Those who suffer from anosmia due to polyps and associated inflammatory conditions often resort to the use of nasal sprays which contain decongestant drugs such as phenylephrine or the longer-lasting oxymetazoline (Afrin is one brand of this). I use such drugs only very sparingly due to two potential problems with them:
Here is a note from one of my correspondents who is using a topically applied decongestant along with a topically applied steroid. My response follows his note.
Subject: nasal polyps
Date: Sunday, December 23, 2001 3:23 PM
I too have suffered from nasal polyps for the last 8 years or so. I'm 47, and I've never had the surgery because my doctor hasn't wholeheartedly recommended it. I have the asthma and aspirin allergies that go along with the polyps, but I keep the asthma at bay with alot of aerobic exercise, such as bike racing. The only time I can smell is after I have taken a course of prednisone. Sometimes it keeps my sinuses clear for up to 4 weeks and then I start loosing my sense of smell again. I do this about once a year. This year I did it a little differently, I took 30mg of prednisone daily for 2 weeks and then stopped with no taper. Towards the end of the two weeks taking the prednisone I started getting my sense of smell back. After 4 good weeks I noticed that my sense of smell was not there all day, the beginning of the end...and by reading your website, I know you've been there. Here's where I tried something new. I started using Afrin in conjunction with Flonase every day and I have kept my sense of smell for over 4 months with no end in site. My sense of smell is not particularly strong, but it's there most of the day. I can smell my shampoo, coffee, deodorant, etc. in the morning. My food tastes better. Good beer tastes great. (I know you too can appreciate that by reading your website.) I can't really get those subtle smells when I'm eating, but it does help my ability to taste. I'd say my sense of smell is probably 60% of the normal person now, but it's a huge improvement. I couldn't smell s**t before, literally. (My dog has graciously allowed me to track it all over the house, get it on my pants while crossing my legs, make a huge mess of things before I saw it.) Anyway, it's not 100% cure but it makes my day to day life at least 100% better. Here's my regimen:
I use one spray of Afrin about an hour after I wake up. If I exercise before that, my sense of smell has already returned and then I do the Afrin. 1/2 hour or so after the morning spray is the best time to eat tastewise, so I often save some leftovers from the night before and eat them then. Then another spray of Afrin 1/2 to 1 hour later. The sense of smell stays strong all morning through lunch.
After lunch, one spray of Flonase. Too much Flonase makes things a little worse. A half hour before dinner one spray of Afrin. Sometimes this keeps the sense of smell going pretty strong through dinner, but not always. The sense of smell then begins to fade as the night goes on, but so far, it always comes back the next morning.
At bedtime, one spray of Afrin, then one (sometimes two) sprays of Flonase.
I also sometimes use BreatheRight nasal strips to hold open my nostrils when eating and that helps some, but looks ridiculous.
I still live in fear of the sense of smell leaving and not coming back, so I must smell my coffee or the soap on my hands every time i think about to be sure it's still there. I know there is an issue with Afrin and becoming addicted to it, but I think the Flonase counteracts that and I don't care anyway. I think this would only work after the prednisone has been used to shrink the polyps.
I would be interested in knowing if this regimen will help others with this same problem. It seems like you are in contact with other nasal polyp sufferers and might be able to pass it on to them.
If you are interested, I will let you know if there are any changes. Thanks for your website, good luck and I hope to hear from you.
P. W.
Karl's Response
I have used nasal decongestants as you describe below. In fact, for many years they provided me with my only relief. Regretfully, however, after years of such use I found that I was dosing myself many times a day just to counteract the "rebound" effect of the decongestants, and such relief was short-lived. Also, by this time the polyps had protruded into my nose, and surgery was unavoidable if I ever wanted to be able to breathe through my nose again. Now I use decongestants only if absolutely necessary, when my Kenalog shot's effects have worn off before I can have another injection. Even then I allow myself only one dose in one nostril once a day, and if I need it again the next day I shift to the other nostril. After the decongestant has opened one nostril I irrigate with isotonic saline and follow that, after allowing some time for the nostril to dry, with a dose of nasal steroid -- I use Rhinocort in the aerosol preparation, which has worked better for me than the water-based sprays.
I shall post a summary of your experience, along with mine, for fellow sufferers to read. Thanks for the note, best wishes for the holidays, and good luck managing your sinus problems.
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This page most recently revised on 25. December 2001.