instruction: hello doctor my father is 54 years old he has a very heavy sneeze when he sneezes he holds it back and he loses consciousness I tell him not to hold it back but he is physically not able to let it go alone is there anything I can do to help him or anything he should do and are there any dangers in his life
output: hi first we need to find out what is the cause of recurrent sneezing if you look into the physiology sneeze is a protective reflex often in response to something irritative and offensive which the body wants to push out in order to prevent it from reaching the lungs and thereby into the circulation most commonly it is dust but can be attributed to other irritative substances such as animal fur pollen smoke fumes etc what can be done prevention of entry of irritative substances is the key and plays a major role in preventing allergic responses this can be effectively done by wearing an n95 mask most times even while indoors in addition a combination of antihistaminic and asteroidal spray containing azelastine and fluticasone two puffs two times a day does wonder holding a sneeze inside can be lethal as it is high pressure reflux and by holding the sneeze reverse pressure can be created which has no where else to go but above to the cranium thereby an increase in intracranial pressure causing a vessel to rupture resulting in a stroke this is a far possibility but in elderly individuals it can happen and is lethal secondly an increase in intrathoracic pressure can also stimulate the vagus nerve resulting in vasovagal syncope causing a brief loss of consciousness it is very important that these measures are followed in order to prevent any untoward incident I hope this helps