Allergy time, what to do about nasal congestion.

[Jerry_NJ]

My main alergy problem is sinus/nasal congestion.  I almost lose the ability to breath through my nose.

My primary care doctor warned about some over the counter preparations that can aggravate my AFib. On my 6 month check up with my cardiologist I asked. He seemed less concerned than my primary care doctor. The understanding I have from him is use whatever works and keep an eye/ear to what my heart is doing.  If the medication worsens my AFib or causes other heart problems I should stop taking it.. As the say goes "if it hurts when I do this, the answer: stop doing "this".  

I have tried the meds in Benadryl (sp?) and Benadryl D.  The second seems to help a little more than the former.  I have not tried any of the expensive stuff widely advertised, but if they work they would be worth the expense.  

A nasal spray containing Phenylephrine Hydrochloride (hope I copied the name correctly, I can pronounce it) give quick relief but one has to be careful not to use that too often.  It seems using it once or twice a day many not cause any problems in the sinus area, and I don't seem to have any unusual heart rhythm problems, in fact I think my heart beats a little easier when I can breath.... seem it should.

What works for you and doesn't upset your heart?

[Jerry_NJ]

I did a search on Zicam Allergy Relief and came up with this thread. So, as I still have nasal congestion problems, I figured I'd give an update.

Now more than a year and a half later, I still have nasal congestion problems when lying down, trying to sleep.  I find, may be driven by aging, too that I now get some fits of anxiety/panic (can't say I know/understand the difference) when I am trying to fall asleep and react to not being able to breath easily - a panic suffocation response, I suppose.  Heck, sounds like I'm getting worse - maybe a psychiatrist is next : (

I purchased a netipot and used it for a while, but have not used in perhaps a year as I didn't get a definite improvement in my condition.  

In my latest effort to get off of Afirin-type sprays I am using saline regularly, several times a day and every time I wake up at night, must be at lest twice about every 2/3 hours, and using the prescription nasal spray twice a day (I can look up the name if of interest) and a couple of times a day Zicam Allergy Relief Gel, which I think is intended to coat the nasal passage to reduce absorption of allergens.  I space out the use so that the prescription  spray isn't followed with any other spray for at least a couple of hours.  I may add netipot irrigation before using the prescription spray at bed time.  Here I note:  I have read a concern about netipot use and nasal infection due to bacteria (I think) in tap water, and have decided to use distilled (bottle water) water.  I have both the premixed powders (salt and baking soda) and have non-iodized salt and soda to mix my own.  

The above effort has been going on for at least a week, and I am getting enough sleep to keep trying.  I will discuss further with my primary care doctor when I get my annual physical exam sometime in the next few weeks.  He may refer me to a ENT (specialist) or he may be able to determine if I have a chronic infection.  In any case I will be off the over-the-counter nose sprays for a couple of months to not have that issue as part of the problem.

[Madge270]

I have eustacian tube issues (and at times that causes dizziness...very unpleasant). My right ear feels plugged most of the time too. So I've been afraid to try a Neti pot. Anyone else have this?  

[Jerry_NJ]

I'm still experimenting with nasal irrigation (absent the "pot"), and am coming to the opinion it is a help in dealing with nasal congestion....and should have not affects on ones' heart rhythm.  Unless, of course, if thinking about it causes anxiety :(

A question: why saline (salt) solution, and not just plain water....same for the saline spray treatments.  What does the salt add to the whole process?

When one brews their own, how much salt?  Is the a dangerous level due to too much salt?

[littlegreenman1]

In regards to the OP about decongestants... many of the non drowsy varietals have "speed" in them and what kind of person with a heart problem needs THAT?  (I didn't - a week of old school red pseudafed is what got me to the ER the first time!)

Regarding the "Neti Pot". I use a NeilMed sinus bottle. I started using it after getting my septum straighteneded last December. (Once you've maxed your out of pocket on an Ablation... might as well get everything else fixed too!)  I use Brita filtered water and the Walgreen's brand of pre-mixed salt/baking soda. Love it. Love it! LOVE IT.  I had a cold coming on a couple weeks back. Irrigated the snot out - cold = gone.

Since, I'm "cured"  - knock on wood  - of arrhythmia...I will use nasal decongestants again... but they are capillary constrictors - so if they're safe for YOU... "salt to taste."

[Jerry_NJ]

Thanks for the help on the Neti Pot.  You, others, may be interested in the medical doctors post about the possible bad side effects of long term "irrigation" of the nasal channels.
http://www.medhelp.org/user_journals/show/138531/Long-term-Nasal-Saline-Irrigation-Helpful-or-Harmful

The good doctor concludes that [paraphrase} "..if it works for you, keep it up", but he does refer to a clinical study that showed it doesn't work well for some.

I looked up Neti Pot and watched a number of demonstrations on "YouTube"... seems to be a favorite subject for "producers", both serious and fun.  As I have used only a syringe that holds no more than a couple CC of liquid there is very little coming out the down-side nostril.  

Last night I used only saline spray and a dry mouth treatment.  I slept fairly well (save the problems of dreams, a subject of past posts) but not as well.  It seems that the dry mouth treatment makes breathing though my mouth easier to take.  I still had dry mouth, but little or no stinging.  I put some gel my nose early this morning and went back to bed.  The nasal breathing improved.  I will try to remember to pick up plain salt and a fresh bottle of nasal gel as my testing goes forward.  In any case I did not use any oral or nasal medications and I am sleeping better.  I will reintroduce the Neti Pot method later after I figure out the effects of the other two steps.  I'd like to eliminate the dry mouth treatment, and if I can it will mean I am breathing trough my nose as I know I don't do well with breathing through my mouth.  

Hope this isn't too detailed, guess all have the choice not to read.

[Janpes]

When I do my flush I am standing with my head tilted only slightly forward. The pot holds a lot of water and there is a constant stream of flushing. It takes time to figure it out and get it right but in the end you will be happy with the results. I swear by my little red nose irrigation pot :)

[Jerry_NJ]

No move planned.  I did place a similar subject on the allergy forum and gave a link back to this thread.

I looked up the Neti pot on Wikipedia and it looked interesting.  I do not have the device, but I do have a syringe and I tried some warm water into the right nostril while leaning over the bathroom sink, left side down.  I may have had my head down too far/low too. After a shot of water in the right side the thought that came to mind was "water boarding".    I think I can get used to it and perhaps all I need to do is hold my head horizontal to the floor (gravity) one side up.  

I did too many different things together last night, including a gel nose spray and a dry mouth gel.  Whatever came of it I got a better night's sleep and my mouth and throat wasn't dry and burning when I woke up.

I am going to try to get better at the water flush (I need to get some non-iodized salt) saline flush along with spray.  I may drop the dry mouth gel tonight to see if it is needed.  

[Madge270]

I hope you'll keep this thread here too, if you move it to the allergy forum.  Had it not been here, I wouldn't have seen it. And there are many others with heart arrhythmias, plus allergies or sinus, who  wouldn't have seen it either.

[Jerry_NJ]

Thanks for bring the original purpose back to mind.  I was concerned that I may be trying to take the thread more in a direction of anything that give congestion relief.  I think that in fact is about where I am as I have not noticed any heart rhythm problems form what I have taken, but I have found and believe that over use of nasal anti-contestant sprays can be cause them to become ineffective.  

As I have already posted, I will try starting tonight to use only a nasal gel and a mouth/throat gel that retards dry-mouth/throat.  I have used the later in the past and did find it allowed me to breath through my mouth when sleeping with less discomfort.

I'll report back my findings... I may continue to take an oral anti contestant, but so far I haven't found one that provides much relief.  That said, I have less nasal congestion right at this moment (9:24 PM EDT/USA) my nasal passage if relatively open and I have been sitting at the TV and computer for a couple of hours.

[Madge270]

I use saline nasal spray, but sometimes use Nasonex nasal spray for short term use, with just one spray in each nostril instead of two.  It helps, reduces swelling and reduces eye symptoms and allergic headaches.  It doesn't seem to affect my PVCs, at least not so far.  I use it only when symptoms are really bad.

[ireneo]

I think the original concern was which medications can be taken without triggering heart problems in those people with heart issues. I hope this thread stays here. And for those that have used any of the medications mentioned above, did you have any palpitations or chest pain?

[Jerry_NJ]

Well, this discussion needs to be moved to the Allergy Community, but I figured this forum would be a good start and I was right.  There are many very helpful suggestions I will examine and try, as needed.

My wife has suggested a "dry mouth" preparation, which I have used in the past, to help me deal with breathing through my mouth. She also said I should use a Zicam nose spray gel - which I think can be used like saline solution, repeatedly without troubling side-effects or damage to membranes (interior nose tissue).  

Relief does come from getting up  and on my feet.  It isn't just lying down that provokes the congestion, just sitting down will bring it on.  Strange.  I may also try a light duty breathing mask when mowing, especially when walking behind a trimming mower or string trimmer.

I must take some solace in the fact that I got by for so many years without any serious allergy problems.  The same can be said about my AFib which didn't produced noticeable symptoms until I was in my 50s, and was diagnosed at age 58.    

I'll copy this thread to my memo area for ongoing reference.   There was more than one "best answer" so I decided not to make a selection.  Thanks to all for best/great help.

[Jerry_NJ]

Thanks, lots of good and consistent input.  Interestingly my Primary Care doctor was concerned about using decongestant meds, but felt using the nose spray no more than at bed time may be worth a try.  I have found that the 12 hour decongestant nose spray worked great for a few nights, then the benefit decreased.

I was mowing grass today, about 1.5 acres of fairly long grass.  I was on a garden tractor, so the whole thing took less than 2 hours.  I didn't notice an increase in breathing problems, but note that cars parked outside are covered in a few hours with enough tree pollen to be easily seen.  Yes, I live out in the country, and New Jersey USA is outside the city areas a rich farming environment... the state is nicknamed "The Garden State".  Some familiar with the state only along the Turn Pike and around the main airport would doubt the appropriateness of the nickname.  I had not had serious allergic reactions in the previous 50 years of living in NJ, and over 20 years where I am now located.

I have used saline solution and have it on hand.  I'll try to use it as a wash and look into the advice given here.

If the decongestants raise my BP or agitate my HR I am unaware of it.  But then I am on a high BB and CCB regiment.

[dmacd74]

My allergist just told me to avoid anything with a D after the name to avoid heart irritability.

[is_something_wrong]

There are two problems with nasal sprays.

Opposite to what one may believe, they don't resolve the snot, they contract the blood vessels in your nose / sinuses. They are so-called alpha-agonists (inverse effect of alpha blockers which are blood pressure medications). The alpha effect of adrenaline is to constrict blood vessels. So the spray works by constrict blood vessels, to make more space in your nose / sinuses.

A problem is that they also may elevate systemic blood pressure to a certain degree.

New sprays also contains a substance almost similar to adrenaline (alpha and beta agonist). This effect is added to prevent a runny nose, because adrenaline inhibits production of slime and saliva (we all get a dry mouth when afraid..) This works directly on your heart, increasing heart irritability, contractility and heart rate.

Why don't you use a prescription antihistamine or antihistamine spray instead?

[Janpes]

Hi Jerry,

You need to flush your sinuses morning and night using the Nasal irrigation. http://en.wikipedia.org/wiki/Nasal_irrigation
I use one of these everyday, morning and night and don't suffer anymore from blocked sinuses/nose anymore. I put 1 teaspoon of salt, add warm water and then pour it through. Just make sure you fully blow your nose well afterwards to get rid of any excess moisture. After that I usually spray a nose oil to keep the insides from getting too dry. Works like a treat.

Ireneo: It actually isn't that bad, at first I thought it was strange but when you get the hang of it it really does work. My daughter does it also as she has had problems with her sinuses.

[ireneo]

All through my daughter's high school years she battled allergies and sinus infections. One doctor finally told her to use normal saline spray when congested. It rinses out the area, eases any dryness in there and has no side effects. Since she started doing that during the bad seasons (for her, in the Spring) she has had no sinus infections. She also has no heart issues but you can't get more neutral than NS.

Some folks use a Neti Pot but there's no way I would pour water in one nostril and out the other. It makes my eyes water just to think of it.

[DeltaDawn23]

I am firmly convinced Allegra was at least partly the cause of my first Afbi episode.  I think the "D" on any of the meds is the decongestent that will speed your heart up.  I have sleep apnea and must breath thru my nose to use my cpap machine.  I use the Breathe Right nose strips, Ayr Saline nasal mist and gel.  I got a nasal rinse bottle from the allergist, but I had a lot of trouble with my ears then, I guess water being forced into the eustachian tubes.  Benadryl was suggested to me.  Coriciden is a cough and cold otc cold med that will not raise you bp.  Hope some of this helps.