Is taking nasal steroids (Nasacort, Flonase) every other day enough?

[HappyGrace]

I just asked the other day about these for dd and ironically now the doc wants to put *me* on them! It's to prevent chronic sinusitis. I HATE taking meds of any kind, always seem to get side effects, plus my mom had bad reactions (dizziness, nosebleeds) with nasal steroids. I am so afraid to take this medicine! But I know I need it. I wonder if every other day would be enough? Does anyone do this?

[Harriet Vane]

I struggle with this one as well. I do not react well to many medicines, unfortunately.

 

I have chronic sinus issues related to allergies. I have found that antibiotics often don't really wipe this out, and that repeated antibiotics results in other uncomfortable side effects for me.

 

The good thing about nasal steroids is that the medicine stays concentrated in the tissues on which it is applied. In other words, it is not systemic, and it is a targeted form of therapy (going right on the infected tissue). The nasal steroids are also really effective--remarkably so, in my experience.

 

Most people take the steroids with virtually no ill effect, which is another plus.

 

I, however, am one of those strange people who do have one, major ill effect from nasal steroids. I find that after a while I cannot sleep. Not upset, just too wakeful. When I am on the steroids for a prolonged amount of time, I will find myself getting 3 hours of sleep at night.

 

So then the difficulty, for me, is which of two icky choices--extended antibiotics or nasal steroid, both of which I react badly to. The compromise for me has been to take just a short course of nasal steroids in concert with saline nasal irrigation, and either allergy pills (Allegra) OR antibiotics if the problem is clearly not an allergy. Sometimes I am able to knock out the infection with just the steroids and nasal irrigation; other times I also need a short course of antibiotics.

 

As I said, most people do not suffer the wakefulness that I do. I would suggest that you give the steroids a try. I see no harm in taking it less frequently than recommended, as long as you do so on a regular schedule (not random, as this would reduce the effectiveness by a large margin). If taking the steroid less often is effective, then you've found a good solution. If not, you can always increase your intake. If you find over time that you are suffering from serious insomnia, then just stop taking the steroid and reserve its use for those times when you are genuinely sick.

 

Another step, if you are doing this for prevention only, is to commit to regular, routine nasal irrigation and see if that helps. You can do this by using a netipot, OTC saline nasal spray, or through homemade irrigation. To do this, fill a large bowl with water that is comfortably warm. Add 2 T table salt and stir until dissolved and no longer gritty. Immerse face, keeping face level. DO NOT inhale or snort. Rather, breathe OUT so that you make bubbles in the water, just for a few seconds. You will feel the water in your nose. This does not hurt or feel weird in any way--it's totally gentle. Rest in the water like this for a count of fifteen, then lift face and blow your nose. Repeat.

 

If you are sick, then do some form of nasal irrigation every 3 hours or so. If you are doing this for prevention, once or twice a day is fine. You may find that regular nasal irrigation is all the prevention you need.