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      05-16-2006, 01:04 PM   #1
vladinecko
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Nasal Spray Recommendations

with allergy season in its peak, i can barely get any sleep at night due to massive congestion. i've read a lot about how all over-the-counter nasal sprays cause "addiction" or in other words, how your body becomes resistant to the sprays effects and give you nose bleeds and headachaes. i tried saline but that does as much as pouring water down your nose, nothing.

do you guys use something that works and isn't full of chemicals that over time make your congestion even worse?
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      05-16-2006, 01:16 PM   #2
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Allergic rhinitis, otherwise known in lay terms as hay fever is a common problem that affects many.

It would be helpful for you to see your doctor so he/she can rule out other causes of congestion (e.g., nasal polyps, sinusitis or other infectious causes, etc.). Several OTC antihistamines such as Claritin are available. Claritin and Zyrtec are essentially non-sedating. Others like Benadryl or Chlorpheneramine cause drowsiness.

You can use saline nasal sprays all you want. The ones such as Afrin constrict the blood vessels in the tissue lining of your nose and can afford you some quick and effective relief. However, if you use these continually for very long, the metabolic waste products that accumulate in the nose tissue cannot be absorbed effectively, and you can develop rebound congestion from what we call rhinitis medicamentosa. Your doctor can also prescribe intranasal corticosteroids, which are safe and effective when used as recommended.
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      05-16-2006, 02:25 PM   #3
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Your mileage will probably vary, but for me:

1. Drink lots of water.
2. to of an Actifed at bed time, but not every night.
3. Nasal strips (those spring like things that go across the nose).
4. Keep the bedroom cold.

Ice water seems to calm things down if I start to have major problems during the day. I suspect that the cold reduces blood flow.
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      05-16-2006, 02:50 PM   #4
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Quote:
Originally Posted by ksfrogman
Allergic rhinitis, otherwise known in lay terms as hay fever is a common problem that affects many.

It would be helpful for you to see your doctor so he/she can rule out other causes of congestion (e.g., nasal polyps, sinusitis or other infectious causes, etc.). Several OTC antihistamines such as Claritin are available. Claritin and Zyrtec are essentially non-sedating. Others like Benadryl or Chlorpheneramine cause drowsiness.

You can use saline nasal sprays all you want. The ones such as Afrin constrict the blood vessels in the tissue lining of your nose and can afford you some quick and effective relief. However, if you use these continually for very long, the metabolic waste products that accumulate in the nose tissue cannot be absorbed effectively, and you can develop rebound congestion from what we call rhinitis medicamentosa. Your doctor can also prescribe intranasal corticosteroids, which are safe and effective when used as recommended.
wow, aren't you a doctor?!

that's exactly what i read about Afrin and such that it causes rebound congestion. and it is true as i was using it for quite some time.

yeah, my girlfriend constantly yells at me for not going to see a doctor but i simply have no time (she'd say now, "well, then you suffer all you want" ).

so something like claritin can actually cure congestion (temporarily)?

thanks!
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      05-16-2006, 02:52 PM   #5
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Quote:
Originally Posted by 742
2. to of an Actifed at bed time, but not every night.
not sure what this is.

you're probably right about keeping it cold. that kind of make sense since the congestion is cause by swollen blood vessels.
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      05-16-2006, 03:35 PM   #6
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Instead of squandering money for temporary relief, tackle the problem at its source: allergens in the air.

What can you do? Buy air filters - go to www.allergybuyersclub.com and purchase any of their multiple air purifiers with HEPA filtration. I wouldn't bother with the UV light stuff...you can easily land filters that can handle large rooms of 15x15ft for $100 each, each with HEPA filtration and pre-carbon filters (that eliminate odor and large particles such as dust).

I have a couple of these purifiers and no wonder why I don't smell my smelly ass dogs around the place!
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      05-16-2006, 05:55 PM   #7
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My doc recommended me to use Loratadine (tablets) and NasalCrom.

Loratadine is used to prevent itchy eyes, itchy throat, help alleviate sneezing and sinus headache.
NasalCrom is a spray used to prevent nasal discharge and sneezing.

He told me to use both in combination. If symptoms still occur or do not reduce then I could use prescription strength medications or even an allergy shot. However he recommended me not to use these types of medications because of possible side effects such as increased heartrate, drowsiness etc...

He also told me not to use Benedryll medications b/c of increased pressure on the kidneys due to the ingredients. So good luck man.

The medications he recommended have worked well so far. Hope this helps.
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      05-16-2006, 08:07 PM   #8
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I use Flonase and that is the only thing that has helped me with my allergies...
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      05-16-2006, 08:08 PM   #9
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Quote:
Originally Posted by Squawks
Instead of squandering money for temporary relief, tackle the problem at its source: allergens in the air.

What can you do? Buy air filters - go to www.allergybuyersclub.com and purchase any of their multiple air purifiers with HEPA filtration. I wouldn't bother with the UV light stuff...you can easily land filters that can handle large rooms of 15x15ft for $100 each, each with HEPA filtration and pre-carbon filters (that eliminate odor and large particles such as dust).

I have a couple of these purifiers and no wonder why I don't smell my smelly ass dogs around the place!
Which one in particular do you have or recommend?
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      05-16-2006, 08:47 PM   #10
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NasalCrom is a good recommendation. It used to be one of the prescription nasal sprays of choice, now OTC and replaced by nasal steroids such as Flonase. You can use cromolyn (nasal crom) every day and it is actually recommended you use it that way. Unlike afrin (phenylephrine) it does not cause rhinitis medicamentosa. You can then use somthing like Claritin (loratadine) on an as-needed basis. Make sure you stay off the Afrin.
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      05-17-2006, 02:06 AM   #11
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Quote:
Originally Posted by vladinecko
wow, aren't you a doctor?!

that's exactly what i read about Afrin and such that it causes rebound congestion. and it is true as i was using it for quite some time.

yeah, my girlfriend constantly yells at me for not going to see a doctor but i simply have no time (she'd say now, "well, then you suffer all you want" ).

so something like claritin can actually cure congestion (temporarily)?

thanks!
Yes, and I've seen and treated so many people with these symptoms, but every now and then someone comes in with something unexpected. The last one I want you to do is to assume I or anyone for that matter can diagnose you over the Internet without sitting down with you, getting a detailed medical history and actually examining you in person.

For true allergic rhinitis, the best solution is AVOIDANCE, AVOIDANCE, AVOIDANCE of allergens that are causing the problem. Loratidine is Claritin, but if the congestion is bothering you, you can take a decongestant along with this or even just a decongestant alone (like pseudoephedrine HCl). I don't much like Claritin-D, because you have to take it twice a day and the pill is huge. Flonase and Nasonex are good intranasal corticosteroid nasal sprays. Nasalcrom is old skool Cromolyn Na+ that has more or less lost it's popularity with the development of newer medications.

There are even some creative applications of Atrovent, typically an asthma drug, that some have tried sticking a baby bottle nipple onto and squirting it in the nose.

One of the allergists I knew once told me of a story in which he told one of his patients to use Ocean Spray (saline nasal spray), but the patient ended up getting the fruit juice instead and squirt that up her nose.

With persistent allergic rhinitis, one could always have RAST or allergy skin testing done to help identify what to avoid.
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      05-17-2006, 02:09 AM   #12
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There are often medical conditions or other concomittant medications that would contraindicate the use of certain medications.
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      05-17-2006, 08:10 AM   #13
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thanks guys! i've never even heard of some of things you mentioned, which is good because the things i have heard of and tried didn't work or didn't work well.

i have a question about saline. does this thing even do anything? because i sure can't feel any relief. but it does give me this very uncomfortable burning sensation in my throat.
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      05-17-2006, 08:45 AM   #14
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Saline is essentially salt water, which is what our cells have in them. When you are treated in the hospital for dehydration, you are usually given Lactated Ringers Solution or Normal Saline solution. When your allergies flare up, the allergens bind to little antibodies that attach themselves to what are known as Mast Cells. These Mast cells then degranulate and release histamines and other components that make your blood vessels more leaky (permeable)--they vasodilate. Your nose tissue swells up. The saline solution may help draw some of the fluid out of the swollen tissue by osmosis. This is why we tell people who have sore throats to gargle with salt water, because the throat tissue is inflammed.
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      05-17-2006, 11:27 AM   #15
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Quote:
Originally Posted by gscone
Which one in particular do you have or recommend?
I bought the older Hamilton Beach air purifiers a couple years ago for about $99 each. They work very well.

My big bro also has an AustinAir Healthmate air purifier - he has two cats and the funny thing is when his friends who are severely allergic to cats come over, the purifiers work so well they don't get any reactions inside his place. The Austins are also great since you don't have the replace the HEPA filter until every 3-5 years.

The Hamiltons suggest you replace the HEPA filters ($45 a pop) every year but they can go on up to 2 years as that's what I'm doing now.

I used to sneeze a bit and get occasional runny/stuffy noses during spring but I'm quite surprised this time around I'm getting nothing.

I also used to take Claritin back in the days when I acquired a newfound food allergy and at the time I had no idea what I was allergic to. The Claritin was mandatory for me because otherwise I'd get hives - I learned, however, that you become dependent on such anti-histamines if you take them for long periods of times...in fact, you reach the point where your mentality depends on it and if you refuse to take the drugs your mind may work against you and coerce your own body to react negatively. This of course isn't as severe as the cases of mild allergies which you guys seem to be talking about.
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      05-18-2006, 08:01 AM   #16
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frogman, while i have you, can you explain to me what is physically happening in your nose before you sneeze. i know almost every time when i'm going to sneeze, i can feel this tickling in my nose and could never figure out what is actually physically causing that tickling.

thanks again for your advice, guys!
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      05-18-2006, 08:32 AM   #17
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Quote:
Originally Posted by vladinecko
not sure what this is.
Actifed is an over the counter antihistamine and decongestant. That is the name brand, there are plenty of generic versions. It is very effective (at least for me), but really puts me into a sleepy, happy la la land. No pink elephants, but I don't mind being around my mother in law. Thus the small dosage taken at night and only during serious hayfever problems.

You seem to be getting good advice on this thread, and I am not an MD by any means. But for non-medical relief, all forms of cold help me. Cold air, cold water, cold showers, ice cubes in the mouth and so on.
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      05-18-2006, 10:21 AM   #18
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Quote:
Originally Posted by vladinecko
frogman, while i have you, can you explain to me what is physically happening in your nose before you sneeze. i know almost every time when i'm going to sneeze, i can feel this tickling in my nose and could never figure out what is actually physically causing that tickling.

thanks again for your advice, guys!
Excuse this medical explanation, but I'm not sure I can answer that question without getting a little detailed.

Allergens in the air, say cat dander, pollen, etc., enter the nose when you inhale. These allergens are little bits of protein that can irritate the lining of the nose in certain people. Let's say you are allergic to your girlfriend. As she sits next to you, pieces of her skin are exfoliating onto you. You breathe this in. This causes your body to stimulate an immune response, so antibodies (which are proteins also), specifically IgE (Immunoglobulin E) attack your girlfriend's skin proteins. What actually happens is that those allergens bind to the receptors on the antibodies, which in turn attach themselves to Mast Cells--funny looking balls that look like microscopic longans (oriental fruit). Those mast cells begin to release histamine, slow releasing substance of anaphylaxis, leukotrienes, things that really irritate the skin and cause your blood vessels to leak out fluid. Your nose tissue (mucosa) becomes swollen, all because you decided to let your girlfriend shed her skin cells on you. This inflammation and irritation causes you to sneeze on her.

What's interesting is that when you feel like sneezing, push on the middle of your upper lip just below your nose. It will often suppress a sneeze. Don't ask me why, because I don't know why. I imagine it's a viscerosomatic reflex.
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      05-18-2006, 11:02 AM   #19
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That's a nice explanation, ksfrog! But you made histamine sound negative - one thing I don't like about anti-histamine meds is that it's hindering a natural process - thus, when taking them, you might also impede immune reactions against natural pathogens/infections. Histamine helps dilate and permeablize blood vessels so that immune defense cells can mobilize and do their work.

I'd like to add that most allergies are the eventual results of acquiring foreign proteins (pollen, pet dander, dead foreign skin, etc.) directly into your bloodstream in a concentration high enough to provoke an immune reaction. An ensuing arsenal of memory immune cells later roam the body, armed with antibodies to attack the foreign proteins, giving you a permanent, acquired allergy.

That's why you don't feed newborn infants dairy milk - because the pH (acidity) of their stomach is too bassic, allowing the dairy milk to pass straight through the stomach undigested into the intestines and then into the bloodstream. The undigested milk proteins trigger an immune reaction and as the baby grows up, he/she will become severely allergic to all dairy products the rest of his/her life. As babies age, their stomach pH levels change to a point where they can digest dairy products and it'd be ok to feed it dairty products then. Same goes with skin creams containing peanut oil - careless mothers who use too much of this can actually cause some of the peanut oil/extracts to leak into the bloodstream of the infant through the skin (or perhaps the babies lick it off their skin/fingers?) and the child may acquire a lifelong peanut allergy.

Interesting, I'd say!

EDIT: On the technical side, ksfrogman - if I was allergic to my girlfriend, it wouldn't be the work of a typical antibody-dependent immune reaction since we're both the same species and have the same proteins...reaction against her dead skin cells would be based off of MHC receptors, leading T cells to do much of the dirty/killing work...analogous in transplant rejections.
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      05-18-2006, 11:41 AM   #20
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as you know, there are lots of autoimmune disorders that are a bit illusive...Hashimoto's thyroiditis, even vitiligo, in which the current thinking is that the body is producing antibodies against self and destroying it's own melanocytes. So technically speaking, one can have an inflammatory response to just about anything, say a sunless tanner the girlfriend used before she desquamated all over vladinecko. I was using that as a humorous example to keep the reader's attention while talking about technical details that might otherwise be boring to read about.

Furthermore, histamine is of course necessary, but necessary and functional processes in the body often respond in a fashion that can also be damaging. Take for instance high fever, or severe nausea, vomiting and diarrhea that can lead to dehydration and electrolyte imbalance, say hypokalemia, which can result in lethargy, muscle weakness, etc. What about hypercalcemia, as in the case of milk alkali syndrome, or endogenous calcium producing cancer, like Oat Cell Carcinoma? Calcium is not bad, but in excess amounts it certainly is.

Vladinecko is asking a simple question, so my so-called detailed explanation was trying to answer it as simply as possible. The girlfriend skin allergy example was obviously not intended to be taken seriously, though since you brought it up, I beg to differ that one could not "technically" be allergic to allergens on ones own species' skin dander.
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      05-18-2006, 11:52 AM   #21
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I use dimetindeno 0.25, fenilefrine 2.50, and solution in a spray called VIBROCIL. In two days im ok but with cigarettes is far worse, the process is endless. Quit smoking and i dont go to places where i meet people smoking.
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      05-18-2006, 12:15 PM   #22
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Hey, ks - I for one enjoy your technical posts. Your posts give me some insight on certain things I would not have known about in the medical domain. I did indeed notice your humor and I didn't mean to offend your post by carping about some technicality.

You brought up some interesting, natural, self-damaging concepts such as vomiting. Would you not concur that suffering from dehydration and/or physical damage to the digestive tract would be better off than completely digesting a stomach-full of toxins?
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