For the past 12 years or so, I've had problems with my sinuses in the spring or fall. It seemed that each season I'd develop a nasty sinus infection, bronchitis or a devilishly persistent cough. Last fall it was a cough that was literally non-stop. My old doctor retired last year, so I went to a new one. The new one gave me some cough syrup, and told me I probably had allergies. So he sent me to an allergist. The allergist tested for 60 types of triggers, and all of them came up negative. He also tested for asthma, which came up negative as well. So he diagnosed me with "non-allergic rhinitis" and told me to rinse my sinuses out frequently, which I do now, and helps somewhat. However I kept coughing, and out of frustration tried a little experiment. I took three over the counter antihistimines (Benadryl, Zyrtec and Chlor-Trimeton) which promptly killed my cough (and also knocked me out for a few hours.) I went back to my general practitioner, and he put me on Xyzal and Symbicort. I'm not sure about the Xyzal, but as soon as I started inhaling the Symbicort my cough died almost completely. The weird thing is that I was later told that Symbicort is an allergy medication.
Fast forward to today...my problem has manifested this spring as post-nasal drip, and I would wake up five or six times a night choking on my own mucus. Since I'm currently unemployed and uninsured, I cooked up my own solution. Right now I'm rinsing my nose out and taking Mucinex, Benadryl, Chlorpheniramine, Phenylephrine and Zyrtec. It mostly works, but I still wake up a couple of times a night and am frequently tired from a poor night's sleep. I've heard mixing antihistamines is not a good idea, but combining them seems to be the only way to knock out whatever I've got.
So the upshot of all this, is what do I really have? An allergy, asthma or "non-allergic rhinitis"? Is there any over the counter medication that would be better than mixing up three different anthishistamines?
Symbicort is an asthma/COPD medication. It's very possible that you have asthma - esp since laying down seems to exacerbate the coughing - and that is a symptom of asthma.
It could be a cough variant asthma or regular asthma. Without being tested by a pulmonologist or an asthma specialist, you won't be able to find out.
That being said, I'm not sure where to send you since it really doesn't appear to be allergy related and we are in the midst of serious allergy season beginnings here. I owuld not continue to mix all those antihistamines. My doc (Jim Bonner in the asthma/allergy clinic at The Kirklin Clinic) allows me to take 10 mg zyrtec twice a day and one benedryl at bedtime if my allergies are really bothering me. But I would never exceed that dosage. Typically I take one zyrtec per day and the one benedryl at bedtime. The bedtime benedryl is to help me sleep (it's the Pm in Tylenol PM) and the zyrtec in the winter is for my wintertime rhinitis. I only take zyrtec if needed in the summer.
Thanks for the response. I know little about allergies and even less about asthma. Still, doesn't the fact that the problem is seasonal and that antihistamines work point to an allergy rather than asthma? Do you think I should repost this to the asthma forum?
Thanks for the pointer to the Kirklin clinic, but currently I'm uninsured and don't have the money for a consultation. So I need to figure this thing out on my own if possible.
It could be allergy induced asthma. There are lots of possibilities here but the fact the the Symbicort worked leads to think it's at least partially asthma driven. The Symbicort would not work for just an allergic reaction.
Maybe you'll get insurance soon and can get a proper work up.
The previous posters are giving you some good advice. You might also consider whether or not you have reflux. I have had "silent" reflux for years. My only symptom when I am refluxing is a chronic cough. Lying down you don't have gravity working for you and the reflux can get worse. Of course, I have a cough as my main symptom for my asthma and some PND. The trigger for the cough isn't always obvious. If you think it may be reflux, you could try Prilosec, Zantac or Gaviscon.
Thanks for all the replies. Unfortunately, I'm now more confused than before. My GP told me that 'non-allergic rhinitis' was a diagnosis frequently given when the diagnostician can't identify the specific allergy. But Titchou seems to think that if Symbicort works, it's likely to be asthma or at least allergy-induced asthma.
I have considered the possiblity that GERD might be the source of the problem. I do sometimes experience reflux, but it either usually comes right up, or manifests as shortness of breath and heartburn. A can of soda and a little Pepto Bismol usually clears it right up. When I've got the persistent cough, nothing except Symbicort is completely effective at getting rid of it. Plus the seasonal nature of the problem I think eliminates GERD as a cause.
I think I'll repost in the asthma forum and see what folks there say.