Allergic rhinitis?

[snix]

My rhinitis is triggered by a lot of things: perfumes, changes i the weather, smoke, dust, pet dander.. and when it's triggered, i sneeze non stop, get itchy swollen eyes, my asthma is triggered and I also get rashes..

I always get the question: "are you tired/sleepy?" because of my dark circles which is said to be caused by my rhinitis.

I have been prescribed to take xyzal whever my rhinitis attacks.. Also the doctor before prescribed me to take zadec twice a day for two years which is a long term prevention ofy asthma, rhinits and other allergies but it was so costly and I couldnot afford ut that I haven't started taking it. That was already 3 years ago.

Now I really want my rhinitis to be cured.

@leletmd- What do you think of this doc? Also any recommendations o some allergologists or ent i can visit? Thanks

[leletmd]

@cerelina:
With all due respect to your pedia, we do not really diagnose Allergic rhinitis that early since infants less than 2 months of age are really prone to develop colds/nasal congestion/sneezing since their nasal anatomy is still immature and not able to filter well. Also, powder and cologne are not considered allergens. They are irritants and thus, they do not cause allergic rhinitis.
Example of allergens - dust mites, pollens, animal dander, feather, molds, etc.
Example of irritants - strong scents such as perfumes, fabric conditioners, smoke fumes (from cigarettes and cars), dust, weather changes, stress

@snix:
From your post, it seems you have a combination of allergic rhinitis and vasomotor rhinitis.
The dark circles under your eyes are called "Allergic shiners". It is a sign that you have prolonged nasal congestion and thus, anti-histamines are not enough to control your symptoms.
Also, the mere fact that your rhinitis already triggers your asthma is a sign that you need to be on maintenance medications and need to be seen by a specialist.
Can you state your preferred location so I can make suggestions regarding the available allergologists? Or you can also google PSAAI and look for an allergologist near your area.

[snix]

^i'm from caloocan but i do work in quezon city so i guess that would be fine too..

btw, the doctor that i mentioned in my previous post was also an allergologist. Was because he already moved to the states. i'm also using a maintenance inhaler right now which is seretide, morning and night. This was prescribed to me to be taken continously to prevent any allergy attacks and so far it isn't working for my allergies though my asthma is controlled.

Should I just start taking zadec? Or is it too late already to follow my previous doctor's prescription? Also, he prescribed it to be taken twice a day. Is that too much? Thanks doc

[leletmd]

@snix:
We use zadec for prevention of allergic symptoms, not ideal for patients who are already having persistent symptoms. I suggest you visit an allergologist first so that you can be properly evaluated since from your post, it seems like it has been years since your last visit to the allergologist. There are a lot of allergologists in QC: St. Luke's QC: Dr. Ortigas, Dr. Rosa Ong, Dr. Eden Macalalag, Dr. Michelle De Vera, etc.; UDMC: Dr. Madeleine Sumpacio, Dr. Manuel Ferreria, etc.

[cerelina]

My  1month old daughter just had her check up today and her colds hasnt improved yet (we can still hear some wheezing sounds, hoarse voice and halak like sounds)  was given amoxicillin for a week prior to this visit according to her pedia there isnt any phlegm in her lungs he is now convinced that its allergic rhinitis he prescribed alnix 0.5ml OD.

I used to be a rep for zyrtec and i am very familiar with the safety profile of cetirizine however im contemplating since the safety studies of zyrtec has been conducted in infants 6 months onwards and my baby is only 1 month old.

[snix]

@leletmd- thanks doc do you know some good allergologists in mcu hospital? or healthway in sm north?  or anyone who has a clinic in caloocan..though there are some allergologists there, i'd like to see good one to diagnose my case. Thanks

[sakuradrops007]

Doc Lelet and fellow girltalkers, I hope hindi masyadong OT ang post ko since this forum is under childbirth and childcare, but I'll talk about my AR. I want to share first yung health history ko. I'm 27 y/o. 2006 I was diagnosed with PTB and pneumonia. I took PTB medications for a year, nagkaroon ng atelectasis yung upper right lobe ng lungs ko. After a year I was diagnosed with asthma and every time I visit my pulmonologist parating my wheezing sa lungs ko even until now. Ang sinabi nya the wheezing could be due to the atelectasis or the asthma. I was prescribed with seretide during that time and antihistamines because may nakita din syang sinusitis. Then by 2008 nag start na yung allergic rhinitis ko and vasomotor rhinitis. Medyo nakaka cope ako with the asthma and everything. Pero lately ang pinakamalala is the vasomotor rhinitis meaning anything na ma smell ko fabric conditioner, perfumes, soaps, shampoos, even the smell of magazines and pen markers would make my throat itch and pag minalas ako I would have fever and have to rest for at 3 to 5 days bago bumuti ulit ang pakiramdam ko. By the way I have post nasal drips. Hindi naman ako sensitive sa smells before (5-6 years ago). I was even using perfumes before and never had  a problem sa stuffs na may mga strong odors. Pero now even the faintest smell of perfume or even shampoos and soaps makes me sick (itchy throat with slight fever, shortness of breath, body malaise that could last up to three days). Doc, will this oversensitivy sa mga fumes forever na? Is there any way that at least ma lessen yung pagka oversensitive ko with these smells? Paano po ang medical management if ganito na sya kalala na nakaka affect na talaga sya sa activities of daily living? Feeling ko kasi tuloy nagkakaroon na ako ng social isolation to avoid lang these fumes para hindi magkasakit. Last time I was sick for more than five days dahil lang nakaamoy ako ng lotion na may strong smell I visited my pulmonologist last week and was prescribed antihistamine (Virlix) and Avamys spray. I'm feeling hopeless na and sometimes it's really depressing to have this kind of condition:(

[leletmd]

@cerelina:
The symptoms you mentioned are all symptoms of infectious rhinitis, not allergic rhinitis.
Allergic rhinitis is episodic. The symptoms occur only upon exposure to the allergen and not present the whole day. This is the main differentiation between allergic vs infectious rhinitis.
I suggest you have your pedia refer you to an allergologist to confirm his diagnosis.

@snix:
Dr. Dan Alcantara has clinics at MCU hospital and also at Healthway SM north. He is a PGH trained allergologist.

@sakuradrops007:
It sounds like you have a heightened sensitivity to strong smells/fumes. Since your symptoms already affect your quality of life, there is already a need for maintenance medications (nasal steroids like Avamys) given for at least 2 to 3 months. I suggest you visit an ENT for definitive management.

[cerelina]

Thanks po

[sakuradrops007]

Hi doc, thanks po. What's the main benefit po ba of taking the nasal steroid (Avamys)? Is it just for the relief of symptoms or will it at least lessen my heightened sensitivity? I will also try to visit an ENT. Can you kindly give me an idea kung ano po ba ang ma oofer na management ng ENT compared sa medical management that my pulmo is doing right now? Thank you very much po for your time and effort in answering all our queries

[leletmd]

@sakuradrops007:
Nasal steroids work against nasal inflammation, thus removing nasal congestion and other symptoms of rhinitis. Once these symptoms are controlled, it might also lead to a decrease in your sensitivity.
The ENT specialist can do nasal endoscopy (sila lang ang trained to do this) to check for anatomical defects or abnormalities like nasal polyps that may be contributing to your problem. Sila kasi talaga ang nagmamanage ng vasomotor rhinitis.

[artemis26]

medyo OT yata ang question ko, pero I' think I'll ask anyway, since active dito si sis leletmd

doc, is salbutamol soley prescribed for asthma? Yung daughter ko kasi was sick last week, started out muna as sipon (yung mucus is watery to yellowish sometimes, moreso kapag umaga, yellow talaga). then on the 3rd day, she started coughing na. 1st day pa lang last week (monday), we had her checked-up, reliever lang ng pedia nya. nag-prescribe ng loraped, then comeback after 4 days if nagpersist. so ayun, by friday, nagpacheck-up kasi nga naguubo na (although hindi naman grabe, wala naman plema, parang mahigpit lang). she prescribed salbutamol. i wasnt there when they went for check0up, kasi if I was, i could have asked right away if may asthma nga yung anak namin. pero sabi ni hubby (sya kasi kasama nun) na wala naman raw plema..yung ubo is because raw yung sipon naiipon, nababara sa throat kapag natutulog (suprisingly, kapag gabi mahimbing naman tulog ng anak ko).

and then it got me worried that repeated AR can lead to asthma. you see kasi, my daughter i think has AR, and ang triggter is ang weather kaya kabisado ko ang nirereseta sa kanya na gamot which are mostly antihistamines (loraped, aerius). so i was suprised na may salbutamol. until now meron syang bahagyang pa-ubo-ubo.

is it best to have her checked with an allergologist or a pulmo?

[leletmd]

@artemis26:
We also give salbutamol to patients with infectious bronchitis and bronchiolitis (both are infections with lung sounds similar to asthma) and asthmatic bronchitis aside from the regular asthma cases. Best pa rin to clarify it with your pedia as to why salbutamol was prescribed.
At the risk of sounding biased, I think it would be best to have her evaluated by an allergologist since she may have both allergic rhinitis and asthma.

[artemis26]

thanks sis leletmd. yesterday she's better na. pero we will sked that visit with an allergologist. mabuti na lang meron malapit, you've mentioned Dr. Danilo Alcantara.

 

[mskathie]

My son has this. It was October/November last year na we noticed na meron syang white line under his eyes at lagi syang nag sneeze every morning kaya we brought him to his pedia and the pedia just prescribed anti- histamine and petroleum jelly for his eyes. Unfortunately hindi naman nawala. So we decided to look for allergologist, and luckily we found Dra. Sandejas. She prescribed allerkid and montemax for three months and salinase spray. Now ok na yung son, follow-up check up kami this weekend to see if my son still need to continue his meds.

[Mommy P]

Just came from the 2nd month check up of my baby..nung chi neck yun breathing niya, may balak daw at allergic rhinitis daw. I told her na bumabahing siya minsan in a day. I have asthma and allergic rhinitis. Niresetahan siya nang allergic (cetirizine), Kaso nag aalangan ako na painumin si baby kasi 2 months pa Lang siya..is it really safe na mag take into ang two month old baby ko?

[agape]

Anyone who tried QUERCITIN supplements for allergies?

[leletmd]

@Mommy P:
Your baby is at risk of developing allergic diseases due to your maternal history, but as I said earlier, at 2 months of age, it is still very early to diagnose Allergic rhinitis. As to giving cetirizine at that age, there are special cases wherein we give anti-histamines early with weight adjusted doses, but of course, the diagnosis of allergy should first be confirmed. I think it would be best to bring your baby to an allergologist for confirmation of diagnosis.

[Mommy P]

Hi sis leletmd

  I brought my baby to dr Manuel canlas, he prescribed solmux broncho, natravox n allerkid for one week. Tig 1 ml ang dosage morning n evening except for allerkid na evening Lang I take. He weighs 14 pounds. Nag pupu siya 3x kagabi, slimy yun pupu niya, and I was thinking nilalabas niya ba yun mga sipon niya?

My only concern is bakamagtutuloy tuloy yung madalas yang pag pupu at bka diarrhea na ang maging result. Medyo worried Lang ako sa liver niya thinking na is he too young na resetahan nang napakaraming gamot.

I hope you can enlighten me. 

[leletmd]

@Mommy P:
What was the assessment during the check up? Antibiotics were given so I am assuming your baby has an ongoing bacterial infection.
I see 2 reasons for your baby's wet slimy stools. First, it is possible that he is swallowing his mucus causing it to appear in his stool. Second, side effect talaga ng antibiotics ang loose stools since most intestinal bacteria gets killed during treatment, even the good bacteria. This is why we sometimes give probiotics during antibiotic treatment. Probiotics should be given 2 hours after the antibiotics are given, never at the same time, unless you want the probiotic organisms to get killed, too.
Ask your pedia na lang if it is ok to give probiotics to your baby.