Prakash Chandran: As we all know, April showers bring May flowers, but they also bring spring allergies or seasonal allergies. Allergy symptoms are often confused with cold and flu symptoms. So what's the difference and how do you prevent seasonal allergies from happening in the first place?

Joining us to discuss is Dr. Aaron Pinion, an allergist and immunologist at Platte Valley Medical Clinic. This is the Kearney Regional Medical Center podcast. I'm your host, Prakash Chandran. So Dr. Pinion, thank you so much for joining us today. Really appreciate your time. I wanted to get started by asking how common are allergies.

Dr. Aaron Pinion: Well, seasonal allergies can affect anywhere from 10% to 15% of the population here in the United States.

Prakash Chandran: Wow. That's quite a large number. And so does it depend on your age or your race or anything like that or does it affect everyone equally?

Dr. Aaron Pinion: Well, it doesn't affect everyone equally. Allergies are more prevalent, I guess, in the teenage years to early 20s to early 30s, is when they normally develop it. And as you age, your predisposition for allergies kind of goes down.

Prakash Chandran: Okay. And what actually triggers the onset of seasonal allergies?

Dr. Aaron Pinion: So seasonal allergies is your immune system's hyperresponse to things that it really should be ignoring. So let's say, for instance, here in the spring, you are having spring allergy symptoms. So what you're doing is you're breathing and tree pollen and the immune system is viewing that as harmful. And it's causing substances such as histamine to be released and that histamine causes your traditional allergy symptoms such as congestion or sneezing or eye itching or eye watering.

Prakash Chandran: Okay. And so when someone takes an over-the-counter medication like Claritin, is that medication actually reducing the immune system's hyperresponse or is it doing something else?

Dr. Aaron Pinion: So what Claritin or the generic form of that, loratidine, exactly does is it just blocks histamine. So it does absolutely nothing to stop the root cause of allergies, meaning the overproduction of these immune cells called immunoglobin E. It just blocks the result of that interaction of the immune cell plus the pollen, which is histamine release. So anti-histamines just block histamine.

Prakash Chandran: Okay, understood. So you talked about some of the symptoms of having allergies, things like congestion, sneezing, coughing, itching of the eyes. And some of that actually correlates to some respiratory diseases. Is that something that you can speak to?

Dr. Aaron Pinion: Yes. So seasonal allergies and respiratory illnesses have a lot of overlapping symptoms. You could experience nasal congestion, postnasal drainage, a drippy nose with either of those conditions. With allergies, you tend to itch a whole heck of a lot. So you may have an itchy nose, you may get itchy eyes, you may get watery eyes. Your eyes may be kind of bloodshot or red. You can get itchy ear canals. You can get an itchy roof of your mouth or itchy throat. Those symptoms are generally absent from a viral infection. So. Itchiness is a differentiating factor. And then, stuff like fatigue and malaise or just generally not feeling well or muscle aches or fevers, those generally occur more with respiratory illnesses as opposed to allergies. But you're right, they do have a lot of overlapping features.

Prakash Chandran: Yeah, Interesting. Another thing, as a relatively new parent, I'm curious about when a parent or myself might start noticing allergy symptoms in my child?

Dr. Aaron Pinion: Yeah, that's an absolute great question, a question I get all the time. So a new child or an infant isn't born with an immune system that is allergic right from childhood from an environmental allergy standpoint. So it takes a few years of exposure to, for instance, tree pollen or weed pollen or grass pollen or mold exposure. It takes your immune system seeing that for a few seasons before you start to develop what's called class switching, which is just changing your immune cell production over to the allergic type of production, that takes exposure in time to develop those types of allergies.

Now, one could develop other allergies called a perennial allergy, which is just a year-round allergy earlier than that. So like for instance, if you have a dog in your house, you may experience dog allergy much earlier, you may experience does my allergy much earlier than you would seasonal allergies. So as a general rule, I mean, you would expect the child to be three, four or five years of age before they start to have seasonal allergies. That's not a hard, fast rule, but that's the most common scenario.

Prakash Chandran: Okay. And I think that people that do have allergies, they obviously don't look forward to it. I'm one of those people. It's one of these things where we just obviously learn to live with. What might you say to people that just kind of are like, "Ha, not another allergy season." What's the best way for them to look at it and deal with it?

Dr. Aaron Pinion: Allergy seasons for my estimation are some of the best times of the year. I mean, spring is, especially here in the midwest, it's the time to get outside. You've just experienced this grueling cold winter, and you want to get out of your house and to be kind of immobilized by pollen and allergy symptoms is not ideal, obviously. So we want people to enjoy life and to not let allergies get in the way of doing their everyday task, especially if it's stuff that they enjoy. So we have medications that can help allergy sufferers, get through the pollen season. And you can use anti-histamines, oral anti-histamines, which will help with some of the allergy symptoms. There are nasal steroid sprays. There are ocular or eyedrops that are anti-histamines. And then there are now nasal anti-histamines as well, too. So we have some great medications and actually a lot of those medications are now over-the-counter that can help treat allergies and they can do so very effectively.

In addition to that, avoidance measures, simple stuff like when you're outside and you've been outside for a long part of the day, you would just come in and take a shower right away. If it's spring and you have spring allergies, to shower at the end of the day every day. That way, you're not getting into bed at night and with pollen all over your skin and all over your hair and just rolling around. And then of course, doing other stuff like keeping your windows shut, keeping pollen out of your house. So when you're outside, you're enjoying being outside. But when you're inside, you have a pollen-free environment and atmosphere.

Prakash Chandran: You know, that totally makes sense. I've always just taken a shower and just have immediately felt better. Just not even realizing that I have all of these pollens that are potentially on me from the day that are causing my body to react to them. So that's great advice.

Dr. Aaron Pinion: There's something else that one could do if they have allergies. And in a perfect world, you'd take your Allegra or Flonase and you'd feel better from allergies and that's it. But, you know, it doesn't always work. Sometimes people's allergy symptoms last despite taking all of those medications or maybe you are an individual that's allergies are controlled, but you don't want to be taking all those, these allergy medications. We have other therapies. I mean, there's something called the allergen immunotherapy that we can do, otherwise known as allergy shots, which is a way to kind of desensitize your immune system. So you're less responsive or less allergic. And it's really the best treatment for allergies. I mean, it's more time-consuming, but it gets at the root cause of allergies and it can help you significantly for years.

Prakash Chandran: Oh, okay. Wow. So you can actually get a shot that actually modifies your immune system and really removes the reaction that your body would otherwise normally have to an allergen. Is that more or less correct?

Dr. Aaron Pinion: Yeah, it's absolutely correct. It's a really great treatment option that we have in allergy, and it can be effective in about 90% of individuals. And you're on a course of allergy shots for years, but then you stop them and then you should feel good to go for years and years and years.

Prakash Chandran: Yeah, very interesting. Now, you know, we've had this excess wind in Nebraska recently. Have you seen it causing more problems for patients lately?

Dr. Aaron Pinion: Wind and dry conditions are some of the most prevalent spreaders of pollen that we have. So the dry windy days that we've had in Nebraska, just getting this microscopic pollen and that's very lightweight and it's just blowing it for miles until it finds somebody's nose to go up or eyes to deposit on. And tree pollen is very sticky. So once it lands on your eyelid or in your nose, it can kind of stick there and cause problems for hours.

Prakash Chandran: Yeah, absolutely. And so that's another question I was going to ask you. You know, we kind of talked about showering when you get home to just wash all of the pollen away. But what can people do to potentially limit their exposure to all of those allergens?

Dr. Aaron Pinion: Another great question. So we know in the spring when trees are pollinating, they release the majority of the pollen up in the air during the early morning hours. So if you're somebody that likes to go out and go on and run throughout your day and you want to be outside and you have allergies, it might be a better idea to go on a run later on in the day and skip that early morning workout during pollen season.

And as I mentioned before, you know, showering, keeping your windows shut, getting a filter for your HVAC system that filters pollen and just creating that clean environment in your home. The other thing that you could do, if you're outside, we're all coming out of COVID, so we're all used to wearing masks and we're all comfortable with wearing masks now as well, too. So if you're outside mowing the lawn or doing something prolonged outside, just throwing a mask on would be a simple way to keep some of those larger pollen granules out of your mouth. Wearing sunglasses, wearing a hat, that's not a bad idea as well, too.

Prakash Chandran: So let's say there's someone listening to this and their allergy symptoms are just awful, it's very hard to deal with. At what point should someone see a doctor for their allergy symptoms?

Dr. Aaron Pinion: I would say you can see a doctor anytime if you've tried some of the over-the-counter allergy medications and they're just not doing the trick. That would be an inappropriate time to see an allergist and we can figure out what you're allergic to and talk about avoidance measures and different treatment options. I alluded to this earlier in the podcast that there's quite a few medications that are available over-the-counter, but not all of them are great allergy medications to take. And we do have preference for some of these medications to take over-the-counter. So even seeing an allergist or your general practitioner and having a conversation about what would work best in my particular scenario would be a great idea.

Prakash Chandran: Okay. Now, I have to ask you about a myth that I hear, well, I think it's a myth because it never seems to work for me, but you always hear that if you have honey from local bees, right? So if you get local Nebraskan honey, that somehow you are protected against allergies. Is that true or is there any truth to that?

Dr. Aaron Pinion: No, there isn't any truth to that. That is a myth. You are a hundred percent right. So, the thought process behind it is the bees are cross-pollinating flowers, and then you're going to get honey from them and have some sort of improvement from that. But in actuality, it's not the flowers that are causing you to have spring allergy symptoms. It's tree pollen and tree pollen, it gets up in the air and blows, so bees actually have no role in that whatsoever.

Prakash Chandran: All right. Well, thank you for clearing that up, certainly for me and for the rest of the audience.

Dr. Aaron Pinion: It'd be nice if it did. I'm sorry.

Prakash Chandran: I know. I know. One question that I always like to end on is given all of your years of experiencing lots of patients as an allergist and immunologist, what is one thing that you know to be true that you just wish more patients knew?

Dr. Aaron Pinion: I would probably say that allergies are highly treatable and a lot of people just live with them. And we have things that you could do to really change your immune system and help you have a better quality of life. And don't be hesitant to reach out to an allergist to see if that can help you.

Prakash Chandran: I think that's such a great point because up until this point, I think that, at least my knowledge and I think probably for the general public, you kind of feel like you're just relegated to the potential over-the-counter medications, or maybe some mild treatments that you can get from a doctor. But one of the things that I've learned today is that there's allergy shots that can actually alter your immune system and help you for years at a time. So that is just an incredible innovation.

Dr. Aaron Pinion: It truly is. And I spent the majority of this podcast talking mainly about nasal and ocular allergy symptoms. And there's also asthma. There's a lot of people that have allergic asthma, which is coughing and wheezing and shortness of breath brought on by breathing in pollen. Allergy shots can help with that as well, too.

Prakash Chandran: Amazing. Well, Dr. Pinion, thank you so much for your time today.

Dr. Aaron Pinion: Have a wonderful day.

Prakash Chandran: That was Dr. Aaron Pinion, an allergist and immunologist at Platte Valley Medical Center. Dr. Pinion is now accepting new patients. To schedule an appointment, you can call 308-865-2263. Thanks for listening to this episode of the Kearney Regional Medical Center Podcast.

My name is Prakash Chandran, and we look forward to you joining us again.