Joey Wahler (Host): They're heightened during the spring months, so we're discussing seasonal allergies. Our guest, Dr. Amulya Amirneni. She's an Allergy and Immunology Specialist for Beebe Healthcare. This is the Beebe Healthcare podcast. Thanks for joining us. I'm Joey Wahler. Hi, Dr. Amirneni. Thanks so much for being with us.

Amulya Amirneni, MD: Hi Joey, happy to be here. How are you doing?

Host: I'm great. Thanks for hopping aboard. First, tell us a little bit about your background and what brought you to Beebe Healthcare.

Amulya Amirneni, MD: So I'm Dr. Amirneni, I'm the Allergist Immunologist at Beebe Healthcare. I am from originally northern part of Virginia. That's where I grew up. I went to residency up north in Massachusetts in Springfield, a little town called Springfield, in Baystate Medical Center, University of Massachusetts. And then I actually did a chief residency there afterwards, and after that I pursued a career in allergy and immunology and ended up doing my fellowship at Johns Hopkins.

So I came a little more south into Baltimore, Maryland, and then I find myself in this lovely area near the beach.

Host: Nice. And so what would you say it was that drew you to this specialty in particular?

Amulya Amirneni, MD: I would say the fact that it is not just one piece of the body. So I feel like it's a very much, you know, systemic field. So there's a lot of different things that could be happening, that I think the broad nature of it, the growing patient population, the growing field. The immunology aspect also interests me. So we're actually allergists, immunologists, because we see allergic conditions, but we also see problems with your immune system.

So I think everything that was just very much, you know, drawing, and once I did an actual rotation in this field, I just grew to love it. Yeah. So I'm definitely happy even being in practice now, for a couple years after fellowship, and it's been a great choice, I think.

Host: That's great. So we hear the term allergy. It's so common. It affects so many people. Two part question to get us started. What exactly are allergies? When we're allergic to something, what's happening with our body and just how common are they?

Amulya Amirneni, MD: Yeah, so allergy is just a term. When we use the term allergen or allergy, it's our immune system reacting in an abnormal way to something that is foreign. Something that is outside our body, whether it's something that you're eating, something that you're maybe inhaling with like spring allergies or the seasonal allergies that we commonly say, something that you may get injected or taken as a tablet form, something that gets contacted on your skin.

So whatever modality you're getting that introduced, it's something that's foreign that your body's reacting to and that is usually abnormal. Then you have the symptoms of it from that reaction. So if it's your nasal symptoms are like more nasal congestion and runny nose and eyes are itchy, watery, you're sneezing, that kind of thing.

Food allergies, you could have something like anaphylaxis, which is a more severe allergic reaction. And allergies are quite common. They're actually one of the more common chronic conditions in the United States. It's very commonly overlooked because it's something that you just kind of live with, right?

So it's just, you know, you just sneezey, you just take a tablet, but it's not something that is often pursued and should be because it does decrease your quality of life on a chronic basis. And we report patients as up to 100 million patients that are U.S. Americans that have allergies of all different types.

And I think there was a report in 2021, they said just that year, there were about 81 million patients have seasonal or nasal allergies that were diagnosed. That's like almost a quarter of the adult population, right? So it's quite common, and it's something that you should definitely, you know, think about either getting treatment about or you know, getting better control of just so you have a better quality of life.

Host: Yeah, those are eye popping numbers to say the least. How about the difference, essentially, between seasonal and chronic allergies, and why do allergies tend to worsen in the spring in the first place?

Amulya Amirneni, MD: So when we term allergies based on those different categories, seasonal basically means your symptoms are only occurring in certain parts of the year. So it could be, most commonly, it's the spring and summer and the fall season that we see a lot of these seasonal allergies. And when you have year round, that's exactly right, you have year round symptoms. So it doesn't matter what season you're in, you have generally chronic symptoms. And usually they're triggered by different groups of allergens, which are the triggers for your symptoms. So if you have seasonal allergies, we think it's more pollen that you're sensitive to. Something like trees, grasses, and weeds are more common in those seasons.

If you have year round allergens, it could be indoor allergies, or it could not even be allergies at all. There could be non-allergic inflammation that you're having. So, based on the nature of when your symptoms are occurring in the year, usually we categorize depending on that.

Host: So, since we're focusing here mainly on seasonal allergies, how would you say Doctor, people can reduce their exposure to those seasonal allergy triggers? And I would imagine, it's a tough balancing act, right? Because you want to be outside in the fresh air and so on, but it's allergy season.

Amulya Amirneni, MD: Exactly. So, there's a few things, a few precautions, obviously, you know, cooping up yourself in the room is not a good thing to do in general, but if you do, or if you are someone that is active, there's a few precautions you can take.

For example, obviously, first and foremost, checking the pollen forecast. The local channels and other things, making sure you're looking at what the pollen count is looking like day to day, especially on days where there's high pollen counts, you want to do take extra precautions on those days specifically.

For example, taking a walk in the morning, particularly if you want to avoid that as much as possible, maybe taking a walk later in the day. Usually pollen counts are higher in the morning time, so that may help a little bit. Wearing protective clothing or things like eyewear or hats. Things to cover your hair and your eyes, just so you don't have contact directly and you don't bring the pollen indoors after you take the walk or have higher outdoor activities.

Things like closing your windows, during daytime especially, but also at nighttime, when pollen can kind of carry itself indoors. Keeping your area clean, making sure you're taking your outdoor clothing or changing clothes, changing your footwear, things like that. So just major concept is keeping things outdoors, outdoors, and prevent them from bringing them in.

So there's a few things like that you can do, but for the most part you want to make sure you are managing your symptoms promptly before it gets really bad.

Host: And speaking of which, I'll ask you, of course, in a moment about seeing a specialist such as yourself, but first, what are the benefits and perhaps drawbacks of over the counter allergy medications?

Amulya Amirneni, MD: Yeah, so obviously there's a lot of options out there that you can use to treat your symptoms for allergies. Some of those include things like nasal sprays or tablets. There are always going to be side effects and things that you may not know about when you're getting these and from the cart and the pharmacies.

So main benefits, obviously they can help you feel better if you're using the right combination. The drawbacks is if you really don't have guidance, you can either overdo it or use the wrong medication that's for you so you can maybe have more side effects than you may want to have. So it really is good to have some guidance especially when you're suffering a lot with your allergies and you don't feel relieved from just using one or two things that you've already tried.

So whenever you are not feeling better, in fact feeling worse, that's definitely a sign you should see someone.

Host: So considering everything you've just discussed so far, when should someone ideally see a doctor about an allergy and what can they expect from their first visit with an allergist like you?

Amulya Amirneni, MD: Typically, like I said, when you don't have improvement with just one or two medications that you've tried, or you're constantly getting symptoms that are pretty bothersome, that you would need some more benefit with, or you would want to know what you're allergic to, and you would want to understand where your allergies are coming from, and also if there's other stronger options, or even long term options, such as allergy shots, I think these are all going to be great reasons to see a provider.

Usually, when you talk to your doctor, whether it's your primary care doctor, or your pediatrician, you know, usually you may be referred to an allergist or you can directly see an allergist yourself. So typically when you're in that question of additional therapies, you know, lack of control, or you're needing that question of what am I allergic to, an allergist would be best.

Host: Now there is, of course, a Beebe Allergy Program. So what services are provided through that? I would imagine that obviously includes testing to see if you do have allergies in the first place because you might not be sure, right?

Amulya Amirneni, MD: Yeah, exactly. So, obviously, we see all sorts of allergies, and we commonly talk about nasal allergies as one of the more common allergies, but we see patients for food, drug, as well as, like, skin reactions, you know, systemic reactions, like we talked about, anaphylaxis, so it's pretty broad in the allergic conditions that we take care of.

We also take care of a lot of immunodeficiencies or problems with your immune system. So, we do see a broad patient base and in general, the main thing is because allergies can happen to anybody, we see patients of all ages. So, Beebe Allergy at Beebe Healthcare has been great, in terms of caring for this population because it does need to be something that is present, especially down here because there is such a need and there's so many patients suffering from this.

So, it's quite a broad type of medical field, but it's very good because it helps patients have a better quality of life.

Host: Absolutely. So to pick up on that, how about the areas that you serve for those unaware? Where are you located and are you accepting new patients?

Amulya Amirneni, MD: Yeah, so we are located in the Rehoboth campus of Beebe Healthcare on 24 in the Medical Arts building for those who are familiar with that location. And we serve local patients in Lewis and Rehoboth area. But we have seen such a wide range of localities because there's just, like I said, there's such a need for an allergist down here.

So, we're seeing patients even up from Dover, down to Maryland area as well. So, there's no real restriction, but that's where we're located and we are accepting new patients. So, it's something that we are rapidly growing. So, definitely, get yourself an appointment as when you think you're the right patient, definitely come in to be seen and get assessed.

Host: If you had to narrow it down to just one or two, Doctor, what would you say you like most about working with the Beebe Healthcare team?

Amulya Amirneni, MD: I would say definitely the collaboration, taking care of these patients with multiple providers together, putting our heads together, communicating with each other, being unified, and caring for the patient together. I think that's the main thing that I love in working with Beebe Healthcare. And the other thing is they're exceptional providers that we're working with. So, you know, adding our expertise and trying to get to the bottom of what could be going on, the complexities of different conditions is definitely rewarding as well.

Host: And to pick up on that, in summary, of course, in your line of work, it's often about what's next, what's better, what's easier, what can help both the patient and the medical staff as well. So, in summary, what would you say you're most excited about for the future at Beebe Healthcare?  

Amulya Amirneni, MD: I'm really excited about Beebe Allergy at Beebe Healthcare. We're growing, like I said, very fast and you know, in a great institution with a great group of physicians and providers and staff that we're working with and growing here and taking care of this exceptional patient population as well. I mean, I couldn't be more excited about that.

Host: It certainly sounds like they're in good hands with you and yours. Folks, we trust you're now more familiar with seasonal allergies. Doctor, a pleasure. Thanks so much again.

Amulya Amirneni, MD: Thank you so much, Joey. It was lovely talking to you.

Joey Wahler (Host): Same here. And to make an appointment, please call 302-703-3393. Again, 302-703-3393. Now, if you found this podcast helpful, please do share it on your social media. I'm Joey Wahler, and thanks again for being part of the Beebe Healthcare Podcast.