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For once, I’m not talking about coping with mental illness. Nope, this time it’s rhinitis—painfully irritated sinuses and ear congestion—which has been bedeviling me since around March.

Negative results on dozens of allergens with the scratch test - good news in some ways, not so much in others.

Negative results on dozens of allergens with the scratch test – good news in some ways, not so much in others.

After months of suffering intermittent but progressively worse symptoms, mainly ear congestion that made everything sound like I was underwater, I complained to my PC and was referred to an allergist. After waiting a month, I finally got to see the allergist. He gave me fluticasone propionate (Flonase) nasal spray and set up allergy testing.

Added to the loratidine (Claritin) I was already taking, the nasal spray was practically miraculous! Between the two, I could almost pretend there wasn’t a problem. But after going off antihistamines for testing and starting to have headaches, the doc said it’s best to use antihistamines intermittently. They lose effectiveness over time, and when you stop taking them, you tend to get rebound symptoms. Kind of like stopping an antipsychotic can trigger psychotic episodes, because the chemicals causing the symptoms continue to build up in the body while the medication prevents reactions to them. Brilliant.

So I went in for a scratch test: negative. For everything. That just means that you’re not severely allergic, they said; the next round of testing might show something different. Rather than doing the standard needle test, because needles typically cause an involuntary vasovagal response (fainting), they did serology instead. I had a single blood draw by my favorite phlebotomist, who never makes me pass out because she has Magic Hands, and the lab ran the tests.

Tuesday we went over the lab results: negative. For everything. Which means I don’t have to: isolate myself in air conditioning, keep windows closed, stay indoors for months, give up hiking and backpacking, and stop line-drying my laundry. None of that would make a difference because I’m not allergic to the outdoors. And that’s a really good thing; I’m grateful that I don’t actually have allergies.

But I went home feeling pretty upset. Not just because of the parking ticket I got while at the appointment, but because this means I’ve been suffering horrible allergy symptoms for 7 months in reaction to…nothing. At least, nothing that can be pinpointed.

After some online research, I learned that non-allergic rhinitis can be triggered by: any particulates in the air (dust, pollen, smog, dander, whatever), changes in temperature and humidity, hormonal fluctuations (but they don’t mention which hormones are the likely culprits), chemical exposure, oral contraceptives, antidepressants, NSAIDs, alcohol, hot or spicy foods, and smoking cigarettes—which I’ll be quitting (again) in another week anyway. Oh, and stress. Yeah, well…

None of those factors is an obvious trigger for me (except, of course, smoking). I can keep an eye on hormonal fluctuations, but my meds and diet aren’t at fault. So all I can do now is try to use a few coping strategies to reduce symptoms. Each one in isolation helps a little bit, but together they might actually make this crap more or less tolerable. At least, that’s what I’m hoping.

  1. Nasal spray – the Flonase really helps, so I’ll just keep using it until things improve. If they ever improve, that is.
  2. Nasal irrigation – forcing a buffered solution (water with baking soda and salt) through the nasal passages helps clear out accumulated goo and soothes sore tissues. I’ll be rinsing my sinuses on a daily basis until symptoms abate. I prefer a squeeze bottle over a Neti pot – the additional force makes it more effective, it’s faster, and I don’t have to crane my neck at a weird angle to make nose-water dribble all over my face.
  3. Humidity management – I can’t control the weather, but I can augment indoor humidity. I’ve already ordered a humidity gauge so I can determine what needs humidifying, but I suspect I’ll end up buying a new ultrasonic humidifier (no wicks or filters to get all yucky and gross) for the bedroom, at least for the winter months. I might also need a portable humidifier for the office and travel – spending a week in New Mexico (at about 26% humidity) was absolute hell on my sinuses.
  4. Decongestants before flying – the pressure changes for takeoff and landing are extremely uncomfortable with the level of ear congestion I’ve been experiencing, so the allergist suggested Sudafed. Unfortunately, it looks like pseudoephedrine is metabolized in part by two enzymes that don’t work “normally” in my body, so I probably have to look for other options.
  5. Cleaner air – we have a huge Honeywell air purifier in our basement, but might need to get additional air filters for other parts of the house. That’s going to be expensive, though – and the replacement filters add up.
  6. Occasional antihistamines – when it gets really bad, I can still pop a Claritin. I just can’t rely on them to keep symptoms in check, or else they’ll stop working.

Maybe by combining these various strategies, the rhinitis symptoms will become more tolerable. I’m going to give it a try for a few months to try to avoid a CT scan and surgery. Here’s hoping, anyway.

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