Transcription:
Allergies in the Inland Empire

Melanie Cole (Host): If you've been sneezing and wheezing and you think it's getting worse, doctors say you're probably right as the rain, the winds and hot temperatures are a horrible mix for anyone with allergies. My guest today is Dr. Sameer Gupta. He's an allergist immunologist and a member of the medical staff at Temecula Valley Hospital. Dr. Gupta, let's first talk about allergies and seasonal allergies. People get wheezing, they get stuffed nose; how do we know at this time of the year that it's not some kind of a spring cold?

Dr. Sameer Gupta, MD (Guest): Very good question, Melanie. Basically most of the time people will be tipped off that this is allergies rather than your run of the mill cold because you have more significant itching symptoms. So the itching of the nose, the sneezing of the nose, the itchy watery eyes are more typical of allergies than they are with a cold.

The other thing is, is how often it's occurring and for how long it's occurring. So usually a cold will kind of be anywhere from three to five days up to at most two weeks. Allergies can span for months at a time, particularly if you have those springtime allergies to the grass and the tree pollen, they could last for at least two to three months. So the time course is also another very important factor in terms of figuring out the difference between your allergies versus the run of the mill cold.

Melanie: So if somebody is starting to get these things, and they're getting them on a regular basis, then what do they do? Because typically people are going to go right away to a pharmacy and get some of the over-the-counter kinds of things. What do you recommend people do when they start to notice these symptoms?

Dr. Gupta: Another great question. So typically going over-the-counter and getting an oral antihistamine such as Zyrtec, Allegra, or Claritin, or their generic equivalence is a great first option to see if that helps out your itchy watery eyes, runny nose, stuffy nose, and other symptoms of allergies.

Also now with the great over-the-counter nasal steroid sprays such as Flonase, Nasacort, and Rhinocort, you have great additional nasal steroid spray options to help out with your really pesky nasal symptoms. That's pretty much a good first step to see if that will help clear out your temporary seasonal allergy symptoms.

If that doesn't work, then usually the next step is to go see your doctor and get an option of getting either allergy testing, either via a blood test or more commonly with the skin test by an allergist, to see if you have allergies, and then if you do, what particular type of allergies you have. Because then they can tailor a custom treatment plan for you based off of those results.

Melanie: Dr. Gupta, before we get into the triggers, and learning about these causes of the allergies, and how the most common allergens- are the recent rains, the Santa Ana winds, are they making allergies worse? Are you seeing that in the Inland Empire that this is happening more regularly?

Dr. Gupta: Oh clearly. The weather and the changes in weather patterns have a tremendous impact on allergies, pollen counts, and how much people can suffer from allergies, particularly here in the Inland Empire. So in California, particularly Southern California, over the past several years we've had some very interesting amounts of rainfall, which has been much needed for our state. But that comes with it the significant increase in plant growth, which then invariably leads to increased pollen counts, particularly for the grass and tree pollen. And so we've seen over the past couple years a significant increase in people suffering from allergies because of these higher than normal pollen counts.

Also you mentioned the Santa Ana winds, and that clearly is another big trigger for people suffering with allergies because as those Santa Ana winds blow in, they then bring along with it a lot of unique pollen, and in particular some mold spores such as alternaria mold spores, that can come in from the desert and can impact and create a lot of allergy symptoms for people who are already set up to develop allergies. So you're 100% right. The weather patterns and those winds are significant triggers for people who suffer from allergies.

Melanie: So then the triggers. I mean if this is what's going on outside of someone's house, how do you fight against that? And is there any way without necessarily using medications solely, is there any way to identify those triggers to see what's going on with the weather, if it's a windy day, or check the pollen levels. Is there any way to know in advance if it's going to be a bad allergy day?

Dr. Gupta: Yeah, you know it is difficult overall for the general person to figure that out on a day-to-day basis. A lot of times the pollen counts can be a surrogate marker and there are certain apps and news channels that will advertise the various different pollen counts that are expected from a day-to-day or a week-to-week basis. And those can be helpful for people who know what their allergic triggers are, but if somebody doesn't know, those may be less helpful.

So one way obviously is by identifying what you're allergic to, and that would entail doing some specialized testing, typically with an allergist to look at what grass, tree, wheat pollen the patient may be allergic to, and then also other indoor triggers, seeing if those may be contributing such as dust mite allergies, cats, dogs, or other animal allergies, and also mold spores.

So once you've kind of identified those sorts of triggers, then being able to avoid them can be a great first step to reducing your allergy suffering. So for example, if you know that's going to be a high pollen count, maybe reducing your outdoor activity that day can help reduce some of your symptoms. Also if you know you're dust mite allergic, putting specialized dust mite covers on your bedding material can help reduce your dust mite exposure, thereby helping to alleviate your allergies that way.

Also we have a very great and unique treatment option called allergy immunotherapy which is basically just a fancy term for saying that we give our patients a little bit of the things they are allergic to in small quantities, and then we slowly increase it up over time to make their body no longer allergic to those agents, thereby curing their allergies. So at the end of the day, if people are using a lot of medications to try to control their allergies, and they're not having great success with it, allergy immunotherapy can be a great option for these patients, and can really help alleviate a lot of their suffering.

Melanie: Wow, that's very cool. And what else can they do at home? Do you recommend things like neti pots, nasal lavage, air filters, pillow cases, all of those kinds of things? Do any of those work?

Dr. Gupta: Oh definitely environmental changes can make a significant impact to people's allergies and how they're suffering from them. Definitely the nasal lavages and those neti pots are a great way of kind of clearing out the allergens that get trapped into your nasal passages and thereby removing them by washing them out, and that can give your nose, which I call nature's air filter, to kind of clear that air filter on a daily basis to try to reduce that allergic inflammatory process that happens in people who have allergies.

The other options of doing those specialized pillow covers, mattress covers, and dust mite box spring covers are very important for people who suffer from dust mite allergies, so that's definitely a great option as well.

The other thing is, is if you have the resources and the ability, you can try to take away carpeted flooring and switching them to more of a hard surface flooring to help reduce the amount of dust mites and animal dander that can be in your indoor environment. As far as air filters go, air filters can be great treatment options for people who are suffering from animal dander allergies, but the literature is not the most convinced with air filtration for the treatment of pollen related allergies or dust mite allergies or mold spore allergies. So it'll all depend basically on what you individually are uniquely allergic to, to then know if air filtration will help you out.

Melanie: What great information. Wrap it up for us, Dr. Gupta, with your best advice about allergies in the Inland Empire, what you want people to know about immunotherapy to help their allergies, treatments, things that they can do at home, and about your team at Temecula Valley Hospital.

Dr. Gupta: Perfect. So you know, in summary, allergies can be quite a debilitating disease and can cause a lot of suffering, and starting off with doing things over-the-counter can be a great first step for people who have more mild symptoms such as over-the-counter antihistamines and nasal steroid sprays. But if you're having more moderate to severe symptoms, instituting more environmental changes, adding on sinus rinses, and particularly getting tested to see what you're allergic to can really help treat and manage these symptoms a lot more effectively.

What's really important is that if you're having moderate to severe symptoms, then by getting those allergies tested, you can then consider using allergy immunotherapy as a way to cure your allergies, and to really kind of impact your symptoms over the long haul without the use of medication.

And so I advise for the patients who are suffering with moderate to severe allergies here in the Inland Empire to get it evaluated by your doctor, consider an allergy evaluation, and then consider allergy immunotherapy if you have a lot of allergies.

Melanie: Thank you so much, Dr. Gupta, what great information. And thanks for coming on and sharing your expertise with this really important topic. Thanks again. You're listening to TVH Health Chat with Temecula Valley Hospital. For more information, please visit www.TemeculaValleyHospital.com. That's www.TemeculaValleyHospital.com. Physicians are independent practitioners who are not employees or agents of Temecula Valley Hospital. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole, thanks so much for listening.