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Introduction: It's another edition of our podcast series, Columbus Community Hospital Healthcasts.

Scott Webb: Millions of Americans have seasonal allergies and pollen released in the spring often triggers sneezing, coughing, watery eyes, and other symptoms. Joining us today to give us the scoop on seasonal allergies is Dr. James Friedlander with Allergy, Asthma, and Immunology Associates PC. So Dr. Friedlander, thanks so much for joining me today. We're coming up on that time of year when many people are sniffling and sneezing. Let's start with the most obvious question here. What are the most common symptoms of seasonal allergies?

Dr. Friedlander: So typically the symptoms of seasonal allergies would include itchy, watery eyes, nasal congestion, or a stuffy nose, clear nasal drainage, some postnasal drip, and itchy throat and sneezing. I would say some patients also complain of headaches and there's a lot of fatigue that patients complain about as well. Those are the most common symptoms.

Host: Yeah, I think that's what usually gets me is I just feel really rundown and then I don't know, you know, is this my seasonal allergies or is this a cold? So maybe you can help us, you know, tell the difference between the two.

Dr. Friedlander: Well, that's a really good question and that question can confuse not only patients but a lot of healthcare providers as well. And really it's because there's a significant overlap of symptoms when comparing allergies and upper respiratory infections like a cold. In fact, some people describe allergies as the cold that never goes away. And so that can be one point to differentiate the duration of symptoms. You know, typically colds will last a week to two weeks, but allergies can last a whole season. There are some other differences. Allergies will not cause a fever typically. You can get a sore throat with allergies, but it shouldn't be as pronounced as it is sort of as the heralding sign of an upper respiratory infection, like a cold. Allergies, you're going to have a clear drainage, with a cold you're going to have a colored drainage that can range from white to yellow and green. And with allergies, again, that typically would be clear. So those can be some differentiating factors.

Host: Yeah, that, that really helps. Because I'm sort of picturing it in my head and I'm like, you know, you're right. Like when it goes on for more than a week or two, it probably is the allergies. So maybe this is an obvious question because of the name, but Dr. Friedlander, what causes seasonal allergies? What types of things are at the root of that?

Dr. Friedlander: Allergies are an abnormal immune response. One of the jobs of the immune system is to make antibodies and antibodies typically are made to fight infections. But in allergic disorders, the immune system creates an allergy antibody rather than an antibody that would, let's say protect you or make you tolerant to a substance. So we can measure these abnormal immune responses by skin testing and blood testing, which can help a patient's allergies. And that can be really helpful in the clinic. The more difficult question is why do so many people have the allergies? And what we know is like many other really common conditions, it's a complex interaction between having a genetic predisposition, meaning it runs in families. And definitely a part of it is an exposure to the environment. And so that's really what's going to be at the root.

Host: And when we compare seasonal allergies with, you know, similar, maybe at least a similar symptoms like hay fever or allergic rhinitis. How do we tell the difference between those?

Dr. Friedlander: So these are all the same, back a long time ago, seasonal allergies were called hay fever and it really is a misnomer as there is no fever and it's typically not an allergy to hay. It's the pollen that is causing those symptoms. But they didn't know that a long time ago. And so it was called hay fever, and still we see patients call it hay fever today, but it's led to a lot of confusion and really good question.

Host: Yeah, that's so funny you say that, because I know for a fact, my grandparents, my grandma, everything was hay fever. Oh it's just your hay fever. Okay. So if someone suffers from seasonal allergies every year, what's the best way for them to control their symptoms? Because I know my wife is, she's a bit of a pharmacist when it comes to the different types of allergy medications and when one stops working, Oh well you need to switch to this one. But you need to give it some time. And she's very plugged into all of that. But maybe there's a better way. Is there?

Dr. Friedlander: That's a great question. The best way is to get ahead of symptoms by starting a medication regimen in advance of the allergy season. So spring is upcoming. Most people are going to wait until they start having symptoms and it's really critical to start in advance. It's much easier to stay well than it is to try and get well once the season has set in. So the most common regimen is using an oral long acting anti-histamine taken once a day along with a steroid nasal spray. And that seems to be the most common and effective one two punch or combination of medications. And if that's not effective and if the symptoms are more persistent or more severe, than it might be worthwhile to get in to see your doctor for some additional suggestions and recommendations.

Host: Well, and I assume that those recommendations and suggestions might include shots and injections. Is that something that you recommend?

Dr. Friedlander: So allergy shots are still the gold standard of treatment for environmental allergies. What the process involves is it's desensitizing a patient to their environment. It is extremely effective. It's much more effective than medications alone, but it's not for everybody. Typically allergy shot patients or patients who either don't want to take medicines or they're not getting enough efficacy from their medications or they're allergic to so many things that they just want it to go away. And so it is a long process. It's frequent injections, but it's so effective, that most patients after completing a course of therapy are very pleased.

Host: That's great to know that it is effective. So let's, so we've talked about, you know, shots and injections and medications, you know, over the counter kind of stuff. Maybe we could just go a little off the beaten path here and talk about some alternative treatments or medicines. What are folks doing? What are you recommending when shots and injections and pills just aren't the right solution for them?

Dr. Friedlander: One natural thing that you can do is a simple saline nasal rinse or a sinus rinse. And what this basically is, is just irrigating the nose and the nasal tissue and the sinuses, to clear away all of the pollen and debris. And that can be an extremely effective thing, especially for people who have side effects from some of the over the counter and prescription medications.

Host: That's interesting that you mentioned Doctor, about the nasal rinse because my wife is a big believer in the neti pot and I always find it sitting on our bathroom counter and she swears by it. She says it's really effective. So there must be something to that.

Dr. Friedlander: It's something that people are sometimes afraid to do, but the ones who do it swear by it. So I agree with your wife.

Host: So Dr. Friedlander, as we wrap up today, anything else our listeners need to know about seasonal allergies, treating them, the work you're doing? Anything else?

Dr. Friedlander: Well, one other thing that people can do is they can track the pollen counts in their area and that can be done on certain websites. And we actually track it in Nebraska, over in Lincoln. And sometimes it's just another step to prepare yourself in addition to taking medications ahead of the season and speaking to your doctor if things aren't going very well.

Host: Yeah, I think that sums it up. You know, learning from you today about getting out in front of this, not waiting until the allergies have already kind of taken over and taken over your life. Get out in front of this, take your medications, get your shots, injections and you know, maybe possibly consider things like nasal rinses and so on. It's quite a battery of things you might have to do, but probably worth it when you compare to the misery, you know, so many people are in due to these allergies. Right.

Dr. Friedlander: I agree. I think that's a good plan and it should be effective for most patients.

Host: Awesome. Well, Dr. Friedlander, thanks so much for your time today. Really appreciate it. Dr. Friedlander visits the Columbus Community Hospital Visiting Physicians Clinic to learn more about the services provided through the clinic or at the Columbus Community Hospital, visit ColumbusHosp.org. That's Columbus, H O S P.org. And if you found this podcast helpful, please share it on your social channels and check out the entire podcast library for topics of interest to you. This is Columbus Community Healthcasts. I'm Scott Webb. Thanks for listening.