Allergies, Control Your Spring (cont.)

GEORGESON:
This parent's suspicion is most likely correct. Forty percent of patients who have allergic rhinitis will also have asthma. There are many triggers of asthma, including allergies, exercise, infections, laughter, crying, sinus infections, and weather changes. If the patient is not responding to Singulair, the patient should also be prescribed an inhaler, which is a bronchodilater, such as albuterol. If the pediatrician is unwilling to prescribe an inhaler for the child, the child should see an allergist.

Since the patient has a history of hay fever and/or allergies an allergist would be a better specialist for him to see as allergists are also asthma specialists and understand the relationship between allergic disease and asthma.

MEMBER QUESTION:
Can postnasal drip be a result of allergies? I wake up in the morning with globs of mucus that drop down my throat but I don't have itchy/ watery eyes or a runny nose.

GEORGESON:
The simple answer is yes. Postnasal drainage can be a symptom of allergies, as well as sinus disease, and not every patient will have sneezing and itching and teary eyes. Each patient's allergy symptoms can differ from person to person.

Postnasal drainage can also be a symptom of a condition called nonallergic rhinitis, which is a condition often seen in adult patients that don't have allergies as a trigger. The best way to make this diagnosis is for a patient with rhinitis symptoms to have negative skin tests.

MEMBER QUESTION:
Is it fact or fiction that eating local honey can actually build my immune system against the pollens that affect me the most in my area?

GEORGESON:
It's fiction.

"A resource would be the AAAAI web site. Information with a map of the country is available that will identify when and where the different pollens will be present."

MODERATOR:
What are the most common allergens that affect people in the spring?

GEORGESON:
In the spring the first pollens that appear are trees, and depending on what part of the country you live in, determine what time this occurs. In the Midwest and Northeast the trees start pollinating in late March, early April. In the Central Southern states they'll start in January.

The next pollen to follow the trees are the grasses. After the grasses will start weeds, and then in the end of the summer, mid-August through fall, where there is a good killing frost, there will be ragweed, which is commonly referred to as "hay fever."

A resource would be the AAAAI web site. Information with a map of the country is available that will identify when and where the different pollens will be present. The official web site is www.aaaai.org. There's a lead article on the home page called Topic of the Month, April 2005, Staying Ahead of Spring Allergy Season .

MEMBER QUESTION:
We never had a killing frost this winter. In fact it was so mild, my geraniums stayed over winter. Does this mean it will be an especially hard spring for allergies?

GEORGESON:
I don't really know, to be honest.

MEMBER QUESTION:
How long does it take for nasal steroids to be effective?

GEORGESON:
There are recent studies that show nasal steroids can begin to improve symptoms within 12 to 24 hours. However, maximal effectiveness will be seen within 10 to 14 days.

MODERATOR:
So you should start those allergy meds a couple of weeks before the season is supposed to hit?

GEORGESON:
I would agree with that.

MEMBER QUESTION:
I always believed mold is a problem in just the summer. Is this true?

GEORGESON:
I live in Michigan and currently our mold count and tree pollen count is very high. So the mold, again, depending on the climate you live in, can be around starting in the spring, summer or fall. In climates that experience frost and snow, this cold will eliminate mold for the winter season. In areas where there isn't a frost, mold may persist all year round if it is a wet/damp climate.

MEMBER QUESTION:
My physician has me taking Qvar 80 for asthma, and I am wondering if the newer medication out there may work better. I am also concerned with side effects.

GEORGESON:
Patients with persistent asthma should be on a daily controller medication. The NHLBI (the National Heart, Lung, and Blood Institute) guidelines for the treatment and diagnosis of asthma recommend inhaled corticosteroids as the preferred drug of choice. Qvar is one of several inhaled corticosteroid medications available.

The side effects from inhaled corticosteroids are very similar between the different products available. If this patient's asthma is well controlled on Qvar I do not see a need to switch medications. It is important, however, for all persistent asthmatic patients to be evaluated every six to 12 months to determine if their treatment is adequate and/or whether or not changes in their treatment is necessary.

"The results of the skin test will help the physician counsel the patient on further treatment options based on the skin test results."