Dr. Grossan's Ear, Nose and Throat Consultant Pages

 
      Allergies
 


Nasal allergy is very common. The number of patients seem to be increasing, probably because of the air pollution.

When the allergy is bad, any chilling can cause symptoms - drink only warm liquids and avoid ice. Here it is very important to drink hot tea before getting out of bed. This is because when the allergy is bad, the regular body thermostat doesn't work well. Instead of warming up after getting out of bed by circulation, the body coughs and sneezes as part of the warming up mechanism. With allergy is important to avoid getting chilled, especially in a movie, this will bring on symptoms. The plants pollinate about 5 AM and 5PM, so it is important to sleep with the windows shut to avoid the 5 AM pollen, and to drive in the late afternoon with the car windows closed. When the allergy symptoms are severe you must avoid spicy foods - hot mustard, hot peppers, etc.. This is because these spices add to the histamine already in your body which makes the allergy symptoms.

Today there are some excellent antihistamines available over the counter. I would start with Chlortrimeton. This is available as a 4 milligram or 12mg long acting (12 hours) tablet. The problem is that everyone reacts differently to these pills. Some people feel drowsy at a small dose. There are other antihistamines that have less sedation for most people such as Seldane or Claritin. On prescription, there are several steroid nasal sprays, such as Vancenase or Flonase. If they work, this is a preferred treatment because there aren't any systemic effects, such as you might get with antihistamines. In 1996 we feel that allergy can be reduced or avoided when there is a family history of allergy if the child is nursed. All children should sleep in rooms with minimal dust. It is important to follow the prescribed foods for infants. For example if eggs are introduced at too early an age, an allergy to this food may develop. Often if a child hates a certain food, he may do so because he is allergic to it.

Be very careful of nose drops such as Afrin and Neosynephrine. All nose drops can be addicting, the more you spray, the more constriction of the nose, then there is rebound and the nose is more congested. Soon, instead of every 12 hours, you have to use the drops every 6 then every four hours! Then, the systemic effect of all that medicine takes over and the person becomes nervous, jittery and sleep is difficult. This is called Rhinitis Medicamentosum. Once this happens, the best treatment is a short course of Prednisone combined with an antibiotic from your doctor. If you have allergies, it is better to pay someone else to clean out grandma's attic because the symptoms brought on from the dust will be extreme.

After exposure to an allergy trigger such as ragweed, just as you might wash your hands to remove dirt, you can use pulsatile saline irrigation to remove offending substances. If antihistamines are not satisfactory, try antihistamine as a nasal spray: dissolve one 50 mg capsule of benadryl in 4 ounces of saline, or better yet, an enhanced nasal moisturizer solution, 3x a day. Or your doctor may recommend Singular as a spray for your allergy: dissolve two 10 mg tablets in 4 ounces of an enhanced nasal moisturizer solution. Spray nose thoroughly 3x a day.

Many years ago there was an excellent treatment for uncontrolled allergy symptoms. They would put a person to complete bed rest and in an allergy free environment for about a week to 10 days. This allowed the patients natural cortisone to regenerate and he would be well. Today, we give cortisone medication to do the same thing, but it is important to remember that if the attack is severe, rest is the best medicine.

 


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Last Update 2003 October 1
Murray Grossan M.D.
ENTconsult@aol.com