Allergy Attacks? Fight Back (cont.)

Member: What role does stress play in asthma attacks? My husband's doctor has him on Paxil to control his stress.

Pien: Stress has been known to exacerbate asthma. Patients with asthma frequently get anxious with attacks and that causes exaggerated symptoms. Patients with asthma have also been known to be depressed due to the disease. Emotional health is important in controlling all illnesses.

Member: Is asthma commonly associated with menopause, and can HRT [hormone replacement therapy] help or make symptoms worsen?

Pien: That's not very well studied. Some women have noted increase in asthma symptoms pre-menstrually, so there's not that much known about asthma and menopause.

Member: Is it possible to control allergy symptoms without medication?

Pien: Avoidance measures can be very effective. Exercise, decrease in weight, and change in diet have been shown to have beneficial effects in decreasing asthma symptoms.

Moderator: What kinds of foods are known asthma triggers?

Pien: Those containing sulfites.

Member: I have mold allergies. How can I test for mold in my air in my home? We had a flood in the basement four years ago. Everything was either removed or cleaned up, but that is when my problems started, what else can I do?

Pien: There are some environmental companies that will measure mold counts both inside and outside of the home. And they can provide control measures to decrease mold growth, primarily with the use of a dehumidifier.

Member: I've had a runny nose off and on for the last two years. After seeing three ENTs on different occasions, they all think it's my two dogs. I have been on nasal spray for some time, but I still get attacks almost every month! What should I do?

Pien: You can use antihistamines and nasal sprays daily to prevent attacks of nasal drainage. If you are allergic to the dogs, avoidance is best.

Member: I have seasonal and perennial allergies, asthma. I take Singulair, Flonase, and Flovent to control symptoms. I started shots in mid-January. Since I added the Singulair last fall, until this week I have not had the intermittent ear ringing and ear fullness that drives me batty at night. If I stay inside completely, it's much less a problem. I do wear a hat to keep spores and pollen out of my hair. Now, with a mild winter, no snow cover, and warm, windy days, the ear stuff is once again keeping me up at night. I use two snorts of Flonase in the morning. Would I get better control with one in the morning and one in the evening (each nostril)? Would Allegra help? I've tried all the others, which had various side effects or no effect. Also, when I'm congested, I snore and keep hubby awake. Sudafed before bed helps that, but at age 50, starting to get elevated systolic readings. How long before I begin to see help from shots?

Pien: Allergy shots appear to be beneficial at higher doses so when you hit the maintenance dose, you should expect to have some benefit. So by the end of the first year, allergy shots should be beneficial. Flonase can be taken one squirt twice per day to provide some nighttime coverage. The maximum dose is two squirts per day.

Member: I'm a 58 year old man. I'm having allergic reactions to something. Mainly mid-afternoon, I experience hives on the back of neck, around the belt area, and tightness in my throat. Benadryl sometimes takes care of the problem, but I am concerned that it may be getting worse. What should I do?

Pien: If the hives have occurred for more than six weeks, they would be considered chronic, and the most common cause of chronic hives are idiopathic. This means the cause is generally something internal, not an external allergen.

Moderator: Unfortunately, we are out of time. Thanks for joining us, members, and thanks to Lily Pien, MD, for being our guest. Sorry we couldn't get to all of your great questions. For more allergy information and advice, be sure to visit the new Allergy Center and the allergy message boards here at WebMD. Be well and goodbye!

Pien: Thank you for chatting with me today.

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