Bill Klaproth (Host):   If you sneeze and cough, have a runny nose and itchy eyes during certain parts of the year, you may have seasonal allergies. With us is Dr. James Turek, a family physician with Tidelands Health Network. Dr. Turek, thanks for being on with us today. So, let’s start with this:  what causes seasonal allergies?

Dr. James Turek (Guest):   Thanks, Bill. Seasonal allergies are caused by the allergens that come out with the plants and trees during different parts of the year. For example, spring is tree pollen time. Summer is grasses and the fall is ragweed. There are also other triggers to allergies that may be perennial such as dust mite and pet dander. Pet dander can have a seasonal component, for example, when the pets are shedding and producing more dander in the springtime.

Bill:  Gotcha. So, is there such a thing, then, as a year round allergy sufferer or is it mainly a seasonal thing?

Dr. Turek:  The year round allergy sufferer usually has some component of a dust mite allergy or something else in their environment that they cannot eliminate that they are exposed to on a daily basis that triggers their allergy symptoms.

Bill:   What are the most common symptoms that you see when it comes to allergy sufferers?

Dr. Turek:  The most common thing we see is runny nose and nasal congestion, itchy eyes, scratchy throat. We’ll occasionally see some coughing. The worst of which we’ll see is someone that has a cough with an asthmatic component where their immune system has just kind of really clamped down their bronchial tubes and caused them to wheeze like an asthmatic.

Bill:  When is it time for someone to see a doctor then?

Dr. Turek:  The best time to see a doctor is if the over-the-counter medicines don’t work or you’re having breathing issues. That’s the best time to come and see us.

Bill:  When you mention over the counter options, for somebody who thinks, geeze, they may have allergies, what’s the first thing I should turn to or try?

Dr. Turek:  Some of the really good non-drowsy antihistamines are over the counter. Two of which are Loratadine and Cetirizine. Those are just once a day and have really a minimal amount of drowsiness associated with them. Some of the older ones such as Benadryl and what not, they have a lot of drowsiness and a lot of times people tend to dose those at night time when they’re sleeping.

Bill:  If someone has tried the over the counter items and they just feel it’s not working and they come to you, how do you diagnose, then, that they have seasonal allergies?

Dr. Turek:  Most of it is based on an historical basis. We’ll ask them what are their symptoms. We’ll also ask them when did they start; what are they and what have they tried for them? What have they not tried for them? The other things that you can do, too, are actually inspect the tissues. If you roll down their eyelids and we see what we call “cobblestoning” under the eyelids, you know there is an allergic component there. You can look into the nose and see that the turbinates – or little pockets in the nose - are all fluffed up and red. The back of the throat, there can also be some cobblestoning there which are tell-tale signs to a physician that allergies are at play here.

Bill:  What’s the most common way for you, then, to treat someone with allergies?        

Dr. Turek:  Most of the time, I’ll try to add something to the antihistamine. There are a couple medicines out there that you can add to the antihistamine that will make it more effective. My go to drug is Montelukast which I’ll add to the antihistamine. That’s a mast cell stabilizer. The mast cells are the cells that are associated with the vigorous part of the allergic response. Many times, with the antihistamine plus that drug, we can get a great response and avoid someone needing to go on steroids or even allergy shots.

Bill:  Once you understand what is causing allergies in that person, is there a way to eliminate them for good in that person or is it simply a management of the symptoms as best as possible?  

Dr. Turek:  The best thing to do is avoidance. If you have allergies in the spring time, I tell my patients to start their antihistamine a couple of weeks before spring starts just to have their system loaded and ready for the allergen. If it is something like dust mites, you can buy protective coverings for your pillows and mattresses and those, actually, are pretty effective at lowering dust mite symptoms.

Bill:  That’s a good point. Can you give us some other tips or strategies that someone can take to avoid allergy triggers? Is it as simple as “I’m not going to go outside?” Things like that?

Dr. Turek:  It could be that simple. It could be as simple as if you’re HVAC system can handle it, putting in a better filter to filter out any allergens. If you have to go out and you have a terrible grass allergy and you need to cut the grass, like most of us do, you may want to wear a mask out there and that would help cut down the exposure.

Bill:  I’ve heard of also taking a shower before you go to bed, washing your hair things like that, too?

Dr. Turek:  That will get rid of the pollens. Most of the dust is associated with nighttime exposure in America.

Bill:  Earlier you were talking about dust mites and pet allergies. Are there other types of triggers for allergies? Like in the summer time, if somebody has a bonfire and smoke or pine needles in the winter? Are there other types of triggers that are not the usual grass, pollen, ragweed?

Dr. Turek:  Those are considered irritants and not allergens. You get a similar response as far as irritated eyes and itchy nose and what not but it’s a different response. It is, more or less, kind of like if you ever to the mall and someone is spraying perfume to try and all of the sudden you’re like “Oh, my gosh” and you get congested. That is more of a mechanical non-allergic response.

Bill:  That’s a reaction to the environment. Right. Somebody is burning fragrant candles and you go in the house and you get a reaction to it. That’s kind of like based on the environment. It’s not like you have an allergy. You’re not allergic to that. Or is that what it is?

Dr. Turek:  You’re not allergic to it, you’re sensitive to it. Just like some people find the smell of gasoline pleasant. Some people say that is very nauseous to them. It can be an individual response.

Bill:  For someone listening right now that thinks they may have seasonal allergies, what is the most important thing that you can say or counsel to them right now? What should they be doing?

Dr. Turek:  Right now, they should be trying to avoid the allergen if they can and taking just a simple over the counter antihistamine to try to fight the symptoms if they’re not bearable.

Bill:  I wander this:  can you develop allergies as you age? My wife now thinks she has allergies. She’s like, “I’ve never had this before. I think I have allergies now.” Can you develop them as you get older?

Dr. Turek:  Sure. One of the theories behind developing allergies is chronic exposure to the allergen. We have a lot of people that move from up north to down south and their allergies go away for some a lot of time until their body starts reacting to the pollen here. So, sure, that happens all the time.

Bill:  Is that something, then, where you’re actually moving to a different location and you’re being exposed to allergens? Or, somebody that lives in the same spot, as they get older, is that something you can develop without going to another area of the country or being exposed to a different type of allergen?

Dr. Turek:  I think what happens a lot in those cases is, in certain seasons, there is a certain pollen load in the air. Every once in a while, it becomes kind of a super pollen spring. We’ve seen it here a couple of times where in normal springs, some people have their symptoms that are going to have them every year and most people don’t; whereas, this year even I had some allergy symptoms this spring.

Bill:  Gotcha. Alright, Dr. Turek, if you could kind of wrap it up for us. Seasonally allergies in a nutshell. What do we need to know that we don’t know right now?

Dr. Turek:  What you need to know is that the simple over the counter medicines with help in most cases. We can add to that by adding another medicine to it. If you have severely intractable allergy symptoms or wheezing that’s not made better by medicines, that’s an indication to get allergy tested.

Bill:  Fantastic. Dr. Turek, thank you so much for your time. One last question, then. Why should someone choose Tidelands Health for their allergy needs?

Dr. Turek:  I think the Tidelands Physicians, we’re all on the top of our game and we can treat them effectively, efficiently and at a reasonable cost where they’re not spending money left and right getting unusual allergy tests.

Bill:  Dr. Turek, Thank you so much again. Very informative. We appreciate it. For more information about Tidelands Health physicians, services and facilities visit TidelandsHealth.org. That’s TidelandsHealth.org. This is Better Health Radio. I’m Bill Klaproth. Thanks for listening.