Tiny Particles

5 days ago I woke up with worse than normal nasal congestion and a sore throat. I typically wake up with sniffles that resolve by 10am. I figured it was some kind of allergy, but wasn't going to see an allergist. Quoth the pig-headed surgeon,"Why see an allergist? What have they to offer me after a battery of horrible tests that involved needles under my skin? Antihistamines or shots...I don't want shots; and I didn't need to go to medical school to figure out how to take antihistamines!"

This summer the morning sniffles became an all day nose blowing fest sponsored by Kleenex and a few nights of complete nasal congestion had me running to Afrin for relief (and I HATE sticking anything up my nose). A few of my Wound Clinic patients have stopped asking me if I was sick and comment weekly,"Will you EVER stop having a runny nose, doctor? Maybe you should see an allergist..."

Long story getting longer: those symptoms 5 days ago have increased in a 1000-fold magnitude. I'd never been so congested in my life. The mouth breathing/ suffocating goldfish routine was relieved by just one thing: Afrin. I did the BIG NO-NO and used 4 doses in a row---now I had it: Rhinitis medicamentosa. Rebound nasal swelling from overuse of intranasal vasoconstrictive medications. I was a stinking Afrin addict. I'd seen patients with it during medical school and remember thinking, "How could you get addicted to something that required sticking it up your nose?! EEUUW!" Let me tell you how: When you feel like your head is going to explode from all the edema in your nasal passages, when you want to drive to the ER and call ahead for a tracheostomy tray, when you're contemplating being sedated and intubated until it all passes over...and the only thing that allows you to get enough oxygen so you can stop thinking those thoughts is that nasty little bottle of magical nasal mucosa shrinking elixir---that's how you become addicted.

For the last 3 days, I've ingested, inhaled, and snorted every antihistamine known to medical science. I broke down and used ONE drop of Afrin in only ONE nostril last night just so I could breathe enough to sleep. I'm planning on riding for one hour today. Kevin doesn't think I should ride outside because I've been so dopey on these drugs. My dad tells me to not operate or make ANY clinical decisions while on these drugs. Lovely.

It's maddening that some tiny particles: allergens? viruses? have completely shelled me. So what does this have to do with triathlon beside being a long-winded excuse for not training for the last 5 days? It has to do with being humble enough to be honest with oneself.

Growing up with a pediatrician dad and a pharmacist mom, I didn't take many sick days from school. First all, faking it was nearly impossible. Secondly, if I did take a sick day and stay at home, Mom would make me do housework (so it was actually better to just suck it up and go to school sick). Being sick and God forbid! taking a sick day meant being frail, weak, and bordering on lazy. As a surgery residents, we'd all get i.v. fluids when we were "sick" just so we could keep working. A sick day was "a sign of weakness"--that horrible wickedness no surgeon wanted to have.

So if I'd just faced the reality that I have seasonal allergies that require some consistent dosing of antihistamines or steroid inhalants, I may not have had to dig myself out of an Afrin addiction. Where's the weakness in taking a Claritin once a day? I hate taking pills and hate even more being sick (which means having to take pills). My body's reaction to the tiny particles is an immunological hiccup, not a character flaw or a moral depravity for crying out loud! So I have allergies...some people have cancer. Neither affliction is a sign of weakness. Get over yourself, Boon!

My dad assures me that in time my immune system will become desensitized to whatever allergen is giving me these symptoms. Good! Now I can skip that visit to the allergist!