The weakness and burning around the eyes could be related to the underlying viral illness itself, as fatigue and eye irritation are common with colds. Additionally, fexofenadine (Allegra) can sometimes cause mild dryness in the eyes, leading to a burning sensation, or slight drowsiness. While paracetamol is generally well-tolerated, the combination of illness and medication can sometimes make you feel run down. Please ensure you stay well-hydrated and rest. If these symptoms persist, worsen, or if you notice any swelling or vision changes, please consult your doctor for a personalized evaluation.

While sneezing and watery eyes can be allergies, your chest congestion, fatigue, and night fevers suggest a viral respiratory infection, especially since fexofenadine hasn't provided relief. Given your heart valve history and medications like acenocoumarol, carvedilol, and furosemide/spironolactone, please avoid over-the-counter decongestants and NSAIDs (like ibuprofen), as they can dangerously affect your blood pressure and bleeding risk. Safe remedies include steam inhalation and saline nasal sprays. Paracetamol is generally safer for fever but should be used cautiously. Please consult your doctor or cardiologist promptly to ensure you receive a safe, tailored treatment plan.

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Please take your wife to the hospital immediately. An oxygen level dropping to 87%, especially during pregnancy, requires urgent medical evaluation to ensure both she and the baby are getting enough oxygen. While her daytime levels are 94-95% on the oxygen concentrator, these morning drops and severe shortness of breath mean her current home therapy is not sufficient. Hospitalization will allow doctors to safely monitor her asthma and COVID-19, adjust her medications like Medrol (methylprednisolone) and Budesal, and provide close monitoring for the baby. Please do not delay; seeking hospital care right away is the safest step for their well-being.

Since fexofenadine (Allegra) only provides temporary daily relief, we should focus on restoring your skin's natural moisture barrier. As we age, our skin naturally becomes drier and more sensitive. I recommend taking short, lukewarm showers instead of hot baths, and using a mild, soap-free cleanser. Immediately after gently patting dry, apply a generous amount of a thick, fragrance-free moisturizing cream to lock in hydration. If the itching persists despite these daily moisturizing steps, please consult your healthcare provider or a dermatologist to explore other potential causes and stronger, targeted treatments.

Since your symptoms resolve with fasting but return when you stop antihistamines like hydroxyzine, levocetirizine, or fexofenadine, we should consider conditions like chronic spontaneous urticaria, a specific food allergy, or histamine intolerance. I reassure you that we can manage this. I highly recommend keeping a detailed food and symptom diary and consulting an allergist or immunologist. They can safely guide you through a supervised elimination diet and help you find a long-term management plan so you don't have to rely solely on daily antihistamines.