Month: January 2026

“Doc, I have sinus,” says almost everybody. At that point, I typically smile and inquire about how long someone has felt bad and explore the sordid details. However, “I have sinus” is kind of a nonsensical thing to say if you really pick it apart.

Sinus is a Latin word. Literally translated, it just means cavity or empty space. All normal people have scads of sinuses. In the head in particular, you have eight — two pairs of four. These eight empty spaces accomplish some of the most amazing things.

Anatomical Details

Your head is really heavy. I’ve actually had the pleasure of hefting a detached example myself. By incorporating these eight empty spaces into the design of your head, God made things considerably easier on your neck.

Your sinuses act as crumple zones for your face, not unlike those of a modern car. When real people get hit in the face it is not much like the movies. The thin, brittle bones of the sinuses and face crunch in on themselves to protect sensitive stuff like your brain and eyes.

Your sinuses serve as antechambers to your lungs. The air that goes into your lungs needs to be clean and warm. Your sinuses take care of that for you. Were it not for this pretreatment, the sensitive tissues of your lungs that facilitate gas exchange would be forever infected and subject to thermal irritation.

That’s actually asking quite a lot. Room temperature air is typically 70 degrees Fahrenheit and 35% humidity. Four inches later, the air headed into your lungs is at 98.7 degrees Fahrenheit and 100% humidity. Your sinuses do that for you, and we don’t even think about it.

To accomplish that mission, your sinus linings are forever secreting mucus, the voluminous, slimy snot that is so delightful in a three-year-old with a head cold. In fact, to process some 20,000 liters of air each day, your sinuses produce roughly half a gallon of snot.

Once that slick, slimy stuff is corrupted with bacteria, fungi, sloughed-off dead skin and good old-fashioned dirt, you simply swallow it so your stomach acid can render everything digestible. Half a gallon. That sounds gross because it is. However, it’s also all pretty normal.

Now Things Get Weird

So, you actually have two separate noses — one on each side of the midline. Each is entirely independent from the other. One of the more frustrating aspects of a typical cold, flu or COVID-19 is nasal congestion. You won’t believe where that actually comes from.

When your head is stuffy, you’ll never actually blow that stuff out. The inside of the sinuses is lined with highly-vascular erectile tissue, not unlike that of the male penis. Don’t think too hard about that. It is this mechanical swelling, not excessive snot, that typically creates the head stuffiness.

The opposite sides of the nose actually become engorged and then relax rhythmically as part of normal everyday life. ENT doctors call this the nasal cycle. At any given time, one-half of your nasal passage is typically kind of sealed off and shut down. If we aren’t sick, we typically don’t notice. Nobody is really sure why this happens, but cats, pigs, rats, dogs and rabbits do it as well. If nothing else, it allows half of the nasal system to rest at a time.

Medical Manipulation

Many nasal decongestants don’t actually work. Steroids and Sudafed are fairly effective, but phenylephrine and menthol like Vicks Vapo-Rub … not so much. Menthol actually tricks your sinuses into believing the air they are passing is cold when it really isn’t. That lets you perceive that your stuffiness is better even though the bogginess of your sinus linings and the caliber of the air passages aren’t much different.

Afrin is topical epinephrine. That stuff works like a champ to decrease sinus engorgement and open stuffy sinus cavities. When I used to fly Chinook helicopters to the top of Mt. McKinley, Alaska, back when I was an Army pilot, we always flew with a bottle of Afrin in our helmet bags.

If you were coming down off the mountain at 20,000 feet and found that you couldn’t clear your ears and sinuses, Afrin would reliably do the trick. The same stuff works well if you have trouble with ear pain on commercial airplane flights as well. The problem always seems to be on descent, seldom while climbing.

However, Afrin is also profoundly addictive. It’s not heroin or fentanyl addictive. It is simply that after a couple of days of regular use you won’t be able to decongest without it. Another couple of days and you won’t be able to decongest with it.

Ruminations

So, why all this jabber about sinus problems in my weekly GunCrank column? I have long asserted that the best way to clear your sinuses is to stand alongside someone firing a Russian AK-74 on full auto or, even better, a Barret M-82A1 .50-caliber rifle.

The blast from those superb muzzle brakes angling out the sides will indeed reliably clear your sinuses. However, if you don’t have one of those awesome rifles handy, you might want to try a little Sudafed. While you’re at it, just take a moment and appreciate the amazing functions of the humble sinuses. Despite being slick, slimy, warm and gross, they’re also actually pretty cool.