Diagnosis: Vasomotor Rhinitis with Some Reflux on the Side

My skin was pricked 71 times. As I sat staring at my forearms, waiting for bumps to develop, an intern doctor sat across from me drilling me with questions: do you live in a house? Do you have hypoallergenic covers on your pillow and mattress? How often do you have sinus pressure? What food allergies do you know about? Are your eyes itchy or watery? Only sometimes? All the time?

She spent the whole 15 minute “let’s see if you get bumps from your pricks” period asking variations of the same thing. I almost felt like it was an honesty test. How often do you get headaches? How often do you get migraines? How often do you get tension headaches? While part of me wondered if she was trying to trick me, at least she was thorough.

She left. I heard her and the real doctor talking outside. They talked for a while. Sinusitis. Headaches. Eye issues. These words peppered their back and forth. Finally they came in, had me sit on one of those uncomfortable lifted medical chaises covered in waxy paper, and started probing me. Lights in the eyes, ears, and nose. Breath in. Breath out. “She’s really inflamed” the real doctor said to the not-quite doctor.

Finally we all sat down. “I’ve got good news for you and I have bad news” the real doctor said to me. “The good: you aren’t allergic to anything. The bad: you aren’t allergic to anything. Your misery stems from more complicated issues unfortunately.”

I have vasomotor rhinitis. My mucus system on hyper drive. Due to fluid accumulation, polyps, and mucosal thickening I am in a constant state of being tired and mildly miserable. Since my rhinitis appears chronic, over time my nasal mucous membranes lining has developed scar tissue or toughened or thickened or something, causing everything to get worse. As the cavities get smaller, the fluid inside is compressed more, creating more and more pressure. This leads to my headaches any eye pain.

He asked how often I have headaches and what I took for them. I told him I get headaches about 3-4 times a week and I take Excedrin. “Often?” he asked. I told him no, sometimes they just go away on their own. Then came the question that shattered me dreams of a happy, caffeinated, bubbly future:

“How much diet coke do you drink?”

“What the *$(! does that have to do with anything?” I asked, though without cursing. He told me I could be drinking to self-medicate, that the caffeine would mitigate headaches I might have due to blood vessel constriction. He also said he noticed I was throat clearing a lot, and that was a sign of reflux. Carbonated sodas were a trigger for reflux and reflux could make rhinitis worse. I told him I didn’t feel like I had acid reflux, that I didn’t have heartburn or any adverse affects to certain foods. He asked how long I’d been drinking massive amounts of diet coke and then responded that after a while your esophagus “toughens up” and forms a protective layer-type thing that is actually really bad for you and could lead to esophagus cancer and lots of other, really bad esophagus sickness things which names I can’t remember now.

“I am going to start you on a regiment to clear out your sinus passages, but for it to be effective you need to minimize your drinking Diet Coke permanantly.” He said. He said his sister was addicted and walked around with a 64 oz cup all the time- that he got my attachment to it. He then stated that I wouldn’t feel better, and I was setting myself up for more problems down the road, if I didn’t cut back.

“How much do you mean by cutting back?” I asked. 12 oz a day he told me forever. @#&(! you I responded back in my head, but just nodded outwardly. I acknowledged I couldn’t do that; I’d get headaches and be a terror for a month. He told me he has pain medication he could prescribe and taper me off on to take while I tapered off my diet coke. Damn real doctor had an answer for everything.

So now I have a long, tapering regiment for prednisone and calan sr. I need to use fluticasone or another cortosol spray twice daily for the rest of my life most likely. He’s also putting me on acid reflux medication for 4 months and we’ll re-assess it at a checkup.

So I’m of screwed. I need to give up Diet Coke. This makes me very sad; I feel like I’m losing one of my most loyal, faithful, calorie-free friends. I honestly don’t know if I have the willpower to give it up; I’ve tried in the past to no avail. But I am pretty miserable now. Not sleeping well, my face always feels stuffed full of cotton, I am foggy, and my eyes are driving me nuts. I haven’t felt well in a long, long time. So maybe it’ll be worth it? Maybe.

I’m going to start by cutting back diet coke to 32 oz in the morning, 32 oz at night and allowing myself 12 oz for dinner. I’ll work out a tapering plan from there.

I was just hoping they would say “eliminate (fill in the blank) from your diet and you’ll be great!” or “get a deep cleaning of your house and don’t let the cat lay on your pillow”. I wasn’t expecting my liquid life source to be exiled by a doctor. That sucks.