Many pats tell me nasal steroid sprays for hay fever don't help. But often this is due to not being taught when & how to use them.
Here are several tricks of the trade which help >90% of my pats to put hay fever behind them.
2/
Nasal steroid sprays take time to build up.
Don't be disappointed if you don't notice a difference for a week or even two. Antihistamine tablets act quickly but nasal steroids need to be used regularly.
If you use them correctly, they are incredibly effective!
3/
Ideally use a nasal steroid spray a fortnight BEFORE the pollen season begins, too late for this year I know.
But put a reminder on your phone for next year.
So mid March if you get spring time hay fever and start of May if you get summer hay fever.
4/
Don't close one nostril when you use your spray. It just pushes the bony septum across and that is not the part where the problem is.
Direct the nozzle of the spray towards the outer wall of the nose.
And point the nozzle back & not up.
Yup - the nose goes back not up!
5/
Don't sniff!
If I could change one thing ...
People sniff their sprays π€¦ββοΈ
Thereby not only eating their snot but also the spray. Unsurprisingly - it won't work as well. It's like putting a moisturiser on & then wiping it off.
If the spray runs out dab with a tissue.
6/
My mother had bad hay fever for years & she suffered unnecessarily. I wish someone had told me this. Hence, why I wrote this thread.
If you want to know more about allergy & how to manage hay fever can I recommend this fab-dab brilliant book π
Normally pollen is too large to enter the lungs, but when a thunderstorm is brewing, updrafts of air can lift whole pollen grains up into the clouds. When exposed to moisture, these grains rupture into tiny pieces and this makes them highly allergenic.
3/
Windy downdrafts then carry these fragments to ground level, resulting in a βpollen showerβ & people can inhale the minute fragments deep into their lungs.
If you have hay fever then this can trigger an asthma attack - even if you don't have asthma.
Cold remedies designed to unblock your nose & nasal steroid sprays, for hay-fever are often found on the same βallergyβ shelf
Do not chose the ones that are marketed as cold relief, decongestants or to treat sinusitis!
2/
You'd think if you had a blocked 'hay-fevery' nose that treatments for a blocked nose would help. And youβd be right. Theyβll help for a few days. But they are not designed for hay fever & if you use them for more than a few days you may develop rebound stuffiness/blockage.
3/
Patients get caught in a vicious cycle of feeling blocked due to allergy, using a decongestant & initially feeling better, but then developing rebound blockage.
There is even a name for this rhinitis medicamentosa. This is why most specialists will not recommend them.
Seen a few tweets where people are reporting #hayfever It is likely this is due to the early tree pollens & suggests birch pollen; the cause of much misery in spring is not that far behind. This calendar from my book can help you work out which pollen is giving you problems
2/
One tip if antihistamines are not doing the trick is to start using a nasal steroid spray 2 weeks before your pollen season.
If buying over the counter, then I suggest to my patients fluticasone proprionate & if via the GP fluticasone furoate but other products work too.
3/
Often pats tell me nasal steroid sprays don't work. There are three common reason why:
1) Stopping them too soon 2) Closing one nostril when using them 3) Sniffing in as using the spray
And as I said above, starting them before you get symptoms can make a huge difference.
Urticaria & a persistent cough can be anaphylaxis.
As can angioedema, wheeze & low blood pressure.
However urticaria & angioedema are not essential to make the diagnosis & in severe reactions may not be seen at all.
2/
The first-line treatment for anaphylaxis is Adrenaline.
Seems easy enough no?
But time & time again studies show a delay in administering it.
Pumphrey (2000). Lessons for management of anaphylaxis from a study of fatal reactions. Clin Exp Allergy 30(8), 1144β1150 β¬οΈ
3/
Contrary to popular belief, facial angioedema does not equate to a patient being at increased risk of developing laryngeal oedema. Although people often worry about laryngeal oedema, wheeze with anaphylaxis seems to trigger less concern.