accustomed to nasal spray?

[bmccasland]

A year ago I was referred to an Allergist for my allergic reaction to something I ate. After discussing that issue, she gave me the once over, and wound up prescribing Veramyst for my slightly stuffy head.

OK, back up. While I lived out west, I pretty much lived on various flavors of allergy meds. Moved back to Louisiana, where I lived as a child, and after the first bad winter (sinus infection) - the doc I saw suggested I go off all allergy meds. Was happily allergy med free (but diagnosed asthmatic) for 5 years. Then last year I happened to need to see an allergist for something other than my nose - my food tried to kill me.

So now a year later of taking Veramyst, and happily being able to inhale through my nose a lung full of air until recently - my head feels like it needs to explode. I've been taking sudafed (OTC) every other day lately, but today even that isn't making the sinus pressure go away.

So my question - can a body get "used" to the nasal spray stuff? I'd like to not have to take anything. I accept the asthma meds, cause I see a difference in my ability to ride. But now even pulling on socks or picking up something off the floor is no fun whatsoever. I almost called my Allergist to get another appointment - but wanted a non-biased opinion, and from someone that doesn't have monetary interest if I procede with taking more drugs. My nose is clear, but my ears need to explode.

Any ideas?

[wolfak]

Veramyst is a corticosteroid - not as likely to develop symptoms of tolerance like some of the other nasal sprays. However, I might suggest you try a saline spray like Ocean or Ayr as a means of helping reduce your congestion more immediately - it will keep your nasal passages moist and it's hypertonic so it will likely help draw the mucous out.

The corticosteroid is a long-term therapy to reduce inflammation caused by allergens - it's action won't start immediately and won't stop immediately after you stop it, because it works by changing protein production in the cells that you expose to it. But, how many sprays (one or two) do you use per day? Have you not used the pump in a while? If so, did you gently shake it and prime it?

Also, fluticasone, the active ingredient is off-patent, ask for a generic substitution to save yourself some money. If you have a good allergist, they should give a crap about your condition rather than getting your moneys.

Finally, it's fall allergy season - you might be getting enough allergens that the dose of Veramyst you are on just can't counteract it. Over the counter claritin or sudafed might help with the congestion until the frost comes.

[Crankin]

I took Flonase for about a year and I had to stop because of nasal irritation and nosebleeds. It worked, though. You could switch to another spray?
I have found the saline based things don't do a thing. Could you have a sinus infection? Allergies can do that to you, if they get really bad.
As one who has lived through allergies, food reactions, and asthma on and off my whole life, I have found that just switching medications often helps. Or sometimes, taking a break from all meds helps.

[Miranda]

We are a housefull of folks that would make a lovely clinical immunology case study for asthma and allergies...

OK, on the doc, if you don't like what he has to say, see another one. I LOVE my asthma/allergy guy so much. He has literally saved me, and the kids from dieing before. I literally leave his office with hundreds of $$$s of meds for free, plus whichever way he can write the scripts to try and help us. Bleah... still, with our new ins, our meds are more than the house payment. Nice Eh? But, it's cheaper than Peds, or reg ICU. Now... my doc's partner is VERY experienced as well... but alas, he is an azz, and a bit tainted in his work I think. I've had other times where I have stayed away from the doc's office because I thought "well, they aren't going to DO anything for me anyways, so why bother". Not a nice feeling. Sometimes a switch up can change that, fwiw.

Yes, we have Veramyst in my house in the drug grocery store. DD just stopped hers, as some of the fields of yellow are dieing. Yippie. (we have both indoor and outdoor though, AND other junk). She has never mentioned the ears/head exploding thing. DD has had both her adnoids and tonsils removed (so has DS, and DH, for me just tonsils). The astha/allergy doc sent us to the ENT. While DD, DS, and DH never showed the classic ear infection signs (like fluid in the ear with the odescope tool), the pressure was from further in. When something like the adnoid tissue is enlarged, it can press on the eustatia (sp? ear) tubes from inside. Once she got them out (they were HUGE), her ear problems went away. DS adnoids were obstructing over 50% of his airway too.

I know exactly what you mean about the ears/head, but without the drainage. This is to the point I was at last season. The last thing we were going to do is a CatScan of my head for the sinuses. For me, it was the infection that never totally cleared up. If any tiny bit is left in there alive, it will re-grow, and the nasty pressue is right there. BUT, with happy dry up drugs, you don't drain. Finally I stayed on enough antibiotics (like over a month) and got better. It took a few different ones with another couple months to do the trick.

I know this is unheard of in the reg doc office. Everyone is very paranoid almost about the over use of antibiotics for resistance. Well, guess what??? It's the folks without our conditions with the common viral cold that have abused the issue. My doc said that's about 90% of the pop the peds sees. They have the viral thing. No antibiotic needed. For US, we are the other 10% of the pop that thing never gets totally better from the bacteria, and need more help to cure. I think with the CT scan, he was going to look for any other type of obstruction or abnormality. But, I got well just before that. I know there is a surgery to drill the sinuses out to drain better, but I would really research the success rate first, and do my drug deal.

Also YES... being on one med too long in a particular drug family will cause resistance (sorta like the antibiotic situation in general). We are also on a first name basis by site with our pharmacist. He told me that as well. Switching things up rx wise can give the allergies a jolt. I almost felt TOO dried up, and actually D/C part of my stuff, and stuck with the antibiotic and Advair. I sound like a 2pack a day smoker on the stuff (btw, never smoked in my life), but somehow I got better. I'm trying the Advair inhailer now, vs the diskus.

OK, that's enough to make you blind reading. But, those are just some things to think about. I know the feeling well. I told the doc if this time he couldn't cure me, I was going to my dog's vet to get put down! Dunno what he'd charge for that lol... but I haven't needed it yet. Good Luck, hun... don't give up.

[OakLeaf]

Ears are very tough to clear even when the rest of your sinuses are completely clear. That's definitely an issue for me. I think ear congestion is best attacked with systemic meds (even though I do hate to take systemics) - and when my ears go, decongestants every other day don't even begin to approach the problem (it's borderline whether a max dose of decongestants will clear my ears or not).

+1 that topical steroids don't usually result in the same dependence that decongestants do. More likely your allergic load just took a big seasonal jump, or it's possible you might have a mild infection too (personally if I get an infection I have the whole array of horrible systemic symptoms, but apparently some people don't).

Are you on Singulair? That has been really great for me. Not only does it pretty much eliminate my mild asthma, but it controls a whole range of allergy symptoms (really the worst ones, the extreme fatigue and a lot of the swelling) that antihistamines never did. And you can take it together with antihistamines if/when you need to.

Have you been evaluated or done a challenge diet to test yourself for food allergies? Those can really increase your allergic load without you being aware of it. If they're relatively mild, like mine, you can manage your food allergies and be strictest about your diet when the seasonal inhalants are peaking.

I'll reiterate that I'm a huge supporter of immunotherapy. Rather than bombarding yourself with drugs, immunotherapy trains your immune system. If your doctor doesn't individually titrate allergens (apparently some don't, even in this day and age), find another doctor. And as far as the convenience factor, lots of allergists will let you give your own shots once you're stabilized on your full dose (I'm leery of doctors who will let you build up your dose at home though) - so it is a PITA for a few weeks each time I get re-tested, but after that I can take care of myself.

In the meantime... have you tried heating pads and postural drainage? Hope you feel better soon - that's so miserable