How to manage persistant nasal blockage?

Q: I am having a problem which started 5 years back and has now reached a level where it is troubling and bothering me to an extent that my work is being affected and I am at the risk of losing my job as well. Around 5 years back, I started with one side nasal blockage which keeps changing the side from time to time. I consulted an ENT specialist who gave me a course of antibiotics and a nasal drops (Nasivion). It didnt work much but I kept using the drops for about 6 months as it used to give me slight relief. After that I left the spray as it was not of much help and showed to other doctors as well and they all used to prescribe anti-infectives which are of no help to me. Steam inhalation makes the problem worse for me as the nostril that is blocked gets more swollen and it becomes completely chocked. But somehow I started living with it as I was becoming used to breathing with one nostril. Every morning when I get up, I have a blocked nose to the side I was sleeping. Then I started developing one side headaches which are accompanied by a sensation of severe nausea. The side that has the nose blockage has the head ache most often. Then I showed to a neurosurgeon for Migraine. I was prescribed Erogatamine tablets which I take many a times. But I am getting bugged with the medicines I am taking these days. Over the last couple of weeks the problem has got intensified and I have persistent headaches with nasal blockage and nausea. I am living in Peru these days and am here for a company assignment. With the rate I am falling ill and missing work, I stand to lose my job which will be a big blow to my career. I am very frustrated and dont know what to do at all. Nose blocakge and one side headache have left me almost paralysed. Kindly suggest what could be best done to come out of this situation. If there is any medical examination which could exactly pin point the cause, it would be of great help to me. Looking forward to your response.

A:Most probably you have rhinitis medicamentosa - a condition due to the use of the nasal drops for too long a period. You should start on a steroid nasal spray (eg. rhinocort). The dose will be told to you by the ENT doctor in Peru, but it is usually 2 puffs each side twice daily. For the migraine you should take Tablet flunarizine 10 mg at night for a month and see. I think you should consult an ENT surgeon before starting any medication.