General Tips Hay Fever

  • One can do an allergy test at pharmacies to see what one allergic is to.
  • One can buy allergy test kits to find out what one is allergic to.
  • Keep windows shut even at night.
  • Stay inside when pollen count is high [avoid walking in grassy open places particularly during early morning (pollen rises in the air and evenings (pollen falls to ground)]
  • Check pollen forecasts and plan your day (World Pollen count (www.meteovista.co.uk).
  • Wear wraparound sunglasses.
  • Shower and wash hair before going to bed.
  • Wash face regularly and avoid scratching your eyes.
  • Remove or shake outer clothing before going indoors.
  • Vacuum preferably with a high-efficiency particle arresting (HEPA) filter  and dust with a damp cloth regularly.
  • Avoid gardening particularly grass cutting and grass areas and picnics/camping.
  • Avoid dry washing outdoors when pollen count is high as this can bring pollen into one’s home.
  • Avoid keeping flowers in one’s home.
  • Wash/comb animals that have been in long grass, keep them out of your bedrooms.
  • Don’t stroke pets or let pets get close to your face and/or try to keep them out of the house as long as possible.
  • Don’t smoke and stop other people from smoking can irritate eyes nose and airways
  • Eat a good healthy diet
  • Use petroleum jelly around nostrils, pollen will stick to petroleum jelly and protect nostrils.
  • Go to seaside holidays or colder mountainous holidays rather than countryside, or visit southern hemisphere when pollen is different.
  • Use air filters at home for cleaner air.
  • Moisturise skin regularly as hay fever and dry skin conditions tends to occur at the same time.
  • Moisturise skin regularly as allergies and dry skin conditions tends to occur at the same time.
  • Use calamine lotion and dab on skin with cotton wool or other soothing creams. Calamine cream can be used (but check ingredients to make sure one is not sensitive to ingredients)
  • Sinus (congestion, blocked , runny nose) tips
  • Sore throat tips
  • Dry cough tips
  • Chesty cough tips
  • Headache tips
  • Eczema tips

Natural treatments and tips (DR Axe)

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  • Simply type the symptom/condition in the search bar and read the informative treatments.
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How to use:

Nasal drops

  • To lie on their back with the head just off the bed and tilted so the chin is highest point of the head.
  • Patients should breathe normally through the mouth while instilling the prescribed number of drops into each nostril (see Image 2). Administration of drops while sitting or standing with the head tilted backwards causes more solution to pass down the back of the throat;
  • To hold this position for two minutes after drop instillation. This enables the steroid to reach the region where polyps arise and reduce inflammation where the sinuses open into the nasal cavity;
  • If multi-dose, manufacturers recommend that the dropper should be cleaned by wiping the nozzle with a clean tissue before replacing the cap.
  • It is important to understand that nasal sprays and drops are not always effective at reaching the sinuses, even post-surgery, and this has lead some rhinologists to advise combining nasal drops with saline irrigation.
  • It is the larger volume that improves penetration to the sinuses.
Image 2: Self-administration of nasal drops

WWW.DNAILLUSTRATIONS.COM

Using nose drops . Kernow Clinical Commissioning Group. 2021.

https://rms.kernowccg.nhs.uk/content/files/

Using%20nose%20drops%20and%20sprays.

pdf(accessed Oct 2021).

Fluticasone nasal spray and drops. NHS. 2020.
(accessed Oct 2021).
Merkus P, Ebbens F, Muller B, et al.
The ‘best method’ of topical nasal drug delivery: comparison of seven techniques.
Rhinology 2006;44:102–7.

 

Nasal irrigation

  • That if they are also using intranasal medication, this should be used after nasal irrigation. This is because the medication will have better distribution and efficacy;
  • To stand in front of a basin, tilt the head away from the bottle, and squirt the solution into each nostril, aiming the stream toward the back of the head, not the top (see Image 7). The solution may flow into one nostril and out the other (see Image 8);
  • To avoid breathing through the nose while preforming irrigation, as this can introduce water into the ear canal potentially leading to infection;
  • Sometimes a burning sensation in the nasal cavity occurs particularly if a non-buffered hyper or hypotonic irrigation solution is used; however, most patients seem to adapt to this.
  • Where possible, the use of pre-mixed irrigation solutions and sterile water should be used to reduce the risk of infection.

 

 

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Image 8: Avoid breathing through the nose while performing irrigation

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Principi N, Esposito S. Nasal Irrigation:

An Imprecisely Defined Medical Procedure.

IJERPH 2017;14:516. doi:10.3390/ijerph14050516

How to perform nasal irrigation. UpToDate. 2021.

https://www.uptodate.com/contents/image?

imageKey=ALLRG%2F71059&topicKey=

PC%2F83012&source=see_link

(accessed Oct 2021).

Nasal sprays

  • To keep the head upright, insert nozzle tip into one nostril keeping the other nostril open;
  • Hold the bottle with the index and middle finger at the top and the thumb at the bottom;
  • To use their right hand to spray the left nostril and vice versa, so that the spray is directed away from the septum (see Image 1). Holding the spray with the same hand as the nostril (e.g. right hand for right nostril) increases the risk of nasal irritation and bleeding since this directs the spray towards the nasal septum​[18]​;
  • That sprays should be administered while they slowly breathe in through their nose. After removing the nozzle, they should breathe out through the mouth;
  • To repeat for the other nostril before cleaning the nozzle and replacing the cap.

Other considerations

  • Overuse of some nasal sprays, such as decongestants, should be avoided as this can lead to rebound congestion (rhinitis medicomentosa), where tissue swelling worsens each time the nasal spray is stopped​[22]​. This creates a cycle of continued use.
Image 1: Self-administration of nasal spray

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Benninger MS, Hadley JA, Osguthorpe JD, et al. Techniques of Intranasal Steroid Use.
Otolaryngol Head Neck Surg 2004;130:5–24. doi:10.1016/j.otohns.2003.10.007
Menditto E, Costa E, Midão L, et al.
Adherence to treatment in allergic rhinitis using mobile technology.
The MASK   Study. Clin Exp Allergy 2019;49:442–60. doi:10.1111/cea.13333
Scadding GK, Kariyawasam HH, Scadding G, et al.
BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis
(Revised Edition 2017; First edition 2007).
Clin Exp Allergy 2017;47:856–89. doi:10.1111/cea.12953
By Wendy K Smith & Azhar M.Z. Hasham
The Pharmaceutical Journal, PJ, October 2021,
Vol 307, No 7954;307(7954)::DOI:10.1211/PJ.2021.1.105205