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DH with Allergies - please help if you can


Mom0012
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My dh has really bad allergies, but resists taking medication because he says “it dries his head out”. Nasal sprays do cause him to have nose bleeds. Without medication, though, he is in misery. He OFTEN has a headache that is so bad that he will have his hands over his eyes while he is talking to me. He is constantly congested and just plain exhausted.

I will admit, I get aggravated that he will not consistently take medication. Lately, he has been pretty sick on the weekends because of sinus pain. I feel sorry for him and I do have empathy, but I have a hard time understanding why he does not try to find a solution for this. He did allergy shots a number of years ago when my kids did them and they helped him. Since he has discontinued the shots, he has gotten significantly worse and the other weird thing is that his allergies are now much worse during the winter months. Allergy shots are not practical for him at this point, but can any allergy sufferers out there point me in a direction for him? What is this “dried out” head thing medication causes him and how can he avoid that?

Nasal sprays have been effective for me and for both of my children. None of us have allergies anywhere near as bad as his, though.

 

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Sudafed type medications dry my head out but histamine blockers don't have that effect at all. Can he take antihistamines like Benedryl or Zyrtec? They work by blocking your immune system from releasing as much histamines which for some people (like me and it sounds like your dh too) their immune system goes into overdrive during allergy season. I take Zyrtec daily year round for hayfever type allergies and because I seem to randomly break out in hives with no identifiable cause. I can take up to two a day according to my allergist. I've never even had it suggested to me by my allergist that we do allergy shots. Hopefully someone else can help there.

I've never heard of anyone getting the dried out head side effect from antihistamines so you might urge him to try a different kind of allergy medicine. I use a generic that I can get 300 pills (that most people just take one a day) for $15.

ETA: I got distracted and forgot to say, I also can't do nasal sprays. They seem to make it worse not better. And the worse in winter doesn't surprise me. Have you had your HVAC system cleaned recently? Do you change the filters religiously and use allergy quality filters? Forced hot air systems are terrible for allergy sufferers. We are slowly converting our house to radiant heat because I can't handle forced hot air and all the dust and dirt they stir up.

Edited by sweet2ndchance
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1 hour ago, sweet2ndchance said:

Sudafed type medications dry my head out but histamine blockers don't have that effect at all. Can he take antihistamines like Benedryl or Zyrtec? They work by blocking your immune system from releasing as much histamines which for some people (like me and it sounds like your dh too) their immune system goes into overdrive during allergy season. I take Zyrtec daily year round for hayfever type allergies and because I seem to randomly break out in hives with no identifiable cause. I can take up to two a day according to my allergist. I've never even had it suggested to me by my allergist that we do allergy shots. Hopefully someone else can help there.

I've never heard of anyone getting the dried out head side effect from antihistamines so you might urge him to try a different kind of allergy medicine. I use a generic that I can get 300 pills (that most people just take one a day) for $15.

ETA: I got distracted and forgot to say, I also can't do nasal sprays. They seem to make it worse not better. And the worse in winter doesn't surprise me. Have you had your HVAC system cleaned recently? Do you change the filters religiously and use allergy quality filters? Forced hot air systems are terrible for allergy sufferers. We are slowly converting our house to radiant heat because I can't handle forced hot air and all the dust and dirt they stir up.


Thank you. That is helpful to hear that you can’t do nasal sprays. Maybe I’ll have him try Zyrtec this week and see how he does with that. My dd has really bad allergies and meds like Zyrtec never did anything for her, but the nasal sprays have been great, so I keep thinking my dh needs a nasal spray.

ETA: And we’re terrible about the filters and stuff. My dh changes them once every few years. Or so. Another thing to consider. We do have a heat pump, but I can’t see us being able to move away from that right now.

Edited by Mom0012
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36 minutes ago, Æthelthryth the Texan said:

Will he go see an ENT or Allergist? They can Rx him better meds than you'll be able to get OTC. He might need to layer the meds during certain times of year. You can take an astounding amount of antihistamine combinations. Azelastine nasal spray has worked the best for me- I have pretty extreme allergies certain times of the year. I add in Zyrtec, Nasacort and Benadryl as needed. Benadryl makes me feel more "dried out" than Azelastine does for instance. But depending on his symptoms, there are myriad different Rx's out there that can help him (some without making him tired), be it eyes, runny nose, etc. that is most affected will determine which is the best course.

Imo OTC is okay for light/medium allergies, but it helps to have the bigger guns at your disposal. I'd really try to get him to see someone if he'll go. Apart from that, consistency of whatever he takes is sort of key- it takes a while for most drugs to become efficient, so if he's only taking them sporadically, then they don't really help as much. 

Is Azelastine Astepro? That’s what works best for my dd. My dh used to take it as well. He did just go to the doctor for a physical a couple of months ago and was given two different allergy pills to try, but part of the problem is he doesn’t take anything consistently. He doesn’t seem to have much self-awareness when it comes to his symptoms or what helps or doesn’t help. I’ll get him to take something for a few months and I can see that he feels better, but then if he has an upset stomach one day, he’ll suddenly attribute it to the meds and stop taking them. It is obvious just from looking at him how badly he feels most of the time though. I can try to get him in with the allergist again. Maybe I will make a chart of symptoms and try to track this for him so he can *see* what helps and what doesn’t. Part of the problem is that allergy symptoms fluctuate.

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So, the doctor had given him a bottle (prescription) for Zyrtec and Claritin. My dh says one of them helped some, but he’s not sure which one, lol. I just had him take a Zyrtec and I will remind him to take Astepro in the morning and he’s agreed to keep a chart (to let me keep one). If he gets the dried out feeling, we’ll drop the Astepro. 

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What is your dh allergic to? If it's possible to reduce exposure to allergens as much as possible? He might be able to function without having to take meds. This approach has worked the absolute best in our family. We removed carpeting,  vacuum rather than sweep, have no shedding pets, removed books from our bedroom, for example. 

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1 hour ago, Carol in Cal. said:

I think he should try Claritin or Allegra.  The 12 hour version.  Those are nondrowsy antihistamines, and they don’t dry out your head like decongestants do.  Plus they are available OTC.  

If the Zyrtec doesn’t work for him, we’ll switch to Claritin. I’m going to keep a list of everything he tries and how he feels about it, so that we can stop going in circles on this.

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Just now, wintermom said:

What is your dh allergic to? If it's possible to reduce exposure to allergens as much as possible? He might be able to function without having to take meds. This approach has worked the absolute best in our family. We removed carpeting,  vacuum rather than sweep, have no shedding pets, removed books from our bedroom, for example. 

He is allergic to many, many things. I’d have to pull his old records from the allergist, but I doubt I’d be able to reduce the allergens to the point of not needing to medicate. We don’t have any pets and I keep the house pretty clean, but I don’t think it’s ever going to be 100% dust free realistically. A couple of months ago, I spent a lot of time decluttering our room and getting it really dust-free, in the hope that it might help him, but it seemed to have zero effect. When we were first married, we were living in a house with no AC, and I noticed that his allergies got much better with central air, but other than that, I’m not sure anything I’ve ever done had had much of an impact for him. We do have carpeting upstairs, and could consider making a change there.

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8 minutes ago, Mom0012 said:

He is allergic to many, many things. I’d have to pull his old records from the allergist, but I doubt I’d be able to reduce the allergens to the point of not needing to medicate. We don’t have any pets and I keep the house pretty clean, but I don’t think it’s ever going to be 100% dust free realistically. A couple of months ago, I spent a lot of time decluttering our room and getting it really dust-free, in the hope that it might help him, but it seemed to have zero effect. When we were first married, we were living in a house with no AC, and I noticed that his allergies got much better with central air, but other than that, I’m not sure anything I’ve ever done had had much of an impact for him. We do have carpeting upstairs, and could consider making a change there.

Getting the carpeting out of our bedroom has meant that both dh and I can sleep better and breath!  Dust lying around is MUCH better than it constantly being moved. Wipe with a wet cloth.

Have your air ducts been cleaned out recently? 

Edited by wintermom
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Do you know if he is a candidate for sublingual immunotherapy (SLIT)?  It would be more convenient than injections.

Mucinex (maximum strength only, not standard dosing) helps with sinus pressure for me.  Using saline spray, like Simply Saline, once or twice daily is also helpful.  It's easy to do in the shower.  

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You will need to talk to a doctor but my doctor has told me I can take more than the standard dose on most antihistamines and like some one else said I can layer them, or take two different ones together especially when I'm dealing with hives but also when my once daily allergy pill doesn't seem to be cutting it. Everyone is different. For me, it was Claritin that didn't do a thing. So let your husband know he may need to try a few different ones and talk to a doctor about dosing and layering to find a med or combination of meds that work for him.

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Oh and good gravy change that filter more often, lol! Not only will it reduce air borne allergens in your home if you get a good one, not one you can see through, it will save wear and tear on your HVAC unit. Every 3 months would be an improvement. Changing monthly would be ideal. Hardfloors rather than carpet is also better for allergy suffers. We only have one room left in the house that needs the carpet ripped out so we can put down plank flooring. 🙂

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I’m allergic to many, many things. And mine seems to be worse in the winter months as well. I just recently found a combo that is helping. It’s not perfect, but much better than it had been. I take an Allegra and use Nasacort spray (triamconolone). And in the evening I use Neilmed Saline Spray Nasal Wash. It’s in an aerosol spray can and you use it like a netipot where you let it flow from one nostril to the other. This seems to help a lot. And if I’m outside in the allergens for a while, I try to immediately shower off inside and change clothes.

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3 hours ago, Kebo said:

Do you know if he is a candidate for sublingual immunotherapy (SLIT)?  It would be more convenient than injections.

Mucinex (maximum strength only, not standard dosing) helps with sinus pressure for me.  Using saline spray, like Simply Saline, once or twice daily is also helpful.  It's easy to do in the shower.  

I did SLIT with my dd for awhile before allergy shots, but the closest allergist I could find at the time was quite a trek and it was so expensive. Since my dh is non compliant much of the time, I’m not sure it would be worth it, but thanks for the idea.

What does the saline spray do for you? Are you using it like a neti pot or is it just to get moisture in your nasal passages?

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2 hours ago, Æthelthryth the Texan said:

Yes, Astepro is Aselastine. Fwiw, allergies can cause GI issues so going off everything can make things worse- in other words, his allergies are more likely to be causing his GI issues than the actual allergy meds.

Personally, I wouldn't drop down to Claritin from Zyrtec for severe- if Zyrtec isn't helping, then Claritin is going to do zilch. Claritin is the lightest hitter in the bunch- I mean seriously light. Claritin, Allegra and Zyrtec is the strength of OTC from lightest to most intense.......Astepro will be more efficient, but can be used with any of those OTC (for a healthy individual). You can double up on the Astepro twice a day for a week or two to get the symptoms under control, and then drop to once a day (theoretically). But the nasal spray will likely have fewer side effects than the oral pill. He could combine the Astepro with Nasacort for instance and see what that gets him, but I get a lot of people are very nasal spray adverse. 

I tried sublingual immunotherapy and it was absolutely a horrible nightmare for me, but they told me many had a lot of success with it, so like PP said it could be worth investigating. I have IBS, so it was a really bad match. But, any type of allergy treatment whether shots or sublingual is going to make things worse before it makes things better, so keep that in mind- he may just revolt overall. Sublingual has the advantage of being less trips to office, but it also can have a lot more GI side effects. 

Nasal rinses can help- but again that just adds to things you are shooting up your nose at some point and that's too much for some people. 

I'd invest in a serious air purifier for your bedroom. They are worth a lot for great sleep! I am allergic to just about every environmental allergen there is per my allergy test (including horses, cats and dogs which we are surrounded by) and have found a happy medium with the allergy med layering. I just am on a lot of them at certain times of the year! That's where an allergist is worth their weight. I have had points where I am on Azelastine, Zyrtec, Nasacort, and Benadryl at night and am fully functional. When your allergies are in full swing, I think the histamines cancel out the sleepiness that comes, or else maybe a tolerance comes into effect. 

But besides drugs, simply things like showering at night, changing sheets and pillow cases often and as PP mention keeping dust down to a minimum- carpet is the Devil for those of us allergic to dust mites! 

Good luck. Hope he find something! I don't know what it is about guys that makes them so treatment adverse, but seems common! 

I am definitely going to do the air purifier in our room and replace the air filters. I guess we will need to consider replacing the carpets, but that will be the last thing just because of the expense. Both my kids would probably benefit from that as well, though.
 

I got him started in the Zyrtec tonight and will have him take the Astepro twice tomorrow and if he’s still having issues, I’ll have him add in Benedryl at night and then maybe Nasacort, honestly, I always thought he needed to pick one med and never realized he could take multiple ones. 
 

I think keeping a chart of meds and side effects and symptoms may help us make some progress too. 
 

Thank you!

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Unless you plan for your husband to take zyrtec daily for life I would not recommend taking it daily now. It is a very powerful antihistimine and going off it can cause massive itching and hives, for a long time (up to many months is not unheard of).

Instead I'd advise no more than HALF a pill, preferably every OTHER day. I'm still cautious about taking zyrtec after my bout of really really bad withdrawal hives, but I will concede that it works very well when I need it.

Benadryl does not have that sort of withdrawal effect, but longterm use of benadryl pills is a risk factor for dementia, and seniors should not take any benadryl at all as it can cause the symptoms of dementia even if they don't have the disease.

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2 hours ago, Tanaqui said:

Instead I'd advise no more than HALF a pill, preferably every OTHER day. I'm still cautious about taking zyrtec after my bout of really really bad withdrawal hives, but I will concede that it works very well when I need it.

Hmmm... interesting, I have not heard of this. Zyrtec is actually what brought my random hives attacks under control. I've not been off it more than a few days since starting it so I don't guess I've dealt with withdrawls from it but definitely something to be on the look out for. Thanks for mentioning it :-) I've had to take antihistamines to be at all functional since I was a very young child (I can remember taking allergy pills as young as age 4) so a once, maybe twice during allergy season, daily pill that actually works is a dream come true for me. 

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If you want kind of milder, non med things that *might* help

-vitamin C daily--2 capsules 3-4X a day (breakfast, lunch, dinner, bed). If he won't take C, you could serve him orange juice daily.

-quercitin--my dd and dh take this. It's a supplement you can buy. 

-run the roomba daily--This is how I got off my asthma inhalers. I got RELIGIOUS on hygiene in my house, especially in the bedroom.

-consider dropping white flour and cheese--the theory there is that allergies start in the gut and that having better gut clearance helps. So more salad and fresh fruit, cut out the white flour and cheese. You could do this in a quiet way and see what happens.

-consider teaching him to do body scans for 5 minutes a day to improve his self-awareness. 

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My dd#1 took Zyrtec daily for years. Neither of us thinks it did anything for her in retrospect. Allergy shots were great while she was at full strength. After she quit Zyrtec, her personality got less combative. Retrospectively, I wonder if it made her irritable. She did not have withdrawal hives/itching but I have read about that side effect.

I hope your DH finds something that works. My DD is allergic to furry animals & pretty much everything green outside so spring is crazy. (She was free of allergy symptoms in the south until late January.)

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My allergy expert son swears by Xyzal.  It covers a lot of different types of allergies and doesn't make him drowsy at all.  Unfortunately, it can not be bought in a  generic form so it is a bit pricier. 

 

edited to ADD:  he did the allergy shots for a year - huge reaction for each weekly shot  - swelling at injection site like 1/2 size of tennis ball - anyways, the allergist specialist suggested he stop as they didn't seem to be effective in his case.  

Edited by Myra
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8 hours ago, Tanaqui said:

Unless you plan for your husband to take zyrtec daily for life I would not recommend taking it daily now. It is a very powerful antihistimine and going off it can cause massive itching and hives, for a long time (up to many months is not unheard of).

Instead I'd advise no more than HALF a pill, preferably every OTHER day. I'm still cautious about taking zyrtec after my bout of really really bad withdrawal hives, but I will concede that it works very well when I need it.

Benadryl does not have that sort of withdrawal effect, but longterm use of benadryl pills is a risk factor for dementia, and seniors should not take any benadryl at all as it can cause the symptoms of dementia even if they don't have the disease.

That sounds awful. I’m sorry you went through that with the Zyrtec. I had not heard of that type of reaction before.

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50 minutes ago, RootAnn said:

My dd#1 took Zyrtec daily for years. Neither of us thinks it did anything for her in retrospect. Allergy shots were great while she was at full strength. After she quit Zyrtec, her personality got less combative. Retrospectively, I wonder if it made her irritable. She did not have withdrawal hives/itching but I have read about that side effect.

I hope your DH finds something that works. My DD is allergic to furry animals & pretty much everything green outside so spring is crazy. (She was free of allergy symptoms in the south until late January.)

My dd took Zyrtec when she was two (major allergies and nonstop ear infections). I vividly remember her laying flat out on the floor on her stomach with her arms and legs spread out after I gave it to her. That’s the only thing it ever did for her — knocked her out.

I put a lot of energy into finding solutions for her and got her to let me use a netipot on her. That’s what made me see that pills were doing nothing for her (tons of drainage when we used the netipot) and that the nose sprays were what were effective. As soon as we started the nose spray, there was no more drainage when we did the netipot and we were able to discontinue those rinses.

I hope your dd is able to keep her allergies under control as spring kicks in!

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51 minutes ago, Myra said:

My allergy expert son swears by Xyzal.  It covers a lot of different types of allergies and doesn't make him drowsy at all.  Unfortunately, it can not be bought in a  generic form so it is a bit pricier. 

 

edited to ADD:  he did the allergy shots for a year - huge reaction for each weekly shot  - swelling at injection site like 1/2 size of tennis ball - anyways, the allergist specialist suggested he stop as they didn't seem to be effective in his case.  

I’ve never looked at xyzal. That’s one I will keep in mind if we don’t get any relief with this other stuff. Sounds like your ds may be as affected as my dh, so xyzal will be my great white hope if Zyrtec and Astepro are flops for him.

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12 hours ago, Æthelthryth the Texan said:

Good luck. Hope he find something! I don't know what it is about guys that makes them so treatment adverse, but seems common! 

I cannot for the life of me understand this myself. He is in so much pain, he is covering his eyes to avoid the light, and yet he doesn’t want to medicate because it dries his head out. He goes to great lengths to avoid any type of medication and I had gotten to the point where I had decided to just set a boundary and distance myself from this issue since I can’t make him take his meds, but he is in enough misery atm that he is willing to let me help him. So, I will try. The second he gets mad at me, I’m throwing my boundary back up, lol.

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Being dehydrated makes the body release histamine, because that releases water.   Eating high histamine foods can make allergies much worse, and headaches too.  You might look into a low histamine diet. Basically reduce aged proteins.  Avoid red meat, pork, any protein that hasn't been stored in the freezer, cheeses, bananas, tomatoes, and vinegar while he's feeling this bad.  I've noticed many people who have drastically worse allergies are on a low carb diet.

Get him one of those water 1 gallon water jugs to help him drink a gallon per day.   He won't feel dried out IF he's drinking enough water.  And consider supplementing with DAO (the enzyme that breaks down histamine, pork sourced, extremely expensive) when he has a headache.

Also if he has a headache so bad he can't function, just bring him a combination of H1 (Benadryl) and H2 (Zantac) histamine blockers with a HUGE glass of water.  Generics are fine.  That will treat the histamine.  Then give him Excedrine (Tylenol, Aspirin, and Caffeine), possibly with a caffeinated drink, but he should drink the water first.

 

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13 hours ago, Æthelthryth the Texan said:

Personally, I wouldn't drop down to Claritin from Zyrtec for severe

Actually, Zyrtec does nothing for me (well, it makes me exhausted, just doesn't touch the allergies), so Claritin is better, but if the OP is documenting this, it'll be clear. But I definitely agree that Claritin is a lighter medication for most people.

Allergies that are resistant to treatment are a red-flag for non-allergic rhinitis. You might need to find a specialist.

I would also get really serious about environment control and daily sinus rinses with a sinus rinse bottle. It should help with the nosebleeds also. Your DH needs to keep himself hydrated, and you might need to get a humidifier for some parts of your house (and find out how to use it without creating mold or making it too wet). Washing all bedding (including mattress pad and all comforters/blankets) WEEKLY in hot water is essential for some people. If your bedding can't withstand that, you can put comforters in the freezer for several days (I think it has to be at least 48 hours) to kill the dust mites, but it's better to have washable bedding. 

I think he should consider a second opinion on the allergy/non-allergic rhinitis question. My allergist has talked about this a bit--he's a specialist among specialists, and he said only about 40% of his patients actually have allergies. The rest have non-allergic rhinitis, mast cell problems, etc. This is the first allergist I've seen that has had enough tools in his toolbox to be sensible about things and not act like I am to blame when the advice doesn't work. 

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All nasal sprays are not the same. If one dries him out, another with a different ingredient may not. I got nosebleeds from one kind years ago, but the newer ones don't do that at all to me. So it really just varies so much. There are at least two different steroid nasal sprays (and you can now get the "sensimist" that is fragrance free and alcohol free/non drying), antihistamine sprays, decongestant sprays, etc etc. 

And then oral meds there are decongestants and antihistamines. If the decongestant dried him up have him try taking it with mucinex - that's what is in the "non drying" sinus stuff - a combination of Sudafed and Mucinex. 

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2 hours ago, Katy said:

Being dehydrated makes the body release histamine, because that releases water.   Eating high histamine foods can make allergies much worse, and headaches too.  You might look into a low histamine diet. Basically reduce aged proteins.  Avoid red meat, pork, any protein that hasn't been stored in the freezer, cheeses, bananas, tomatoes, and vinegar while he's feeling this bad.  I've noticed many people who have drastically worse allergies are on a low carb diet.

Get him one of those water 1 gallon water jugs to help him drink a gallon per day.   He won't feel dried out IF he's drinking enough water.  And consider supplementing with DAO (the enzyme that breaks down histamine, pork sourced, extremely expensive) when he has a headache.

Also if he has a headache so bad he can't function, just bring him a combination of H1 (Benadryl) and H2 (Zantac) histamine blockers with a HUGE glass of water.  Generics are fine.  That will treat the histamine.  Then give him Excedrine (Tylenol, Aspirin, and Caffeine), possibly with a caffeinated drink, but he should drink the water first.

 

Interesting. He just started on a low carb diet today. Of course.

I will try your headache recommendation and suggest he increase his water intake. He tends to drink tons of coffee and then feels it gets his stomach upset.

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8 minutes ago, Ktgrok said:

All nasal sprays are not the same. If one dries him out, another with a different ingredient may not. I got nosebleeds from one kind years ago, but the newer ones don't do that at all to me. So it really just varies so much. There are at least two different steroid nasal sprays (and you can now get the "sensimist" that is fragrance free and alcohol free/non drying), antihistamine sprays, decongestant sprays, etc etc. 

And then oral meds there are decongestants and antihistamines. If the decongestant dried him up have him try taking it with mucinex - that's what is in the "non drying" sinus stuff - a combination of Sudafed and Mucinex. 

I’m not really familiar with Mucinex. I’ll have to look at that. I am really hoping keeping a chart gives us some clarity about what works and what doesn’t with the nose sprays.

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FYI, you can get Mucinex with and without Sudafed in it, and you can get it in different strengths. My family takes it without Sudafed--we often need it when we don't need Sudafed, or we need it longer than we need Sudafed, so we just take them as separate meds.

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2 hours ago, kbutton said:

Actually, Zyrtec does nothing for me (well, it makes me exhausted, just doesn't touch the allergies), so Claritin is better, but if the OP is documenting this, it'll be clear. But I definitely agree that Claritin is a lighter medication for most people.

Allergies that are resistant to treatment are a red-flag for non-allergic rhinitis. You might need to find a specialist.

I would also get really serious about environment control and daily sinus rinses with a sinus rinse bottle. It should help with the nosebleeds also. Your DH needs to keep himself hydrated, and you might need to get a humidifier for some parts of your house (and find out how to use it without creating mold or making it too wet). Washing all bedding (including mattress pad and all comforters/blankets) WEEKLY in hot water is essential for some people. If your bedding can't withstand that, you can put comforters in the freezer for several days (I think it has to be at least 48 hours) to kill the dust mites, but it's better to have washable bedding. 

I think he should consider a second opinion on the allergy/non-allergic rhinitis question. My allergist has talked about this a bit--he's a specialist among specialists, and he said only about 40% of his patients actually have allergies. The rest have non-allergic rhinitis, mast cell problems, etc. This is the first allergist I've seen that has had enough tools in his toolbox to be sensible about things and not act like I am to blame when the advice doesn't work. 


We’ll see what happens with the Zyrtec. He has a bottle of Zyrtec and a bottle of Claritin from his last doctor’s visit and he felt like one of them helped him some, but he doesn’t know which one. He thought it might have been the Claritin, though.

He definitely has allergies, but I guess non-allergic rhinitis is an additional possibility. But is there anything that can be done about it beyond  environmental control and nasal rinses? Honestly, I’m willing to make an effort, but it is highly unlikely he is going to consistently do anything. He’s hard working and wonderful in many ways, but developing new habits is not a strength for him.

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9 minutes ago, Mom0012 said:

He definitely has allergies, but I guess non-allergic rhinitis is an additional possibility. But is there anything that can be done about it beyond  environmental control and nasal rinses? 

You'd have to see a specialist to know. My allergist has doubts about people who test as "allergic to everything" after a certain age. It sounds to me like it's a gray area, honestly, but at least a specialist might have more suggestions.

But yes, rinses are a huge, huge part of this. And environmental control.

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Honestly, with the ongoing rhinitis you describe I would be quite alarmed about the possibility of a colonized infection. I am not trying to be overly alarmist--my son had a colonized infection, and the potential for this to affect the brain is serious. 

I doubt either Claritin or Zyrtec will touch this at this stage. Both are quite mild, though they may be an option once he's got the fountain under control. The problem is that allergy medicines are primarily preventive. It takes a HUGE medical response to tamp down an allergic reaction that has built up to full bore. That is what your husband is experiencing right now--a raging, uncontrolled allergy response. My sister experienced this, and it was really hard to get her asthma and allergies under control. Typically that means 1-3 months on a heavy-duty protocol and then tapering down to a maintenance protocol.

I think your husband should see an ENT as well as a new allergist and get a full workup that looks at both allergies as well as infection.

I also think your husband would benefit from responding with a number of tools at once.

For allergies alone:

--Zyrtec taken religiously. It is likely his doctor will allow a larger dose than what is normally prescribed in order to tamp down the current situation. If I had my druthers, I would have your husband take Allegra (fexofenadine) as it is much stronger. 

--A nasal allergy steroid such as Nasacort or Nasonex. You can definitely do this while also taking systemic meds.

--Routine sinus irrigation using a NeilMed bottle. I would also supplement with a saline nasal spray throughout the day during the initial tamp-it-down stage. Many saline sprays come formulated with a moisturizer.

--As much environmental control as you can manage in the form of washing sheets, clothes, keeping the house dust-free. And I would strongly recommend wood or tile floors especially in the bedroom. Whether or not he is allergic to dust, it is still an irritant for inflamed nasal and throat tissues.

--IF there is a colonized infection, he will need to consider antibiotics. However, systemic antibiotics will often not address sinus issues very well. My son's ENT recommended a life-changing protocol. We dissolved a three-inch strip of Mupirocin topical antibiotic into lukewarm distilled water along with the salt packet that comes with the NeilMed bottle. Shoot that mixture through both nostrils (half the bottle per nostril). Then follow up with a Qvar inhaler. To do the inhaler, place a baby bottle nipple with the tip cut off over the mouth of the inhaler. Place baby bottle nipple into the nose and disperse one puff per nostril. My son did this for six weeks to knock down his colonized infection.

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5 hours ago, Katy said:

Being dehydrated makes the body release histamine, because that releases water.   Eating high histamine foods can make allergies much worse, and headaches too.  You might look into a low histamine diet. Basically reduce aged proteins.  Avoid red meat, pork,

That's interesting. One of the things the nutritionist did when I was having severe MCS (chemical sensitivities) and increasing allergies to food, to everything, was pull me off red meat.

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18 hours ago, Mom0012 said:

I did SLIT with my dd for awhile before allergy shots, but the closest allergist I could find at the time was quite a trek and it was so expensive. Since my dh is non compliant much of the time, I’m not sure it would be worth it, but thanks for the idea.

What does the saline spray do for you? Are you using it like a neti pot or is it just to get moisture in your nasal passages?

The saline spray helps clear out the nasal passages and rinse out allergens.  I imagine the effects are similar to a neti pot, but much more user friendly and confined to the nasal passages, not the sinuses..  

Edited by Kebo
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4 hours ago, Harriet Vane said:

Honestly, with the ongoing rhinitis you describe I would be quite alarmed about the possibility of a colonized infection. I am not trying to be overly alarmist--my son had a colonized infection, and the potential for this to affect the brain is serious. 

I doubt either Claritin or Zyrtec will touch this at this stage. Both are quite mild, though they may be an option once he's got the fountain under control. The problem is that allergy medicines are primarily preventive. It takes a HUGE medical response to tamp down an allergic reaction that has built up to full bore. That is what your husband is experiencing right now--a raging, uncontrolled allergy response. My sister experienced this, and it was really hard to get her asthma and allergies under control. Typically that means 1-3 months on a heavy-duty protocol and then tapering down to a maintenance protocol.

I think your husband should see an ENT as well as a new allergist and get a full workup that looks at both allergies as well as infection.

I also think your husband would benefit from responding with a number of tools at once.

For allergies alone:

--Zyrtec taken religiously. It is likely his doctor will allow a larger dose than what is normally prescribed in order to tamp down the current situation. If I had my druthers, I would have your husband take Allegra (fexofenadine) as it is much stronger. 

--A nasal allergy steroid such as Nasacort or Nasonex. You can definitely do this while also taking systemic meds.

--Routine sinus irrigation using a NeilMed bottle. I would also supplement with a saline nasal spray throughout the day during the initial tamp-it-down stage. Many saline sprays come formulated with a moisturizer.

--As much environmental control as you can manage in the form of washing sheets, clothes, keeping the house dust-free. And I would strongly recommend wood or tile floors especially in the bedroom. Whether or not he is allergic to dust, it is still an irritant for inflamed nasal and throat tissues.

--IF there is a colonized infection, he will need to consider antibiotics. However, systemic antibiotics will often not address sinus issues very well. My son's ENT recommended a life-changing protocol. We dissolved a three-inch strip of Mupirocin topical antibiotic into lukewarm distilled water along with the salt packet that comes with the NeilMed bottle. Shoot that mixture through both nostrils (half the bottle per nostril). Then follow up with a Qvar inhaler. To do the inhaler, place a baby bottle nipple with the tip cut off over the mouth of the inhaler. Place baby bottle nipple into the nose and disperse one puff per nostril. My son did this for six weeks to knock down his colonized infection.

He’s seen allergists in the past. I wonder if he should at least try an ENT. Honestly, I have very little faith in doctors unless we’re talking about something really obvious like a broken arm. But maybe he should see an ENT and make sure he doesn’t have a sinus infection.

He does seem to be feeling better today. He rated his allergies as a 3 tonight with a 1 being him feeling great and a ten with him feeling his worst. This weekend, he was rating his allergies at an 8. I’m thinking this is where the chart may really help him.

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4 hours ago, Harriet Vane said:

--IF there is a colonized infection, he will need to consider antibiotics. However, systemic antibiotics will often not address sinus issues very well. My son's ENT recommended a life-changing protocol. We dissolved a three-inch strip of Mupirocin topical antibiotic into lukewarm distilled water along with the salt packet that comes with the NeilMed bottle. Shoot that mixture through both nostrils (half the bottle per nostril). Then follow up with a Qvar inhaler. To do the inhaler, place a baby bottle nipple with the tip cut off over the mouth of the inhaler. Place baby bottle nipple into the nose and disperse one puff per nostril. My son did this for six weeks to knock down his colonized infection.

That's really interesting information. Was it a biofilm?

A family member has had antibiotics dissolved into a waterpik and then flushed into sinuses. I don't know if it was Mupirocin. Interesting.

3 hours ago, PeterPan said:

That's interesting. One of the things the nutritionist did when I was having severe MCS (chemical sensitivities) and increasing allergies to food, to everything, was pull me off red meat.

The problem with low histamine diets is that they don't all agree. It's really important though to have meat that is not aged. 

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He is feeling much better already! He rated his allergies a 2 tonight on a scale of 1-10 and he was so happy. Also, he is not snoring tonight! This is huge! Usually, I can hear him snoring from downstairs and I am actually sitting next to him in bed and he is not making a peep! 
 

Thank you! I will have him continue with the Zyrtec and the Astepro and update later in the week. I also bought some stuff for his nose to help avoid nosebleeds and I’m going to look into the mucinex in case he starts saying his head is dried out. Yay! Fingers crossed this continues.

 

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On 3/2/2020 at 8:01 PM, Mom0012 said:

He is feeling much better already! He rated his allergies a 2 tonight on a scale of 1-10 and he was so happy. Also, he is not snoring tonight! This is huge! Usually, I can hear him snoring from downstairs and I am actually sitting next to him in bed and he is not making a peep! 
 

Thank you! I will have him continue with the Zyrtec and the Astepro and update later in the week. I also bought some stuff for his nose to help avoid nosebleeds and I’m going to look into the mucinex in case he starts saying his head is dried out. Yay! Fingers crossed this continues.

 

 

How wonderful! So happy for you both!

Can I ask how he's taking the Zyrtec and Asterpo? Daily doses? Both each day?

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It sounds like you guys are on the right track to getting things under control.  I'd just like to second or third the neti pot recommendation.  I am a HUGE baby and resisted neti pot/ nasal irrigation for forever, up until I was preparing for nasal surgery (deviated septum) and couldn't shake a bacterial infection despite antibiotics.  Antibiotics plus neti pot finally cleared it and I could get the septum repair.  After that, I used the neti pot religiously for 6 weeks and the ENT said he'd never seen a nose heal so well or so fast.  Now I use it on an as-needed basis and it's No Big Deal.  It really isn't.  Watch some youtube videos on how to do it right.  It's not rocket science, just keep your mouth open and breathe through your mouth as you do it.  I've never had water go down my throat or into my lungs or anything else, though when my nose was really blocked, it would sometimes also run out of my open mouth, which is not a big deal or uncomfortable.  

It's like having a room air filter for your sinuses.  🙂  

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I had bad problems with repeated sinus infections for a period of time. Finally, instead of just patching up things, I saw a doctor who took xrays of my sinuses. He showed me the inflammation, and then an area of infection that he said was probably never clearing up completely between times. He used a combo of OTC things and a longer dose of Augmentin (can't remember the length right now), plus saw me regularly for about six months. It made a huge difference for me.

At another time, Zyrtec worked great for me--for about a month. Then I started having weird nightmares and terrible insomnia, and had to quit taking it.

I haven't had too many problems recently. Last year, I got a cold and bought this nasal rinse kit at Walgreen's https://www.amazon.com/NeilMed-100-Sinus-Rinse-Complete/dp/B000RDZFZ0/ref=sr_1_5?keywords=nasal+rinse&qid=1583358855&sr=8-5

Having used a couple of different methods of washing my sinuses, I found this the easiest to use. Do be careful with cleanliness, etc., if you choose to do a sinus wash, because you can introduce bacteria and make things worse.

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On 3/3/2020 at 11:44 PM, IfIOnly said:

 

How wonderful! So happy for you both!

Can I ask how he's taking the Zyrtec and Asterpo? Daily doses? Both each day?

Thanks! He’s taking the Zyrtec in the evening and a spray of Astepro  in the morning.

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On 3/4/2020 at 10:08 AM, Monica_in_Switzerland said:

It sounds like you guys are on the right track to getting things under control.  I'd just like to second or third the neti pot recommendation.  I am a HUGE baby and resisted neti pot/ nasal irrigation for forever, up until I was preparing for nasal surgery (deviated septum) and couldn't shake a bacterial infection despite antibiotics.  Antibiotics plus neti pot finally cleared it and I could get the septum repair.  After that, I used the neti pot religiously for 6 weeks and the ENT said he'd never seen a nose heal so well or so fast.  Now I use it on an as-needed basis and it's No Big Deal.  It really isn't.  Watch some youtube videos on how to do it right.  It's not rocket science, just keep your mouth open and breathe through your mouth as you do it.  I've never had water go down my throat or into my lungs or anything else, though when my nose was really blocked, it would sometimes also run out of my open mouth, which is not a big deal or uncomfortable.  

It's like having a room air filter for your sinuses.  🙂  

It’s not a bad idea. He’s used one before, just never consistently. I think he’s too tired and rushed to use it in the morning (he gets up for work at 4:30 am) and then I am usually at work when he goes to sleep in the evening. It’s really a matter of finding a consistent time  for me to remind him to use it. I’m averse to greeting him from work with a netipot in my hand, lol.

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18 hours ago, Jaybee said:

I had bad problems with repeated sinus infections for a period of time. Finally, instead of just patching up things, I saw a doctor who took xrays of my sinuses. He showed me the inflammation, and then an area of infection that he said was probably never clearing up completely between times. He used a combo of OTC things and a longer dose of Augmentin (can't remember the length right now), plus saw me regularly for about six months. It made a huge difference for me.

At another time, Zyrtec worked great for me--for about a month. Then I started having weird nightmares and terrible insomnia, and had to quit taking it.

I haven't had too many problems recently. Last year, I got a cold and bought this nasal rinse kit at Walgreen's https://www.amazon.com/NeilMed-100-Sinus-Rinse-Complete/dp/B000RDZFZ0/ref=sr_1_5?keywords=nasal+rinse&qid=1583358855&sr=8-5

Having used a couple of different methods of washing my sinuses, I found this the easiest to use. Do be careful with cleanliness, etc., if you choose to do a sinus wash, because you can introduce bacteria and make things worse.

The Zyrtec is really knocking him out at night. My thought was to try cutting it in half after a couple of weeks. Or to find something to rotate it with. It can never just be simple, can it? I will check out your link.

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6 minutes ago, Mom0012 said:

It’s not a bad idea. He’s used one before, just never consistently. I think he’s too tired and rushed to use it in the morning (he gets up for work at 4:30 am) and then I am usually at work when he goes to sleep in the evening. It’s really a matter of finding a consistent time  for me to remind him to use it. I’m averse to greeting him from work with a netipot in my hand, lol.

I'd be so happy if someone greeted me with a prepared neti pot!  It's such a hassle to boil the water, then wait for it to cool to body temp!  🤣

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1 minute ago, Æthelthryth the Texan said:

Have him try taking the Zyrtec at different times in the day this weekend. Different people will react/metabolize drugs at a somewhat different rate, so he may actually have less of that antihistiamine "hang over" if he takes it at a different point in the day. He just needs to play around with it for a bit. 

Have you been able to take Zyrtec long term without an issue? I know everyone is different, but I’m wondering if I should try to rotate it with something else?

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3 hours ago, Æthelthryth the Texan said:

When I took only Zyrtec for a long period of time (say six months) a couple of years ago, I definitely had a weird couple of day withdrawal of sorts when I dropped it cold turkey, where I got super itchy for a bit- my skin felt crawly and itchy- in much the same way codeine makes me feel. It was a weird couple of days. I think I even posted about it here. It passed quickly though and I had no issues after getting past that. 

Since using the Azalastine (Astapro) as my mainline treatment though, I have had zero issue going on and off Zyrtec as needed. I usually drop the Zyrtec first when the pollen count drops, and am more typically on the Azalastine maybe 9 months of the year altogether, where as the Zyrtec I tend to be more sporadic, and it's no where near that amount of the year. Now I do use the Azelastine twice a day when counts are high here, so that is different than how your dh is taking it...... I live in Southern Texas where things are perpetually in some sort of bloom so the pollen counts here come fast and hard. Anyway, I think staying on the Azalastine a few more days when dropping the Zyrtec helps taper down for me, so I've never had the withdrawal issue again. I have yet to have had a problem dropping the Azelastine either as far as withdrawal symptoms. 

But someone up thread mentioned that when you hit into a full out severe allergic reaction or response, it can take quite some time to tamp the body's response down, so the fact that he is responding so quickly to the Astapro + Zyrtec alone bodes well for him. Especially only taking the Astapro once a day. He has room to up dosages as needed, and has more options available for layering if ever needed, which is what you always want. Margin to increase dosing is nice, rather than needing to max out to get things under control and then you have no where left to go, if that makes sense. 

I"ll also add in that it's a good time for him to be using those and not a steroid based nasal spray (Nasonex, Nasacort, etc.) if at all possible. I'm sure I will have some argue with me here- but those can definitely affect your immune response, and this isn't a great time of year for that. By design they tamp it down a bit- that's how they work as a steroid based drug to shut down the allergic response. And so right now with flu at such a high rate, Nasacort would not my drug of choice to recommend if these others are working well for him and giving him relief. You want to keep that immune system up while still controlling the allergies. If he needs the extra boost, then that's one thing, but if he's managing fine without a nasal steroid, just let that be for now if possible. But once viral activity rates drop around the US as the weather changes, Nasacort can be a nice addition if his symptoms increase with spring/summer pollen levels. 

And of course my disclaimer, I am not an MD. I just worked on a lot of infectious disease and other allergies trials in a former life, and there's a lot of overlap with what is an allergic response versus what is a viral response and so on..... But definitely go talk to an allergist at some point again if you can get him.Things change with age, so a new panel could be helpful.  The meds they have available now are absolutely insane with what some can do- miracle level. The research is becoming increasingly complex and specialized to where I don't think most generalizations hold anymore and they definitely have a LOT more options at their disposal to help him Rx wise than the things people have mentioned in this thread - things like interleukins etc- if he finds the right allergist and/or has a more severe outbreak and needs a heavier hitter med.  Allergies are most definitely not straight forward at all- and are quite complex over the old way of looking at things like "oh it's hay fever, here have some Benadryl". 

Anyway, hopefully he keeps improving! Good luck! 


Thanks for writing all of that out! I appreciate it. Once he’s had a week or two of relief, maybe we’ll cut back on the Nasonex and see how he does with a lower dose or just the Astepro. I’ll have him experiment over the summer with Nasacort. There’s a new allergist at the practice I’ve been taking my ds to for his food allergies and I’ve been happy with her for him. Maybe I’ll take dh to see her in case there are better suggestions for him than what we’ve gotten from allergist visits in the past.

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