Nasal Polyps - Update (Steroid Sprays)

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Andi - 30 May 2007 14:16 GMT

Hi everyone,

after my last post, the ENT prescribed me nasal drops (Xylometazoline)
and a steroid spray (Triamcinolone). He told me to take two drops and
two sprays twice a day in each nostril (in the morning and evening, = a
dose of 440mcg/day).
However he didn't mention that the nasal drops should only be used a
couple of days. After reading the package insert (which warns about
using it for more than 3-5days), consulting with some friends studying
pharmacy and researching a bit on the net, I discontinued use of the
nasal drops after the third day. I didn't feel they were necessary
anyway as I was neither congested (the only obstruction is the polyp)
nor did I notice any effect from using them. I kept using the steroid
spray with good effect until now. However two days ago, I became
suspicious and I calculated the number of sprays I already used. As
expected (the package insert says a minimum number of 120 sprays), the
spray was empty last night.

My current ENT is on holiday at the moment and my next appointment is
only in two weeks. Do you think I should try and find (yet :/) another
doctor to prolong my prescription?
I've also been wondering if it is common to use these sprays in both
nostrils when the obstruction is only in one of them? (I had/have the
sinusitis and the polyp just on the right side. At the moment I'm not
sure if there is still some sinus inflammation as I don't feel any pain,
even when I press on the area).

And if I get another prescription, maybe it is a good idea to try
Nasonex (Mometasone)? I've read that it works especially well for polyps
(for the current spray there is no mention about polyps in the package
insert. But in Germany Nasonex has recently been approved for use with
nasal polyps). And I read that the sense of smell improves with Nasonex,
too. However the study (conducted in Germany) has been paid for by the
company producing Nasonex, so who knows if it really has any advantage
over other steroid sprays. Another similiar study in the US is here:
http://www.medicinenet.com/script/main/art.asp?articlekey=57034

Other than that I've been trying to keep up some healthy habits (regular
sport, not too much stress) as well as nasal irrigation twice daily with
a netipot. And on a whim I just ordered the Sinus Buster a couple of
days ago.
The situation as it is now, is managable for me but I would like the
polyp to shrink some more (and it would be nice to have improved sense
of smell from the right nostril).

Andi

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Ghamph - 30 May 2007 23:28 GMT

> Hi everyone,
>
> after my last post, the ENT prescribed me nasal drops (Xylometazoline)
> and a steroid spray (Triamcinolone). He told me to take two drops and
> two sprays twice a day in each nostril (in the morning and evening, = a
> dose of 440mcg/day).

> However he didn't mention that the nasal drops should only be used a
> couple of days. After reading the package insert (which warns about
[quoted text clipped - 36 lines]
>
> Andi

I think the drops might be decongestant. If you can breathe a little
through your nose you can stop the decongestant.
The steroid spray is the best stuff to get rid of inflammation.

Doctors are trained to use caution for most people if you are new to
steroids.
My latest prescription is for one year supply. 90 days x 4 refills =360
days supply. Flunisolide total for one year =1600 metered sprays

I have had chronic sinusitis for three years and have done 8 or 9 bottles of
Flonaise before. What works best for me is to spray as needed up to six
sprays in each nose hole throughout the day. After the polyps shrink back
to almost normal I do only two to three sprays in each side spaced
throughout the day.

Last week when I started the new stuff I did 2 days x 6 sprays each side per
day - third day 5 sprays - fourth day 4 sprays - day five 3 sprays and
today I did 3 sprays but could have gotten by with two I think. Flonaise
calls for fewer sprays on package directions, than the kind I have now.

It's nice to breathe again. I sometimes use more in my right side than the
left because the right polyp is larger.
Time will tell if I start to build resistance to Flunisolide as I did with
Flanaise. But so far it's quite effective.
It's thinner than Flonaise, finer spray slightly cheaper (I got it free) and
200 sprays per bottle. There are several kinds of steroid spray to choose
from. Perhaps people can switch kinds when they build resistance.

The doctor prescribed Loratadine (Claritin) antihistamine for allergy. I
don't think I needed that. The antibiotic the Doc prescribed didn't clear
up anything either. The steroid spray has immediate effect.
Jamffer

Reply to this Message

Murray Grossan - 01 Jun 2007 04:21 GMT

On 5/30/07 3:28 PM, in article 135ruo2kpkpuq06@corp.supernews.com, "Ghamph"
<ghamph@localnet.com> wrote:

>> Hi everyone,
>>
[quoted text clipped - 76 lines]
> up anything either. The steroid spray has immediate effect.
> Jamffer

Re nasal polyps: Several writers have published that they don't see much
difference between one cortisone spray va another.
With nasal polyps maost doctors keep you on these for anti-inflammatory and
to try to prevent re-occurance. Remember that any infection will enlarge the
polyps. Most persons are sensitve to salicylates and these will enlarge the
polyps too.
Will daily irrigation prevent polyps reoccuring? I have have had some
success and some failures so the answer is not in yet.

Reply to this Message

Ghamph - 02 Jun 2007 02:38 GMT

> On 5/30/07 3:28 PM, in article 135ruo2kpkpuq06@corp.supernews.com, "Ghamph"
> <ghamph@localnet.com> wrote:
>
>> > It's nice to breathe again. I sometimes use more in my right side than

the

> > left because the right polyp is larger.
> > Time will tell if I start to build resistance to Flunisolide as I did with
[quoted text clipped - 16 lines]
> Will daily irrigation prevent polyps reoccuring? I have have had some
> success and some failures so the answer is not in yet.

Hello Murray; It might be that irrigation could help prevent polyps, but
most people don't think of irrigation till the problem gets chronic.

I haven't irrigated for one week since I started Flunisolide spray. It
works about the same as Flonaise except the Flonaise is thicker and calls
for fewer recommended sprays.

I spray a little more often with the Flunisolide and get comparable results.
My right nostril is more or an issue and with more sprays, there is better
results.

My left side requires two sprays/day and right 4-5/day. I hope that the
right shrinks more is a few weeks, time will tell. At least I can breathe
again quite normally. The V.A. doctor seemed to sympathize with my
condition and stated, "This should keep you from running out". 400 sprays
plus three available refills of Flunisolide V.A. paid. With a good supply
of steroid spray, I don't require irrigation.

I'm thankful for the V.A. Clinic. My ENT would only give me one bottle at a
time of steroid spray. The V.A. doctor gave me a one year prescription.
That might be because the V.A. gave me a full physical, I'm not sure. It's
nice to breathe through my nose again.
Jamffer

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