Stuck in Throat - POST NASAL DRIP - HELP!

[cats8398]

Does this go on forever?  I have had thick constant post nasal drip for weeks now.  This is dreadful. It sits in the back of my throat and won't move.  I'm a singer and now can't perform.In  the past I've had thin secretions and only when I have been sick or exhausted. I was a smoker for many years but quit 8 years ago but had a "slip" for about two months from extreme stress and started again.  I never hydrated myself much at all with water.   I went to an ENT... I've been drinking 64 oz of water.  Humidifier on constantly.1600 mg of Guiafensen... and a steroid pack which I start my second day on and I don't see any improvement. I hoped the steroid would really help.  I took a couple inhalations of Flonase and it stuffed me up so much I'm afraid to use it again.  I don't know whether to take an antihistamine as I know it thickens but I need to stop the drip.  My ENT told me not to take it.  

My questions are:  How long for the oral steroid to help... or won't it?
Does the stuffiness from the Flonase go away & should I use it?
Should I take antihistamines and Decongestants?
Also... I ordered the nasal irrigator... does it really make a difference or is it just a "small help" with PND?  One thing my doctor said that made me question him was when asked if smoking could have alot to do with this he said no.  I thought that it could be a major factor.
One really important question I had (I know I have a lot) was that I read that the damage done to the cilia (sp?) is really damaged by smoking and that it is irreversible. I hope not.

[National Jewish]

Postnasal drip is drainage from the nose and sinuses dripping down the back of the throat.  There could be several reasons for this drainage.  One reason is an allergy.  A second reason is a non-allergic, non-infectious inflammation in the sinuses that can linger after a cold.  A third reason is chronic sinusitis.  Postnasal drip can effect your voice, especially your singing voice, as a result of irritation of the throat and vocal cords.  You may experience the postnasal drip as a constant feeling of mucus at the back of your throat.  Typically this is worse at night when you lay down to sleep.  Generally this irritation feels the worst when you wake up and gets better as the day goes on.  The mucus may "sit" there, especially when it is thick.

The fat content in dairy products can thicken mucus.  Generally eating dairy products with less fat content is helpful.  Drinking plenty of water will help to thin the mucus so that it moves more easily.  As long as you are not on a fluid restriction you should be drinking 6 to 8 8-ounce glasses of non-caffeine non-alcoholic fluid daily.  So drinking 64 ounces of water each day is great!  Clearing your throat can irritate your vocal cords and effect your voice.  When you feel the need to clear your throat sip some water to clear the mucus.

An antihistamine can dry up the postnasal drip.  However, as you have noted, it may make the mucus thicker and more difficult to move.  So it would be best to follow the recommendation from your ENT to avoid antihistamines.  A decongestant like Sudafed® (pseudoephedrine) can thin the postnasal drip and decrease the swelling so it drains easier.  Check with your ENT to see if this would help you.  Often a decongestant is taken only when the postnasal drip gets bad.  It may be more helpful to take the decongestant on a regular basis.

A nasal wash helps remove mucus and germs from your nose and sinuses.  This can temporarily lessen your postnasal drip.  Please read our Nasal Wash MedFact at http://www.nationaljewish.org/medfacts/nasal.html for more information about this technique, including the use of the nasal irrigator that you have ordered.  Share this information with your doctor to see if you would benefit from this daily treatment.  Doing a nasal wash before using any nasal spray can make that nasal spray work better.

A steroid pack will help when it has decreased the inflammation in the nose and sinuses.  This is an oral steroid that is stronger than a nasal steroid spray, like Flonase® (fluticasone), so it usually works faster.  The exact length of time will depend upon the amount of inflammation.  Since a nasal steroid spray is weaker, it does not provide rapid relief of symptoms, but it is less likely to cause side effects.  It may need to be used every day for several weeks to months for it to help.  By controlling the inflammation in the nose and sinuses this usually lessens stuffiness, prevents your postnasal drip, and allows your singing voice to return.  Sometimes it takes the decongestant and the nasal wash followed by the nasal steroid spray ALL used routinely to keep the postnasal drip from bothering you.  Another suggestion to talk with your doctor about is trying a different nasal steroid spray to find one that doesn’t stuff you up.

In the healthy lung, nose, and sinuses there are small hair-like projections called cilia that clean by moving mucus up and out.  Smoking can paralyze or permanently damage this cleaning system.  When you quit smoking your lungs, nose, and sinuses begin to recover from the inflammation caused by the smoking abuse.  Coughing up mucus or having postnasal drip shows that this cleaning system is working again.  When you smoke this mucus just stays in your lungs, nose and sinuses.  As long as you have quit smoking before there has been permanent damage then you will get better as the cleaning system cleans.  This may take up to a year after you stop smoking.

Congratulations, you have made a wise decision to stop smoking!  You may want to look at our Quit Smoking Topic Center at http://www.nationaljewish.org/topic/smoking_cessation.html for ways to help you stay smoke free.  Also check with your doctor for other quit smoking resources in your area.

[starion]

Time to see a GOOD allergist to help you.  Your doc has to help you figure out WHY you have the post nasal drip--what triggers you.  This can often been done by testing--blood test (RAST) or skin testing.  Once you know what you're sensitive to, you can try reducing your exposure to these "triggers" and reduce your post nasal drip.

The allergist will help you develop a plan that will help get your allergies udner control as well--avoidance and medication and even possibly allergy shots.

Here's a page with info about nasal saline wash--it REALLY helps many folks:

http://nationaljewish.org/medfacts/nasal.html

Here are other sites you may also find useful:
http://nationaljewish.org/understanding/allergy.html
http://nationaljewish.org/medfacts/allergic_rhinitis.html
http://nationaljewish.org/medfacts/mites.html

Good luck--hope this helps.
For me, I have tried all the antihistimines & decongestants & found that the ONE that works for me is Zyrtec.  Others have found different ones and/or combos work for them.  I also find that Flonase nasal steroid works great for me as well.  The nasal wash helps when I need it, but I don't use it daily though some folks do & find it extremely helpful.
Starion

[andyrox]

Something you said triggered a thought. You may not have PND at all and maybe have LPR (Reflux of the Larynx). This is common with singers. Go on google and search LPR reflux. Your symptoms sound very similar. Did your ENT do a scope??

Good luck!