Mum's rhinitis

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Mum always has rhinitis which I suspected is the same as mine i.e. vasomotor rhinitis. This is more or less confirmed by the result of the 107 allergen test.

Normally, she would just need to use nasal steroid spray (Avamys) and take antihistamine (ceterizine) for a period of time. However, earlier this year, the symptoms didn't improve and it was debilitating: woke up in the morning feeling the stuffiness and pain, took medicine and needed to nap 4 hours before feeling good enough to be awake but couldn't do her usual exercise routine.

So she consulted Dr Yeoh and was prescribed antibiotics and another anthistamine. She felt much better soon but relapsed shortly after finishing the medication. Consulted the doctor again and was prescribed another round of similar medication. Again, same results. As expected, Dr Yeoh recommended that she consult an ENT specialist. 

In anticipation, I've asked mum to ask Dr Yeoh to recommend an ENT specialist based in mainland Penang. Going to island is a hassle. So, it's a happy coincidence that Dr Yeoh's recommended specialist, Dr Choo, is at Bagan Specialist Centre. Yay!

As expected, Dr Choo performed nasal endoscopy: sinus passages were clear and so CT scan not needed. Unsurprisingly, he prescribed nasal steroid spray and antihistamine. I was most interested in the brand choice: Ryaltris is a nasal steroid spray which has antihistamine, first time I heard of such combo, and Bilastine is the antihistamine, much more expensive than ceterizine or loratadine. He also recommended rinsing the sinus passages. If the symptoms are still bad in a month's time (follow-up appointment date), then CT scan would be ordered.

During the next one month, mum's rhinitis gradually got better until to the point that she could resume her usual morning indoor walking exercise. Morning nap, if needed, was only an hour. Pressure and pain subsided a lot. Doctor prescribed the same treatment for the next 3 months, which surprised me. However, if possible, he asked mum to reduce the dosage of the spray (one spray per nostril, instead of two) and antihistamine (alternate day) after a month.

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