Q+A with my ENT

I have been seeing doctors for a long time.  I used to have a regular doc, an ENT, and allergist, a pulmonologist, and a gyn.  I never saw the regular doc much.  The allergist and ENT I would see often.  I also used to see the pulmonologist often for asthma, until we discovered my dairy allergy.  After I stopped dairy my asthma got much better and now as long as I avoid dairy my asthma isn't a problem.  Now I just get kinda wheezy when my allergies are bad.  The gyn I used to see more but nothing helped my cycle without messing me up in other ways so now I only see a gyn rarely for exams.

Now here in NY I am only seeing an ENT and an allergist.  I tend not to ask many questions when I have appointments.  I usually just want them to be over and I am a bit too shy and embarrassed to ask much.  Also, most visits they have students or other docs in to look at me, poke and prod, etc since I seem to be such an interesting case they want to share and that also makes me not be in the mood to ask questions.  This week however at my ENT visit this week, there was no other docs or students and I felt really at ease for some reason so i asked him questions and so I wanted to share a bit of how that went in a Q+A type format.

Q: Why is it that sometimes my allergies affect my nose more and other times my sinuses and how come unless my allergies are bad, my eyes aren't as bothered and same with my ears? 

A: Your nose and sinuses are affected more because for you, once an allergen gets in there it has a hard time getting out, partly because of your excessive congestion and sneezes that aren't very forceful.  Sometimes your sinuses are more sensitive/irritated and sometimes your nose is, and that is what leads to you feeling your allergies more in your nose or your sinuses at any given time.  For your eyes, its easier for the allergens to leave, so its often not as much of a problem.  Eyes and ears tend to get more affected when allergies are worse because nose, sinuses, ears, eyes, etc are all pretty much connected so when the mucus membranes in one area get very irritated, it tends to spread.  One reason why your eyes can tear up so much is that when your allergies are bad the tube leading from your eyes to your nose swells shut and the tears have no where to go.

Q: Why do my allergies last longer than other peoples'? 

A: A few reasons.  One is that your body creates an allergic response with histamines and other chemicals than other patients I have seen, to even a small amount of allergen, and that's also why your reactions are so intense.  Another reason is again the extreme congestion and non-forceful sneezes keeping the allergens in place longer.  Also, the simple physical irritation of the mucus membranes makes them more sensitive to repeated allergens and your gets irritated very easily.

Q: How come I don't cough much and my throat doesn't bother me that much? 

A: Usually, a runny nose tends to run forward out the nose in kids and out the back of the nose in adults.  That's why you see more snotty noses in kids, and in adults its more of a post nasal drip, which also irritates the throat more and causes coughing.  Besides the insides of your nasal passages being smaller in diameter than they should be, they are also closer in shape to a child's structure so most of the mucus comes out the front and not the back.

Q: How can my nose sometimes make so much snot?

A: The main way all mucus membranes respond to an allergen is by swelling, leaking fluid, and irritation (and yea I (Kate) understand that...I have had allergic reaction on other mucus membranes too, which is a hassle!).  A major reason you nose seems to make so much snot is just the fact that most of it comes out the front of your nose instead of going down the back.  When I look in your nose, it is hard to make out much because everything inside is so swollen and when mucus membranes are swollen up against each other it tends to cause more mucus production.  Your nose does build up some mucus, which is why when you bend forward it comes out faster.  The front areas of your nostrils are often filled up with mucus, which is why we need to clean out that area before we can look into your nose.  Your mucus membranes are often creating mucus at a very fast rate. 

I also asked him why the front areas of my nostrils were always filled up with mucus and he told me since I am not able to blow my nose and I don't squeeze or pinch my nose (cause that would send me into sneezing fits), the mucus that builds up there tends to stay there more than it otherwise would.

Those were my main questions.  I think I might have asked one or 2 more.  If I remember then I will post them.