I've had chronic sinusitis since a February 2005 cold and subsequent
sinus infection. I've been using papaya tablets the last few months
and would appreciate comments from anyone else who has used them -
they're definitely doing something for me, but I'm not sure exactly
what! My ENT hasn't had any experience with papaya. I need to decide
whether to continue papaya and irrigation, or opt for surgery.

Background:

Once my sinus infection was cleared up, I was left with a persistent
pressure and strange fuzzy sensation - when things are relatively
'quiet'. I've had this 24 hours a day since March 2005 - at times
mild, but they've never gone away. When my sinuses are acting up, the
pressure increases, I get a roaring in my ears, and the fuzziness
feels more raw, like a rash. This happens irregularly, one or two days
a week. Symptoms are at the top and back of the head, moving around
slowly.  Everything always acts up when I lie down, so my sleep has
been disturbed for some time.

CT scan shows thickening in the ethmoid and maxillary sinuses - but my
symptoms sound more like sphenoid sinus problems to me (which seem
clear on the CT scan).

I've been using steroid sprays the whole time; currently
beclo-methasone (a really old one, I gather, but it doesn't irritate
my nose like Flonase did). When I stop, which I have tried several
times, eventually symptoms get much worse - so I think the steroid
spray is helping.

I've had two courses of prednisone, which dampened symptoms for a
month or so each time but didn't stop them.

For the last 7 months I've been irrigating once a day with a Neilmed
bottle. I think that has helped as well, though not dramatically -
although the one cold I had during this time was much less problematic
than usual, and went away much more quickly.

Recently:

For the last three months, I've been using papaya tablets. I started
with 4-5 a day. They had an immediate and dramatic effect - the vague,
heavy pressure I usually experience resolved to a very specific, tight
pressure, like things pressing together, and there were lots of creaks
and pops as things moved around. It felt like some of my sinus
passages were unsticking and pulling apart after being glued together;
the symptoms move about on vertical path running from the top of my
head to the back of my head. I was initially very optimistic that
maybe this would be the start of my final recovery - but then things
stalled.

For the last month or so nothing has changed. I can fell things
sticking/unsticking throughout the day, and occasionally things feel
totally open, but never for long. At night, symptoms were actually
worse - when I lie down, things shift around and there is very heavy
pressure until it all eventually sorts out.

I tried a few things - reducing the papaya to 1-2 tablets a day seems
to help at night, a little. I used NAC for a couple weeks, and it did
seem to thin my mucus production and clear out some coloured mucus,
but I had to stop because it was upsetting my stomach even when taken
with lots of water.

So, my questions are: what the heck is happening? Does papaya usually
work this way? Should I keep taking it? How long might it take to
resolve things if it is working?

Also, is it possible that this is really sphenoid and not ethmoid
sinus problems? I think ethmoid symptoms are supposed to get worse
when you lie down, but the top and back of the head location sounds
more like sphenoid problems. Though it's hard to locate things inside
your head precisely, I suppose.

I haven't really had anything like the flu-like symptoms of my initial
infection, but is it possible I have an asymptomatic infection still?
I do get coloured mucus occasionally (though never much, and my nose
is always clear). Initially I had a 2-week course of (cefuroxime? A
sulfa-based antibiotic, anyhow), which helped very quickly, but I then
had an immediate cold and relapse after stopping. Another two weeks of
a different antibiotic (sorry, can't remember this one) also seemed to
work, but I again had a cold, which left me with my current symptoms.
Haven't had any antibiotics since then.