Sinusitis FAQ

3rd day without antihistamines

Question:

On Sat, 30 Dec 2000 10:16:35 -0000, "Christine Glen" <christine.g…@btinternet.com> wrote: >Don/Gary >Thanks for this. It isn’t the same as the stuff I’m on, which is called >Flixonase Nasules (basically Flixonase is the UK name for Flonase). It’s a >liquid that comes in pre-measured amounts(in squeezy ampoules), and you >squeeze it up your nose, and adopt a kneeling-with-forehead-to-floor >position for five minutes. This manoevre too is supposed to increase access >of the drug to the frontal sinuses.

That is very interesting.  It is a slightly different drug and delivery mechanism, but still exactly the same idea of delivering liquid or partly-liquid steroid to that tricky hard-to-reach frontal area by bending over for 5 minutes. Actually I am very interested to find out that those ampoules exist.  They sounds like an excellent approach to deliverying the drug to the frontal recess and sinuses. > I’ve had it prescribed for severe polyps >combined with sinusitis in my frontal recess and sinuses. It’s supposed to >reduce the size of everything prior to a fifth ESS in January. We’ll see!

A fifth surgery- that is sad that you have to go through with it.    Very best of luck with it!

Response:

Don Brady <dbr…@pobox.com> wrote: >He said Flonase can be more irritating.

I am using Flonase right now. What is this other spray you are talking about, and how do spray it in, then get upside down because I don’t know how one sprays upside down.

Response:

On Sat, 30 Dec 2000 21:40:59 GMT, Mike D <gojun…@mail-.com> wrote: >Don Brady <dbr…@pobox.com> wrote: >>He said Flonase can be more irritating. >I am using Flonase right now. What is this other spray you are talking >about, and how do spray it in, then get upside down because I don’t know >how one sprays upside down.

Dr. Kennedy suggests Nasarel if your sinus openings are currently open. Otherwise he suggests Nasonex, if they are not.     Flonase should be ok too, but he just said it can be irritating. These are all nasal steroids that are mostly very similar, though.  The choice of one over the other is going to be a second-order issue,  I think. Different otolaryngologists seem to have different views on which one is best. Personally, I trust his experience and judgment. To a degree, I think it may also depend on which sinuses are in what condition. In my case, he did a complete  spheno-ethmoidectomy, (-ectomy means removal), including removing all of the bony ethmoid/sphenoid partitions, so I think he is not too concerned about the sphenoids and ethmoids any more.    And the maxillaries (cheek sinuses) are clear and open now too.   Actually all my the sinus openings (even the frontals) are wide open now.    He actually makes sure they stay open by very frequent follow-up visits in which he keeps pulling off scar tissue that forms etc. until it is stabilized.  I have had a *lot* of visits (I am almost starting to feel sorry for the insurance company!).    If, in your case, they did not give you frequent enough visits to keep them open until they healed, I personally think that may be (or border on) medical malpractice.   Maybe the medical director of the Otolaryngology Clinic on the University side would be someone you could talk to about that. But they cannot easily do direct surgery on the frontal sinuses, so they are hard to fix if they are affected.   Mine are – I have frontal sinusitis too. In some people, the sinusitis has not reached the frontals and sphenoids yet. By leaning over for 5 minutes after spraying, with a partly liquid spray such as Nasorel, you can let it start to work it into the frontals, if the ostia are open.  Probably the same for the ethmoids and others.  If you lie on a bed, you can at least spray sideways to a degree if not upside down.  I think the FAQ has some notes on irrigating into the frontals that may explain better.  It would be a bit different but based on the same anatomy.

Response:

Everyone is different. I have allergies also and I stopped taking antihistamines. My allergist said they only work on the symptoms anyway and don’t do anything to help my sinusitis, so I just don’t take them. I don’t like the way they make me feel either. Barb

Response:

> let my allergist talk me out of it last time I saw her she likes >Flonase. I have tried it for six months I don’t.

I don’t like Flonase either. It has a perfume in it that smells bad and drives me nuts. I use Rhinocort aqua. It seems to work great, no perfume or bad taste/smell. Barb

Response:

On 30 Dec 2000 04:07:50 GMT, collgra…@cs.com (Gary) wrote: >My opinion is it is one of the best steroid anti-inflammatory sprays. It comes >in a pump spray it  is actually Fluinsolide hope I spelled it correctly at any >rate it is liquid. I hang my head upsidedown for about 5 minutes after I use >it,.

That is very interesting that you also do what Dr. Kennedy suggested – hanging the head upside down to roll it into the frontal sinuses, provided they are open.  (If they are not open, he suggests Nasonex instead). Did you learn this head down manoeuver  from the U. of Pennsylvania or somewhere else? >I let my allergist talk me out of it last time I saw her she likes >Flonase. I have tried it for six months I don’t.

He said Flonase can be more irritating. >Hope that helps.

It is very helpful to get feedback from others.

Response:

Don/Gary Thanks for this. It isn’t the same as the stuff I’m on, which is called Flixonase Nasules (basically Flixonase is the UK name for Flonase). It’s a liquid that comes in pre-measured amounts(in squeezy ampoules), and you squeeze it up your nose, and adopt a kneeling-with-forehead-to-floor position for five minutes. This manoevre too is supposed to increase access of the drug to the frontal sinuses. I’ve had it prescribed for severe polyps combined with sinusitis in my frontal recess and sinuses. It’s supposed to reduce the size of everything prior to a fifth ESS in January. We’ll see! Christine

Response:

My opinion is it is one of the best steroid anti-inflammatory sprays. It comes in a pump spray it  is actually Fluinsolide hope I spelled it correctly at any rate it is liquid. I hang my head upsidedown for about 5 minutes after I use it,. I let my allergist talk me out of it last time I saw her she likes Flonase. I have tried it for six months I don’t. Hope that helps.

Response:

On Sat, 30 Dec 2000 00:02:33 -0000, "Christine Glen" <christine.g…@btinternet.com> wrote: >Don >Excuse my ignorance, but what is Nasarel?

I did a web search and found http://www.pslgroup.com/dg/5FC6.htm among other hits. >Is it a liquid version of flonase? >Does it come in a squeezy kind of ampoule? I’m wondering if it’s the same as >something I’ve been on for the last month or so (which is called something >else).

Actually it is still a nasal spray much like the others. However, Dr. Kennedy says it stays partly liquid, and that I can lie face down on the bed afterward for 5 minutes and roll it into my frontal recess/sinus, which is the most difficult to reach otherwise and also the hardest to heal. He only suggest Nasrel for those with patently open sinuses. If they are closed, he suggests Nasonex.

Response:

Also here is an excerpt from Dr. Tichenor’s site http://www.sinuses.com/faq.htm#180 ====================================================== Can I use antihistamines to treat sinusitis? Under rare circumstances, antihistamines are used, but only if allergies play an especially prominent part in the symptoms. Because of the fact that antihistamines tend to be drying, we usually try to avoid them in treatment of sinusitis. The mucus in the sinuses may then get dried out and is plastered up against the wall of the sinuses. The bacteria love it because they are trapped inside the sinuses with nowhere to go. They reproduce like crazy and since the mucus is dried out, a blockage in the small drainage canal can occur and so mucus remains inside the sinuses. Unfortunately people feel better initially because the volume of fluid in the sinuses initially is reduced, but eventually symptoms return. ========================================================

Response:

Don Brady <dbr…@pobox.com> wrote: >Also here is an excerpt from Dr. Tichenor’s site >http://www.sinuses.com/faq.htm#180

Thanks Don. I woke up today itching a lot on my head and neck. It stopped after an hour. I definetely am sensitive to something but I am not going back on zyrtec. I feel much better today than I have in a couple of weeks. My nose doesn’t feel as dry and tender. I think that zyrtec was really bad for me. I have an appointment with an allergist so I feel good about that.

Response:

Don Excuse my ignorance, but what is Nasarel? Is it a liquid version of flonase? Does it come in a squeezy kind of ampoule? I’m wondering if it’s the same as something I’ve been on for the last month or so (which is called something else). Christine – Hide quoted text — Show quoted text -Don Brady <dbr…@pobox.com> wrote in message > For people with open ethmoids /frontals, Nasarel was recommended instead by U. > Penn’s Dr. Kennedy,  since it is partly liquid and can be allowed to wash into > the frontal recess.

Response:

I stopped taking my antihistamine this week. Today is the 3rd day. I stopped on the recommendation from people here. I was worried about drying out my sinuses, especially now that I have a nasty infection. I am a bit unsure about the whole thing. I have seasonal allergies so I know what an allergic reaction feels like. I just don’t feel that now. I do, however, feel some itching in my skin, mostly on my face and head. I have sneezed 6-7 times, nothing unusual. Don’t really know if I need the antihistamine or if it really hurts me when I do use it. If it’s harmful what will I do this spring when all the pollen comes? Seems like there is a downside to everything. Should I ask my ENT for NasaCrom? Should I start back up on the antihistamine but be sure to use saline nose sprays 4-6 times a day? Will that prevent drying or what? Thanks

Response:

On Fri, 29 Dec 2000 00:55:00 GMT, Mike D <gojun…@mail-.com> wrote: >I stopped taking my antihistamine this week. Today is the 3rd day. I >stopped on the recommendation from people here. I was worried about drying >out my sinuses, especially now that I have a nasty infection. >I am a bit unsure about the whole thing. I have seasonal allergies so I >know what an allergic reaction feels like. I just don’t feel that now. I >do, however, feel some itching in my skin, mostly on my face and head. I >have sneezed 6-7 times, nothing unusual. >Don’t really know if I need the antihistamine or if it really hurts me >when I do use it. If it’s harmful what will I do this spring when all the >pollen comes?

From what I gather nasal steroid sprays are the best control for nasal allergy symtoms.  If you use them, you should not need anti-histamines. Anti-histamines have other side-effects too. In ternms of nasal steroid spray, I was told that Nasonex is less irritating than Flonase. For people with open ethmoids /frontals, Nasarel was recommended instead by U. Penn’s Dr. Kennedy,  since it is partly liquid and can be allowed to wash into the frontal recess. – Hide quoted text — Show quoted text ->Seems like there is a downside to everything. >Should I ask my ENT for NasaCrom? Should I start back up on the >antihistamine but be sure to use saline nose sprays 4-6 times a day? Will >that prevent drying or what? >Thanks

Response:

Filed under: Frontal sinusitis

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