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Wednesday, April 16, 2014
Severe Allergy Trouble
I am a 25 year old male who relocated to Cincinnati from Atlanta about 1 1/2 years ago. I am a native of Ohio but lived down south most of my life. Since the age of around 6 I've had serious allergy and sinus problems including nine sinus operations and several attempts at shots. Presently I have been on shots for 6 months and starting to have reactions as I did when I was younger yet not to the extent as to asthma and anaphlaxis. Currently I take Zyrtec, childrens' Sudafed, Wilson's Solution (gentamycin and saline nasal irrigation). My PCP is part of the UC medical system and may refer me to your office if I continue to become more symptomatic. Will there be any more medications developed in the future? I heard of possible gene therapy to shut down IgE production. Thank you in kind for reviewing my situation and questions.
You have a complicated condition which requires further evaluation. There are associated conditions that can predispose individuals to recurrent sinus infections such as allergic rhinitis, non-allergic rhinitis, immunodeficiency, and structural problems which it sounds like you have had based on recurrent surgeries. It is important to implement environmental control measures in the home and work (if possible). I am not keen on Wilson's solution, as this can lead to antibiotic resistance. Many individuals with recurrent sinusitis have coagulase resistant staph colonizing their sinuses which do not respond well to antibiotics. I would favor regular irrigation of your sinuses with saline (salt) solution using the Rinoflow which is a compressor with an attachment to deliver microionized saline into the nasal cavity and paranasal sinuses to continuously clean out the sinuses. It sounds like you don't tolerate decongestants well as you are taking very small doses. This further emphasizes the need to address the above issues I am raising. Good Luck!!
Jonathan Bernstein, MD
Associate Professor of Medicine
College of Medicine
University of Cincinnati