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Spring
Allergies
Spring and summer are the seasons for allergies related to
pollens. The tree season begins in February and runs thru June. The grass
season begins in about April and runs thru about mid-July. The weed season begins
around late June and runs until the fall rains set in strongly.
If you are lucky you know just about when your allergy season
will be. For some of us, some years we get it and some years we don't. A few
unfortunate souls have all three seasons with different plants in each giving problems.
The truly unfortunate have year round allergies to things such as dust mites.
The typical hayfever symptoms consist of itchy watery red
eyes, sneezing, post-nasal drip of fluid going down the back of the throat, cough, watery
runny nose, sinus and ear pressure or pain, sometimes exacerbations of eczema (an itchy
skin condition), and sometimes exacerbations of asthma with wheezing.
What should you do ?
The primary treatment for any allergy is to avoid what you
are allergic to ! It sounds simple, and if you can do it then as the Nike ad says,
"Just do it".
Do you smoke ? Quit !
Take an antihistamine. These are good first line
drugs to treat the itchy, watery eyes, sneezing and sometimes even the asthma.
Over-the-counter preparations include the old stand-by drugs: chlorpheniramine and
diphenhydramine. They work, but often will make people sleepy. The recent
report from the Annals of Internal Medicine (7 March 2000, 132:354-63), tested
people in a driving simulator after giving them a dose of alcohol, Allegra,
diphenhydramine (Benadryl), or a placebo, found that overall performance was most severely
impaired using diphenhydramine or alcohol. Allegra and placebo were about the same,
i.e. no drowsiness or impaired function driving a simulator.
So, these drugs work, but can be dangerous for driving or other activities where you
need complete alertness. You may want to consider relatively non-sedating
antihistamines if your job or hobbies dictate the need.
Eye symptoms alone can be treated with cromolyn eye drops.
They work quite well.
Nasal symptoms can be treated with nasal steroid sprays,
cromolyn spray, antihistamines, sometimes decongestants, and perhaps a few others.
We would have to discuss this in detail.
Similarly, asthma symptoms can be treated with inhaled
steroids, possibly inhaled cromolyn, and sometimes antihistamines. All the standard
therapies with albuterol, alupent, etc. may be helpful, too. Should you have
significant asthma, always use your inhalers or nebulizer first to treat your symptoms !
Do not depend on inhaled steroids to break an attack ! They will only work to
prevent an attack. Once you are in an asthma attack, use your albuterol inhaler or
nebulizer to get out of it. If you can't break it, call me, or go to the Emergency
Room nearest you if the situation is deteriorating rapidly !
You may have heard of allergy "shots".
There are two types of these. The first, is an injection of a long acting
corticosteroid into a muscle. If you know your allergies only last for 2-6 weeks
every year, at a fairly set time, then this may work well for you. The second, is
allergy desensitization shots. These require evaluation by an allergist. They
are best used for people with more serious problems who are bothered for more than 6 weeks
out of the year. They work modestly well if you can clearly identify what you are
allergic to. However, it may take 3-5 years to build up the whole effect of these
shots.
So, those are some of my thoughts about allergies. A
lot more can be said, but for the basics this should be enough.
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