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Managing Seasonal Allergies

Dr. Sproul discusses Seasonal Allergies.  Dr. Sproul talks about the common symptoms related to allergies, usual treatment options, and tips for helping with them.

Managing Seasonal Allergies
Featured Speaker:
Matthew Sproul, MD
Dr. Matthew Sproul is a board certified family medicine physician with expertise in both urgent care and family medicine. He began his medical career in 2005, serving as an urgent care physician with Carolinas Medical Center in Charlotte, NC followed by years of experience with numerous major health systems in the Triangle area. His clinical interests include pediatrics and adolescent health, sports medicine, wilderness & travel medicine, and he is committed to providing outstanding and compassionate care. In his free time, Dr. Sproul enjoys running and writing.
Certifications
Board Certified, American Board of Family Medicine

Education
Medical Degree: University of North Carolina School of Medicine

Residency
Carolinas Medical Center, Charlotte, NC

Professional Memberships
American Academy of Family Medicine
North Carolina Academy of Family Physicians

Office Location(s) : Raleigh and Cary offices
Transcription:
Managing Seasonal Allergies

Amanda Wilde (Host): You have a tickle in your throat, your nose is stuffy. Your eyes itch. Is it a passing cold or is it a persistent allergy? Well, today we'll identify common allergy symptoms, tips for helping with them and treatment options.

This is WakeMed Voices, a podcast from WakeMed Health and Hospitals in Raleigh, North Carolina. I'm Amanda Wilde. And with me is Dr. Matthew Sproul, Urgent Care Physician at WakeMed. Dr. Sproul, welcome to the podcast. Thank you for your time today.

Matthew Sproul, MD (Guest): Thank you very much. Thank you for having me.

Host: Allergies can feel like a cold. So we how we know when we have an allergy?

Dr. Sproul: It can be tough because there is a lot of overlap with a lot of the symptoms. With allergies, it helps to pay attention to the patterns of the season and how you react at different times of the year. So usually in fall and spring, when the environmental allergen load is the highest, people tend to notice the symptoms then, but the symptoms of a cold can also be the same as allergy. So it can be tricky at times.

Host: Well, what causes the symptoms that we identify with allergies? You said it's seasonal. So it's in the air?

Dr. Sproul: It can be seasonal, but it can also, a lot of people have year round allergies. So it can be things in the environment that you come in contact with on a day-to-day basis. Allergens that are seasonal, tend to be the pollens and tree molds and different grasses that bloom at different times and what they put into the air and what we breathe in can trigger our body's immune reaction. And that's what an allergy is. Our body senses, something that does not belong. Or it recognizes it as foreign and our body responds by putting out a lot of mucus, having irritation and itching in the eyes, watery eyes, to try to flush any allergens out of the eyes. And it's similar to a cold because that's when a virus does the same thing, it invades, it attacks our body and our body recognizes that it doesn't belong.

Host: So allergy is an immune reaction. A cold is a virus. Do allergies also hit you differently than a cold, for example, is it immediate when you come into contact with something that you are allergic to or it sneak on you later?

Dr. Sproul: It can be both depending on how sensitive your body's immune system is. So some people get through bad allergy season and only have a little bit of a sniffle or a little post-nasal drip or scratchy throat. And the similarities to a virus are the symptoms we get from a viral infection is our body's immune system reacting to that virus the same way our body's immune system would really react to an allergen, but usually with allergies, it is the combination of sneezing, runny nose, stuffy nose, maybe itchy or watery eyes, maybe red eyes, that all tend to happen together. But sometimes one before the other.

Host: Now I often say to people that I have a chemical sensitivity because certain cleaning chemicals and perfumes make me cough and sneeze, but what really is a sensitivity. And when is that an actual or are they the same?

Dr. Sproul: They are the same. You know what is sensitive is your immune system. And when that encounters something that it knows doesn't belong, shouldn't be there, it tells your body to, respond and try to clear it out. and so that's a sneeze, your body's natural way of clearing your nasal passage.

Host: So there's the sneeze and coughing is sort of the same thing. I imagine. You're just trying to get rid of whatever it is that your saying doesn't belong.

Dr. Sproul: Yeah, a cough is like the lungs' way to sneeze. It is being irritated or aggravated by something that's gotten into the airways. And that could be an allergen, that can be a virus. And, you know, that can trigger a cough. Many of other things can also cause cough. And that's why you're looking for the constellation of symptoms and putting that together to tease out whether it might be allergies, it might be a cold or oftentimes it can be a combination of both. And that can be real tricky.

Host: Does one make the other worse?

Dr. Sproul: It tends to because the body is now responding to two different invaders at the same time. So that can cause a heightened response.

Host: Now you work in urgent now urgent often do you run across allergies?

Dr. Sproul: Very commonly, definitely with any change in the season, folks start having symptoms that are typical. And if someone's new to an area or isn't aware that it's an allergy, they may be concerned they have a cold. With the pandemic, any cough or sneeze tends to evoke an anxiety response in a lot of folks because of everything we've gone through recently. But I think it's a very common issue that we deal with in urgent care.

Host: And then how do you treat those cases that urgent care with allergies?

Dr. Sproul: You know, it depends how bothered folks are by it. And there's lots of different options and people respond differently to different options, but usually I will determine where a person is with their treatment threshold. Are their allergies bad enough that they want to start trying a medicine for it? The common treatments for allergies are now mostly available over the counter, which is very helpful in managing them. But sometimes just taking a benadryl can relieve, for a short time, allergy symptoms. But there are longer acting options that are available over the counter, like the long acting anti-histamines like loratadine or Claritin or Zyrtec, cetirizine. And those are oral pills taken once a day to help control allergies.

Another good option is a nasal steroid spray, and those are the medicines like Flonase, or Nasacort or Rhinocort and those tend to help more with nasal and eye symptoms predominantly.

Host: So there's a range of allergies. There's a range of treatment options. Should I be consulting my doctor about that, or because things are readily available over the counter, do I try it myself?

Dr. Sproul: I think if there's concerns or questions, or if you're not certain what would be the best option or the best combination of treatments, then it's best to consult your doctor. A lot of people have the same type of symptoms at the same time each year, and they get very comfortable managing it without advising from the doctor because they've done it before. But anytime there's uncertainty or questions, then good to know what your doctor recommends.

Host: And what of reactions do you see to treatment? symptoms go away or

of and they come How does work?

Dr. Sproul: It varies for everyone. So folks can take one allergy treatment and get control of their symptoms. And then they decide, I'm going to take a vacation from this to see if my allergen has moved on. And if they stop taking the medicine and the symptoms don't return, then they don't have to do anything further, but they could come off of it and see that the allergy symptoms return, the stuffy nose, the drippy nose, the watery eyes, the sneezing, or the coughing, and they can get back on. Some folks are on one line of allergy treatment and it helps, but it doesn't completely relieve them of the symptoms. And then you may go on to doing a second or even a third medicine if your allergies are very bothersome.

Host: Now I've often heard you can develop allergies in life or conversely, if you've had allergies in childhood, they might actually go away as you age. Is that true and if so why is that?

Dr. Sproul: That's very true. And yeah, we all wish we had a very good understanding of that. And another facet of that is folks who have regular seasonal allergies and have one year that they don't develop them or they're real mild or the next year they come back with a vengeance. And that's the body's immune system.

One of the treatments we have for allergies is immunotherapy, and that is repeated very small exposures to an allergen, to desensitize our body. And folks can live in one place for many years and then develop allergies during a particular time of the year that they've never struggled with. And that tends to throw people off a lot.

And it's really just the complexity of our immune system and what it encounters on a regular basis. And sometimes, that allergy develops and that people for a loop.

Host: Is any way to reduce potential allergens around us?

Dr. Sproul: Yes there are and that's the hallmark of allergy control is identifying what you're allergic to and if possible, limiting that exposure. But when it is pollen outside, that means avoiding being out there when it's very windy or making sure that you are changing your air filter in the home. So you're limiting allergens circulating inside the house.

And, there's some things you can avoid. There's some things you cannot. Some people who have dust mite allergies can use dust mite covers on pillows to try to limit exposure to so that they're not having more constant reactions or issues related to that.

Host: Now that we've talked about all this, I feel like I still don't know how to figure out if I did have a allergy to dust mites, how I would understand that, how I would figure that out that I had it, you know, but it's persistent. So I guess that's one of the things that makes it an allergy, right? It, it doesn't go away.

Dr. Sproul: It would be chronic symptoms that aren't going away or if you start putting dust mite covers on that help limit exposure that improve, symptoms, but there are ways of doing testing either, blood tests to see how your antibodies react, or the amount of antibodies that react, or doing a skin test where you are given a small amount of allergen and you watch for the reaction on the skin of your immune system to that allergen. So there are ways of figuring it out that can be very helpful, but they have to fit with what's happening clinically.

Host: So it sounds to me like when you have these kinds of symptoms, you have to be really aware of your environment and what's going on around you, that awareness is key.

Dr. Sproul: Yes, it is. And familiarity and pattern recognition because it does tend to follow a seasonal pattern if you have seasonal allergies, but there are plenty of allergens that aren't just related to a change in season.

Host: So make sure you notice what's around you, if you have these symptoms and if you do have allergies, diagnosis and treatment can make a significant difference. That's nothing to sneeze at. Sorry. I had to say it. Thank you, Dr. Sproul for this useful information that affects so many of us. I appreciate you being here.

Dr. Sproul: My pleasure. Thank you again for having me.

Host: To learn more about WakeMed urgent care, please visit wakemed.org. I'm Amanda Wilde with WakeMed Voices brought to you by WakeMed Health and Hospitals in Raleigh, North Carolina.