Doc’s Digest Medical Advice from Dr. Sayre

Have you noticed how many different types of sneezes there are?

In my opinion, sneezes are just about as unique to an individual as his or her fingerprint. My mother, born in the era of steam engines, does this “choo-choo-choo-Choo, AHHH-CHOO!” thing, with each “choo” louder than the last, and the final refrain being the loudest of all. I once worked with a nurse that whooped like a warrior charging into battle each time she sneezed. It scared me half to death the first time I heard it! I seriously thought she had been stabbed or something at the nurse's station. I charged out of an exam room to come to her rescue, only to find her nonchalantly blowing her nose.

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... I, LIKE MILLIONS OF OTHER IN OUR COUNTRY, SUFFER FROM THE SCOURGE OF ALLERGIC RHINITIS ...

I will sometimes pant before sneezing, each pant comprised of a rapid, short inspiratory phase, followed by a prolonged expiratory phase. It is sort of like winding up a toy, preparing for a sudden release of potential energy. The sneeze that punctuates this ritual will often violently convulse my body. Although my sneezes are not particularly loud, I have actually dislocated ribs in the past by simply sneezing.

I hate sneezing! Which is unfortunate, because I, like millions of others in our country, suffer from the scourge of allergic rhinitis.

Allergic rhinitis is a condition manifest by inflammation and mucus production in the nasal passages. The cause is an exposure to something in the air that precipitates an allergic reaction. Most of the time allergic rhinitis is accompanied by sneezing, itchy and runny eyes, a runny nose, and a feeling of malaise. I even get irritable when my allergies are bothering me.

Keep in mind that sneezing and a runny nose can result from conditions other than allergic rhinitis. Viral upper respiratory infections can cause sneezing, as can a variety of irritants encountered in our home and work environments. Bacterial sinus infections will sometimes be associated with sneezing as well. And, of course, children will sneeze if a foreign item has been placed up the nose. (Someday I’ll tell you about all the weird things I’ve found in kids’ noses and ears.) For the most part though, persistent sneezing is the result of an allergic response to something in the air. Mold, pollen, animal dander, and dust mites are probably the most common of these allergens.

So what’s a sneezer to do?

Avoidance of the offending allergen is the best first option. I have a really profound reaction to mice for example, and unfortunately, cats also render me a sneezing, wheezing invalid. So our house has lots of mousetraps, but no cats. (Truth is, even if we didn’t have allergies, our house would be devoid of cats. They’re sneaky. This is my personal opinion and not necessarily that of HSLDA, or the rest of my family members for that matter. I like a more predictable pet like Kitty, our Saint Bernard.)

Some folks have problems with dust and dust mites. Good options to minimize exposure include ripping up carpets and replacing them with hardwood flooring, eliminating stuffed animals from the bedroom, and thoroughly cleaning house once a week. (“Right,” you’re thinking. “Like that will ever happen.”) Throwing pillows in the dryer once a week for a short cycle kills dust mites and minimizes mold growth in the fabric or feathers of the pillow. By the way, pillows are fairly inexpensive, so change your pillows frequently and it will go a long way in helping prevent allergic symptoms.

Mold is a major problem in many areas of the U.S. It is primarily a function of excess moisture, so minimizing moisture can be helpful. When we built our house, the plumber vented our bathrooms into our attic. Needless to say, 13 people taking showers and baths pumps a fair amount of moisture into the attic. I recognized this fact too late to prevent the inevitable consequences . . . so we have a mold problem! Clorox does kill mold, but once mold gets a foothold, it can be very difficult to eradicate.

Medication options for allergic rhinitis are many, and vary with respect to a medication’s mode of action, side effects, cost, and delivery mechanism. Over-the-counter antihistamines can be very effective, but most have the side effects of somnolence and dry mouth. There is one non-prescription antihistamine that is nearly devoid of side effects, is fairly effective for most people, and is not very expensive (compared to those requiring a prescription). It is called loratadine (Claritin).

If avoidance of allergens and/or the use of over-the-counter antihistamines is not effective, it may be necessary to consult with your physician. Prescription options are many, and include various types of nose sprays and non-sedating antihistamines, used separately or in combination. Note that I have intentionally eliminated decongestant nose sprays as a treatment option. These create a dependency, and should be avoided for the treatment of allergic rhinitis.

If avoidance of the offending allergen is impossible, and medication is ineffective, allergy testing with desensitization therapy is a reasonable alternative. Although this can be both expensive and inconvenient, I have seen some real success with this approach. I close with a word of wisdom I learned from my dad. “When you're out with your honey, and your nose is kind of runny, you might think it’s funny, but it’s not.” (Sorry, I couldn’t resist!)

About the author An HSLDA board member since 1997, Dr. Rodger Sayre is a family physician, and his wife Mary is a registered nurse. They live in Tunkhannock, Pennsylvania, and teach their 11 children at home. Dr. Sayre received his medical degree from Thomas Jefferson University in Philadelphia and maintains board certification in family practice. A Geisinger Medical Group associate with a busy practice in Nicholson, Pennsylvania, he is a member of the Christian Medical Association, the American Academy of Family Physicians, and the American College of Sports Medicine. Please Note The views of guest columnists may not reflect the views of Home School Legal Defense Association.