ENS and Allergy Meds
Hi Dr Houser You had mentioned starting on my meds again for my allergies before my June 5th appointment. I am on Zyrtec but I am wondering about XYZAL. Is there anything you can tell me about this new allergy med as compared to a Zyrtec? js

I have had several patients tell me they thought it was better than zyrtec. Also, generic zyrtec may be dilute/weak according to patients. The problem is getting xyzal covered by insurance with seeming good alternatives OTC.

Hi Doctor Houser Prior to my turbinectomies I was getting allergy shots which did not seem to help me much, if any. Very soon I plan on going to the Allergy Associates of Lacrosse, WI to check into sublingual immunotherapy. It has worked well with friends and family members, but is this safe as compared to shots? It seems to be more effective and widely used in Europe. js

I do not think more effective is a proper statement, possibly as effective is the description for SLIT. The safety profile and patient convenience are the real plusses with SLIT. Unfortunately, SLIT is not covered by insurance in the US.

Dr H- Can you tell me why one side of a nose may swell more than the other? My right side was hacked more than my left but it is the left that feels hollow-very odd? js

Though TE disagrees, I still think there is an element of neural regrowth that may be assymetric. This is also why some with turbinate excision do not experience ENS. Yes, I saw a subject yesterday with 20% IT on each side, complaining of dryness and nothing else. Cotton test made him feel plugged up - he feels his breathing is good. Does he have ENS - yes. Mild - very.

Dr. Houser- I think you are exactly right because I had very bad crusting on the left side post op for weeks and the doc said he went more on the surface. There is nothing there on that side...very, very hollow!! However, when it gets really, really cold the right side is worse, but it is also the side that has a tendency to swell and fluctuate more. I want to know if you think this is okay. I have written a very generic letter about myself, your article and Chris Martin's book. I have got the names of a lot of ENT doctors in Illinois and I plan on making copies of your article to send with my letter. However, are you losing money by me doing this? Also, would I be breaking any copyright laws- I suspect I am? I think this is my way of a grass roots effort to bring awareness but I think if others did it in their prospective states it could make an impact. js

I do not lose anything, but the paper is copyrighted by the Archives of Otolaryngology. You should probably get their approval 1st. Technically they would stand to lose money (docs might have paid for the article), but in reality I would not expect any downloads from them. In the end you are advertising the journal so they should approve - but do seek their approval to keep yourself above reproach.

Doc, as you brought me into this. I wonder if you are game for a public analysis of js's CT scans (if js agrees of course) in which I intend to prove how the alteration of his nasal cavities correlates precisely with his symptoms? js, if you could - I'd appreciate if you would write down a concise list of precisely what your symptoms are and upload a link to at least 10 pictures of your CT scans from the front of your nose till the mid-line coronal section. This should be interesting.

game on

OK. js, It's your move. Here's a good place to post up your CT's: http://www.flickr.com/

Hey Guys I actually would be willing to put my CT scans on this forum for public display, however, I have not had a CT scan since my surgeries. I only have the scan from before the surgeries. Both my IT's were hacked and the tip of my right inferior turbinate was amputated as well. Symptoms: Hollow on my left side Rush of cold air (exacerbated of course by the cold winters) Very, Very light sleep Right ear ache that wraps around my jaw down to the throat (off and on but especially during the winter) Very thick/sticky mucus Dry palate and sore throat during the late fall and during the winter Hard to breath when I exercise I actually I do not feel too bad right now because I am severly allergic to grass so I am currently stuffy with spring kicking into gear. I should say I feel stuffy but my nasal passages are still very patent. js

You can put mine up, too - they are with Dr. Houser, though. All the same symptoms here.

js, if you didn't have a CT taken since the surgery - I don't understand what you are basing your confidence on what was actually resected in your nose and how much? We all know all too well, from our own experiences and many others here that thought they knew, that you cannot rely on what is written in your post-op report or what your operating doctor told you, especially when they see how unhappy you are... You say - this and that were hacked so and so much, but really you have nothing to base it on unless you get a CT and see for yourself. Once you get that CT scan I am quite confident that your symptoms will correlate precisely with your altered nasal anatomy.

Hi TE... I have not been back to my ENT doctor who had performed the surgeries. He is a horrible communicator, so I went and got my records on my own. I am not going to get a CT scan to prove a point. What effects my life are the symptoms I face on a daily basis whether I have had my MT's or IT's resected. I will certainly get one if it will help with the cotton test or therapy, but at this point I am going to wait. You are right, I do not know how much has been resected, but the reports were very specific on technique. All along I thought my MT's were partially resected, but I was certainly wrong when I got the reports back. js