Sinus Hygiene: What do you do to help prevent asthma flares?

@lenchiksf This is a great question! For years, I thought I had to simply react to my asthma, but three things happened in my life to change my approach. Six years ago I was diagnosed with Bronchiectasis, another lung condition and 2 infections - Pseudomonas & Mycobacteria Aviums Complex. That began almost 2 years of strenuous antibiotic therapy, along with a daily exercise called Airway Clearance. The active process of airway clearance convinced me I could have a positive effect on the condition of my lungs.
Then, 2 years ago, my pulmonologist switched my asthma treatment protocol from daily (sometimes several times) use of levalbuterol nebs and/or inhaler, with a steroid for flares, to a new inhaler -Symbicort. That was a game-changer for me, as it combined a long-acting beta agonist with a low dose inhaled steroid.
Finally, last year I was introduced to inhaled azelastine as my primary daily anti-allergy med (supplemented during heavy pollen season by Xyzal) I also use sterile saline to GENTLY rinse out my sinuses - usually an ounce or so, not the 4oz that goes in the NeilMed bottle (or I use Simply Saline aerosol) whenever allergies threaten, but not every day unless I have a cold. Years ago, my ENT told me "There's such a thing as irritating your sinuses by doing too much. Nature takes pretty good care of you, so try not to upset the natural balance."

By gaining better control of allergies and inflammation, plus having a long-acting med on board to keep airways open, I have reduced exacerbations from almost-constant to about once a year. And being conscious of when there is mucus in my lungs, I can do more to move it out with airway clearance, so there is no nice warm moist breeding ground for the infections that used to plague me.

Not to say all is perfect - I am still sensitive to poor air quality and high winds, which I avoid when possible.

What routine do you use?
Sue

Thank you Sue
I would like to hear/learn more about sinus rinse with an ounce (with Simply Saline Aerosol) ?
I only know conventional way:). I use Himalayan Chandra Neti Pot Complete Sinus Cleansing System (Amazon) and add budesonide liquid form rx-ed by ent. I use filtered and boiled water, but i came across somewhere that it needs to be distilled water (still need to follow up on that )
My allergy/asthma and ent md tell me to do rinse once a day and use Azelastine hydrochloride nasal spray twice per day. I never heard of inhaled azelastine that you are using, but i can ask my allergy md. I wonder if its the same or two completely diff meds.
I am in a flare up stage, its worse this past week, have tons of sinus pressure and mucus. And of course i am using more nebulizer these past few days to relieve asthma symptoms. I am not looking forward to oral steroids and abx due to side effects. I did see someone mentioned there is topical abx for sinuses though. I will ask ent if i can try.
Yes , air quality also not good (in Bay Area) nowadays. We had storms, many people with power outage and burning wood to stay warm.
Thanks again,
Lena

I use the same azelastine as you do.
As for the sinus rinse, since I don't use any meds in it, the small aerosol bottles of saline work for me - no boiling, cleaning, rinsing and sterilizing...
Is your problem primarily in your sinuses? If not, you might want to ask about Symbicort (or generic) inhaler - budosenide plus formoterol (long acting version of albuterol-type meds) that will get more med into your lungs.
Also, with a flare-up, has your ENT done any culture of sinus or sputum to see exactly where you are infected, and with what bacteria? And if you are feeling unwell, are you sterilizing your Neti Pot after using it a few times?
Sue

Thank you Sue ! All of above is helpful !
Much Regards,
Lena