Constant sinus drainage-need advice

[JennyCoulon]

Our 13 year old has constant sinus drainage. He has allergies but takes singular and zyrtec. He does sinus rinses as well as always blowing his nose. Does anyone have advise on getting this under control? His lungs are always clear but the drainage causes constant coughing. We have told his pulmonary team because this has been a battle for years sometimes like Spring and Fall it is worse with the weather not knowing what it wants to do. He takes Qvar after treatment in place of Advair and it doesnt seem to really help. Please help...

 

[LittleLab4CF]

This can become its own problem but I have used oxymetazoline nasal spray (Afrin) almost forty years, contrary to all the warnings never to try it. It is very easy to fall for the sudden dilation and drying of mucus membranes Afrin's generic moisturizing spray is the best way to go if you try it.

Do not let your kid posess the atomizer, I went from the recommended 12hr dosing to every three hours. This was prior to a moisturizing formula and between overdosing and the very dry air, I hastened the need for my first sinus surgery. Using a steroid nasal spray like Flonase 12hrs off from the OTC Afrin+ may relieve some misery. Zyrtec may be too much with the nasal sprays and if you can stop it with a net benefit to your 13yr old's wellbeing, so much the better.

Flonase is prescription and it would be wise to discuss the oxymetazoline w/moisturizer spray. There is little risk in trying the OTC spray just for a week or two. Both Singulair and Zyrtec are antihistamines of a sort, if this massive drainage is seasonal, your only real help will be through allergy shots, following a patch test. If you are fairly certain the source is molds, don't waste your time on shots. Molds are rarely treatable, not completely so maybe get that patch test.

LL

 

[nocode]

I (30, female) suffer from the same problem.. I am constantly blowing my nose, especially after I have a coughing fit. If you find something that works, let me know!
Good luck.

 

[ymikhale]

My dd has the same problem. We tried all the nasal spray and allergy meds but nothing works. I am thinking of taking her to naturopathic doctor since it is not a specific CF issue. Looking forward to learning what works for other people, especially kids

 

[sdeuber]

I rinse my nose/do nasal irrigation at least once a day with saline solution. You can use a neti-pot or a syringe or the waterpik option (just google "nasal irrigation"). I use a glass (16 oz) of water and dissolve about one teaspoon of salt (regular table salt, but have used Himalayan salt as well) and rinse both nostrils plus a few gargles.
If the air quality is bad or if I feel a cold coming I do it twice/day. if it's getting worse I use Alkalol (http://www.alkalolcompany.com/) - 50/50 alkalol and water.
Doing it with kids: one of my sons just does it, my other one almost has a meltdown . I try to tell them it is like jumping into the salty ocean.

 

[JennyCoulon]

Thanks for your responses. I checked the CF center to see what they suggest again. They want him to take 20 mg of Zyrtec rather than the 10 mg he has been taking. They also want him to bump up doing his Flonase noise spray to 2 sprays per nostril 2 times daily. I also did make an appointment with a very good pulmonologist, internal med doctor that my niece saw for the same issues years ago and she hasnt had a problem since. The problem with her being so good is she is now scheduling for the emd of October. He has been doing the Nedi-pot woth the regular solution in the morning, at night and before his soccer practices and games. I wondered about using salt, have you found there is an extra benefit using that rather than the rinse packets? Thanks

 

[LittleLab4CF]

A lot depends on how much dried up mucus is produced each day. Times I have been fighting an infection might take an eye watering potion. Daily maintenance with a tepid salt solution disolves salty mucus, and kills pathogens on contact. It also toughens the mucusal lining. That is my experience, and it is common advice.

 

[ymikhale]

I tried to use hypertonic nasal wash, but our CF doctor warned that it might irritate the nose and make things worse. Go figure.

 

[LittleLab4CF]

From everything you have said, everything is pointing at allergies. An easy naturpathic method of desensitizing a peron's allergies is through the purchase of local honey, purpose grown around the worst local plants, allergy speaking. Heathfood stores carry them everywhere I have been. As for the allergy patch test, now you have clarified this as a seasonal allergy effect, I especially recommend having one done.

Maybe you have been through the process yourself with less than stellar results. I went through the patch test as a teen and reacted to nearly every catagory of alergen. My doctor suggested what would be years of shots and I suggested that I'll deal with my own problems. The flip side of this came when some mold/dust was causing life threatening reactions at home and work. Hoping the treatment of allergies had advanced in the twenty years since my last experience with an allergy specialist, I went in for an evaluation. It really has advanced a great deal. Molds are still a problem to desensitize but nearly everything seasonal has an effective and short term treatment.

This is a personal bias but I don't like antihistamines. More to the point, they don't like me. Benadryl and the like put me dead to sleep, "drowsy" is an understatement for me. Conversely the non-drowsy formulas hit me like a dose of meth. I have never had meth but a prescription that will remain nameless nearly agitated me to violence, over a donut! In years that I was really suffering, I took and became adjusted to a non-drowsy prescription antihistamine.

I guess, knowing that Zyrtec will help with his misery is worth the trade off. I am not up on pediatric treatment of allergies so a lot is based on second hand results. We all grow out of most allergies. The people who have really bad allergies, like your kid, don't seem to grow out of them and sooner or later have to see an allergist. Maybe now is a good time? Any and all nasal sprays will begin to loose effectiveness, it may take more and more antihistamine to treat allergies and then where are you? This is just a potential outcome, the die isn't cast, but as you say, this isn't necessarily a CF issue.

Hope things continue to improve,


LL

 

[ymikhale]

Thanks for your post LL! I am rushing to buy Paris honey right now. DO you have an idea how long it takes to see some improvement?

 

[LittleLab4CF]

Sorry, it depends on a lot of variables. I noticed significant improvement after a couple months. My neighbor's 4yr old took a month but this was a big improvement especially for my neighbor's child.

Various claims are made on local "allergy honey". Some say to expect much slower improvement, as in several months. What's to lose? It's honey!

LL

 

[ymikhale]

thanks LL, just wanted to get an idea. I like to try different things but i like to know at what point i need to ask myself questions whether it is working or not. Of course honey is not a med, as you rightly noticed, but with a 5 y/o it is more difficult to commit to taking something for a long time on daily basis if there are no results.

 

[LittleLab4CF]

It used to take years of allergy shots to do this so honey filled with local allergins is considerably better. I too am skeptical of anecdotal information that has way too much promise. A big reason I went for a patch test a few years ago was a bad summer of allergies. We had xeroscaped the yard and had a thick layer of fresh cedar chips. Cedar chests are great killers of bugs and I seemed to be a bug that summer. Turns out it wasn't cedar terpinoids but good old mold. I had extracted the VOCs and such from some of the cedar and brought it to their lab with a few other goodies to modify for a test spot or two, so as I did, you can bring suspect flowers, bath mold swabs, and such. Allery shots are well tuned to do their job in a month on average. This is according to NJH's Asthma and allery center.

I opted for the local honey. Honestly, allergy treatment is about as variable as people. A test with honey for a month, will tell you some things. There will be a measurable change at a month of taking it. At that time you should have an idea how adaptive your child will be to allergy treatment, natural or medical.

As I understand the honey, it works like the shots by exposing the body to allergens. Oral ingestion generally doesn't raise a histamine reaction, like the shots the body gets accustomed to the allergens and there ends the allergy, for life. Honey worked best when I had begun the next allergy season. I wasn't religious taking it through the winter but it landed on my toast a few times a week.

Honey is a little intense for me these days though I was a honey bear as a kid. I haven't had allergy honey or a need for it since that period. There is only so small a jar of honey and once it is purchased.....

Honey doesn't have to be forever,

LL

 

[ymikhale]

thanks LL for all the detailed info. I am in the city and my dd's allergies do not seem seasonal, but since she came back from vacation at her granparents'place, which is in the country side, things got much worse, so I am pretty sure at least part of it has to be the pollution. I pray that honey works (she takes it religiously even though she does not like the taste), her doctors don't prescribe allergy meds unless it is seasonal, she took some antihistamine for months with zero results.

 

[SoyaSauce]

Instead of using just a neti pot or simple sinus pot rinse, I used a sinus rinse machine, I have found it to be very effective in keeping my sinuses clear when done constant basis, whereas the net pot the solution just sits in the nose and ears. The sinus rinse machine pulses through the sinus and doesn't drip into your ears and drains faster rate.

 

[LittleLab4CF]

SoyaSause,

That brings back a memory. A pulsing sinus rinse (machine) was just hitting the market when I was prescribed a Water Pik attachment. Can you share the product information? BTW in spite of the pulse effect of Water Pik, the attachment for sinus rinse has no pulse effect, just a slow even fill.

LL

 

[LittleLab4CF]

Considering the polution you are speaking of is Paris, I tend to agree. This type of allergen, particulates like soot will wash out with rinsing. Paris is large and ancient everytime I have been there, allergies hit me hard. Urban allergens that evade sinus rinse can be chemical polutants, and gasses like ozone. For a virtually paved landscape, Paris seems to have lots of plant and animal life so part of DD's allergies will be in the honey.

Is it the tase of the honey or is it just intense? I used to down honey straight from a spoon, tne last time I tried that I was trying to end some hiccups, yuk! Let's see, honey on ice cream, honey in a smoothie,on toast, glase on cookies or salmon if you like to grill. Honey mustard for a meat lunch sandwich or honey and peanut butter sandwich.

Considering a significant amount of dd's life is in a place packed with more potential allergies than many cities. I might be a good idea to see an allergist. Many people grow out of allergies, optomistic as this is, with CF it may save years of suffering if she can be helped

 

[ymikhale]

Thanks LL for the info and the message of optimism. I do rinse my dd's nose and she has a CPT therapist who comes by daily and does it really well too, but so far there has been no relief. I did take her to do allergy tests, they showed mild sensitivity to dustmites (is it the right word), but nothing else. Maybe I should ask for an expanded test of some kind that covers other stuff (she was tested for respiratory allergens like dogs, cats, pollen trees etc)? In terms of honey, the taste is not that big deal, she like a certain kind of honey but no the PAris one, not sure why. But I igive it to her as a vitamins and she accepts it so far. I started with 1 bug teaspoon a day. Do you think it is enough?thanks

 

[LittleLab4CF]

It looks like you are doing all of the right things as much as I realize that may not be great news considering the goal is to figure what to do next. Dust mites is right and their waste is a common allery, easily treated. Chances are good you are keeping DD's environment fairly allergen free but you may be onto something. You describe a difference in allergy symptoms when she has gone away for a while and returned. It seems to confirm she has allergies but this is an important distinction to solidify. Does she have a bad allergy causing this drainage or is the cause something else? A histamine response includes other symptoms such as watery, itchy eyes and itchy skin and should be present to some degree with an allergy. Zyrtec does a particularly good job masking these symptoms compared to the nasal mucosa so you need to think through what you have observed in her to say this is or is not allergy.

It is possible the constant sinus draining is a difficult CF issue or or possibly a chronic sinus infection, maybe hidden from detection, shown only in sinus drainage. I don't remember being particularly allergic when I was a kid but I thought gulping mucus was what everybody did.

If she is improved with Zyrtec and Flonase spray, chances are good this is an allergy. It might be good to find an allergy specialist or clinic that routinely scans for a broad range of non seasonal allergens. National Jewish Health (NJH) in Colorado is a world leader in respiratory treatment and was where I most recently investigated testing and treatment for allergies. It's also where many CFers go including myself.

Anyway the testing is expanded well into groups of urban allergens like diesel components, fuel oil combustion components, inscecticides, food additves, soaps, detergents and lotions just for openers. Before your heart sinks at the idea of so many tests, it can be done surprisingly fast. If there is a strong allergic reaction going on, the allergen can be isolated and DD can be desensitized. As I may have mentioned, molds are hard to treat so either exhauts them first or last. She actually has been scanned for most molds in her skin test already so I am guessing an expanded test will result in a solution. Urban pets make for some surprising neighbors.

As for a teaspoon daily for allergy honey, that is just right.

LL

 

[ymikhale]

hi LL, you got it exactly right: i have done everything i could think of to improve her environment, this has been going on for a few years now and gradually getting worse. We tried different sprays and anti histamines but got no improvement. The doctor told us that it might or might not work. She does not have watery eyes, but sneezes often and sometimes has itchy skin. It is a kind of a blurr in terms of symptoms. I will ask what exactly she was tested for, not sure it is as extensive as i thought. Thanks for your input, we have an appointment next week, I will try to push them to tackle it: Colorado is a long way from Paris!