Transcription:
Spring Allergies

Bill Klaproth (Host): Hmmm, spring. It’s a great time of year as temperatures get warmer and flowers start blooming and the trees start blooming, but for many people, spring is not welcome because of spring allergies. Here to talk with us about spring allergies is Dr. Amit Kumar an asthma and allergy specialist at Southern New Hampshire Health. Dr. Kumar, thanks for being here.

Amit Kumar, MD (Guest): Heh Bill. I’m happy to be here with you.

Host: So, excited to talk to you about this topic because allergy sufferers when spring comes, man it can be tough for them. So, let’s dig into this. So, let’s talk about spring. Why do allergies get worse in the spring?

Dr. Kumar: So, Bill when we get the seasonal change that comes up now in the spring and we get all that nice warm weather, with it, the trees start to pollinate and bud and when that tree pollen starts to hit the air, that’s when some of that misery begins for a lot of our allergy patients. Patients start to feel runny nose, itchy eyes, sneezing, just from a lot of that tree pollen that gets up into their nose and sinuses. So, usually, when we think about spring allergies, it’s usually the trees that are the culprit.

Host: So, the wind blowing, obviously blowing that pollen around, it’s easy to be outside and gosh this warm weather is great, a nice warm breeze and then that pollen is right in your nose and right in your system.

Dr. Kumar: Exactly. And think about it, that’s when we want to be outside, we’re outdoors more, the kids are usually out doing some sports and on those soccer fields and they get a good healthy dose of some of that pollen that when it gets a chance to get up there and if you make antibodies to the trees, then that’s what kind of elicits those allergic reactions that we all deal with. Whether it be runny nose or sneezing or itchy eyes or watery eyes. It’s all a consequence of making some of those allergic antibodies to that pollen.

Host: So, who is most at risk then for spring allergies? Do we know who that type of person is?

Dr. Kumar: Well so, it kind of goes back to that concept we’ve discussed before that patients who have allergies, sometimes have a tendency towards some other allergic diseases too. So, sometimes patients will have food allergies. Sometimes patients will have eczema. Sometimes patients will have asthma. So, a lot of those patients, the fourth part of that kind of tetrad is seasonal allergies. So, oftentimes when I’ll see somebody young and I’ll see them the first few years for food allergy or maybe potentially eczema; every year I see them back, I keep asking the families are they starting to now develop some spring allergy symptoms which is quite common to occur in those groups. And then there’s other people that don’t necessarily have those risk factors but just with time, and age they start to notice that as they are outdoors more, that they happen to get some of those seasonal issues.

But usually when people have some of those other allergic states; they are little bit more prone to allergies or if they have family histories where mom and dad or siblings have allergies; those patients tend to carry a little bit higher genetic risk for developing some of those symptoms.

Host: That’s interesting. So, you’ve been mentioning runny nose, itchy eyes, sneezing; how do you know if its allergy or common cold for people that may not have had allergies their whole life? How do you tell?

Dr. Kumar: So, that’s a great question. So, we get that question a lot and a lot of times when we see patients in the spring, it can be sometimes hard to tell because there are still some of those late winter viruses that are creeping into the spring that can kind of confuse matters. I mean typically what I tell patients is that if you are having a fever or a very sore throat or green yellow drainage coming from your nose; then that’s usually indicative that you probably have a cold or sometimes if people say my nose is really stuffy and I just keep blowing out thick green or yellow drainage from my nose for weeks on end, that’s usually typically more indicative of a sinus infection or a cold going on.

Allergies tend to be more watery, itchy, you tend to have the clear drainage more often than not and that’s confusing because sometimes when you get a cold the first few days are a little bit clear. But if it’s going on a week or two later and it’s kind of thick or colored then you know it’s probably more of a cold and less apt to be the allergies in those situations.

Host: Well that’s good information on how to tell and earlier you mentioned age. Dr. Kumar, can you develop allergies as you get older?

Dr. Kumar: You can. So, sometimes patients we’ll have them as youngsters and then there’s other people we meet that will be adults that will get allergies and oftentimes – I’ll sometimes even see some geriatric patients and I’ll tell them that the chances are low you developed allergy this late into adulthood but once in a blue moon they’ll surprise you as well. They’ll have allergies that all of the sudden develop in their 60s or 70s and they never had allergies before. But that tends to be a little bit more rare overall.

Host: So, Dr. Kumar, as spring turns to summer; do the spring allergies then generally go away?

Dr. Kumar: So, yeah, so the way we think about it is we think about spring as being the tree pollen season and then summer as we get into like the first few weeks of June, we start hitting the summer pollen and that tends to be the grass pollen and then as we get into like mid to late August into the first of second week of October, that tends to be like ragweed and weed season. So, depending on what your triggers are; that kind of dictates when you are going to have your symptoms.

Here in New England, we tend to see a lot of very strong spring allergy and then some summer allergy but not to the same degree that we see with the spring so we have some grass sufferers that have a hard time in the spring, but it’s usually not as vigorous as our spring allergy and then we do see a healthy amount of fall allergy to with the ragweed and weeds that creep up later in the season.

Host: So, let’s talk about treatment. How do you commonly treat someone with spring allergies?

Dr. Kumar: So, usually we use a very combined approach on things. Oftentimes when we see patients, we will have them come in and they’ll do some skin testing with us to see what they are allergic to so we can define formally what they are allergic triggers are. And then based on that, then we lay out multiple options for patients. Some patients we’ll start off with just taking an over-the-counter a long-acting, non-sedating antihistamine such as Claritin or Zyrtec or Allegra as a way of trying to control symptoms. Oftentimes I tell patients those therapies can be somewhat beneficial, but a good prescribed nasal steroid spray oftentimes can be helpful as well and those nasal steroid sprays are actually available oftentimes over-the-counter as well these days. That was a recent change in the last few years. So, people can use those – if you use those sprays on a regular basis, it tends to help control the symptoms a little bit more optimally.

In addition to that, we have some other prescribed nasal spray options like antihistamine nasal sprays. There is a medication called Montelukast which blocks another part of the allergic cascade which can also be added to augment the effect of these things.

And finally, if somebody is just kind of fed up with their allergies, they can consider doing allergy shots which is a way of trying to desensitize somebody over time and make them less allergic to the things that they are allergic to. But when go on allergy shots it’s a big commitment. You have to come in once a week for a good almost eight months and then after that, you are onto monthly and usually people who want to choose that as an option are kind of fed up with their allergies or have failed medications or just can’t get over their allergies otherwise. So, that can be an option for some as well.

Host: Right, and since people can get over-the-counter medications for this, at what point should they see their doctor? If it’s just not working at all?

Dr. Kumar: Yeah, so I tell patients to be cautious. When we say that over-the-counter options are appropriate, we say certainly you can use the antihistamines. We tell patients that over-the-counter nasal steroid sprays are relatively safe but even when they are on those, it’s good to have a doctor check your nose once a year to make sure that there is no changes occurring from that.

Sometimes people get confused too because certain over-the-counter nasal sprays like Afrin or oxymetazoline, those are topical nasal decongestant sprays. Those are actually not safe to be used for more than three days at a time because they can be somewhat habit forming and we usually caution patients against using those over long periods.

But you’re right, we usually see patients that tend to have more refractory symptoms or if patients want to know exactly what they’re allergic to. Oftentimes when they come to the allergist office we also go over like environmental measures, how best to kind of keep the home kind of pollen free and give them some guidelines on those things as well. So, it usually depends on how severe the symptoms are and what the person is kind of trying to think of in terms of their medication regimen and things.

Host: And always good to consult with your physician first. Last question Dr. Kumar. Do you have any other advice to help spring allergy sufferers?

Dr. Kumar: Yeah, so there are a lot of simple things that we mention to people when they come in. We oftentimes tell patients to – when they are at home to try to keep the windows shut when the pollen is blooming outside that can be helpful to keep the pollen from entering indoors. We tell people to run the air conditioning. Sometimes that helps to clean the pollen out of the air. Sometimes people will get a HEPA filter air filtration system for the bedroom or where they are sleeping just to get the pollen out and sometimes we tell people simple things like if your child is outdoors and they’re playing a sport and they come back in and they have long hair, there’s a tendency for that pollen to collect on people, so we tell people to take a nice shower after being outdoors to just kind of rinse the pollen off.

But you know all of those things can be again, helpful in addition to the medicines in terms of trying to control symptoms.

Host: That’s a really good tip about kids playing outside or even maybe you have got a pet; you dog is outside rolling around and coming inside the house and shaking the fur. Really good tips to beware of that. People might not think of that but really good to be mindful of those types of things. Dr. Kumar, thank you so much for your time today. Very informative as always. For more information, please visit www.snhhealth.org, that’s www.snhhealth.org. This is Simply Healthy a podcast by Southern New Hampshire Health. I’m Bill Klaproth. Thanks for listening.