Brief Answer:
Need more information

Detailed Answer:
Hello,
Thank you for your query.
I'm Dr. Shuba Hariprasad and will be answering your query today.

I would like some clarifications from your to help you better:
- how old are you?
- what exactly are your symptoms?
- how frequently do they occur and how long do they last?
- do you have any other allergies? (other than dust)
- what tests/scans have you done so far? And what are the results? (blood tests, consultations and scans/x-rays)
-Have you been told that you have a deviated nasal septum?
- are you pregnant or planning for one in the near future?
- do you have any other medical issues or take any medications?
-does anyone In your family have any allergies or anything similar to what you experience?
-where do you live? Describe your environment?
-do you have air conditioning? Any water leakage /seepage in your home?

Cetrizine has not shown harmful effects in pregnancy but enough controlled studies have not been done in pregnant people.
Personally I would advice against using any medications in pregnancy unless it is more beneficial and absolutely necessary as side effects will be there and is not known if it is harmful or not.

I would like to hear back from you with the above requested clarifications so that I may assist you more appropriately.

Wish you good health
Regards,
Dr. Shuba Hariprasad

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Brief Answer:
please see below for details

Detailed Answer:
Hello,
Thank you for the follow up and clarifications

I am sorry that I couldn't answer earlier.

To answer your earlier questions first :

- Antihistamines are generally not safe to take during the first trimester of pregnancy (this is when the organ development in the baby occurs) due to risk of developing malformations.
If absolutely necessary, the older antihistamine (first generation- such as chlorpheniramine and hydroxizine is recommended). These cause more sedation than the newer ones (cetirizine) but have lesser risk for malformations in the baby.
IT is also vital to stay well hydrated while taking these medications, especially while pregnant.
Once the first trimester is over, cetirizine and desloratidine are considered safe and have fewer side effects for the mother.

- Surgery for maxillary sinusitis would depend on whether there is a physical obstruction to the opening of this sinus into your nose.

A few more queries-
- Did your symptoms start all of a sudden 5 years ago? were there any major events during that time? like changing a house or moving across states, travel, changes in food?

- How does it affect your eyes? watering? itching? redness? Does it start with your eyes and then progress to sneezing ? or both simultaneously?

- do you wear glasses? if so, what is your power?

- how frequently do you have these symptoms ? (once a month, for instance?)
Does it occur more during the cold weather or rainy season? or more during the summer?

- is the CBC (complete blood count) the only test you have done?

- any fever during these times? how long do these episodes last and how do they go away (antihistamines only, or antibiotics )
- are the secretions that occur during this time watery or thick? what colour is it? any throat irritation or bad taste in the mouth during this time?
do these episodes occur more in the mornings?

- Do you work? what is your occupation?

I recommend:
- an ENT (ear/nose/throat)specialist consult to check for deviated nasal septum.
- a CT scan of the facial bones and sinuses to check for any structural abnormalities of the sinuses
- monitor trigger factors (pollen,dust mites, spores, cobwebs, dust, weather changes, strong odors, even bright light). Maintain a diary to check for possible triggers.
- steam inhalations thrice a day (dry mucosa in your nose and throat can trigger allergies)
- plenty of water.


If there is no structural abnormality, the plan would be to avoid all trigger factors or desensitize you to certain allergens (substances that trigger the allergy). The latter can be done in case of pollen, food allergies but are not effective in case of dust.

Other possible triggers can be checked by an allergy test, which includes a series of small pricks containing the allergen, on your forearm. If you are allergic to any of those, there are injections you can take over a few months (once a week or so) that can help you over come those allergies.
For this you would need to see an allergy specialist after you have consulted an ENT specialist as suggested above.

If there is a structural abnormality, it is possible to surgically correct it. please note that surgery does not treat an allergy but can relieve any obstruction that is causing secretions to collect in your sinuses that result in inflammation/infection (sinusitis).

It is very important to maintain a diary monitoring your symptoms, when it occured, what you did that day, what you ate? everything !!! this will go a long way to help with the treatment.

I had a patient a couple of years ago with year round allergic rhinitis and frequent infections. she couldn't tolerate antibiotics too often. however, she went on to seek homeopathic treatment along with allopathic medications for severe symptoms.
She called with a clear nose a month later and said that for the forst time in years , she found relief. she still does have allergies but once or twice a year with manageable symptoms. she didn't experience any side effects either.

Hope I've answered your queries and have been of help.

Please let me know if there is anything else I can help you with.
Wish you good health

Regards,
Dr.Shuba Hariprasad

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