The Dragon Lady's Journey

First thing, yes, I am back up and stumbling, however, I may not be posting every day like I was before my fall. Yesterday, I had a great day, but by the time I got home, I was exhausted. I usually write my blog in the evening, especially when I have a busy morning ahead. Last night I was exhausted, and then I did not sleep well. I chose not to put much pressure on myself rather than pushing out a less than acceptable blog post. This will be my planned routine moving forward.
Today’s topic is Allergic Rhinitis aka Seasonal Allergies. Here in the central Virginia area, we are in the midst of a beautiful spring with lots of new green leaves, flowering trees, flowers, and of course the grass is growing. Every morning when I go out to my car the layer of pollen on my car is a little thicker and a little brighter. It’s a beautiful time of the year, there is just one big drawback, allergies!
I have had multiple people ask me about OTC (over the counter) treatment for allergy symptoms, not just from friends, but I even had someone ask me in the allergy aisle of my preferred grocers. I thought this would be a perfect opportunity to review the topic. Yes, I am a medical provider licensed to practice in Virginia, however, I am not your provider. If you are on any medications, have a history of high blood pressure, and or heart problems, please consult your provider and pharmacist before starting any new medications, even OTC meds.
Before we talk about treatment let’s talk about the symptoms. The “classic” symptoms are runny nose (rhinitis), itchy and watery eyes, sneezing, and sinus pressure. Now let’s talk about the not so “classic” symptoms: they include post-nasal drip with and without a cough, a sore throat from the post-nasal drip, difficulty sleeping, fatigue, ear pain, headache from the sinus pressure, nausea and even vomiting from mucus drainage. Many of these are missed or thought of being caused by other illnesses. Mucus can be clear, white, yellow, or green. The color of your mucus does not indicate whether you have a sinus infection. If you are treating your allergies and still having sinus pressure, ear pain, and headaches, and or if you start having fevers and chills, you should be seen by a medical provider.
Now, let’s talk about treatment. The first line of treatment is to avoid the allergens, if you are going to be doing yard work wear a mask covering BOTH your nose and mouth. Afterwards, change your clothes, take a shower, and use a saline spray to rinse your nose. Change your filters both in your house and in your car. If you are driving, keep your windows closed and have your fan set to recirculate, not pull air in from outside. Keep your windows in your house closed, and use a HEPA filter on your vacuum. Yikes, that sounds horrible.
So, if you don’t want to have flashbacks to 2020, what do you do? I still recommend the mask when you are mowing your grass, and using a saline nasal spray several times a day. Then add a nasal corticosteroid, i.e. Flonase, or Nasacort. That’s right the first line of medication is NOT a pill, it’s a nasal spray, but NOT Afrin. STAY AWAY from Afrin! Use your saline spray BEFORE your nasal steroid. These are most effective when used daily for at least 10 days.
If you are using the nasal spray and are still having symptoms or you can’t tolerate the nasal spray, there are oral decongestants and or antihistamines. Oral decongestants are fast release or short acting medications such as pseudoephedrine (Sudafed), or coricidin, that help with the runny nose and sinus pressure. Antihistamines directly battle the cause of the symptoms, these can be either short acting like Benadryl or Chlor-timatron or long acting such as Zyrtec or Allegra. They can be sedating, even Zyrtec or Allegra, if you find that to be a factor, try taking them at night. If you have tried all of those, it is recommended that you add them to each other.
What do I mean by that? You start taking Flonase, but you are still miserable, you add Sudafed, but it makes you jittery or you are still suffering. Then you add Zyrtec, so now you are taking Flonase, Sudafed, and Zyrtec, you are doing much better, but some days you are still miserable, now what? Have you tried Astelin or Astapro? It is a nasal spray, and warning, it tastes nasty, but it works. There are also allergy eye drops for both short acting and long acting relief. If you are still miserable, see your medical provider, and remember summer is coming.
This is a long post, I hope that I have pointed you in the direction of relief. Here is a link to the treatment guidelines, you may have to create a profile to view it, but this is a much better website that WebMD 🙄 https://emedicine.medscape.com/article/134825-overview