I have a part-time job which is listening to audios about market research in biomedical/pharmaceutical companies. These companies want to introduce a new drug/treatment or device and they try to explore both patients' and healthcare professionals' opinions about existing products and problems in the current management of a condition. I have already heard patients experience different types of diseases caused by viruses, when patients deal with death most of the time, and also degenerative diseases which we can barely understand sometimes what the patient talks about. Sad stories and sometimes encouraging ones sometimes.

  However, one of the projects that most fascinated me was about chronic rhinitis, why? First: I suffered a lot from that in my life, mostly when I lived in Rio de Janeiro, Brazil. I was born there and lived there until my 34 birthday. I can say that every year was challenging with bad flares. I didn't face the risk of dying, but my life quality was bad, with 24h large amount of mucous production that used to make me breathe with my mouth, so my nose was totally ineffective in breathing. In addition to that, this mucous never stopped dripping in my throat so I used to have constant coughing, also around 24h / day, very annoying coughing that also used to give me a bad sleeping quality. I tried many things, and saw many different doctors but never heard about a cure. Avoid allergens? I tried, always using vacuum cleaners with HPA filters and not using carpets. While in flares, the doctors used to prescribe me corticosteroids, both oral and local nasal, that was the only thing that used to help me a bit to reduce the mucous production in addition to using the saline solution in my nose to wash the mucous. When I moved to Canada, it improved more than 90% ( now I have 1 or 2 flares a year). I only lived here in small cities, so my theory is that I was allergic to air pollution. Rio is very polluted and the air quality turns out very bad, especially in the winter. Rio's winter isn't so cold compared to Canada, however, it rains less compared to summer and the cooler air avoid that the pollution goes up, so we breathe all the car/industry gases.

pollution fog in Rio http://atmosphere.eng.br/noticias/estudo-mostra-impacto-da-poluicao-na-saude-de-moradores-do-rj-e-de-sp/

  Maybe I found my problem, but while I listened to other people's problems, I heard about people that were young or old and living all their lives with this condition. And the same thing: current drugs most of the time don't help a lot. Some of them can get some relief from them, but still, the annoying mucous production comes back. They aren't dying like a deadly virus or cancer patient, but still, they can't have a normal life. They sleep badly either because of the clogged nostrils or the coughing. This could affect their social life as well. Some of them even had their voices affected, even without smoking one cigarette they had that hoarse voice. That project was heard before the COVID19 pandemic, I wouldn't be surprised that these people also suffered prejudice while entering a business or a hospital, since if you have any COVID19 symptoms you couldn't leave home.

  Another thing that was pretty clear in the interviews is that the diagnosis is difficult to get in there since any virus that infects the respiratory tract brings these symptoms, and it is challenging even for a chronic patient to differentiate a virus infection to a chronic rhinitis allergy flare. In addition to that to make things confusing, since it is something that also affects me is that after a virus infection, most of the time comes a flare of chronic rhinitis. Sometimes is a dumb virus that just makes you cough a bit, but then you remain weeks or even months with this ridiculous mucous production. And doctors aren't magicians to guess what happened to you. They have the experience to try to help you to contain the symptoms and also see signs of infection. If you leave also this huge amount of mucous around it can bring what? bacteria! So that is the most terrible risk for these patients, if they don't keep cleaning the mucous, bacteria come and bang! You get sinusitis, which can bring fever and other problems, so here it comes the antibiotics to help as well when you reach that. So that's the most important thing is to keep using saline solution and making sinus washing, it doesn't stop much mucous production, but it at least avoids bacterial infection.

https://www.fda.gov/consumers/consumer-updates/rinsing-your-sinuses-neti-pots-safe

 So diagnosis is tricky, I talk about my experience with that, many, many doctors didn't help anything with that, just let me go home saying that I had a virus and I would improve in the future. The treatment also is tricky, sometimes they help, sometimes not. That's why in addition to me I heard some patients that the only solution was to move to another place. But they can bring some relief: oral antihistaminics (Allegra, Claritin, Aerius) and nasal corticosteroids (Flonase, Nasonex, and many others). And as a last resort oral corticosteroids, since they bring many side effects should be avoided.

  I don't have a scientific number in the pocket, but I would say that it is very frequent this type of problem, so if you are one of these persons that feels daily with problems like that and tried everything, maybe it is time to move out?