Plain Advice

I am a walking contradiction. I have an official diagnosis of Obsessive Compulsive Disorder (OCD), which is widely known for its very organized and clean tendencies. And in some situations I am very organized (and almost always very clean). But in many many ways I am a disorganized mess. I won’t try to explain my theory on my inconsistency here (I’ll save that for another post), but I do want to share a very simple organization tool that I recently rediscovered.

It is so simple that it is almost embarassing. Anybody who can write can implement it.  What is the tool you ask? A running “to do” list. 

Almost too simple to discuss.  But sometimes, the simple ways of doing things are the most powerful.  And sometimes, tweaking something just a little bit makes it exponentially more useful.

At work, especially, I am bombarded with endless tasks (as a social worker, I am constantly receiving new information about my cases that need follow up). In my 8 years at this work, I have not found a satisfactory way to keep track of all these things that need to be done. I have tried different approaches, but often the methods were too complicated or time consuming for me to sustain.

Last week I was feeling particularly overwhelmed and frustrated at my lack of organization. So I pulled out a legal pad and made a list of all the things in my brain that needed to get done. It turned out to be a pretty long list. For the next several days, each time I wondered what to do next, I looked at the list. I was able to redirect myself and remember what I needed to be doing. While talking on the phone (which always creates more work for me) I would just jot down reminders to myself on this list.  Not on sticky notes, which tend to get shuffled around and lost.  But on my legal pad that I had right there at my desk (I now prefer the legal pad because I can fit so many more items on one page due to the length of the paper).  That way, it is there, at the center of my work.  

In the past, my to do list wasn’t as effective as it could have been because I tried to take it with me everywhere I went.  It usually ended up lost in the bottom of my bag, or not there at the very moment I needed it, which is usually when I am at my desk.   I tried keeping the list electronically, but because I dropped my Palm Pilot and lost all my data on more than one occasion, I decided that paper is for me when it comes to important details.

The best thing about this very basic way of doings things?  My productivity went way up. And my anxiety level went way down.

At the end of the workday, before leaving the office, I can look at my list and feel confident that all the urgent items for the day have been crossed off.  Which means that when I get home, I am home and don’t have that nagging feeling that something was left undone.  I can also get a glimpse of what I need to be prepared for the next day.

When the list outgrows the paper, I just transfer all the items that are not yet done to another page and then start fresh from there. 

With my list in front of me, I don’t need to remember so many details.  Seeing the whole list on one page (remember, legal pad) makes me feel more in control and aware of the big picture of what I need to do.   I don’t have to go looking in different places for all the things that I need to get my tasks done (such as fax and phone numbers). Another perk of this approach is that when an intern or assistant asks if there is anything I need help with, I can turn to my list and immediately delegate a task. Without having things written all in one place, I never knew offhand what I could ask someone else to do. So I ended up doing it all myself (and usually at the last minute).

My advice to you is obvious… if you are struggling with being disorganized, use a running to do list.  If you have tried it in the past unsuccessfully, try it again.  Look for small ways to improve your system to work more efficiently.  Get back to the basics.  It just might be your ticket to being more in control of your life.

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I wrote an article a few weeks ago about how, after 2 years of being severely dependent on nasal spray, I was able to free myself from this nuisance. It was through the Rhinostat system that I was able to do this.

I am writing this article to give more detailed information on this product which has truly given me back my life (or at least, a functioning nose). Rhinostat system is an effective way to treat rebound congestion associated with prolonged nasal spray usage.

Rebound Congestion

The active ingredient in over the counter nasal sprays is a topical vasoconstrictor that temporarily reduces the size of the nasal turbinates, opens the nasal airway and provides decongestant relief from congestion. These sprays are very effective at relieving nasal congestion during the common cold, and also during bouts of nasal allergies.

The recommended period of time for using nasal sprays is up to 3 days. Using past this period of time will typically result in rebound congestion.

Topical nasal sprays act as an agonist to sympathetic a1 receptors in the blood vessels of the nose, signaling those vessels to contract. By decreasing blood flow to the lining of the nose, the tissue becomes less congested and mucous production is slowed.

After several days use of nasal spray products, the receptors become unregulated, requiring more frequent and higher doses to prevent the rebound congestion that results when the medicine wears off.

Rebound congestion causes extreme discomfort (I can attest to this). Because the nasal mucosa becomes abnormally swollen and enlarged, the nasal airway becomes completely blocked. This discomfort is relieved by the administration of another dose of nasal spray. As soon as the temporary effect of the last dose of spray wears off, another dose of spray is required to provide relief. This is how the nasal spray addiction is born.

Implications for the Addict

Nasal spray use is not a pretty sight. Most people are not comfortable snorting spray in front of people. For this reason, the nasal spray addict often develops secrecy around their addiction. They excuse themselves from social settings, wake up in the middle of the night and learn how to integrate the use of the sprays into their daily routines, in solitude.

Like any other addiction, it is very important to those addicted to spray to have it readily available. They keep a bottle of Afrin in their pocket or purse, their nightstand, glove box, backpack, briefcase and anywhere else necessary to ensure that it is readily available when needed. Most nasal spray addicts know every retail store in their neighborhood that carries the product.

Some people continue in their nasal spray addiction for years, even for the rest of their lives (On the Rhinostat website, there are reports of people that have been addicted to nose spray for over 40 years!).

Different Types of Treatment

The only way to break the cycle is to quit using the spray. This can be done in two ways, often referred to as “going off cold turkey” or “weaning”.

Going cold turkey, or all at once, is extremely uncomfortable, and can last for 4-7 days before the nose starts to funcion normally again. Typicall, physician’s advise patients to use the cold turkey method to brek the addiction. This was the advice my own doctor gave me. However, I was never able to motivate myself to live through the misery. There was never a convenient time for me to lose excessive amounts of sleep or go through the days not being able to breathe through my nose (I can’t imagine it would ever be convenient to anyone).

The biggest key to helping people successfully get off nasal spray is to help them minimize the discomfort while doing so. Rhinostat has developed an extremely effective way of doing this. While “cold turkey” was for so long considered to be the only way to get off nasal spray, Rhinostat came up with a way to gradually wean the patient off the stuff. Because the change is gradual, the discomfort is minimal and completely manageable.

How Rhinostat Works

The Rhinostat system is based on the method of “dosage titration”. This method allows for gradual & comfortable withdrawal from decongestants while maintaining nasal inspiratory flow.

Rhinostat kits are individually formulated for each rhinitis medicamentosa patient, depending upon the active compound in the decongestant nasal spray the patient is currently addicted to. Rhinostat provides the user with an apparatus that allows them to progressively reduce the concentration of the active compound in their decongestant. Depending upon the particular brand or type of spray, this will either be:

Oxymetazoline hcl (Most Common in USA)
Phenylepherine hcl (Second Most Common in USA)
Xylometazoline hcl (Most Common in Europe, Canada, Australia)
Naphazoline hcl (Rare in USA, more common in Asia)

Rhinostat apparatus

The Rhinostat apparatus is comprised of two bottles. The first bottle (dispenser bottle) contains a decongestant nasal spray formulation identical to the user’s current decongestant spray (based upon one of

the compounds listed above). The Rhinostat diluent solution (second bottle) is identical to the decongestant nasal spray formulation, without the active ingredient (vehicle placebo). The Rhinostat apparatus allows these two solutions to be precisely combined, thereby giving the user control of the dosage strength. The target rate of reduction (dosage titration) is 15% per day.

Dropper Bottle vs Spray Bottle

One issue that I had with the Rhinostat system was the method of medication delivery. The system comes with a dropper bottle instead of the spray bottle that I was accustomed to. Rhinostat reports that a spray bottle is not used in their kit because the titration is difficult to measure in such an apparatus.

I attempted to use the spray via dropper, but I was unsuccessful. I could not do it without getting the compound down my throat, which was very uncomfortable. This problem, in fact, caused me to procrastinate using the Rhinostat system for several months. Since then, I have also read accounts of others who have had the same problem.

The solution I found took a little more time, but it was worth the results. I simply used an empty spray bottle (I had no problem finding one of those around my house!) Every morning, I would pour the solution to the Rhinostat dropper bottle, add the appropriate amount of saline solution, and then I would put the compound back into my spray bottle. This way, I was able to use the spray comfortably as I was used to doing.

Rhinostat Disclaimer

Although Rhinostat is an effective method of weaning off nasal spray, its effectiveness is dependent on several key factors. The Rhinostat method is most effective for those patients who have no other underlying medical or physiologic conditions contributing to their rebound congestion (such as allergies or a deviated septum.) Patients who do have allergies that are contributing to their rebound congestion should consider discussing with their physicians the use of intranasal steroids along with Rhinostat.

Customer Service

The Rhinostat system worked for me on my first try. However, if for some reason your treatment fails on the first try, they will send you a second kit for free. An example of why the kit may not work the first time around is if you develop a cold while you are trying to wean from the medication.

The cost of a kit of Rhinostat is currently $35.00.

Rhinostat is also offering kits for free as a way to get the word of their product out to medical professionals. On their website they will direct you as to how you can get your free kit by going through your doctor. Therefore, even if you cannot afford Rhinostat, you can still try it.

Conclusion

If you are suffering from nasal spray addiction, you know how frustrating and inconvenient it is. I just got back from a camping trip with my family. While I was there, I thought back to last summer, and realized that we did not go camping at all. It may sound crazy, but a large part of why was because of my nasal spray addiction. At that time I was waking up every night, sometimes multiple times, and using nasal spray just to sleep comfortably. The thought of doing so while sleeping in a tent, waking everybody up while looking for nasal spray, walking to a bathroom or at least away from the tent in the dark by myself (again to avoid waking everybody up with my snorting) was very unappealing.

I cannot tell you how great it feels to be free from nasal spray. After the first week of using Rhinostat, I was amazed at the change in my life. And the process of weaning off the spray was painless. At times I would feel anxious, worried that I was going to experience discomfort, but as I used the system I found that there was no reason to worry. I know it sounds silly, but this is not an exaggeration.

I also recommend that if you have questions about Rhinostat , their website is very useful and informative.

Lastly, if you have experienced nasal spray addiction, or have kicked the nasal spray habit, please share your story by leaving a comment.

Thanks for stopping by, and happy breathing!

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Yesterday in my office… I’m a social worker by day… I was buried in paperwork and plugging along on my computer. I tried to get on the internet but as soon as I typed anything into the browser, I got that dreaded error message “Internet Explorer has encountered a problem and needs to close. We are sorry for the inconvenience”. I tried a few more times, and the same thing happened. Yeah, yeah. Enough with the apologies.

So I picked up the phone and dialed tech support.

We have really great computer whizzes in our office. I have never been down to the basement where they are stationed, but I always imagine that it is a concrete room with lots of wires and computer equipment everywhere (see picture below).

The tech who answered my call listened as I told him the problem. He asked if my computer was on, and I said yes. Within a split second, something took possession of my screen. It was a little freakish and then I realized it was only him, accessing my computer remotely.

I was intrigued as I watched computer guy go through and try to find the problem on my device. He would open and close windows faster than you can say “laptop”. He would click on things and speak as he went, as if I could understand a single thing he was talking about. He would point to a string of letters, punctuation and numbers and say “see how nonsensical this file is? It looks suspicious to me”. I would verbally agree with him, but on the inside I was thinking that it looked about as suspicious as the UPC barcode on a bag of chips.

After watching computer guy delete, update, install, uninstall and reinstall things for about 45 minutes, I finally said “how do you figure out what is wrong?” (he still hadn’t identified what was going on).

He explained “when you look for a computer problem, you have to first determine whether it is equipment/hard drive related, or if the malady is more of an issue in the registry and/or files”.

Now it was clear as mud. What is a registry? The only thing that comes to mind is the one stop shopping sensation, Super Target, where I have gone many times to buy gifts from bridal and baby registries. Somehow, I didn’t think that was what he meant.

I must have been giving off a confused aura, because he decided to make an analogy that he thought I, as a social worker, could relate to. He said the hard drive/equipment would be like identifying a physical problem in a person, where a registry/file problem would be more like an emotional problem.

When he said this, I wanted to burst out in laughter. Was he telling me that my computer may have an emotional problem? Yeah, that is just what I need. A computer that needs therapy. Somehow, when I log onto my computer each day, I enjoy that it is not a person and not in crisis. I thought I was safe from these things in computerland.

But he was serious, and he continued to talk about this analogy for a long time.

Finally, after about 2 hours (yes, 2 hours…) computer guy said “done”. He had me try the internet and it was working like a charm. He apologized for taking so long, but I was just so happy that my computer had regained it’s sanity. 2 hours is not a long time compared to the years it takes some people to work out their issues in therapy.

My advice? None for now. I just wanted to share this heartwarming story.

If you are computer savvy, please excuse my complete ignorance if I used the wrong words or terms in this article. I am just going off what I remember from computer guy.

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