Winter Nosebleeds (Epistaxis)

Murray Grossan, MD.  About the author: Dr. Grossan is an otolaryngologist and head and neck surgeon with the Tower Ear, Nose and Throat Clinic at Cedars-Sinai Medical Center in Los  Angeles and the founder of the Web based Grossan Sinus & Health Institute (http://www.grossaninstitute.com). He is author of Free Yourself from Sinus and Allergy  Problems Permanently.

Winter is coming with nasal dryness and bloody noses. Let’s avoid them this year.

People live in the desert and don’t get dry nose and epistaxis (nosebleed) Why do we get them in Wisconsin? Chicago?

Because in the desert the body is adapted to the dry condition, just as we adapt to humid conditions.

But in Chicago we have extreme changes of temperature, plus rapid changes from very cold to very hot and dry. The poor nose can’t keep up.

If you do get a nosebleed, here are some suggestions that I give to my patients:

How to stop a nose bleed.

1. A Don’t panic. The more the panic the higher the blood pressure the more the bleeding.
2. B Forget about the dress, its already bloody and anxiety and trying to keep further blood from it raises the blood pressure and more bleeding
3. C Apply outer pressure from the outside. Use your finger to press the soft part of your nose to the midline.
4. Ice to lip, and back of neck is good. Sit up.
5. Pressure from the inside is good – gauze, tissue, applied inside and slight pressure from the outside helps
6. If you have nose drops such as Neosynephrine or Afrin, put this on cotton and apply it into the nose over where you think the bleeding is coming from
7. Stay calm. Stay off the phone. Anyone you call will tell you horror stories about their Aunt’s terrible nose bleed and make you nervous.
8. Sitting up is better than lying down. If you lay down you raise the pressure to the nose.
9. If bleeding persists, go to the ER.
10. If bleeding is controlled, stay quiet all day. Don’t go skateboarding.

Remember it is very rare for anyone to bleed to death from a nosebleed.  Neither I nor my 4 associates have had such a case, though we have had hundreds of bad nosebleeds.

To prevent nosebleeds, in winter keep a pan of water in the room. Have plants in the room that take a lot of water. If you are traveling, hang wet towels in the bedroom.

NeilMed NasoGel is useful. This introduces a product that moisturizes at two levels – the nasal level and the cellular level. This special moisture allows natural products that defend the body against dryness and infection to come to your aid. Comes in two variations, drip free gel spray and gel tube.  It is over the counter, no prescription is needed.

It is water soluble, so no problem with it lodging permanently in the lungs like water insoluble products.

If you are susceptible to nosebleeds, regular use of the gel twice a day helps prevents epistaxis. Recommended to use after the bleeding has stopped.

Bactroban ointment is primarily an antibiotic that requires a prescription and doesn’t have a nasal tip, so there is waste. Helps clear up infections associated with nosebleeds and may be prescribed by your doctor after the bleeding has stopped.

Neosporin ointment is also useful, but more persons are showing sensitivity to this product, and it is not designed for nasal use.

NeilMed NasoGel is specifically designed for nasal use.

In addition to Winter Dryness there are dozens of other causes of epistaxis that physicians must consider. These include hypertension, effects of drugs and herbs – including Ginko Biloba.

Persons on Coumadin and other blood thinners should be diligent about keeping the bedroom moist and the nose moist too. Stick to pans of water or plants with lots of water rather than a vaporizor.  Vaporizer may moisten the air too much and bring on an increase in mites as well as destroy the wallpaper.

Vitamin C and bioflavinoids all help strengthen the blood vessels as does Rutin.

Nosebleed with sinus infection may speak for a certain kind of bacteria that requires an antibiotic or just may be from the nose being so raw.

Recreational nasal drugs significantly cause nosebleeds. Cocaine will cause the blood vessels to clamp shut, cuts off circulation and leads to ulceration and nasal bleeding.

Certain industrial products lead to thinning of the membranes and subsequent epistaxis.  Various paint solvents and thinners are some of these. Skydrol is one I am familiar with because it is used as a solvent inside of airplanes during manufacture. If you experience burning when exposed to chemicals, consider washing the nose by lavage after exposure to remove the products.

Use of the various Cortisone sprays – Nasarel, Flonase, etc over time may cause thinning of the membranes and lead to epistaxis. I have my patients alternate with the Breathe.ease XL Nasal Moisturizer gel to “restore” the membranes so they can continue with the spray that works for them.

What if you have seen the doctor, been treated and still are having nose bleed? Probably you need an antibiotic to clear the infection that is usually associated with a nasal bleeding.  But also check: are you taking an herb that leads to bleeding like Gincko Biloba or Ephedra?

In one of my difficult epistaxis patients, I and my nurse had repeatedly asked him if he was taking ANY medication. Finally on the third visit his wife volunteered that he was taking Gingo! He shouted, “But that’s not a medicine, that’s an herb”

With extreme dryness, hard crusts may form that lead to nose picking and a resultant epistaxis. Copious use of Breathe.ease Nasal Spray helps clear this up – this liquid not only softens the crusts, but helps restore the cilia that defend the nose.

Allergy does not cause nose bleed unless you blow your nose too hard.

Winter or summer, certain medications can lead to nosebleed – such as aspirin products.  Some antihistamines can dry the nose excessively and there are numerous drugs for heart and other conditions that have a nasal drying effect.  Before stopping the medication, see if you can maintain moisture adequately, especially water in the bedroom.

There are still nosebleeds that require a doctor’s inspection and evaluation so if these simple measures don’t work, see your doctor.

There is an area called Hesselbach’s Triangle on the nasal septum, near the front, where blood vessels can expand and become fragile. If a single vessel is the culprit, the doctor may wish to anesthetize the area and then cauterize it with an acid or electric current.  Since it is anesthetized, it won’t hurt.

The important thing is to rest, relax and help your poor nose to heal.

For more information, visit:
www.grossaninstitute.com
www.ent-consult.com

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Prevent Children’s Sinusitis

Murray Grossan, MD.  About the author: Dr. Grossan is an otolaryngologist and head and neck surgeon with the Tower Ear, Nose and Throat Clinic at Cedars-Sinai Medical Center in Los  Angeles and the founder of the Web based Grossan Sinus & Health Institute (http://www.grossaninstitute.com). He is author of Free Yourself from Sinus and Allergy  Problems Permanently.

The American Academy of Otolaryngology – (ear nose and throat) in conjunction with the American Academy of Allergy is urging parents to take steps to prevent their kids from growing up with chronic sinusitis.  Children are born with sinus cavities and they can be infected at any age.

Often sinus problems start in childhood.  Number one cause may be the child blowing the nose too hard.

Parents are urged to teach their kids:

Blow the nose GENTLY or not at all. Heavy blowing spreads the bacteria to uninfected areas including the ears and irritates the delicate nasal membranes so they can’t function to protect against disease.

THE TWELVE RULES:

Here are 12 rules to teach the kids to avoid them growing up as a sinus patient – rules from the Tower ENT Group at Cedar Sinai Medical in Los Angeles.

1. If you see a green drainage from one side of the nose only, think of a foreign body – a raisin or a nut. Best to have this removed by an ENT specialist.
2. Insist your child blow his / her nose GENTLY
3. Follow your doctor’s instructions regarding medications. Never stop the antibiotic before the recommended dose. This is how we develop drug resistant bacteria.
4. Make sure your child is up on his immunizations.
5. Try to avoid the child getting chilled.
6. Don’t overheat the bedrooms.
7. Child’s bedroom should preferably be as bare as possible. No moth flakes, insecticides, or dust makers. Any rugs should be washable every six weeks.
8. Pets should be kept out of the bedroom as well as out of the bed.
9. Moisturize the bedroom in cold or dry weather. Best method is to use pans of water for evaporation.
10. Avoid nasal sprays with Benzalkonium or Thimerosal as these may irritate the nose.
11. Avoid smoking in the child’s presence
12. If there is considerable dust, use a Hepa filter. Do not use an ionizer or a deodorizer.

KEEP MOISTURE BELOW 50%

There are some common sense steps to prevent a life of sinus misery for your child.  It is very important to keep the moisture at no more than 50%.  If the moisture goes above 50% this encourages mold growth. Check for leaks that may grow mold. A regular light bulb turned on in a damp closet or basement is a mold deterrent.

COLORED DISCHARGE

Colored discharge from one nostril only suggests a foreign body. Needs to be removed.

Yellow green drainage that persists for more than a week suggests a sinus infection. Three of these episodes / year suggest a chronic sinus infection.

If your very young child has a persistent nasal / sinus infection, ask your doctor about performing Proetz sinus irrigation. This is an inexpensive treatment parents can do at home. Here the child is placed with his head lowered and dilute nose drops are placed in one nostril and suctioned from the other with a simple nasal aspirator till all the colored pus is removed.  Complete directions at NeilMed Pharmaceuticals.

For the child 5 or older who has persistent sinus drainage, ask your doctor about using pulsatile irrigation to remove the pus and thick mucus to allow the natural healing to take place.  Units such as the Hydro Pulse Nasal / Sinus Irrigator and NeilMed Sinugator are gentle enough for kids to use age 5 or older, and most kids (and adults) appreciate the relief they get.  Because the pressure is regulated exactly right, it is much safer than sniffing from the hand or syringes where the pressure can be too high.

IS IT ALLERGY?

Is it allergy? It is very important to follow your pediatrician’s instructions regarding the age at which foods are started. This helps avoid allergies. Your doctor’s advice re breast feeding is also an allergy preventer.

If your child is sneezing, eyes look puffy, but he is free of fever or fatigue, note the date on your calendar. Often you can tell what the allergy is due to by using the pollen calendars available on the net such as at www.pollen.com

Often the allergic child has what we call the Allergic Salute – the back of the hand and sleeve is continuously wiping the nose with a wide motion.

Your doctor may recommend one of the cortisone sprays. At this time these nasal sprays have been in use for decades. Or doctor may recommend one of the allergy medication sprays. Today there are sprays that combine a cortisone with an allergy medication.  Of course, any medication is best not taken if it isn’t necessary.

MORNING SNEEZING

Morning sneezing and hacking? Usually this is an effort of the allergic child to get warm. Prevent this by having warm drink in bed before getting out of bed. Usually a thermos does well.  Avoid stepping on an icy cold floor – that sudden temperature change causes sneezing.

By having that warm drink – breakfast in bed – often the full day of sneezing may be avoided.

If the child has asthma, it is even more critical to prevent and clear sinus problems.

THE ADENOIDS

Does your child have sinusitis or enlarged adenoids?  Adenoids are the tonsil- like tissue in back of the nose. With sinus infection they may enlarge and block nasal breathing. Or they may enlarge on their own usually accompanied by enlarged tonsils. Before you rush to have surgery for this condition, ask your doctor about measures to shrink the adenoids.  Clearing a sinus condition is the first step in getting adenoids back to normal size. Other methods include anti-inflammatory medications, often combined with antibiotics.

Using the Proetz sinus irrigation method to be sure to clear any sinus infection can be effective in clearing an enlarged adenoid.

You don’t need an X ray to determine if adenoids are a problem: the child snore, gets ear infections, is cranky, tired, has bad breath. Occasionally they are poor eaters.

In a recent report, some of the children diagnosed with attention deficit syndrome, were totally normal after adenoid surgery cleared their mouth breathing.

Your doctor may recommend fruit enzymes for sinus-adenoid problem.  Papain from papaya or Bromelain from pineapple, such as the product Clear ease™. These are called proteolytic enzymes because they reduce swollen tissue and thin the mucus.

One reason the Allergy and ENT groups want to call attention to sinus and other childhood ailments is so that the parents can appreciate that a child who is constantly mouth breathing and is snoring,  is not a healthy child.  He / she may not sleep well, have bad breath, and be constantly fatigued, cranky, or run down. Such a child deserves care so they can grow up and not be one of the 35 million persons who now have sinusitis.

Despite the daily barrage of advertisements, the best thing for your child’s cold is still chicken soup, tea with lemon – honey, and bed rest.  For best information, consult your doctor.

For more information, visit:
www.grossaninstitute.com
www.ent-consult.com

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How Humming Helps Sinus and Allergy

Murray Grossan, MD.  About the author: Dr. Grossan is an otolaryngologist and head and neck surgeon with the Tower Ear, Nose and Throat Clinic at Cedars-Sinai Medical Center in Los  Angeles and the founder of the Web based Grossan Sinus & Health Institute (http://www.grossaninstitute.com). He is author of Free Yourself from Sinus and Allergy  Problems Permanently.

Nasal Cilia

In your nose you have tiny cilia, which are like oars. In health they beat in harmony, in synchrony. When a bacteria or dust particle enters the nose nasal cilia propel the particle to the back of the nose; there it is swallowed and disposed of by the stomach acid.  Then the bacteria don’t remain in place long enough to multiply and cause disease

Sinus Symptoms

Sinus symptoms are caused by lazy nasal cilia.  In postnasal drip, the cilia move slowly. This allows the mucus to thicken and grow bacteria.  Hence the gloppy feel and the odor, and the constant hawking.  If the cilia move too slowly, then bacteria remain in place and multiply and you get a sinus infection. This is why it is so important to get the bacteria out of the nose and sinuses.  You get sinus pain when bacteria multiply within the sinus cavity and cause pressure.

Why do cilia slow down? Are you stuck behind a diesel bus? Smog in the air? Do you work where odors and dusts harm the cilia? For example, persons exposed to chromium dusts get many of these symptoms.

Allergy followed by Sinus Infection

Allergies contribute too, but in a roundabout fashion. Initially, in allergy, the cilia speed up. Here the nose drips and there is excessive sneezing-which blows out the pollen. But, after several weeks of symptoms, the cilia are exhausted and then bacteria remain in place and multiply.

If you think of the movements of the nasal cilia like the movement of the guitar strings, that is what you need to do to restore nasal cilia- strum the guitar.

Humming is Healthy

Hum! When you hum you set up a vibration in the air. That vibration does several things. It vibrates the mucus layer and breaks up the thick bonds so that the mucus is thinner and more liquid. The thinner liquid allows for better cilia movement.  This is why drinking lots of lemon/ lime helps. This in itself allows better movement of the cilia.

Humming also vibrates the cilia. Know how your fingers tingle when you touch a piano at a certain note or chord? Recall how soldiers marching across a wooden bridge in perfect step can set up a vibration that causes a bridge to vibrate too? That is the kind of action you can get from humming.

However, you need to get the right tone. Usually the lower into base you go, the better. If you put your fingers on your cheek, that can tell you when you reach the right pitch by the vibration sense.  The more you feel the vibration, the greater the benefit to your cilia movement.  This is why the yoga masters do “ooooommmm.”

Pulsatile Irrigation

Indra Devi, the Yoga Master, demonstrated to me an effective method of getting proper cilia movement.  They alternately sniff saline in and out the nose in a rhythm that is ideal for activating the nasal cilia. This explains why she and her followers were sinus free.

The pulsatile irrigator is a mechanical way to follow the Indra Devi method. This device gently sends a stream through the nose and sinuses at a pulse rate to stimulate nasal cilia. At the same time the pulse rate also removes the stale mucus and massages the nasal tissue in order to bring better circulation to the area.  This massage brings in natural healing elements

If you are stuck behind a diesel bus and inhale the fumes, your cilia will be slowed.   Here nasal saline pulsation at the correct speed will restore the correct cilia rhythm.  Just as you need to pluck the guitar string gently to get the correct tone, a pulsating irrigator such as the NeilMed Sinugator or Hydro Pulse™ Nasal/Sinus Irrigator is designed to deliver the correct pressure. The correct pressure is needed so that you don’t force material into your ears, as you might do where the pressure in unregulated.

Sinus Surgery that Fails

No matter what the sinus pathology, it is always best to restore cilia movement before performing sinus surgery.  Normal cilia movement drains the sinuses, therefore restoring cilia should correct the sinus pathology. . This is why in my five- person surgery group we always try pulsatile saline irrigation to restore cilia function before recommending surgery.

We have learned that even after the best sinus surgery, it takes time for the good cilia harmony to return. You need to restore that cilia movement as soon as possible after any nasal /sinus surgery. That way, you avoid the need for antibiotics after sinus surgery.

Additional aids for sinus problems include tea, lemon and honey, and good sleep.  Green tea is best- with or without caffeine.   The goal for pulsatile saline irrigation, humming, tea, etc is to reduce the need for antibiotics.  Antibiotic abuse has resulted in bacteria developing resistance to those drugs.  Therefore, clearing the sinus infection without drugs is very important.  When you understand the rhythm of the nasal cilia you have a means of avoiding the need for antibiotics.

How is the weather?

Unfortunately we have had a wet spring and the allergists are predicting an increased amount of pollen this year.  Let’s avoid a sinus infection and sinus pain.

Since these methods work, why not try them, hmmmm?

Source: Free Yourself from Sinus and Allergy Problems- Permanently C 2010

For more information, visit:
www.grossaninstitute.com
www.ent-consult.com

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Snoring? The 10-cent and 50-cent cure

Murray Grossan, MD.  About the author: Dr. Grossan is an otolaryngologist and head and neck surgeon with the Tower Ear, Nose and Throat Clinic at Cedars-Sinai Medical Center in Los  Angeles and the founder of the Web based Grossan Sinus & Health Institute (http://www.grossaninstitute.com). He is author of Free Yourself from Sinus and Allergy  Problems Permanently.

Many people snore. The problem is that snoring that disturbs the partner, can develop into snoring that severely affects one’s health, such as Obstructive Sleep Apnea. (OSA) Obstructive sleep apnea is a condition in which the sleeper doesn’t get enough air. This means that for periods of time the nose or throat is blocked and the percentage of oxygen that gets to the brain is reduced. The partner may notice that for periods of time her husband has stopped breathing!

Why does obstructive sleep apnea occur? The word apnea means no air. A stands for not, and pnea stands for air. The causes vary. Sometimes the soft palate and uvula are enlarged and very heavy. When he sleeps on his back, the heavy soft palate falls back and blocks the airway.

A frequent cause originates from the nose; there may be blockage due to infection, growths in the nose called nasal polyps, allergy, or adenoid tissue, (located above the throat, behind the nose) that enlarges to block breathing. A common cause of snoring is enlarged tonsils. In kids, the tonsils and adenoids may be so large that the kid barely breathes in sleep, causing him to snore loudly, be tired and grumpy, and have bad breath. Obstructive sleep apnea is an advanced form of snoring that can develop from simple snoring.

Alice experienced snoring at age twenty-five that annoyed her roommate. It was a symptom of a sinus condition. She ignored the condition and took pills when it bothered her. However, because she didn’t get good sleep, she ate excessively to overcome her next day fatigue and gained weight.

As her weight increased, her throat tissues became heavier, as did the fat in her neck. Because of her eating before bed,  she developed acid reflux. This swelled her throat tissues and made her snoring worse. Eventually she developed obstructive sleep apnea and had to use a breathing machine to overcome her airway blockage at night.

Note the vicious cycle: because Alice was fatigued the next day, she ate excessively for energy. Because she ate excessively, the throat tissues grew heavy and blocked her breathing, so she was more fatigued and ate more, and the snoring became worse.

Fortunately, there are simple remedies: the ten-cent and the fifty-cent cure. For those whose snoring is caused by a drooping nose, which closes a valve of the nasal airway, if you raise the tip, that valve opens. Cut a three-inch piece of ½-inch medical grade tape, start under the nasal tip, elevate the tip, and then secure the tape on the bridge of the nose up to between the eyes. With the airway valve open, there is less or no snoring.

If you lie on your back, the tissues of the throat fall back and block the airway. If you sleep on your side, the tissues fall forward, and the air passages are opened. To sleep through the night on your side, secure a used tennis ball to the back of a T-shirt; when you sleep on your back, the ball will nudge you gently and you will turn onto your side, and stop snoring. This is the fifty-cent cure. There are some very expensive gadgets that signal you to turn to your side when you snore from lying on your back. Actually, I prefer the ball because it doesn’t disturb your sleep pattern, as some of the electronic ones do.

Nasal blockage often is caused by bacteria in the sinuses. Normally the nose contains millions of tiny hairs called cilia. In health, these cilia move in synchrony to move bacteria out of the nose, to the back of the throat, where they are swallowed. When the cilia fail, bacteria sit there and multiply, and this leads to chronic nasal congestion and blockage due to infection. To restore the good cilia movement, patients use pulse rate saline nasal/sinus irrigation. The pulse rate of the irrigator is designed to match the normal rate of cilia pulse movement; that frequency is ideal to restore normal cilia function and clear sinusitis and postnasal drip.

Swollen fatty throat tissue is corrected by using a throat attachment to the pulse irrigator, the Hydro Pulse™. It is designed to remove bacteria from the “holes” in the tonsils and to massage throat/tonsil tissue. By restoring good nasal airway and reducing puffy throat tissue, many people’s snoring is relieved. Making the throat muscles stronger keeps the tissue from blocking the airway. By repeating these throat exercises, the muscles become firm and strong, just as weight lifting does for flabby arms.

Throat Exercises

• Hold the tongue up against the hard palate. Say the vowel sounds- a, e, i, o, u. Place the tongue in front of the roof of the mouth. Then slide it all the way to the back of the roof of the mouth, repeat the vowels in various positions for three minutes.
• Press the tongue hard against the hard palate. Press frequently.
• Press the tip of the tongue into the spot just behind the upper incisor teeth while pushing the back of the tongue into the floor of the mouth. Now do this pushing on the lower incisors.
• Swallow keeping the tongue on the roof of the mouth.

Do these three minutes each. It takes time to build and strengthen muscles by exercise and the throat is no exception. As the snoring problem gets worse, symptoms of acid reflux appear.  Here too, you have a vicious circle. The more acid from the stomach that irritates the throat, the more snoring from swollen tissue occurs. Gasping for air in sleep because of nasal blockage is a factor because the gasping tends to push the stomach upwards.

To prevent the acid reflux problem, keep the head of the bed elevated. Don’t eat for three hours before bedtime; avoid excess spices. Avoid alcohol before bedtime.

To aid sleep, the bedroom should be dark. You should go to bed at a regular time, with a set routine that you repeat each night, so as to set your sleep clock. Losing weight is a definite way to cure snoring, but very hard to do when snoring is present, for the reasons discussed here.

Why is good sleep without snoring important? It is estimated that at least thirty percent of traffic and industrial accidents are related to poor sleep; she fell asleep while driving and drove over the cliff.

On the other hand, opening the nasal valve, using a ball to nudge you to sleep on your side, using pulsatile irrigation for the nose and throat, and doing the throat exercises are easy to do; and when started early, can be effective to assure a good night’s sleep for you and your partner.

For more information, visit:
www.grossaninstitute.com
www.ent-consult.com

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Is It a Cold, Flu, Allergies or Something Else?

Murray Grossan, MD.  About the author: Dr. Grossan is an otolaryngologist and head and neck surgeon with the Tower Ear, Nose and Throat Clinic at Cedars-Sinai Medical Center in Los  Angeles and the founder of the Web based Grossan Sinus & Health Institute (http://www.grossaninstitute.com). He is author of Free Yourself from Sinus and Allergy  Problems Permanently.

How to tell what it is and the best way to treat it:

Sniffling, sneezing and wiping your eyes? You might assume you have a cold…but not so fast! These symptoms also can come from the flu, allergies, something similar to an allergy, or even from something else entirely—sinusitis! Telling these five conditions apart can be tricky, even for doctors, but knowing the difference is the key to getting the most effective treatment.

COLDS

Colds can be caused by more than 100 different viruses. Your symptoms will depend on the specific virus you are infected with.

TELLTALE  SIGNS: In addition to common cold symptoms such as sneezing, a sore throat, congestion and/or a cough, you may also have a low-grade fever, mild body aches and aching, swollen sinuses. Symptoms usually last a week or two.

My favorite cold remedies: Get into bed and rest! Chicken soup, hot soups and decaffeinated green tea with lemon and honey may help, as chicken soup and green tea have anti-inflammatory properties that help fight infection. If you can, watch a funny movie. Some research shows that laughing promotes healing. If you need help sleeping, try 3 mg to 10 mg of Melatonin, an over the counter sleeping aid.

For an immune-boosting herbal cough syrup: Mix one-half teaspoon each of cayenne pepper and freshly grated gingerroot, two tablespoons each of honey and apple cider vinegar and four tablespoons of water. Take one teaspoon every few waking hours.

THE FLU

The flu will make you feel awful.

TELLTALE SIGNS: Symptoms can be the same as a cold, but you will have significant body aches and probably a fever. The flu also comes on more suddenly than a cold.

My advice: Get a flu shot once you have recovered, or in advance. If you still come down with the flu, stay home for at least 24 hours after any fever is gone so you will not spread the virus. Adults over age 65 and those with any chronic health problem should take an anti viral drug such as oseltamivir (Tamiflu) to avoid flu complications including pneumonia. Anti-virals work best if taken within 48 hours of starting to feel sick.

ALLERGIES

Allergic rhinitis (nasal allergy) is caused by a hypersensitive immune system that identifies an otherwise innocuous substance as harmful and attacks it, causing uncomfortable symptoms.

TELLTALE  SIGNS: Nasal allergies can cause symptoms nearly indistinguishable from a cold—congestion, sneezing, red and runny eyes, scratchy throat, etc.—but allergies do not cause the mild fever or achiness of a cold. With seasonal allergies, you get symptoms from exposure to pollen (trees in spring, grass in summer and weeds in fall). Allergies to pet dander, dust, etc., tend to occur year-round.

Helpful: Use a diary to track your symptoms and the times they occur. It will help you distinguish allergies from other conditions.

My advice: Steroid sprays such as fluticasone propionate (Flonase) and azelastine (Astelin) work for most people with less risk for side effects than antihistamine pills. Avoid strong odors and spicy foods, which can worsen nasal allergies.

NONALLERGIC RHINITIS (Vasomotor Rhinitis)

This condition causes virtually the same symptoms as allergies, but is not a true allergy that involves the immune system. Non-allergic rhinitis is triggered by specific irritants such as certain odors, smoke and exhaust— or even changes in the weather.

TELLTALE SIGNS: With nonallergic rhinitis, standard allergy medications fail to relieve symptoms, and allergy tests are negative. Postnasal drip (an irritating flow of mucus down the back of the throat) tends to be worse with nonallergic rhinitis than with seasonal allergies.

My advice: Avoid irritants that you are sensitive to and consider using the prescription drug Ipratropium Bromide (Atrovent), an inhaled nasal spray that helps relax and open air passages. This drug can cause side effects including dizziness, so use it only when needed and at the lowest dose possible.

SINUSITIS

Sinusitis is tough to diagnose because it often occurs in conjunction with colds and allergies because of excess mucus from congestion providing an optimal breeding ground for bacteria and viruses.

TELLTALE SIGNS: Congestion accompanied by tenderness and a feeling of pressure around the eyes, cheeks or forehead. In addition, when you blow your nose, the mucus will usually have a yellow or greenish color. Fever may be present as well. Symptoms can last for several weeks (acute) or even longer (chronic).

My advice: Prescription nasal sprays such as TK  help open the airways. Acetaminophen (Tylenol) or naproxen (Aleve) work for sinus pain. Bromelain (from pineapple) and papain (from papaya) also help reduce pain. Antibiotics are not always needed for acute sinusitis.

Natural Remedies for All Sinus Problems!

Nasal cilia (tiny hairlike strands) help clear mucus from the nasal cavity. Slow-moving cilia can lead to nasal and sinus irritation and congestion.

To stimulate cilia:

 Hum. It may sound far-fetched, but the vibrations from humming break up and thin accumulated mucus. Patients of mine who hum for a few minutes several times a day tend to get fewer sinus infections.

Keep the nose moist by using a preservative-free saline nasal spray such as NeilMed NasaMist Hypertonic Saline Spray, available at Walgreens and online. Do daily irrigation with a NeilMed NetiPot or NeilMed Sinus Rinse.

Stay warm. Cold temperatures can slow the movement of nasal cilia, so wear a jacket, a hat and scarf to keep warm. Additionally, avoid cold beverages and drink hot green or black tea, which contain L- theanine, an amino acid that increases ciliary activity. The excess fluid will also help thin and clear mucus speeding recovery.

For more information, visit:
www.grossaninstitute.com
www.ent-consult.com

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