Surmounting sick sinus syndrome.

When I first saw this term on a report of a consultation with a heart doctor, I was confused.  I thought sinus issues were the responsibility of ear, nose and throat doctors, also known as ENTs.   So how does a sick sinus fall within the expertise of a heart doctor?

In fact, about 10 years ago, I visited an ENT because the headaches, congestion and infections related to my sinuses were becoming more frequent than I preferred.  He examined me and concluded that I had a deviated septum.  He also gave me some tips on how to keep the sinus and nasal passages so that perhaps the congestion would subside, and I would have less headaches and infections.  But the problem has never completely disappeared.  I thought “Wow – maybe the heart failure doctors will have a solution to my sick sinuses – like killing two birds with one stone.”
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I have since learned that my knowledge of my anatomy is far more limited than I ever admitted.  You see, there is a sinus node in your heart.  I guess maybe it is like names of cities throughout the United States.  For example, there is a Springfield, Virginia and a Springfield, Missouri.  An Arlington, Virginia and an Arlington, Texas.  A Charleston, West Virginia and a Charleston, South Carolina.  The list goes on, and the cities are very different from each other.  Just like the sinus in the heart and the sinus in the head are very different.  There is no connection between the two and each serves a different function.  So if you ask the heart doctor for some tips to avoid your sinus congestion and headaches, he or she will not be amused.  The heart doctor is concerned about arrhythmias that may develop in your heart, and is not concerned about mucus clogging up your sinus cavities and causing headaches.          

But in my defense, I am apparently not the only person who has experienced confusion with respect to this topic.  The website for Medical News Today tells its readers that:  “Sinus arrhythmia does not relate to the sinus cavities in the face but to the sinoatrial or sinus node in the heart.”

According to the Mayo Clinic:  “The sinus node is an area of specialized cells in the upper right chamber of the heart that controls the rhythm of your heart. Normally, the sinus node produces a steady pace of regular electrical impulses. In sick sinus syndrome, these signals are abnormally paced.  The heart rhythms of a person with sick sinus syndrome can be too fast, too slow, punctuated by long pauses — or an alternating combination of these rhythm problems. The syndrome is relatively uncommon, but the risk of developing it increases with age.  Many people with sick sinus syndrome eventually need a pacemaker to keep the heart in a regular rhythm.”  In fact, a number of articles I found referred to the sinus node as your “natural pacemaker”. 

Another term for sick sinus syndrome is sinus node dysfunction.  What havoc does this dysfunction create?  In an article on the Cleveland Clinic website, Dr. Burce Wilkoff says that a slow heart rhythm deprives your organs of oxygen and nutrients.  The result can be dizziness, shortness of breath and fatigue issues.  Or as Dr. Wilkoff puts it, “you simply don’t feel good because your body isn’t getting enough blood to supply your need to breathe, move and think.”

So what do the sinuses in your head do?  According to the American Sinus Institute:  “Sinuses are open cavities in the head, but they are not bare bones.  Each sinus cavity has a mucous membrane lining that allows very slow ventilation into and out of the sinus. The slow ventilation allows the space in sinus cavities to be filled with a high concentration of carbon dioxide and a low level of oxygen. This creates an environment hostile to most germs.”  So I guess the sinus cavities serve as the germ terminator?  The ASI also says that we would not be able to lift our head off the pillow if we did not have these four major sinus cavities to lighten our skulls.  That may be true, but I can also tell you that when those very same cavities are filled with congestion, my head feels so heavy that I almost can't lift it off the pillow.

Having endured sinus congestion, infections and headaches for many years, I know the symptoms and the consequences.  But I had no clue when I first was diagnosed with sick sinus syndrome what the symptoms were.  Do you know?  Well, having traveled with me through the blot posts, you may have guessed dizziness, shortness of breath and fainting.  If so, you are correct. 

According to the heart rhythm society’s website (hrsonline.org) these symptoms can occur:  slower than normal pulse (bradycardia); fainting (syncope); feeling tired all the time (fatigue); weakness; shortness of breath (dyspnea); chest pain (angina); disturbed sleep; confusion; and heart palpitations (feeling like your heart is racing, pounding, or fluttering).  Of this list, I think the only two symptoms I did not have were chest pain and heart palpitations.

So what causes sick sinus syndrome?  According to hrsonline.org, like a number of the things I suffer from, the exact cause is unknown.  But here are some risk factors:  age; previous heart attack (myocardial infarction); medications to treat high blood pressure and other heart diseases; hyperkalemia (too much potassium in the blood); thyroid disease; sleep apnea; heart surgery.  Of these risk factors, the only one I know for sure I have is age.  I know that sometimes my potassium level is a little over the normal amount, but I would not necessarily consider that it is too high.
 
So what are the symptoms of a sinus headache?  According to the Mayo Clinic website:  the list of symptoms includes: Pain, pressure and fullness in your cheeks, brow or forehead; worsening pain if you bend forward or lie down; stuffy nose; fatigue; achy feeling in your upper teeth.  Yes - In my case, I experience all of these things with a sinus headache.  The Mayo Clinic also tells us that “Sinus headaches are headaches that may feel like an infection in the sinuses (sinusitis). You may feel pressure around your eyes, cheeks and forehead. Perhaps your head throbs.”  I have to admit that there is less throbbing in my case.  But there is a whole lot of pressure going on. 

Even though the sinus cavities and the sinus node are distinctly different parts of the body, it is my theory that perhaps they were like evil twins conspiring to make my life miserable.  The evil sinus node twin was beating too slow causing me to faint and always tired.  The evil sinus cavity twin was the location for some awful headaches that also made me feel fatigued.  No wonder I felt bone tired and muddled.  And geez – if I would try to rest during a bout of sinus headaches and slow heart beats, the pain would feel worse when I was lying down.  I was miserable. 

But happily a new sheriff came to town in the form of an electrophysiologist.  He nabbed one of the sinus twins by implanting a pacemaker.  This device regulates my heart so that it beats regularly at about 60 beats per minute.  So in theory this disabled one of the sinus conspirators. 

Unfortunately, I still have the sinus headaches creating havoc on occasion.  You might ask if there is something I can take to resolve the sinus congestion/headaches?  Can’t you just take a decongestant, you ask?  Well if you have read other posts, you probably know the answer to that.  Decongestants fall into the category of drugs that a heart patient on my heart meds should not be taking.

​But rather than be bummed out by this, I choose to look at the glass as half full.  I have been enduring sinus congestion/headaches for most of my life.  I know the drill.  And as long as the other sinus is under control, I’m good.