Achoo!

By Michaela Gibson Morris/NEMS Daily Journal

The nose will tell.
Abused by seasonal allergies, red and runny noses, along with itchy eyes, are as sure a sign of spring as blooming trees.
This spring there’s plenty to sneeze at in Northeast Mississippi. Tree pollens are already out in force, and grass pollens are just weeks away from emerging.
Although specific trees, grasses and weeds are the pollen-producing culprits that trigger seasonal allergies, the weather is the key factor in the severity of an allergy season.
“Mother Nature is fairly consistent in the production of pollen,” said Dr. Robert Irwin of Tupelo, a board-certified allergist. “Rain can wash the pollen out of the air.”
However, that doesn’t help everyone with allergies.
“The damp, humid conditions can push the growth of mold,” which causes lots of people allergy trouble year round, Irwin said.
Northeast Mississippi is a tough place for people with seasonal allergies.
“In our climate, the seasons tend to run together,” said Dr. Matt Oswalt, a board certified allergist in Tupelo.
Tree season starts in March. Grass pollens emerge in May. Weed pollens emerge in mid-July and stick around until the first killing frost, usually in November, said Dr. Thomas Glascow, an Oxford family physician who has a special interest and training in allergies.
“At most, you get a three-month break,” Glascow said.
That doesn’t mean you have to suffer.
“Treatment is the most effective we’ve ever had,” Irwin said.

Know the source
Allergies are caused by an over reaction of the immune system, treating pollen or other allergens as threats. Colds are caused by viruses. But the difference between a cold and allergies can be subtle.
“The main thing is persistence,” Oswalt said. Seasonal allergies come about the same time every year and then fade after that particular pollen has run its course.
Both cold and allergies are likely to involve clear, runny noses. A fever is unlikely with allergies. Yellow, greenish discharge can suggest an infection.
“You can get an infection on top of allergy problems,” Oswalt said.
So why not just put up with the allergies if it’s going to go away in a few weeks?
“The biggest argument for treatment is potential for complications,” Irwin said.
The post nasal drainage can set people up for bronchitis and pneumonia, Oswalt said.
Chronic sinusitis can impair quality of life, in some cases getting so bad it could require surgery, Irwin said. In small children, it can lead to chronic ear infections. Seasonal allergies are a trigger for many people with asthma, which can be life-threatening if it is not controlled and managed.

Tools for control
There are three key tools in the fight to control allergies: avoidance, medications and immunotherapy.
Avoidance works well with food and animal allergies, but is much more difficult with seasonal allergies.
People with seasonal allergies can take common sense measures such as keeping their windows closed when the pollen that affects them is at its most intense and replacing air conditioning filters monthly.
Oswalt does recommend people with grass allergies consider making other arrangements to get their lawn mowed, or at least use a mask to limit exposure.

Medications
To control seasonal allergies, people have a range of options including over-the-counter and prescription medications, Oswalt said.
Many people can control their symptoms with over-the-counter medications like Claritan and Zyrtec, both of which are available in generics.
If the over-the-counter medications don’t work well, physicians have an arsenal of prescription medications including oral medications and nasal sprays that are very effective.
Steroid and antihistamine nasal sprays, which are prescription-only, can do a great job of controlling runny noses.
However, these prescription sprays shouldn’t be confused with over-the-counter topical nasal sprays, Irwin said. Those sprays, like Afrin, are very effective in the short term, but can cause problems if they are used continuously.
For folks who get itchy watery eyes, there are three or four different prescription drops that can help.
“It’s important to check with a doctor to make sure it’s not pink eye or another eye infection,” Glascow said.
People with truly seasonal allergies – and many are allergic to more than one thing – may be able to wean off the daily medicines and then start them before their allergen repairs.
“You’ve got to start a few weeks before typical allergy season starts,” Oswalt said.
Glascow, Oswalt and Irwin said they don’t prescribe much pseudoephedrine, the active ingredient in medicines like Sudafed, which will become a prescription-only drug in July under a new Mississippi law.
“That’s not something we reach for to treat allergies,” Glascow said.
Pseudoephedrine dries up the post-nasal drainage, but it doesn’t address the underlying issues.
“We want to directly control the allergy response,” Oswalt said.
Medicines like Zyrtec and Claritin work very well in controlling the allergy response, but need to build up in people’s systems before they get relief.
Over-the-counter medicines aren’t a bad place to start. However, if you’re not getting relief in a week or two, it’s definitely time to see a doctor.
“People just wait until they’re desperate,” Glascow said. “If in 10 days, you’re not improved, you probably need to check with a doctor.”
Even if you’re pretty sure it’s allergies, it can be a good idea to get input from your doctor, Irwin said. Some other conditions – like hypothyroidism – can mimic seasonal allergies.
“One should be secure in their diagnosis,” Irwin said.
It also can be easy to misinterpret what’s really causing trouble. Someone who gets itchy eyes, runny nose, congestion after mowing the lawn might think they have a grass allergy, but in fact be sensitive to the mold, which is growing in the damp undergrowth, Irwin said.

Immunotherapy
For people who don’t get enough relief from medications, immunotherapy can be very effective.
“If it’s severe enough and can’t be controlled with medication, you can start with allergy injections to desensitize,” Oswalt said.
Immunotherapy involves carefully testing to see what particular allergens are causing an individual trouble and then planning out a series of injections customized to the individual. More than 80 percent of people have success with immunotherapy, Irwin said.
“It has to be carefully thought out,” Irwin said.

Key allergy culprits
Tree pollens start emerging in late February and peak in March.
Grass pollens come on strong typically in May.
Because of the wet, humid climate, mold is an issue all year round.
More info: American Academy of Allergy Asthma and Immunology – aaaai.org

Asthma camp
Controlling seasonal allergies, which are a big trigger for kids with asthma, will be one of the topics covered at the annual Camp Breathe EZZZZE.
The medically supervised camp for kids 6 to 12 with asthma pulls together traditional camp activities and asthma management education.
The camp will be May 31-June 3 at Tishomingo State Park. Registration is due by April 1. Fee is $100; scholarships are available. Call (662) 377-4706 or (800) 843-3375). Applications can also be downloaded from the Camp Breathe Ezzzze Web site at www.nmhs.net/camp_breathe_ezzzze.php.