Debilitating persistent allergic rhinitis

[happydays]

Hi, I am 35 years old. I have always suffered with a form of allergy since I was 18 months old. From severe eczema and asthma up to 27years old; This is only minor now but the last 7 years I have suffered with severe allergic rhinitis which is making my life a misery and I need help?
The Dr has prescribed various antihistamines, eye drops, nasal sprays and tablets. I am on the highest dose and last medication they say I can try.
Usually I have a bad attack every two weeks for a day or two at the most then it goes. This I either have to battle on at work, or if I am at home I go to bed with a ice bag on my face which helps a bit.
However I have been suffering with more frequent and lasting attacks. This one is going on for two weeks now!
I am at my wits end as is affecting my work(am a teacher and counsellor), my private life severely and social gatherings- I have two weddings this year, both am bridesmaids for and I am honestly hoping I dont have an attack.
My symptoms are hot itchy burning throat, burning itchy nasal passages which swell up, streaming eyes. My right eye I have allergic eye disease(saw specialist 5yrs ago who said no help for it) which is often so intensely itchy I often just rub it in my sleep and it is very raw in the morning. Once it starts itching it is so hard to ignore.
I am now waking up in the night with a very itchy throat and nose. Apart from ice and sleep nothing helps..
I do all I can to help myself- i have all anti allergy bedding, blinds, avoid chemicals where I can and no pets.
I am miserable and at a loss at what to do?
The last time I saw a Dr, month ago, they said there is nothing else. I mentioned immunotherapy and she didnt know what it was.
I have down my own research and found A few allergy clinics but unsure..
Please can you give me some advice and guidance?
Many thanks, A

[Dr Joanna Lukawska]

Dear A
I am very sorry about your very troublesome condition.
It sounds like you have not seen an Allergist and I believe this would be very helpful.
It would allow you to get a precise diagnosis and appropriate treatment.
BSACI website will help you find a Clinic that is nearest to where you live.
Based on what you describe your allergic rhinitis is likely to be triggered by house dust mite (however skin prick/blood tests are the only way you can establish this for certain).
You may need several treatments at the same time in order to control your symptoms (oral antihistamines, nasal steroid spray, eye drops: antihistamines +/- mast cell stabilisers +/- steroids-these are prescribed only under specialist supervision ), we also use new generation oral medication such as Montelukast, which is helpful for some patients.
If your symptoms do not resopond to the combination of the above measures, your Allergist would consider introducing immunotherapy. This treatment involves a process of desensitisation in a form of injection or tablet/drops (depending on your preference). Again this type of treatment is available from a specialist clinic only.
You are doing all the right things by trying to manipulate your living environment with hypoallergenic bedding etc, unfortunately these measures often have only limited benefit.
Your Allergist would also be able to advise you regarding the ad hoc treatment for special events such as the wedding you are due to attend. Even with immunotherapy it may not be possible to completely cure your condition, but I am sure better symptom control is a very reasonable goal.

[happydays]

Dr Lukawska
Thank you for your advice and quick reponse. This is the most help I have had in a long time and never been offered to see an Allergist. Thank you
I just went on BSACI and could not find an allergy clinic near by, in fact anywhere? Perhaps it is not working. I know for a fact near Great Ormond St- there is an Adult Allergy clinic. Are theses clinics NHS?
The treatments you mention, can I get them all through the Dr if I ask?
Many Thanks
A

[Dr Joanna Lukawska]

Hi A
Thank you for your kind words.
There are several NHS Allergy Clinics, I admit most are in and around London. If you go into BSACI website, then "Professionals" and then "Clinics" - it will give you a map and a list of NHS Allergy Departments/Clinics.
Most of the treatments I have mentioned can be prescribed by the GP and are often used in combination rather than - "Try this and if it doesn't work we will try something else". The only treatment exclusive to the Allergists is immunotherapy and I have seen it work very well in patients with severe House Dust Mite allergy (but again not always) and of course in pollen allergy. All the best. Joanna