Dear vermontrunner,
Thanks for the query
Stuffy nose with nasal discharge following exposure to wood smoke seems to be an exaggerated response to allergens. You have already used pseudoephedrine (Afrin) to reduce the nasal congestion, but it has given you only temporary relief.
I feel you would require a steroid nasal spray and an antihistaminic for some time to control nasal irritation. Also, continue using the saline nasal drops (it keeps the mucosa hydrated), drink plenty of warm water and do steam inhalation to relieve the nasal congestion and irritation.
According to the examination findings of your doctor, the nose seems to be clear and there are no signs of infection. It is very unlikely that a doctor would miss a perforation of the nasal septum. The symptoms of the septal perforation include recurrent episodes of dryness of the nose followed by nasal bleed, whistling sound while breathing (if the perforation is small), any history of infection of nasal septum followed by pus discharge from the septal region, septal surgery, snorting of long duration, etc. Most of the septal perforations happen in the front 1/3 of the nose rather than behind the nose, and can be seen easily, even on self examination using a mirror. And, hence it is very unlikely that a person will miss the perforation.
Hope that this information helps and hope that you will get better soon.
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Best Regards,
Dr. Naveen Kumar.
It may also be relevant that I haven't had a nosebleed in probably 20 years (I'm 32 now) and that the air has been very cold and dry where I live. The slight discomfort I'm feeling is nonexistent when I take a hot shower and when I run.