Hello - I Am A 69 Yo Male. Generally Healthy.

Posted on Sun, 31 Mar 2019

Question: Hello - I am a 69 yo male. Generally healthy. RARELY get a cold and no flu in 15 years. After VERY warm December, in January & February VERY cold here. This sinus issue started about XXXXXXX 1 when weather changed. I have had for 2 months now "inflamed" sinuses and drainage. Not like a cold and not blowing my nose much as with a cold. I have a history of vasomotor and allergic rhinitis, (mold & dust mite allergy) and post nasal drip, but this is worse. No cold, and no infection. Lungs & bronchials are "clear" on auscultation with stethoscope by the doctor. CT sinus scan showed no congestion, just inflammation of sinuses. No other symptoms but mucous discharge, not coughing much. Early in morning after getting up I cough out clear or very pale green mucous after some warm water, and it is gone by 45-60 minutes. No coughing or problems during the day and no sinus pressure or tenderness. Chest X-Ray = 100% normal. No other symptoms but off & on hoarseness from throat clearing. I can't take decongestants or Flonase like "steroid nasal sprays" due to glaucoma. Doctors said use netti pot/saline spray, steam, expectorant, push water, humidify the air, etc. I am doing those things.

They say I have to "wait it out." It's getting frustrating. Anything you can offer that I can do that might be of some help additionally, or to have my doctor check out would be greatly appreciated. - Thanks, XXXXXXX

Answered by Dr. Dr. Rajat Basak (1 hour later)

Brief Answer:
It seems allergic rhinosinusitis

Detailed Answer:
Hello and welcome to Ask A Doctor service.

It's evident from your symptoms that you are having allergic rhinosinusitis. Continue fluticasone nasal spray. Take steam inhalation after nasal spray with karbol plus capsule. Take antiallergic tablet montelukast levocetrizine at bedtime. Along with fluticasone you can take solsprey nasal spray. These medications will decrease your inflammation but your allergy won't be eradicated. So you have to increase your immunity. Do nasal breathing exercises. You can start some yoga or moderate exercise. Lead healthy lifestyle. Wash bedsheets,curtains thrice weekly. Stay away from allergens. Drink plenty of water.

Please review if you have any queries.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Rajat Basak (11 hours later)

Dr. Basak,

You did not read my letter carefully. I CANNOT take Flonase or any other steroid nasal spray due to my glaucoma. I have had my eye specialist and two other doctors tell me that! I know that I have allergies and have an antihistamine I can take. I am already steaming and drinking plenty of water, as I told you.

You gave me no new information and prescribed for me things that are contraindicated for me given my pre-existing medical conditions which I detailed to you. I am sorry to have wasted your time and mine also apparently.

Answered by Dr. Dr. Rajat Basak (42 minutes later)

Brief Answer:
Hii. There are no options other than nasal spray in allergic rhinitis. You

Detailed Answer:
Hii. There are no options other than nasal spray in allergic rhinitis. You might have overlooked the last part of my paragraph. It was written that you have to increase your immunity to avoid allergy. I had also written about the measures to increase your immunity and to avoid allergens.
Flonase is not contraindicated absolutely in glaucoma patients. Studies have shown that majority of patients of glaucoma has used flonase without increase of ocular pressure but in a certain group of patients the ocular pressure has increased. So either you follow the preventive measures or you monitor your ocular pressure in first few week after using flonase spray and plan accordingly.

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Prasad