Thursday 22 March 2018

Prepping for sinus season and what to do after dry January

Ask the GP

Sinus congestion
Sinus congestion

Nina Byrnes

Advice from our GP on how to relieve your sinus symptoms and on the damage which binge drinking does.

Question: I have a recurrent sinus infection and no matter what I do, I can't seem to shake it. I have tried steroids, antibiotics, but nothing seems to work. I work full-time hours and have a busy life with small kids, but I exercise regularly and eat well. Have you any ideas?

Dr Nina replies: Most people assume that blocked runny noses in winter are caused by infection. This isn't actually the case. Sinus congestion is rarely caused by infection, it is more commonly caused by rhinitis or hay fever. This can occur any time of year. It is estimated that 15pc of people suffer from some form of hay fever, with 80pc of those with asthma thought to be affected. Hay fever causes sneezing, runny or blocked nose, and itchy eyes, ears and throat. These symptoms may also lead to sinus headaches and a loss of sense of smell. Seasonal hay fever can make summer miserable for many people.

Most treatments are better at keeping symptoms at bay rather than treating them, so if you suffer in summer I would advise starting treatment each year before symptoms occur. If winter is your trigger it may be worth starting treatment in October. Summer triggers are grass, pollens and weeds whereas winter triggers tend to be dust and moulds. The trigger isn't always obvious.

You can buy many treatments over the counter but always talk to your pharmacist. Older antihistamines can be very sedating and so the newer less-sedating ones are preferred. Nasal rinses may remove allergens and pollens from your nasal passages, which may help.

Your doctor can prescribe you alternative antihistamines, nasal sprays and eye drops. Taking all of these medications together often works better than any one of them alone. The newest therapy on offer is sublingual immunotherapy (SLIT). There are two treatments available at the moment, both of which protect against grass pollen-based allergies. These must be prescribed by a specialist and need to be started several months before grass pollens peak. If grasses are a trigger now is the time to consider this.

There are things you can do at home to help. In spring and summer, avoid cutting grass or activities that expose you to grassy areas. Stay indoors when the pollen count is over 50 - the wesbite has a daily pollen count. Keep windows and doors shut. Don't keep fresh flowers in the house. Shower when you come in from outside to remove any pollens from your clothes.

Keep pets outside or wash them regularly. Dust regularly with a damp cloth and vacuum regularly with a HEPA filter. Don't dry your clothes on an outside line. If you do go outside consider placing Vaseline at your nasal opening to catch any pollen that might try and get in.

Wear wrap-around sunglasses to keep pollen away from your eyes. Keep car windows closed and consider placing a pollen filter.

In winter look at your environment. Ensure adequate ventilation and avoid damp rooms and offices. Keep surfaces clean and dust-free, and avoid heavy furnishings and carpets. Unfortunately, there is no cure for this condition so managing it is important.

Question: I completed dry January, but am fearful of the effects alcohol will have on my body if I begin binge-drinking again this month, after 31 days alcohol-free?

Dr Nina replies: Dry January has become a popular phenomenon with many people trying to undo the damage that a month of excess may have done. There is no doubt that abstaining from alcohol may have some benefits, but in order to avoid the negative effects of alcohol on the body it is essential to manage alcohol intake throughout the year.

Binge drinking at any time is not good. Alcohol is absorbed very quickly into the blood stream and its effects peak after 40 to 60 minutes. Initially it causes a sense of well-being, relaxation and reduced inhibitions, however as levels rise it can lead to slurred speech, reduced rational decision-making, increased anxiety, slowed reactions, and ultimately can lead to confusion, stupor, loss of consciousness, coma and death.

Ingesting on average one to two standard drinks causes the initial sense of well-being but any more than that can cause blood alcohol levels to rise rapidly bringing on the other effects. Chronic excessive use of alcohol increases the risk of psychiatric conditions, heart, gastrointestinal and liver disease and a several cancers.

Many people who drink do so in moderation. However, there is a more sinister side to the legacy of alcohol in Ireland. Alcohol plays a role in one-in-three road traffic accidents in this country. It is one of the most common reasons for admission to psychiatric units, and is associated with increased crime, assaults and violence. It is thought that over half of all drinkers in Ireland have a harmful pattern of drinking.

Alcohol has been around since prehistoric times and is there to be enjoyed. The take-home message is simple if you stay within safe limits on an on-going basis, it can be enjoyed and adverse effects on you and those around you are unlikely.

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