Would you get second opinion? (ENT / allergies)

officerjudyhopps

Mouseketeer
Joined
Dec 10, 2017
Maybe second opinion isn’t the best use of words but it’s the only thing I could think of.

Backstory: For a year now I’ve had really bad headaches, sinus infections, and general sinus irritation. I went to primary care dr to figure out migraine vs sinus. She gave me some prescription medication for 6 weeks and it didn’t work. Migraine ruled out so she then sent me to ENT. ENT at first appt said get MRI and allergy tested. I got my allergy test a week or so ago and I reacted to everything: trees, grasses, cats, dogs, weeds (basically everything but mold). Scheduled follow up with ENT dr.

Follow up: ENT dr said I’m allergic to a lot of things but I don’t show many symptoms (vs the person who shows all the symptoms of allergies). I really only have itchy watery eyes, sinus/nasal congestion, and sinus pressure. ENT dr said he won’t treat allergies until I get MRI to rule out other issues for headaches (like nerve issue or brain issues) but did suggest taking Claritin and a prescription nasal spay (like Flonase) daily which seems to be helping a lot.

So my question is: is it time to go to an allergist and see if allergist will start shots to fully treat allergies? I’m beginnig to think my headaches were just severe sinus irritation and not actually headaches at all (since pain killers like Tylenol or the prescription the primary care Dr gave me didn’t work). Or just continue using Claritin/Flonase for treatment since it seems to be helping? No one in my family’s has allergies and we aren’t really sure what to do.

Any advice is appreciated!
 
If the allergy meds were working for me I'd probably stick with those. DH started the allergy shots a year ago and he's just now on the 3/4 strength dose. He still reacts to his allergens and still regularly takes allergy meds. Supposedly when he's been on full strength dose for a while he won't react to his allergens anymore, but it's been a long uncomfortable process to get there. A couple coworkers who have tried the shot process quit halfway through, so I don't even know anyone who's actually completed it.

Maybe another poster here will have some shot experience to share - I'm kind of curious how effective the process is as DH hasn't seen any improvement yet.
 
I have sinus issues, I have never been diagnosed with anything but I do treat with advil sinus when needed.
During allergy season I use Flonase (and the Advil when needed).
Very humid or very dry air also gives me sinus issues.
I don't go to any doctors because I know what my headaches are, the triggers and the treatment that works for me.
If I were you I would have started with an allergist, but if these headaches are new and just suddenly started I can see going to several specialists. Before you get an MRI see an allergist.
 
Most people I know with chronic sinusitis and symptoms like yours are allergic (as you've discovered). The best treatment is really nasal sprays. Before they were readily available, my friend had sinus infection after sinus infection during certain times of the year. Since he's started using them (10 years now), he hasn't had one. You really don't want to get into allergy shots unless you have severe allergies and, even then, they may not be helpful.
 


An allergist isn't going to automatically start allergy shots OP.
My ds has pretty bad seasonal allergies, he's allergic to pet dander and has food allergies. Allergy shots were a last resort if OTC meds didn't work. He's been seeing an allergist since he was 2 and has yet to do any shots because he manages fine with OTC stuff.
 
First.... For something you can do now. Try the new Xyzal allergy meds.
I believe it is one of the best. My son has good results with this, and has used it from back when a prescription was needed.

Who did your allergy testing?
I would only recommend a good Allergist, and not a general physician or anyone else.

IMHO, going to an ENT and getting MRI's etc... before basic allergy testing is backwards.

IMHO, if you have tested positive for several if not many allergens, and are not being recommended treatment, especially 'shots' for the common respiratory allergens that you mention, that seems off as well. Yes, of course, they are 'optional'.... and you don't have to do them, or anything... But, with many of the common respiratory allergens (pollen, etc...) they are effective.

To the prev. poster... I believe that it is thought that shots are more effective when started at an younger age, before adulthood.

I probably would have seen an allergist much earlier on...

Good Luck!!!!!

If you are waking up and your symptoms seem to be worse in the morning, this could be very telling.

PS: If dust mites or possible sensitivities to things like fragrances/chemicals might be an issue, totally re-outfit your bed. Get a high quality full protection mattress cover, pillow covers, etc... and use absolutely NO fabric softeners when you wash your sheets. We found this to be hugely helpful!

I have always used the Tide Free detergent, and been especially careful about softeners, since my son has always had skin issues, since he was tiny.
 


This has been a particularly severe allergy season here. I haven’t been able to smell or taste much for two months now.

I have been to two allergy specialists(MDs). Both times all allergens developed ‘bumps’. Both times I was told I showed no allergies. The last time the doctor told me that while I had no allergies, I should take two allergy pills a day, every day.

My best advice is to get a Neti bottle(Neilmed is my favorite brand), Neti salt, and distilled water. When your allergies are bad, try using your Neti bottle twice a day.
 
If you are treating the allergies with Claritin and Flonase and your headaches are going away, I would discuss it with the ENT again about just starting the shots. If he refuses, I would consult an allergist and perhaps another ENT and get another professional opinion.

I have had terrible allergies since I was about 12. It started with dogs and grew into just about everything - indoors and outdoors. DH and I discussed getting a dog before we got married, but he wanted me to see an allergist first. I went and got tested. It was confirmed that I was allergic to everything, except horses. The doctor told me I could never get a dog because my allergies were so bad. He said if I got a dog, my symptoms would get worse, turn into asthma, and I would die. He told me repeatedly if I got a dog I would die. I left so upset but also irritated that he offered no solution, even for the triggers I couldn't control, like dust, pollen, and mold.
I decided a few months later to see an actual ENT. He was wonderful. I got retested before that appointment with his office's allergy department. The testing itself was even more pleasant! He explained thoroughly what I was allergic to, how I could treat it now, and a treatment plan that would improve my quality of life. He gave me a sample of Flonase in his office and told me to use it that night. I had the best night's sleep in years that night! I could actually breathe out my nose lol! He also started me on allergy drops. I get a vial every 3 months, and 3 times a day I put a drop under my tongue. They're more expensive than shots, but it saves me from having to drive 30 minutes to his office every week. I had to get retested every three months so they could adjust my vials, but only for 10 allergens. I had 2 never get better, but I can't tell.
I should also mention, I now have 2 dogs and a cat and my symptoms are almost nonexistent! If it's a bad pollen day, or if I clean and kick up some dust I might sneeze a few times, but before treatment I was so miserable. I was living with a cold 24/7/52. I'm curious, you says your itchy and watery eyes and sinus issues aren't enough symptoms to treat, that's ridiculous. He should be willing to make your symptoms no longer exist! That bothers me. I'm curious as to what he considers "all the symptoms".
 
I have been to two allergy specialists(MDs). Both times all allergens developed ‘bumps’. Both times I was told I showed no allergies. The last time the doctor told me that while I had no allergies, I should take two allergy pills a day, every day.

How big were your 'bumps'? All of the allergens usually cause some sort of reaction because of how they are applied, but if the bump isn't big enough, you're not actually allergic to the allergen. I had bumps become the size of quarters my first time getting tested.
 
When you had the allergy testing, the allergy doctor didn't discuss any treatment plan with you? I recently had allergy testing and the nurse did the testing, collected the results and then the doctor came in the room and made his suggestions (mine are severe enough that I am on the shots now).
 
I have lots of allergies and they can be pretty severe. I would try over the counter meds, some saline nasal mist, maybe a neti pot. Headaches are one of my symptoms for sure. Allergy shots never worked for me.
 
Maybe second opinion isn’t the best use of words but it’s the only thing I could think of.

Backstory: For a year now I’ve had really bad headaches, sinus infections, and general sinus irritation. I went to primary care dr to figure out migraine vs sinus. She gave me some prescription medication for 6 weeks and it didn’t work. Migraine ruled out so she then sent me to ENT. ENT at first appt said get MRI and allergy tested. I got my allergy test a week or so ago and I reacted to everything: trees, grasses, cats, dogs, weeds (basically everything but mold). Scheduled follow up with ENT dr.

Follow up: ENT dr said I’m allergic to a lot of things but I don’t show many symptoms (vs the person who shows all the symptoms of allergies). I really only have itchy watery eyes, sinus/nasal congestion, and sinus pressure. ENT dr said he won’t treat allergies until I get MRI to rule out other issues for headaches (like nerve issue or brain issues) but did suggest taking Claritin and a prescription nasal spay (like Flonase) daily which seems to be helping a lot.

So my question is: is it time to go to an allergist and see if allergist will start shots to fully treat allergies? I’m beginnig to think my headaches were just severe sinus irritation and not actually headaches at all (since pain killers like Tylenol or the prescription the primary care Dr gave me didn’t work). Or just continue using Claritin/Flonase for treatment since it seems to be helping? No one in my family’s has allergies and we aren’t really sure what to do.

Any advice is appreciated!

OP, I am going through something similar. Over a week ago I had horrible bed spins (I don't drink) and could not catch my balance. The bed spins subsided, but the dizziness persisted so much that when I turned my head to look at the clock three days later I lost my balance and fell on my rear. My GP thought Meclizine would help, but it made everything worse.

I finally saw the ENT today, and he did not even discuss allergies with me. He tested me for Benign Positional Vertigo, but the in-office results were inconclusive. He prescribed an MRI, which I've scheduled for later this week. The MRI will not only show if there is a neurological issue but if there are issues with my sinuses. I would suggest getting the MRI first before chasing allergy remedies.
 
OP, since the meds you're on are currently helping you, I might give it a little more time to see if that trend continues. I also wanted to ask, you've been having these symptoms for a year and nobody told you to take Claritin and Flonase before now?
 
OP, I am going through something similar. Over a week ago I had horrible bed spins (I don't drink) and could not catch my balance. The bed spins subsided, but the dizziness persisted so much that when I turned my head to look at the clock three days later I lost my balance and fell on my rear. My GP thought Meclizine would help, but it made everything worse.

I finally saw the ENT today, and he did not even discuss allergies with me. He tested me for Benign Positional Vertigo, but the in-office results were inconclusive. He prescribed an MRI, which I've scheduled for later this week. The MRI will not only show if there is a neurological issue but if there are issues with my sinuses. I would suggest getting the MRI first before chasing allergy remedies.
I have had that happen before and went through all the testing, including head MRI. It's scary. Mine lasted for three months and I was afraid to even drive. I was taken to the ER once from a doctor's office when things were spinning so badly I couldn't stand up without feeling like I was going to fall down. When I stepped off an elevator going down, I'd practically fall flat on my face. It was awful. I thought I was going to lose my job since I couldn't drive. I went to a friend's house where they'd built a porch up high over the yard, and I couldn't sit out there, I felt like I'd fall. Etc.

In my case, what happened was that I'd gone on a rickety old wooden roller coaster and my head had shaken enough that the little crystals inside the inner ear had somehow dislodged, which allowed fluid to get in there. And it took three months to clear out. So these things can take a while to heal.

Many people get a similar sensation from seasonal allergies. There is a reaction to the allergens inside the head, and structures there - sinuses, inner ears - fill with fluid. If the fluid stays there long enough, bacteria can grow, and you get an infection. (I also had double ear infections that caused me a lot of problems during my three months of hell.) Anyway, the aforementioned decongestant and Flonase are usually what helps to get rid of some of that fluid.

Good luck, I hope you feel better soon.
 
I second the recommendation for the Neti pot/sinus rinse system. I have battled allergies for years and resisted every time someone recommended it but the past two allergy seasons have been particularly terrible for me and I would prefer to not go down the route of allergy shots. I started using the NeilMed sinus rinse bottle about 18 months ago and it does offer some additional relief beyond what the Zyrtec and FloNase offers. If the Claritin and FloNase are really helping you, I would stick with them for a while before investigating shots. When my allergies are particularly bad, I use the FloNase and the NeilMed rinse twice a day.
 
I have had that happen before and went through all the testing, including head MRI. It's scary. Mine lasted for three months and I was afraid to even drive. I was taken to the ER once from a doctor's office when things were spinning so badly I couldn't stand up without feeling like I was going to fall down. When I stepped off an elevator going down, I'd practically fall flat on my face. It was awful. I thought I was going to lose my job since I couldn't drive. I went to a friend's house where they'd built a porch up high over the yard, and I couldn't sit out there, I felt like I'd fall. Etc.

In my case, what happened was that I'd gone on a rickety old wooden roller coaster and my head had shaken enough that the little crystals inside the inner ear had somehow dislodged, which allowed fluid to get in there. And it took three months to clear out. So these things can take a while to heal.

Many people get a similar sensation from seasonal allergies. There is a reaction to the allergens inside the head, and structures there - sinuses, inner ears - fill with fluid. If the fluid stays there long enough, bacteria can grow, and you get an infection. (I also had double ear infections that caused me a lot of problems during my three months of hell.) Anyway, the aforementioned decongestant and Flonase are usually what helps to get rid of some of that fluid.

Good luck, I hope you feel better soon.

Thank you! My sister had the dislodged crystals, and she said it took a couple of days before she felt better. My biggest challenge is showering. I have to leave the door open and the curtain partially pulled back so that cooler air flows through. Last September I blacked out in the shower twice but that was due to having pnuemonia, low blood pressure, and dehydration. At least I learned from that instance and am taking precautions this time.
 
I would go to the ENT. AND a functional medicine dr (I'll explain in a bit)

I had sinus surgery in February (3 surgeries in one: septoplasty, turbinate reduction and polyps removal) and I feel so much better.
I've always had terrible allergies. I would get frequent sinus infections, and terrible debilitating headaches. When I was tested by my allergist, he said my back lit up like a Christmas tree.
I now get two allergy shots twice a week. I still take Zyrtec daily, as well as Mucinex, Singulair, and the occasional nasal spray.

I also see a functional medicine dr. I have chronic inflammation, so I'm on an anti-inflammatory diet (no dairy, etc.) to calm the inflammation in my body. If you research leaky gut you will find a lot of correlation between the sinuses and our gut. Between diet, my surgery, my shots and daily maintenance I am feeling much better. I'll probably always be allergic to many things, but these steps help me function day to day.

Best of luck!
 
Ive been dealing with sinus issues with my husband for over 35 years. He's had the sinus surgery too, which only lasted for a while, and has a neti pot, etc. Things are actually better for him since he changed jobs, I believe a lot of his problems were occupational.

My son had bad seasonal allergies which turned to asthma years ago (now resolved), and my daughter has sinus and respiratory issues, too - all related to seasonal allergies. DD has had allergy testing and it was inconclusive. The recommendation for all of them has been to pre-treat before allergy season starts in the spring AND fall. So I buy a lot of Claritin and Flonase. DD took Flovent this year, too, as a preventative, since over the winter she had prolonged bronchitis. It's a pain for them to deal with.

One thing that has really helped us was getting central air conditioning installed. So now we keep the windows closed and the allergens don't really get in from outside. They still are exposed when they're outside, but it's not like they're inside with a fan blowing them around their heads all night.

For those who are having some of these issues, look around your environment to see if there's anything you can do to help with exposure.
 
Just so you know, allergy shots don't always work. I've had chronic sinusitis for 8-9 years now and I've seen a bunch of doctors, all they do is throw more allergy meds at me. I am supposed to take zyrtec, flonase, a prescription nasal spray, and cingulair, plus I use an inhaler daily. I find the migraine/sinus thing with your doctors to be weird--there is a difference between a sinus headache and a migraine but I get migraines that are triggered by sinus pressure, I hope one of your doctors considered that possibility. I've also had migraines triggered by strong chemical smells (artificial air fresheners, perfume, laundry detergent, etc.) and I wonder if that is somehow related to my allergies. I use allergy meds, regularly rinse my sinuses with a saline spray, and do things to reduce my exposure to allergens, but there are these things called WoodyKnows Nasal Filters that I want to try; you can buy them on amazon but I'm not going to try to link to them because Amazon is having problems with their site right now. Anyway, you could try that too.
 

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