DEAR DR. DONOHUE: My problem is water. I can’t stop it from dripping out of my nose. The liquid is clear, without any odor. It has the consistency of drinking water. My sinuses do not hurt. Claritin makes me drowsy. Can you suggest a panacea? – S.J.

ANSWER:
Clear nasal discharge comes about for many reasons. Allergies are one cause. You mention no allergy symptoms like sneezing or itching, so I’ll skip those causes.

A condition called vasomotor rhinitis is high on the list of nonallergy causes. It brings an outpouring of clear, watery discharge from any number of triggers: temperature changes, alcohol, strong odors, airborne irritants and the I-don’t-know-why category.

Some medicines bring on a constant drip: NSAIDs (ibuprofen, Aleve, Advil, aspirin and more), ACE-inhibitors (blood-pressure medicines), calcium channel blockers (another variety of blood-pressure drugs) and the birth-control pill.

Nasal polyps – small growths springing from the nasal lining – can cause nasal dripping.

An unusual but dangerous cause is a leak of cerebrospinal fluid. Many years ago I mentioned this, and a young woman asked her doctor to check for it. He rolled his eyes but agreed to do so. It was, indeed, the cause of her watery nose. A check to see if the drainage contains beta-2 transferrin proves or disproves the cerebrospinal-fluid cause. Check with your doctor about this. A leak has to be surgically corrected.

A treatment that won’t hurt and could help is saline (saltwater) nasal spray, obtainable in all drugstores. Astelin nasal spray is an antihistamine used for both allergic and nonallergic runny noses. It doesn’t make you sleepy. Cortisone nasal sprays such as Flonase and Rhinocort are a giant step up on the treatment ladder.

If the family doctor can’t find an answer, an allergist or an ear, nose and throat doctor might.

DEAR DR. DONOHUE: My husband of 54 years is to have a test for Addison’s disease. Just what is it? – B.M.

ANSWER:
It’s a slowdown by the adrenal glands in the production of their hormones. They make an array of hormones, one of which is cortisone. People are surprised to learn that their own bodies make cortisone. They think of it as a medicine. Cortisone is involved in the production of high-energy fuel. It’s also involved in the mobilization of fat and the promotion of glycogen (sugar) storage. Another adrenal hormone, aldosterone, partakes in regulation of blood pressure. It also adjusts body sodium and potassium. A deficient production of adrenal hormones causes weight loss, fatigue, weakness, low blood pressure, skin pigmentation, salt craving and abdominal pain. If the deficit isn’t corrected, it can be deadly. The diagnosis is made by checking the blood levels of adrenal hormones and by stimulating the adrenal glands. If they fail to respond to the stimulus, the doctor knows for sure something has gone wrong.

Treatment is straightforward, replacement of the missing hormones in tablet form.

Formerly, TB was the major cause of Addison’s disease. Today, in developed countries, the major cause is an attack on the glands by the body’s own immune system.

DEAR DR. DONOHUE: I had several MRIs and was put on IV antibiotics. Doctors said I did not have cancer. I had something called pseudomonas. What is it? – P.C.

ANSWER:
Pseudomonas (SUED-uh-MOAN-us) is a bacterium found in soil, on plants, in water and just about anywhere you look. It’s a common cause of hospital infections. The skin, blood, urinary tract, eye, ear or lungs (pneumonia) can be the places it infects.

It’s a difficult infection to treat. Doctors have to use antibiotics whose names aren’t familiar to the public.

Can you expand a bit on your symptoms and where the site of your infection was?

DEAR DR. DONOHUE: Is impetigo the same as a herpes cold sore? My 4-year-old has something that looks like impetigo to me. To my mother, it’s a cold sore. How do you tell them apart? – P.G.

ANSWER:
Impetigo can be just about anywhere, and it’s caused by the Staph or Strep germ. It starts as a group of small blisters that soon become covered with pus. The pus dries to form a golden-yellow crust. Impetigo happens mainly to children, and most often during the hot, humid summer months. Antibiotics applied to the sore or taken by mouth often are needed to cure it.

A cold sore is a herpes virus infection. It starts out as a group of blisters on a patch of red skin, and almost always is on the lips. It doesn’t have the golden crust of impetigo. A first outbreak of a cold sore can cause a fever, headache, sore mouth and sore throat. Antiviral medicines can heal cold sores more quickly, but small ones don’t call for special treatment.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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