated connection happening in my body that causes real physical symptoms. Visceral hypersensitivity happens because my nervous system is overly sensitive and amplifies everything into pain that might not affect someone else the same way.

How does it happen? Extreme constant stress from a few years ago that I couldn't manage, which got out of control and affected my digestion system (mind-gut connection), which caused my brain to associate food and drink with danger, which led to my body now reacting in painful ways by default, even in times when I feel no stress at all. It's something my body has learned, and it's something that has to be unlearned, and that starts in the mind.

How do we fix it? 

• Stop thinking about stomach problems or fixating on it or researching it, which keeps it always on my mind and watching for danger or symptoms. This is easy to say but hard to practice when my body has learned to react negatively to everything, every day. How can I ignore my stomach when it's obviously huge and painful? I've also believed I was doing the right thing by reading and researching and trying everything in order to fix myself, but apparently it may have made things worse.
• Low dose of Nortriptyline for a few months, an anti-depressant that will calm and relax my digestive tract and my mind-gut connection that obviously is broken and hypersensitive from things like years of chronic stress. At a low dose, it's not used to treat depression, but it's effective at calming stomach problems from functional dyspepsia. I've always felt stress affect me physically and make me sick, but I'm shocked at its ability to wreck my body like this, and for this long. Stress (and multiple health problems) was building for years and leading up to 2019, The Year That Broke Me for lots of reasons, followed by the wild and stressful pandemic year of 2020 and every stressful year since. I'm much better at staying too busy taking care of everything and everyone else and what they want or need but not stopping to take care of me and what I want or need, and my whole life this tendency of mine creates a lot of stress I can't regulate, and then I get exhausted and sick and can't function. Now, even after all I've done to lower stress in my life in the past year, my body still defaults to this bloated, painful reaction every time I eat, even if I don't feel stressed at all. My body has gotten used to responding this way and can't stop on its own. A low dose of Nortriptyline should disrupt the mind-gut connection enough to get me back to normal, but it usually takes several weeks or months on that medicine to start seeing results for digestion problems. And then I have more work to do in my life to calm my body and help it manage stress better. Gut problems take a loooooong time and much trial and error to fix.
• Gastro-Intestinal Psychology to stop the cycle of worrying about what to eat and worrying about daily actions to keep from hurting. The idea is: I'm scared everything will hurt me, and then those thoughts cause the very pain to happen that I'm worried about. Apparently I need to unlearn phrases like, "This food will hurt me" and "I'm in pain and I can't stop it" and "This will never get better" and "My body is broken" and "I should cancel plans today and go back to bed." I'll need to learn better phrases like, "I might hurt this morning but I can feel better by tonight" and "This food is good for me" and "I can heal" instead of giving up. Part of the whole healing process is reintroducing the foods I've been told to restrict and be scared of, and at this point that might be harder mentally than I realize, but eventually my body will calm down and most foods should not cause pain anymore. Do you know in the past year I've only eaten one apple? It was on the restricted list for so long, and now I'm scared to try one. Another huge part of healing is figuring out what causes me stress and finding better ways to cope with those things and calm my nervous system down. I don't have anxiety though I sometimes feel anxious; however, I often feel stressed. If I were to sit and write out everything I'm currently stressed about, the list might be around 50 things. Most of those I don't feel I can do anything about because they're out of my control, but they affect me. Maybe I need to write all the stressful things down and make a plan for each item. My doctor gave me a handout for GI psychologists that I can make several appointments with for the next few months to help me through the whole process. I looked into it and it will cost $3,000! Or I can research and find resources online to try it on my own first. I have a "cognitive behavior therapy for gastrointestinal problems" book coming in the mail.
• Deep diaphragmatic breathing exercises my doctor wants me to try that will help my stomach and digestion. There are videos online she said are great at guiding me through this. 
• I'm going to have to learn to take care of myself, say no instead of people-pleasing, find daily routines that calm my stress and help my stomach, learn to eat regular food again, and reframe my thoughts until my body follows and doesn't believe it's in danger anymore. I have all the tests from the past 18 months as proof to tell my mind my body is working. It's going to take time and lots of work to turn this around, but it's possible, and that gives me hope I haven't had in a long time. I'm also going to be realistic, because functional dyspepsia can't be cured but it can be managed, put into remission, and the symptoms can be reduced to a point where I won't notice them much. So that's the goal.

Here's some more (copied) info about FUNCTIONAL DYSPEPSIA:

Functional dyspepsia is a common chronic disorder of gut-brain interaction characterized by persistent upper abdominal pain, burning, early fullness, or bloating, specifically without structural abnormalities on endoscopy. It is frequently linked to visceral hypersensitivity, abnormal stomach motility, or post-infection inflammation. Treatment combines lifestyle changes, acid-suppression medication, and sometimes neuromodulators. 

Symptoms
Functional dyspepsia symptoms are usually meal-related and include: 

• Postprandial fullness: Uncomfortably full soon after eating.
• Early satiety: Inability to finish a normal-sized meal.
• Epigastric pain/burning: Pain or burning in the upper abdomen, not necessarily related to eating.
Other symptoms: Nausea, excessive belching, or bloating.

Causes and Risk Factors
The exact cause is often unknown, but it is considered a disorder where the gut and brain do not communicate properly, often involving:

• Delayed stomach emptying: Food stays in the stomach too long.
• Visceral hypersensitivity: The nerves in the stomach are hypersensitive to normal function.
• Post-infection inflammation: Excess white blood cells (eosinophils) in the duodenum.
• Risk Factors: These include lifestyle factors like smoking, chronic anxiety/stress, and the use of nonsteroidal anti-inflammatory drugs (NSAIDs). 

Diagnosis
Diagnosis follows the Rome IV criteria, which require symptoms to be present for the last three months, with onset at least six months prior. Crucially, an endoscopy must be performed to rule out ulcers or other structural diseases. 

Treatment Options
Management focuses on symptom relief:

• Dietary changes: Avoiding fatty/spicy foods and eating smaller, more frequent meals.
• Medications: Proton pump inhibitors (PPIs) to reduce acid, H2 blockers, or prokinetics to improve stomach emptying.
• Neuromodulators: Low-dose antidepressants may help reduce the pain signals from the gut to the brain.
• Lifestyle: Stress reduction techniques and smoking cessation.

Prognosis
Functional dyspepsia is a chronic condition that can have a relapsing and remitting course. While it is generally not life-threatening, it can significantly impact quality of life.

Here's some more (copied) info about VISCERAL HYPERSENSITIVITY:

Visceral hypersensitivity is a condition that affects the way your body interprets signals from your internal organs, particularly the gastrointestinal (GI) tract. Often associated with conditions like irritable bowel syndrome (IBS), visceral hypersensitivity can lead to heightened sensitivity to normal sensations, causing discomfort and pain.

At its core, visceral hypersensitivity involves a heightened response to stimuli within the GI tract. Normally, the gut sends signals to the brain to indicate sensations like fullness, hunger, or discomfort. However, in individuals with visceral hypersensitivity, these signals are exaggerated, leading to a perception of pain or discomfort even in response to mild stimuli.

The exact cause of visceral hypersensitivity is not fully understood, but it’s believed to involve a complex interplay of factors including genetics, gut microbiota, psychological factors, and environmental triggers. Stress, anxiety, and certain foods may exacerbate symptoms in susceptible individuals.

The symptoms of visceral hypersensitivity can vary widely but often include abdominal pain, bloating, altered bowel habits, and general discomfort in the abdominal region. These symptoms can significantly impact quality of life, leading to missed work or social activities and contributing to emotional distress.

Managing visceral hypersensitivity typically involves a multi-faceted approach. Dietary modifications, such as eliminating trigger foods like spicy or fatty items, can help reduce symptoms. Stress management techniques, including relaxation exercises and cognitive behavioral therapy, may also be beneficial in mitigating symptom severity.

Medications may be prescribed to help control symptoms, including antispasmodics to reduce gut contractions, antidepressants or anti-anxiety medications to address psychological factors, and pain relievers to alleviate discomfort.

In severe cases, where conservative measures are ineffective, more invasive treatments such as nerve stimulation or surgery may be considered.

In conclusion, visceral hypersensitivity is a complex condition that can significantly impact daily life for those affected. By understanding the underlying mechanisms and implementing appropriate management strategies, individuals can work towards achieving better symptom control and improved quality of life.

In the Lab