Surviving Urban Sinus Problems

In the eyes of Robert S. Ivker, a physician from Denver in town this week to speak to air pollution researchers, Los Angeles has a dubious distinction: It’s the clogged sinus capital of the country.

Hearing that, Santa Monica allergist Bernard Geller took mock offense: “That’s the pot calling the kettle black.”

On at least one point the doctors do agree: Los Angeles, Denver and other major cities have more than their share of sinus sufferers. That’s because the condition often worsens as traffic snarls and air quality declines.

An estimated 31 million Americans have sinus problems, and about 2 million of them are in Los Angeles, claims Ivker, who recently wrote a guidebook, “Sinus Survival,” available at many health food stores.

Filter, Humidify Air

The sinuses, eight air-filled cavities behind and around the nose and eyes, are connected to the nasal passage via thin ducts. Lined with mucous membranes, they help filter and humidify the air we breathe.

Sinus problems, often painful, can start when the mucosal tissues become inflamed, as in chronic sinusitis, or when they become infected, as in acute sinusitis.

A yellowish post-nasal discharge is one telltale clue to acute sinusitis, Ivker said. At the root of sinus problems may be an allergic reaction, a bacterial or viral infection or exposure to irritants such as air pollution, Geller said.

Sinus problems often worsen whenever air quality declines, Santa Ana winds kick up or humidity levels plummet, Ivker and Geller agreed.

For infected sinuses, medical attention and antibiotics are usually needed, Ivker said. For chronically inflamed sinuses, the two experts advised, there are plenty of help-yourself measures to minimize the misery, such as:

--Stay in a clean air environment when feasible; retreat indoors if possible.

--Drive with the air conditioner in your car on the “recirculate” mode.

--Use over-the-counter salt-water nasal sprays and decongestants; avoid excessive use of such treatments.

--If humidity levels are low, use a humidifier with distilled water.

Heavyweight Walking

First, exercise fanatics who burned out on high-impact activity discovered walking. Then came “power walking” or “fitness walking.” Now, there’s fitness walking with a weighted vest--a sure route, proponents say, to burning more calories, toning muscles faster and increasing strength, heartbeat and endurance.

Advertised heavily in a walking magazine, the weighted vests range in price from about $45-$150 and are sold, mail order, by several firms. Most of the vests are canvas, “one-size-fits-all” and have pockets, front and back. By inserting steel weights, sand or water in the pockets, wearers can shoulder loads of 2 to 50 pounds. The power-walking vest introduced by Basci Fitness Products in January, for instance, includes eight weight pockets and 2-pound weights, allowing for a total capacity of 32 pounds; the Logjammer vest, another product, holds up to 50 pounds of steel weights.

Sukru Basci of Basci Fitness Products says the vests are more convenient than carrying hand weights, can help raise the heart rate to the aerobic or “training” zone vital for cardiovascular fitness and can help tone leg muscles faster than walking without weights. Walkers should add weights gradually, he cautioned, taking several weeks to work up to a maximum comfortable load.

The vests “seem safe,” said Susan Johnson , director of continuing education for the Institute for Aerobics Research, Dallas. “They’re easier to deal with than hand-held weights and eliminate the risk of throwing off posture, which can happen with hand-held weights.” The muscle-toning claim also is plausible, she said, but walkers shouldn’t expect dramatic or immediate results.

Caffeine and Diet Aids

Combining caffeine with higher-than-recommended doses of over-the-counter diet aids can elevate blood pressure substantially, according to a study published this month in the American Journal of Medicine.

Researchers compared use of diet aids with phenylpropanolamine (PPA), a substance also found in decongestants and cough-cold medicine, in 16 subjects. Significant blood pressure increases occurred over several hours after taking 150 mg of PPA--about the amount found in two diet pills--and after taking 75 mg PPA plus 400 mg caffeine, about the amount found in three cups of coffee.

In the young and healthy, transient hypertension could lead to stroke, said David Rosenberg, a research biologist at Uniformed Services University of the Health Sciences, Bethesda, and a co-author with Dr. C. Raymond Lake of the Uniformed Services University and others. They advise caution in use of over-the-counter diet aids, warn against doubling doses and suggested that “requiring a prescription for these drugs is a means of emphasizing their potential risks, especially when more than the recommended dose is taken.” Their study was funded by the National Institutes of Health.

But another researcher claims such diet aids are acceptable over-the-counter products.

In a study of more than 800 people taking diet aids with phenylpropanolamine--work funded by Thompson Medical Products, manufacturer of Dexatrim appetite suppressants--Dr. John P. Morgan, medical professor and chairman of pharmacology at City University of New York Medical School, said he found a very slight blood pressure rise. Those with highest initial blood pressures had less of a blood pressure rise after taking the diet aids than those with lower initial pressures, causing Morgan to speculate there may be a built-in protective mechanism. He expects his study to be published soon.