When You Struggle To Breathe Every Day: Life With Allergic Rhinitis

Over 400 million people worldwide suffer from allergic rhinitis which remains underdiagnosed & mistreated.

Life With Allergic Rhinitis.

(Illustration: Kamran Akhter/FIT)

Imagine living your life on a timer, to have every minute of your routine mapped down to one task alone – cleaning your nose. As ‘ugh’ as it sounds, welcome to my life. No matter what the weather is, my nose is perennially blocked.

On an average, I get a good 2-3 hours of regular, nasal breathing, after which, I start breathing from my mouth. That’s when my timer usually runs out.

What follows is a day of laboured breathing, reduced energy, and the slow shutting down of my system.

(Illustration: Kamran Akhter/FIT)

As per the World Allergy Organisation (WAO), “Over 400 million people suffer from allergic rhinitis around the world, which to a large extent remains underdiagnosed and under-treated,” and I happen to one of them.

According to my ear, nose and throat (ENT) specialist, Dr Shailesh Kothalkar’s diagnosis, I have all three common respiratory illnesses together, which are, allergic rhinitis, a Deviated Nasal Septum (DNS), and chronic sinusitis.

What follows is a day of laboured breathing, reduced energy, and the slow shutting down of my system. This happens because the most routine task of our lives, which is breathing, becomes difficult to me. I spend all my energy trying to breathe, while also managing to eat, talk, think, walk, and work.

After changing three ENTs across India – till I finally found the right one only recently in 2021 – here is what I have learned so far.

A Low-down Of My Conditions

Allergic Rhinitis: You know the early morning nasal congestion that we all go through after waking up? Yeah, I have that throughout the day. Any kind of antigens, which are particles like dust, pollutants, chemicals found in aerosols, or even certain kinds of food, can trigger an allergic reaction.

In rhinitis, a combination of nasal mucosal inflammation, edema, and increased mucus production can lead to airflow obstruction, the WAO report further said.

All this leads to a dull headache that doesn’t go away, until I take an antihistamine pill. This pill, in turn, makes me continuously drowsy, low, almost as if I’m on an autopilot mode, walking around like a zombie.

All this leads to a dull headache that doesn’t go away, until I take an antihistamine pill.

(Photo: Kamran Akhter/FIT)

Dr Kothalkar, who is based in Nagpur, explained, “There are broadly three types of antigens that cause allergies to us – airborne, consumed from food, and from chemical exposure to perfumes or pollution, among others. Since the cause of this illness is from particles or exposure that is beyond our control, there cannot, therefore, be a one-stop solution. Some genetic predisposition to it also adds to the woes.”      

Deviated Nasal Septum: The nasal septum is the cartilage and bone in your nose. The septum divides the nasal cavity (inside your nose) into a right and left side. When the septum is off-centre or leans to one side of the nasal cavity, it has “deviated,” explained an article by the Cleveland clinic. Medically, this is known as a deviated nasal septum.

My septum has deviated completely to the left side leaving me with just one cavity open to breathe from. Club this reduction in cavity with inflammation inside my nose, and this calls for a party inside, with the allergens and mucus being the guests of honour.

This lack of oxygen directly hits my attention capacity, motor abilities, and concentration skills. Even surgical treatment of the DNS may not provide complete relief and there is always a chance of it relapsing down the line.

Chronic sinusitis: Chronic sinusitis occurs when the spaces inside your nose and head (sinuses) are swollen and inflamed for three months or longer, despite treatment. This common condition interferes with the way mucus normally drains, and makes your nose stuffy, said Mayo clinic.

While Dr Kothalkar explained all these issues to me in depth, he made it clear to me that none of these conditions have a permanent solution. “A lot of lifestyle changes, and maintenance therapy, is required to mitigate these symptoms,” he said.

The Next Step: Exhaustive Tests For Allergies

At my ENT’s clinic, I was given an exhaustive list of things that may be causing my allergies. But then, is there a particular test that identifies exactly which antigen causes it? The answer, unfortunately, remains elusive.

While you can opt for the allergy panel at your pathology lab to understand broadly what causes you these allergies, I have been told that these panels usually are inconclusive.

At my ENT’s clinic, I was given an exhaustive list of things that may be causing my allergies.

(Photo: Kamran Akhter/FIT)

When I raised this point with Dr Kothalkar, he said,

“While we cannot control what we are exposed to, we can limit our exposure to things that are in our surroundings. For example, make sure that you keep your living spaces free of dust-mites, moisture, pollen, and dander from pets. Some seafood like different types of shellfish contribute to this illness too. This is what is known as maintenance therapy. These subtle, basic changes will add a significant improvement to your life.”  

Wearing masks in your daily life will also help, Dr Kothalkar added. But nothing changed much, really.

Self-Doubt That Stems From Chronic Illness

In 2020 February, I was on vacation with my cousins in Dubai, UAE. On this particular day on our trip, I remember, we were going to board a ferry to take us to the old city.

But, from our house in the city to the ferry stop, my nose had already blocked completely. I was desperate to find a pharmacy to buy an antihistamine or at least to find a washroom to sort myself out. If I wouldn’t have, the entirety of that day would have gone in me trying to breathe better, and my slowness would have reduced the group’s speed too.

I had to put in a lot of work mentally to come to terms with the fact that I have a chronic illness which is even more severe due to the DNS and the chronic sinusitis, and that I am not incapable or incompetent.

“First things first,” Dr Kothalkar had said back then, “Allergies can be controlled but not entirely cured."

He added that long-term exposure to medicines, especially the high-power steroids given to treat rhinitis, has reported side effects. Therefore, exercising caution is much needed.

An N95 mask, steamer, eucalyptus oil, and good old Levocetrizine are my new best friends.

(Photo: Kamran Akhter/FIT)

“Maintenance therapy is the way ahead where you take precautions like reducing the floating particles in the air. Vacuum the house, clean your bedsheets twice in hot water and hang them in the sun to kill microscopic antigen. Observe and identify the triggers as well” he added.    

While this remains one of the most common respiratory illnesses, I have found only a handful of people who understand what I go through or know what kind of care they require. People who know how to take the right care for themselves are even lesser, thus making the path to recovery lonely.

“The minute you accept it, the faster you will move towards treating it. There is no shortcut to this treatment, but if you build a routine towards it, it will pay-off in the long run. A change of place might also help in improvement,” he added.

With the handbook on this illness learnt by heart, I have been trying to move towards a better life. An N95 mask, steamer, eucalyptus oil, and good old Levocetrizine are my new best friends. Will I eventually lead a painless, headache-free life? I don’t know. But for now, my Neti pot awaits me.