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RAF481 - Why I'm Sick 3 Months Out of the Year · Running: A FEVER

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  Running: A FEVER. Why I'm
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  Sick 3 Months Out of the Year.
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  Welcome to Running: A FEVER.
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  My name is Michael Davis and this is
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  a show about fitness, diet, and medicine.
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  My goal is to live a long, healthy,
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  happy, active life right up to the very
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  end.
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  It's all about livin' long and lovin' life.
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  For the last two years I've been getting
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  sick about twice a year, usually in the
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  spring and late summer or fall.
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  It's kind of like a cold with congestion,
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  runny Nose, sore throat, but no fever usually.
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  This normally wouldn't be that big a deal,
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  but it takes me about six weeks to
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  recover.
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  Sometimes more, which is a pretty big deal.
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  The last time this happened was March of
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  this year.
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  I went to my primary care provider and
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  She didn't know if it was caused by
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  allergy or something else,
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  but it turns out I had a really
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  bad sinus infection.
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  Antibiotics mostly cleared it up, but even after
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  I started breathing again weeks later,
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  my voice was still affected and I could
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  feel some congestion somewhere in my sinuses.
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  It took about two months to completely recover.
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  I had complained to my PCP about the
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  fact that this happened often and the long
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  recovery time.
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  So she sent me for a sinus CT
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  scan and referred me to an ear, Nose,
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  and Throat specialist,
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  also known as an ENT doctor.
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  The official name is otolaryngologist, but I am
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  just going to say ENT.
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  The VA had not sent him my CT
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  scan, but fortunately I brought the report with
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  me just in case that happened.
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  I'm not sure if it helped, but I
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  explained how I was getting sick for three
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  to four Months Out of the Year
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  and hoped it could help me do something
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  about it.
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  He asked me a lot of questions.
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  What had I tried in the past?
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  Had I ever used Flonase or Astelin in
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  combination?
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  What other medications have been prescribed?
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  Did I have seasonal allergies?
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  Did I have sleep apnea or another respiratory
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  disorder?
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  Did I have acid reflux?
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  After all that, he concluded that I probably
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  had recurrent sinusitis.
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  That means that I experienced inflammation, which cleared
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  up in a few weeks, and then happened
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  again later,
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  repeatedly occurring, then clearing up, then recurring again.
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  This is opposed to chronic sinusitis, which would
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  be continuously having a state of inflammation in
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  your sinuses,
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  Or acute sinusitis, which would be inflammation that
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  came on suddenly and lasted a short period
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  of time.
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  Having determined this, he prescribed what he called
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  a regimen that consisted of three things to
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  be done on a daily basis.
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  The first is a saltwater rinse using a
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  product called NeilMed Sinus Rinse.
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  I've actually used this a number of times
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  and have had it in my medicine cabinet.
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  It consists of a bottle with a top
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  designed so you can hold it up to
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  a nostril.
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  I will just show you the bottle that
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  I have right here in this top part.
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  You just kind of stick up to your
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  nostril.
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  You squeeze the bottle, forcing water to go
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  in one nostril, wash out your Nose, and
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  then go out the other nostril.
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  Then you repeat it from the other side.
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  The water is mixed with a powder that
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  comes with the bottle, and you can get
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  refills.
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  As I understand, it is mostly salt.
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  He emphasized that I should use distilled water,
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  which I had not done in the past,
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  but I am doing now.
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  The other difference is that I had used
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  warm water from the tap.
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  Now I was pouring the distilled water from
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  a gallon jug, and it's cold.
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  It Doesn't have to be, but I haven't
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  gone to the trouble of heating up the
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  distilled water.
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  It's not very pleasant, but you get used
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  to it.
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  If you've ever been in a swimming pool
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  and somehow got water up your Nose, you
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  know kind of what it feels like.
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  I'm supposed to do this on a daily
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  basis to keep my sinuses free of irritants.
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  The other two are easier, just nasal sprays.
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  One may be familiar.
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  It's called Flonase or fluticasone.
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  This common over-the-counter medicine is a
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  corticosteroid that works by stopping your immune system
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  from overreacting to allergens like pollen, dust, and
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  pet dander.
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  It reduces swelling.
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  Flonase targets multiple inflammatory substances rather than just
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  histamine,
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  which many common over-the-counter remedies are
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  designed to block.
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  The other medication is Astelin, which is also
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  a spray.
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  Astelin hydrochloride.
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  By the way, I just noticed that many
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  medications, especially over-the-counter nasal sprays
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  designed just to clear up the Nose rather
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  than treat the underlying condition,
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  have HCL in the name, such as Phenylephrine
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  HCL, also known as Neo-Synephrine.
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  I always thought these were highly diluted forms
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  of hydrochloric acid, but that's not the case.
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  The HCL does stand for hydrochloride, but it
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  isn't the acid itself,
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  but the drug is combined with hydrochloric acid
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  in the manufacturing process to form a salt
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  that is more easily absorbed by the body.
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  Hydrochloric acid would probably be very harmful even
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  in diluted doses.
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  Astelin is one of those over-the-counter
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  antihistamine remedies that I mentioned before.
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  These medicines work by binding histamine receptors,
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  preventing the histamine from attaching and triggering allergy
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  symptoms,
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  such as sneezing, itching, and runny Nose.
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  But Astelin also exerts a broader anti-inflammatory
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  effect
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  by inhibiting the synthesis and release of other
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  inflammatory mediators,
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  including leukotrienes, chemans, and cytokines.
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  I remember cytokines from discussions about COVID that
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  mentioned a cytokine storm,
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  which is a severe life-threatening immune system
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  overreaction.
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  Two sprays of each of these along with
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  washing out my sinuses with a saline solution
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  every day.
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  I've been inconvenient but a lot more convenient
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  than being sick for a quarter of every
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  year,
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  making me tired, making it hard to sleep,
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  making it difficult for me to sing, and
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  even record a podcast.
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  It remains to be seen whether this treatment
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  works. Hopefully it does.
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  Otherwise, I would expect the problem to start
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  again around the August-September timeframe.
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  I will report back.
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  But in the meantime, I suggest that if
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  you have a similar problem, talk to a
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  doctor.
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  Your situation may not be hopeless.
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  Don't just chalk it up to allergies or
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  being around sick kids or something.
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  There may be a solution.
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  Well, I hope this topic has helped you
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  understand a little bit more about sinus problems.
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  And until next time, if you've got the
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  fever, keep it burning.
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  And if not, catch the fever.
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  And I will see you next time on
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  Running: A FEVER.