I would certainly add in an AI right away. Nolvadex is only going to bind to selective estrogen receptors, where asan AI, like Adex, will keep you from producing as much estrogen to begin with. Keep in mind that it is going to take several days to see a difference once you add the AI in. It's not going to have an effect on the existing estrogen, so you will have to wait for that to clear. Within 2 wks, you should see a noticable difference. I would start with.5mg EOD and then adjust down once you have a handle on things.
Also, increase your water. The more you drink, the more you will flush. And remember that gear can make you more sensitive to sodium, so regulate your sodium