Question
My child always says their nose is blocked and they can’t breathe before going to sleep, and they scream in frustration. But they are fine once they fall asleep. Sometimes there is mucus, sometimes not, and there is always a feeling of mucus congestion in the nasal cavity. They always cough to clear their throat. There are small lymph nodes in the neck. The nasal problem has been going on for almost two years, especially prone to illness during the change of seasons when cold and hot temperatures alternate.
Answer
The adenoids begin to shrink gradually as children grow to around 8 or 9 years old. If the condition does not significantly affect them before this age, surgery is not necessary. However, if it severely affects sleep and breathing, surgical treatment may be required. I consider that there may be allergic factors as well, which could be why it keeps recurring. This can be treated with traditional Chinese medicine, but first, we should start with daily physiological saline irrigation 2-3 times a day, which has no side effects and can be continued indefinitely. It is the first step in treating various types of rhinitis. Once this is done well, some mild cases may improve without medication. Nasonex belongs to a hormone medication and should be taken regularly; continue for one month to see if there is any significant effect. If the mucus is yellow and purulent, antibiotics such as cefalosporins can be added. If it is not particularly yellow, antibiotics may not be necessary. The Chinese herbal medicine Biyuan Tongkao can be used for 2 weeks.