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Recurring nosebleeds
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aconrad posted:
I would like some information on what to do. About 1 1/2 yrs ago I went to see a local ENT for weekly nosebleeds I was having. Since then I've had my nose cauterized 4 times and each time the bleeds return. They've gotten much less severe. The last cauterization was 6months ago and I didn't have any bleeds until 2wks ago now they're coming almost daily. He owns the medical group where I went; they are the only ENT's in town. I saw one of his colleagues once when he was away and he couldn't find any problem. He makes it sound like, though not an everyday occurrence, having multiple cauteriztions isn't completely rare. I need to say that sometimes the bleeds end as quickly as they began. I do have a deviated septum and he said at some point (not yet) I might want to consider having it repaired and that would probably stop the bleeds. I don't want to go that route yet, partly because we don't have insurance. What would you suggest I don next? There does seem to be some correlation with the change of seasons, ie, winter to spring and summer to fall.

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Rod Moser, PA, PhD responded:
Have you ever had your blood tested for a bleeding disorder? Are you taking any aspirin or medications that can thin your blood? Do you have allergies? Do you tend to pick your nose?

Most nosebleeds are anterior (near the opening of the nostrils), but without a hands-on examination, I would not know if you need to have this bleeding area cauterized again.

One more question for you....Please describe how you STOP your nose bleeds.
 
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aconrad replied to Rod Moser, PA, PhD's response:
I have no blood disorder that I'm aware of. I don't take aspirin or any other NSAID, but I do have some kind of rhinitis that is episodic. l will have constant drainage and periodic coughing that can be intense. This will last a couple of months and several months later return. No doctor I've been to knows the exact reason. I have noticed that nosebleeds seem to definitely occur during this this, usually not until it's been going on for a several days or few weeks.

The nosebleeds have been diagnosed as anterior not posterior.

I stop the bleeds by pinching the fatty part of my nose firmly from 5 to 10 min and that usually stops them. I get tired of doing that sometimes and bought a clamp that does the same thing when I don't want to.

Thanks for your reply.
 
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Rod Moser, PA, PhD replied to aconrad's response:
You are doing the proper first-aid for nosebleeds, but you do not have to pinch both sides....just compress the bleeding side against the nasal septum.

If it is bleeding from the same side, then it is back to having a cautery again. Allergies may, indeed, be playing a role, so that is something you may need to investigate.

How long do your nose bleeds last? Are you having any brusing on other areas of your skin surface that is not from an obvious injury?

What is your age?
 
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aconrad replied to Rod Moser, PA, PhD's response:
That's something I'd never thought of, just compressing one side against the septum. So obvious. Thanks for the tip.

I'm 63 yrs. old.

I can't remember the last time I had a bruise.

The bleeds last 5 -10 min with pressure. Before going in for cautery the bleeds would last as long as 45min, so that's one thing that has definitely improved.

Just for information, the last time I went in for cautery; 7 months ago, I had 3 nosebleeds the following week and was about to schedule an appointment to have it done again . . . when they stopped as quickly as they began. I'm beginning to wonder, if in some people, nosebleeds are a little like low back pain. Not everything works for everybody, some thing don't work at all and there is more that medicine doesn't know that it does? Not an accusation, just a thought.

Thanks again for replying.
 
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Rod Moser, PA, PhD replied to aconrad's response:
One more suggestion....

Get some over-the-counter Neosynephrine Nasal Spray to have on hand in case you have a nosebleed that will not stop with direct compression. Moisten a wad of tissue or cotton ball with the nose spray and the epinephrine in the nasal spray will shrink the blood vessels and help it stop. This is not a cure, however, but would be a good addition to your home first-aid kit.
 
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aconrad replied to Rod Moser, PA, PhD's response:
Another excellent idea. Thanks for your time and help.
 
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Rod Moser, PA, PhD replied to aconrad's response:
You are welcome....


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