Ups and Downs of Allergic Rhinitis
Several years ago, my allergist at the time asked if I ever experienced nasal congestion. Now, I consider myself pretty on top of things, but that… Yeah, until she asked, I kind of didn’t really think about the fact that my nose was stuffed up all the time, or that it could have an impact on my asthma. It was one of those things that happened, I somehow got used to it, and didn’t really consider it again—especially because I don’t have much of anything in terms of allergies.
Fast forward a few years—my allergist had prescribed me a nasal steroid spray, and I used it for… awhile, I guess. Then, at some point three-ish years ago, my current asthma specialist (who is awesome. We’ll call her Dr. Smartypants because she’s super freaking smart, and also cool) decided “Hey let’s take a look at your sinuses.”
Dr. Smartypants then thought she spied a polyp or something in there, amongst all the other goo (what she said was more along the lines of “a lot of thick mucus”, but goo seems appropriate), and considered that it might be causing me some increased issues with my asthma. She referred me to an ENT (ear nose and throat specialist), and I saw him about six months later (you know, after Googling him and finding videos he and his colleagues made while in med school… Legitimately best doctor Google EVER). In the meantime, I started up on (probably less than continuously) saline rinses—which I hate—and nasal steroids again.
My ENT appointment was pretty uneventful—I saw the resident first, who scoped my sinuses and throat to see my vocal cords (vocal cord dysfunction is often something that either mimics or coexists with asthma, and causes issues breathing—as far as I know, my vocal cords are just fine). I was kind of dreading the scope, but it wasn’t as bad as I thought it would be, even though I have a super-sensitive gag reflex (the resident did say that the week prior he’d had someone throw up on him… So, I’m glad I didn’t engage in that activity!). The scope is simply a small plastic tube that they slide in through your nose and take a look around and then snake it into your throat and ask you to say “hello” to see how your vocal cords work. The attending doctor came in, and said “So, you have bad asthma,” I kind of shrugged—what do you say to that? “I guess?”
The resident had taken a video of the scope (at my request, because I wanted to see it! Also I was his learning experience for the day since he had to learn to use that feature!) so instead of getting scoped again, we just watched the video. While I, once again, had a bunch of mucus-y crud in my nose, everything else checked out fine—not much inflammation, no polyps.
The verdict was that my sinus issues were not likely making my asthma worse. I didn’t have to return to ENT but if I needed to, I could just call, and I could continue on the nasal steroids and saline rinses as needed. Or at least that’s what I interpreted it as being—and Dr. Smartypants who referred me didn’t seem to disagree, and that lady is on top of her consult notes.
Here we are a couple years later–the late Spring when my asthma control started to deteriorate, I bumped up my meds like I do, and go on with my life. Then the night before my appointment with my asthma specialist, I realized—duh, I could maybe start the Nasonex again (and probably not using the stuff that expired in 2012!). When I saw Dr. Smartypants the next day, she agreed with my plan, and prescribed me a fresh run of Nasonex (with a less negotiable sounding dose than my previous adventure). We agreed that we weren’t too optimistic that it would help my lungs much, but, I guess my sinuses could do with some attention every once in awhile! I’ve been taking it again for a week now, and while I find that it definitely works quickly, as anticipated, my asthma is about the same as it was.
Even when stuffed up, though, my sinuses don’t usually bother me enough to demand my attention. My symptoms are pretty mild, and primarily limited to my nose. It’s kind of a problem that it’s not a problem, as I don’t respond to increased nasal congestion when it pops up. Since we’ve determined the effect of my sinuses on my asthma is questionable, I’m fortunate that this isn’t a huge deal for me—although, the catch-22, is that if it did make my asthma worse, or if I had other allergy symptoms, I’d be more motivated to deal with it!
Do you have sinus issues caused by allergic rhinitis along with your asthma? Do you find that keeping these issues in check helps with your asthma control, or—like me—is it here-nor-there for you?