Patient: Hi,I’m an 18 year old female and when I sleep my face sort of blows up and my nose becomes humongous. It’s been happening for about 2 years now. I look like a completely different person. I tried every kind of different pillows, I tried sleeping on a recliner to no avail. I tried my doctor and showed pictures, she said she can’t understand why it’s happening and said I should try a nasal spray (Nasacor) and an antihistamine but still to no avail. Please help, I’m so extremely desperate.
Doctor: Welcome to Ask The Doctor. We are here to help you.You seem to be suffering from Allergic Rhinitis. Since you have bee n on treatment with anti-histaminics and nasal spray which didn’t help, i would advice you to first of all get a X-Ray Para Nasal Sinuses (PNS) and Serum IgE levels done.X-ray would help to rule out any nasal polyposis, which might be the reason from your recurrent sneezing.Serum IgE levels will help us to be sure that this is actually allergic or something else.If the X-ray PNS shows slight sinus infection, then it can be treated with conservative treatment. But if the infection is severe, you would require surgery for the same.Conservative management includes:1. Steam inhalation 4-6 times a day.2. To take anti allergic like Levocetrizine3. In cases, who don’t respond to anti allergic drugs, Fluticasone Nasal spray.4. Shirt course of antibiotics like Amoxycillin and Clarithromycin.Since you have already tried all this, i would advice you to go for a longer duration of treatment say for 4-6 weeks.If your X-ray PNS and Serum IgE levels are normal, then this can be due to excessive Parasympathetic stimulation or Trigeminal Autonomic Stimulation, that is relatively difficult to treat as this is a natural body’s response.I would also like to point here, that in case you have severe headache, reddening of eyes associated it sneezing, this can be Cluster Headache. The Cluster Headaches are transient come for a few seconds and stay up to few minutes and are associated with watering of eyes, redness of eyes, watering from nose. There are few drugs like Pregabalin or Carbamazepine which helps in cluster headache but actually the mainstay of treatment is oxygen therapy during the acute course.Share my opinion with your doctor.I hope it helps.Stay Healthy.