Why does it always involve meds... How about the Netty Pot. Works for me and it's an option for everyone.
Hi Barbara,
Treatment of nasal sinus disorders doesn't always involve medications. Some of my patients that avidly follow recommendations for environmental controls (reduce indoor dust mite, mold and irritants), remove carpets and pets, and in some cases get allergy shots, often require little to no medications.
People with very mild allergy problems may not require medications at all. Nasal saline rinses may be enough. Unfortunately, I see many patients that have more severe nasal-sinus problems. Conservative/alternative measures are rarely enough but I still recommend some of them.
The Neti Pot is often not enough for moderate to severe rhinitis, especially if allergy triggers are a major problem. I linked an article in an above response which reports on a subset of people that had more sinus infections while doing daily nasal rinses.
The same shoe doesn't fit all in the complex world of allergic airway problems. But I am glad you have a solution that works for you (excuse the pun).
J. Thompson, MD
Whats the best way to use a inhaler to pretreat exercise-induced asthma? Should I do it 15-20 before or an hour before. These new inhalers dont seem to work as well as the older CFC inhalers.
Hi Mr Fitzgerald,
Thank you for you question. The relatively HFA inhalers have been discussed in several postings on MyAsthmaCentral.com. I noted some characteristics of a few brands on a previous posting linked at the bottom.
Many people share you feelings about the HFA inhalers but I have found that trouble shooting inhaler technique, spacer use, cleaning of the mouthpiece and sampling different brands can often remedy the problem.
I also try to de-emphasize the need for these reliever inhalers by addressing maintenance treatment with good controllers (less need for reliever medicine if the asthma is well controlled).
Two puffs of a reliever brand of albuterol 15-20 mins before exercise is most often recommended by doctors for prevention of exercise induced asthma but it doesn't always work. This means a re-visit to your asthma care provider is in order. There are other steps (some mentioned above) that may be considered in evaluating why this is the case, and how to treat it.
Good Luck! (Here is the link: HFA-Inhalers)
J. Thompson, MD
I have never had allergies or sinuses in my life untill I got pregnant. I started getting them about 4 months into my pregnancy, and now my son is 5 months old and they have never went away. My nose is always congested, I am constantly blowing my nose. I sneeze on a regular basis throughout the day. Is this normal after being pregnant? I don't know what to do.
OMG! Amanda,
How did I miss your comment/question? A thousand apologies to you. I'm sorry I didn't hit you back with a reply sooner.
I guess you have a 9 month old now. How are your allergy symptoms currently (I understand if you take your time answering, or don't at all...)?
Pregnancy can make allergies worse, or better actually. There are some women that first learn of having allergy (and sometimes asthma) after becoming pregnant. We don't exactly know why, but we are convinced it has something to do with the hormone shifts (Duh..., you might be thinking).
In your case, the nasal sinus symptoms began during pregnancy but did not end after delivery, even after 5 months. That suggests your pregnancy unleashed a tendency that had been latent up until your pregnancy. This is not unusual. Sometimes this type of phenomena happens at the start of menstruation, or at menopause (similar times when all, of a sudden, allergies can get worse or better).
More answers can be obtained by getting evaluated by a board certified allergist. You should have allergy skin testing to confirm whether your problem is in fact related to allergen exposure, or something else. You can also be given advice on what medications to take (or could have taken
).
This reply may all have very little value to you, four months after the fact. Gosh Amanda, at times (like this) I feel like I am just re-arranging furniture on the Titanic.
Good Luck!
J. Thompson, MD
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Hi I too suffered from congestion for years (about 40). It's very frustrating to get stuck on the "merry-go-round" of treatment. I was concirned about long term side effects of nasal steroid use. To me it just makes sense if a medication "really" works, you shouldn't have to keep taking something year after year, impacting your overall health, just to keep "Big Pharma's" pockets lined...
I have, however, found a "cure" not just treatment, to nasal congestion which is all natural and comes with NO negative side effects. It's nasal cleansing or rinsing. I use a product called Nasal Care.
Once a day in the evening and only 1/4 of what they tell you to use works for me!Don't be misguided this is NOT a neti pot, it's a much easier implimentaion. By good nasal hygeine you eliminate ALL flu viruses, allergens, pollen even mold and bacteria. Since I have been using this product, I haven't had any congestion! Even in summer! I couldn't even breathe before without cortisteroids. I'm so happy to have found a safe and easy solution to my congestion and you can too. I am now drug free & breathing clear consistently!
Hi Gloria,
Thank you for your comments. I am very happy you have a system that works for you. Unfortunately, nasal rinses with saline as well as with minerals and herbs have a limited affect on many people that I see in my office. I am familiar with Nasal Care and no doubt there are people it may help. But much like many treatments, prescribed or alternative, one solution doesn't necessarily work for all or the majority. Nasal steroids, alone, don't work for many people. That is why it takes a comprehensive approach to achieve success when the problem is severe or longstanding. This means identifying the nature of the problem (through allergy testing), avoiding established triggers by doing environmental controls, taking medications that have been proven to work for many of people through clinical trials, and in some situations, allergy shots.
Nasal saline rinses have been an additional recommendation by sinus doctors and allergists for several years. Recently a study showed that nasal rinsing on a daily basis my lead to more sinus infections in some people (click here to learn more).
Bottom line: Every person has his or her own set of triggers that add up to their symptom complex. There is not a magic bullet, shot or nasal spray/rinse that works for everyone. But the comprehensive approach I outlined above (with occasional nasal rinses) works for most, according to many review articles and my experience.
Thanks again,
J. Thompson, MD
Hi Dr. Thompson!
Yes, you are right not "all" treatments work the same for everybody. As usual you are being your diplomatic self, to my emotive replies...
, but I must ask you what about the long term effects of steroid use? I do believe you need to get to the source of what triggers congestion.Inflammation in the body isn't a good thing. This, what is actually at the bottom to heart disease not just elevated cholesterol as the drug companies would have you believe...
I haven't talked to you in awhile I hope you and your family have a wonderful Thanksgiving!
Ms. passionate Gloria...
Thanks Gloria,
My family is doing well thank you!
Nasal spray steroids may cause local irritation after short or long term use. There are no common side effects associated with the use of intranasal steroids. They don't have cumulative side effects. I have followed patients, friends and family members on them for more than 10 years. Some people only need them seasonally but others for most months of the years. They do not have a time limit in children or adults. They represent a steroid that the body makes on a daily basis (cortisol type). Since it is topical, and at a dose smaller than what the body generally makes, they are safe for most people to use long term.
Allergy nasal problems are not curable by any treatment to date. Some people are fortunate to control symptoms through medications, or as in your case, through nasal rinsing (acknowledging that others do share your experience). A remission period may be established by good treatment with medications, allergy shots or by chance. But sometimes the problems return later in life. I see some people more than 70 years old with allergy nasal problems that have resurfaced.
Best Wishes!
J. Thompson, MD