I can't breathe through my nose (Part 2)

Continued from Part 1.

Chronic allergies

After getting me started on Flonase, my ENT sent me for allergy testing, which revealed that I have a strong dust mite allergy, but nothing else very significant. My mom reminded me that I was allergy tested when I was little and the results were the same. In fact my parents put hardwood floors in my bedroom instead of carpet when we moved to Portland, though my sister and I switched rooms after a couple years and the carpet never seemed to bother me. I've occasionally woken up with a stuffy nose over the years, but hypoallergenic sheets and pillow cases never made much of a difference.

After a couple months on Flonase, my nose was no better than before, and this was early-COVID so all elective surgeries were still on hold. I was still skeptical that my nasal congestion was due to allergies, but given that the test was strongly reactive I agreed to try Singulair. After a couple weeks I actually felt like my sinuses were clearer and I had more energy during the day. I started lap swimming and running again. I was still fairly somewhat congested at night, so I continued using Breathe Right strips.

The fact that the Singulair helped made me think that allergies really are what's going on. So I started immunotherapy for dust mites with a new under-the-tongue tablet called Odactra. Think of it like allergy shots without the shots. For the first 1-2 months it gave me a lot of inflammation and itching under my tongue, but then my reaction to it subsided completely, which made me think it was starting to work! The literature suggests that the body develops a local tolerance to the antigen after a couple months, and a system response after 6 months to a year (See [1] and [2])

Fast forward to this month, even with Singulair I'm still struggling with nasal congestion at night and sometimes during the day. It feels like it's not working as well as it did a few months ago. So I went back to my ENT and asked to move forward with a turbinate reduction surgery, with the idea that Odactra will prevent them from growing back long term. We decided not to fix my mild deviated septum or valve collapse at this point. I think the evidence really points to turbinate hypertrophy as the leading order issue, and I'd like to avoid septoplasty and rhinoplasty if at all possible.

So that's where things stand now. The turbinate reduction surgery is scheduled for the end of the month, and hopefully it will give me some relief!

Continued in Part 3.

Posted by Abraham