A Tissue Issue

when the problem's right under your nose

Welcome readers, new and old. By the time you see this, I should be happily ensconced in my little place on Tokyo’s windiest street, trying to remember how to use the stovetop and microwave and showering my four-year-old granddaughter, M, with IRL kisses every chance I get. “Grammie, I love you more than anyone in the world!” she told me recently. I was only a bit deflated when I heard her say the same to her mother, father, and finally her fiancé, Monkey-Monkey. As I keep telling myself, love is not a pie. And you can spread it around by tapping the ❤️ above, thank you!

While I’m here, weekly HNTFUYF posts will arrive as usual, likely flavored with a taste of Japanese culture. Will I be reviewing this milkshake? Probably not. And in the folder labeled “Takes a Lickin’ and Stops Tickin,’” there’s already this story about a revolting development at sushi conveyor belt dineries. I hope other news is more appetizing, less vexing. But before we leave the land of the vexed, a reader query.

Q: I have an appearance issue I hope you’ll be able to help with. My nose is like a drippy faucet all the time. I have, of course, considered the weather and allergies but have found there is no day or season when I don’t have this water-like drip. My sister and mother both suffer from the same issue. (One lives in Southern California and the other in South Carolina.) I have to keep tissues on me everywhere I go. This has got to be one of the greatest annoyances of aging. Please help!

A: Oh boy, your question unleashed a flood (sorry) of sweet memories about my mom. What I mean is my mom, in her later years, complained bitterly about her runny nose. Which says a lot about her character, because she occasionally had other, more difficult issues she might have complained about but…never a peep. Sometime after I hit my 70s, I began to notice similar leakage. (Mom, I wish you were here so we could commiserate!) But I probably wouldn’t have tried to figure this out if it weren’t for you, dear drippy-nosed reader. So thank you—and thank you to cosmetic plastic surgeon and ENT doctor Michelle Yagoda for her explanation.

As is our intention here at HNTFUYF, let’s start with the positive. “All things considered,” says Yagoda, “while vasomotor rhinitis [fancy terminology for our dependable drip] is certainly a nuisance, it is a benign one.” Benign, a word that generates increased satisfaction and joy the older we get. And now Yagoda excuses herself from accusations of medical mischief: “I’m not providing patient-specific medical advice about the drippy nose question because I’ve never seen or examined the reader in person or via telemedicine,” she says. “The cause and treatment of a drippy nose can vary. But I’ll address a common cause when the problem surfaces in older patients.” I’m good with that. You?

As we age, our bodily parts and systems show signs of wear and tear, says Yagoda. Things break, fall off, slow down, and, for some of us speeding incautiously along an uneven sidewalk, get tripped up. An aging nervous system can experience a similar kind of imbalance between its parasympathetic functioning (the one that brings our body into a calm and restorative state) and sympathetic functioning (the one that prepares our body to fight or flee). The annoying result? A trip, in which the tumbling manifests as watery discharge from the nose.

A clear drip can be regular or sporadic, says Yagoda. It can be triggered by odors, foods, emotions, or changes in humidity and/or atmospheric pressure. (What? Not the tides?) Unlike allergic rhinitis, seasonality and measurable hyperactivity of the immune system are not associated with it. In defense of the human body, Yagoda reminds us, “If you stop to think about it—let’s take a moment here 🙏—the body is a truly incredible piece of machinery, often lasting nearly 100 years with minimal maintenance.” Obviously, our personal definitions of “minimal” and “maintenance” may vary.

So what to do about our delicate plumbing problem? “I find the most effective treatment for age-related vasomotor rhinitis is a prescription anticholinergic (not anti-allergy or anti-inflammatory) nasal spray,” says Yagoda. Big caveats: Don’t use an anticholinergic nasal spray if you have closed angle glaucoma (the most geometric condition I’ve never heard of), blockage of or an inability to completely empty your bladder, or (finally, dear readers, one thing most of you don’t have to think about) an enlarged prostate.

I have a couple of civilian recommendations for you, too. If the skin around your nose becomes red or sore from a constant drip, this stuff helps enormously; I apply it at bedtime. And speaking of tissue, these are the only ones I ever use because they smell like a spa and behave almost like cloth, meaning they never tear or crumble in your pocket or bag. In the winter, I buy them in bulk. And when I lived near New York City’s largest, most treasure-filled flea market, I collected cotton and linen antique hankies (for around $0.25 apiece, then). If only I could bring myself to use them, they’d be a stylish way to deal with a very unstylish problem.

A Moment of Personal Nose Horn-Blowing

HNTFUYF was recently included in a roundup of the “23 Best Health and Wellness Newsletters of 2023” by the (what else?) health and wellness website Ness. Thanks, Ness, and thanks to all you HNTFUYF-ers for inspiring me with your thoughtful questions and comments. xo

HNTFUYF, a Payola-Free Zone

Readers, a few of you have asked if I get a cut from sales when I mention a product. I do not. I only mention products I’d like to buy myself, and therefore think you might like, too. I share this so you know my recommendations are offered without obligation.

Val Asks You

Don’t be shy! What’s your most vexing or intractable appearance issue? Send your beauty-related questions to valeriemonroe@substack.com. If I don’t have a good answer, I’ll find someone who does.