Chronic post-nasal drip limiting my speaking voice

November 7, 2016 9:55 AM

I have chronic post-nasal drip. It's not literally all the time, but whenever I stay up an hour or two too late, it turns on like a faucet and continues to pour down my throat for a week or more. I have it far more often than not. It coats my vocal cords and screws up my voice in a variety of ways, which sucks extra because I'm a standup comic.

The coating of the vocal cords means I have to monitor my breathing and swallowing to avoid voice cracks, which interferes with my timing. I also can't consistently change my voice in any of the standard ways that sell a joke - it's like once I've found a 'channel', I have to stay on it or risk going silent. My voice is also a bit quieter than normal and while I can project it, it leaves me with even less control over the nuances and I can't comfortably do it for that long anyway.

Suggestions for either fixing the issue or working around it? I don't have health insurance (again, standup comic) and if/when I get it, it will be Medicaid. I realize the likely solution is to see a doctor though so let me know what kind and what conditions I should ask them about if I win the lottery or give up and get a real job. 26/F.

posted by randomname25 to Health & Fitness (13 answers total)

A combination of OTC Zyrtec and Flonase (or sometimes just Flonase) has helped with this and my constantly runny nose. Keep in mind that you have to use Flonase consistently for it to work, and it takes a week or two to start being effective, but there are also side effects to its long-term use. I also use a sinus irrigator with warm distilled water + sinus rinse powder mix occasionally, also on recommendation from my doc. It might be helpful to see if it helps to irrigate maybe 30 minutes before a set.
posted by quiet coyote at 10:04 AM on November 7, 2016 [1 favorite]

Have you thought about nasal lavage, like quiet coyote suggests? It changed my life. A neti pot or irrigator with warm water, and a pinch of kosher (noniodized) salt, and baking soda.
posted by answergrape at 10:21 AM on November 7, 2016

Ugh, I had undiagnosed allergies for the longest time, and this was the most aggravating of the symptoms.

Selfcare: Allegra (180 mg fexofenadine, none of the other formulations). Sinus rinse regularly to prevent enough build up in my sinus cavities. Sleep with head elevated. I bought this bed frame, with the intention of getting a nicer one later. But it works well.

Doctors Stuff: Eventually it was determined to be a low grade but persistent allergic reaction to dust mites, trees, mold, pollen. Very common after moving across country, because your immune system isn't familiar with that climate. I got shots for the dust mites, the worst of it, and continue to take the Allegra for the rest. (The theory is that shots work best when directly targeted). But during the 4 year interim of symptoms, I was briefly diagnosed with Sleep Apnea, Asthma, COPD, and the biggest one: Being Fat and Female*. So there's obviously symptom overlap there.

I mention this because I had to lobby hard to get doctors to move past this hurdle, despite a lot of the symptoms being contraindicated by my weight. Like weight related breathing issues are due to difficulty on the inhale portion, while my pulmonary function tests showed the issue during the exhale.
posted by politikitty at 10:25 AM on November 7, 2016

Response by poster: Sorry to threadsit - how often do you have to irrigate? Sometimes it's difficult to find privacy immediately before a performance and all the equipment looks like it would require a bigger bag to lug it around, but I'm willing to do that if necessary.
posted by randomname25 at 10:31 AM on November 7, 2016

In the short term for symptom relief: I definitely recommend nasal irrigation with NielMed sinus rinse premixed packets. You can pick up this at any drugstore. Isotonic saline is a surprisingly effective and gentle moisturizer anti-inflammatory.

Irrigating morning and night should help with the symptoms. You wouldn't necessarily want to do it right before a show, but you can experiment with timing to get the best results.
posted by muddgirl at 10:34 AM on November 7, 2016

I had this problem for over ten years. Nothing worked until I did the Whole 30. Imagine my surprise when it revealed that I was allergic to a shitload of foods! My asthma and lifelong "seasonal" allergies, along with with post nasal drip, cleared up for good. Whenever I cheat and sneak in some of the foods I know I'm allergic to, everything comes right back within a week. Try the Whole30.
posted by LuckySeven~ at 10:34 AM on November 7, 2016

Best answer: Definitely irrigate after the show, unless you want to work "surprise sinus drain" and/or "luminous boogers" into your act.
posted by scruss at 10:39 AM on November 7, 2016 [5 favorites]

Yeah, I would experiment with timing of irrigation. For me, there's a period in which my sinuses aren't draining out the irrigation stuff anymore but haven't built up any phlegm yet- I personally wouldn't have surprise drainage/boogers after 30 minutes. Morning and night was what was recommended by my doc but these days I do it on an as-needed basis. Also, my doc recommended Flonase after irrigation, since it would get rinsed out with the irrigation.
posted by quiet coyote at 11:39 AM on November 7, 2016 [1 favorite]

+1 for Flonase and a neti pot.
posted by onecircleaday at 11:39 AM on November 7, 2016

You have to be very careful with it, because if you use it for more than about three days at a stretch you'll develop dependency and rebound congestion, but for occasional, short-term use I find that nothing dries out my sinuses like Afrin. It's like a sledgehammer. Opens everything right up and dries me right out.

Just don't fuck around with it, this is not one of those "oh, most medical warnings aren't as big a deal as they sound" situations. You will definitely get dependency and rebound congestion if you use it regularly, and it sucks ass. But damn does that shit ever work.
posted by Anticipation Of A New Lover's Arrival, The at 11:42 AM on November 7, 2016 [1 favorite]

For nasal irrigation, add it to your nightly routine. Start every day. I think it took about a week before I could regularly get the water to easily snake from one nasal passage to the other without hitting a lot of resistance. Once you get to that point, you can start to ease back.

I never got around to liking the sensation, so my ideal is once every other week. (Or never, but that gets me back to a sore throat after a month, which needs every day for a few days to clear up) Before allergy shots, it was more like every other day. (Which relieved the nasal drip, but still had the general fatigue of constant immune response)

I find that I prefer this cordless electric option.
posted by politikitty at 2:55 PM on November 7, 2016 [1 favorite]

The Neilmed system works well, but for quick relief, I find that simply chewing a strong mint gum really gets things flowing. My go-to gum is the Mentos "pure-fresh" peppermint.
posted by jimmereeno at 6:35 PM on November 7, 2016

I had a similar problem a few years ago. It turned out to be chronic acid reflux - I didn't get heartburn, but my sinuses reacted with a post nasal drip and swelling in my vocal chords (which manifested as a feeling of a lump in my throat), which limited my vocal range and caused hoarseness. I got treated and its under control enough for me to perform now.

I didn't get properly diagnosed until I saw a Ear Nose and Throat specialist. But after that my GP was able to treat me.

YMMV.

But you might try taking some over the counter antacids for a few days and see if anything changes.
posted by His thoughts were red thoughts at 7:29 PM on November 7, 2016