Dear Dr. Roach: As we all know, a good night鈥檚 rest is very important to overall health. In my case, if I can get through the night without my nose getting congested or plugged up, everything is fine. But on many nights, at some point overnight, one or both of my nostrils eventually plug. And I can鈥檛 sleep breathing through only one nostril or my mouth, as it will become bone dry, forcing me to get up and use an over-the-counter decongestant. Overuse of these OTC decongestants isn鈥檛 a good thing, either. Any suggestions? Please advise. J.H.
Nasal congestion is a common problem and people frequently complain of it being worse at night. The first concern I have is whether you are being exposed to something at nighttime that is causing the congestion. Allergens that get on your face and clothes can worsen symptoms at night, so it can help to change clothes and wash your face when you get home. Some people even need to shower and wash their hair. Dust mites can be a problem; special coverings for pillows and mattresses can solve that problem. Pets, curtains and rugs are frequent reservoirs for home allergens. An allergist may be necessary to test to see whether you are allergic to something you can avoid.
OTC decongestants, especially those with oxymetazoline (such as Afrin) can cause terrible withdrawal symptoms if overused. If medication is necessary, there are better options, including antihistamine nasal sprays, mast cell stabilizers and steroids. But it鈥檚 absolutely worth your while to do what you can to avoid allergens, if possible, rather than take medication to treat the symptoms.
聽聽 聽 聽聽聽
Dear Dr. Roach: My daughter, age 68, mentioned to me that she started to have weakness in her right hand, to the point that she鈥檚 unable to lift a medium-weight object. She dismissed the problem and doesn鈥檛 want to see a physician. I am concerned that this might be the onset of a muscle- deteriorating disease. Should I be? A.L.
You are right to be concerned and she should see a doctor right away. There are many possibilities, ranging from a peripheral nerve disorder (such as carpal-tunnel syndrome) to a central nervous system problem (such as stroke or multiple sclerosis) to a nerve/muscle problem (myasthenia gravis). Carpal tunnel is probably the most likely cause that I see in my primary-care practice. Early treatment is critical in order to preserve function. 聽
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to stions to [email protected].
