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Surviving Spring

by Eileen Glanton Loftus

It may be allergy season, but that doesn’t have to prevent you from enjoying the fresh air.

Just a few short months ago, South Jersey residents were dreaming of spring. But when spring sprung, it unleashed its annual torrent of pollen, fresh grass and flowers, sparking a heavy wave of seasonal allergies. Spring is the most challenging season for the millions of Americans who suffer from allergies. Even if you sailed through childhood without any, they could still be the reason you’ve been wheezing, sneezing and itching lately. Allergies can develop in adulthood, local doctors say, and can change over time.

Allergies have become more prevalent, with as many as one in five Americans affected. Medical professionals are not certain why allergies have become more common, says Dr. Jay Mirmanesh, medical director of Advocare Pediatric & Adult Medicine in Marlton, Sicklerville and Voorhees, but some possible factors include environmental changes and societal trends that have seen fewer children playing outside.

“There is a school of thought that says that with more kids being kept inside, they become unable to tolerate things in nature, and their bodies develop allergic reactions,” he says.

Inside an allergic reaction
An allergy is a specific reaction of the body’s immune system to a certain substance. A healthy immune system works all the time to keep germs at bay and prevent a person from getting sick. When a person develops an allergy, his or her immune system is interpreting a substance as harmful, and reacts strongly against it. That reaction can come in the form of sneezing, itching, rashes, wheezing or vomiting.

Allergies can range from very mild to life-threatening. The most severe allergic reaction can cause anaphylaxis, which requires immediate medical attention. Food allergies, such as peanut allergies, are the most common triggers of anaphylaxis and should always be monitored by a medical professional, such as a doctor who specializes in allergy and immunology.

Although food allergies have become more prevalent in recent years, they are still less common than seasonal or environmental allergies. The most frequent complaints local physicians see include allergies to pollen, grass, animal fur and dust mites.

When to get help
For some, allergies will never be more than a minor annoyance. They can suffer through a few weeks of sneezing, then will move on with no lasting effects. But for patients with more severe allergies, or with other health complications, treating and managing their allergies can dramatically improve their quality of life, doctors say.

“Along with the itchy nose and the runny eyes, allergies leave you feeling kind of foggy and tired,” says Dr. Joseph Cavallaro, head of Cavallaro Family Practice in Voorhees. “If it’s affecting your work or your child’s school work, it’s worth seeing a doctor.”

Dr. Andrew Martin, chairman of pulmonary medicine at Deborah Heart and Lung Center in Browns Mills, says allergies are sometimes misdiagnosed, most commonly as upper respiratory infections.

“If that’s the case, you might get put on an antibiotic, which will not help your allergies at all,” he explains.

Allergies and asthma often occur together, and if allergies go untreated in a patient with asthma, it can cause complications. “If the symptoms go untreated, that can lead to aggressive management of the asthma, with steroids, and those have some tough side effects,” Martin says. “You want to avoid that if possible. If you treat your allergies aggressively and early, you may be able to avoid greater complications down the road.”

The best options for treatment
Doctors say the course of treatment for allergies generally begins with a patient trying an antihistamine over the counter. Two popular varieties are Zyrtec and Claritin. “You take them once a day, they’re non-sedating, and they often work very well,” Martin asserts.

If those drugs don’t help relieve the allergic symptoms, the patient might move onto a stronger drug, like Chlor-Trimetron or Benadryl. Those medications are likely to cause drowsiness, but may alleviate the allergies, Martin says. Patients can also use decongestants and eye drops to help reduce specific symptoms, and if over-the-counter medications don’t work, doctors can prescribe drugs, as well.

If OTC or prescription antihistamines aren’t doing the trick, a patient may be asked to consider immunotherapy—also known as allergy shots. In this treatment, the patient starts by receiving small doses of the allergen in an effort to build up a tolerance. Over time, the patient receives greater doses of the allergen, until the body is resistant to it and no longer creates an allergic reaction.

Don’t discount the importance of removing allergy triggers from your home, though, Mirmanesh stresses. If a person is allergic to dust mites, for example, you may need to vacuum very frequently, or cover mattresses with a plastic cover. A mold allergy may be improved by keeping the environment drier than normal by using fans and dehumidifiers.

Testing for allergies
A patient who is considering immunotherapy will be asked to undergo a panel of allergy testing. That helps doctors pinpoint the specific substance that causes the allergic reaction.

“With testing, we can target one or two allergens for the desensitization process,” Martin says. “You can’t desensitize a patient to 15 things.”

Testing involves scratching the skin and exposing the patient to different substances to see which ones trigger allergic reactions. The skin test delivers highly specific results; Cavallaro says more than 40 allergens can be identified through such tests.

The testing process, which may be conducted by an allergist or, in some cases, a general practitioner, will also include a family history and a discussion of the patient’s lifestyle and exposure to common allergens. Allergies and asthma run in families, so if your parents and grandparents suffered, you may, too. Also, these ailments are closely related, so if a patient is diagnosed with asthma, they will also run a greater risk of developing allergies. Smoking and/or other obvious pollutants can also increase the risk of allergies.

Testing can also help you determine the best timing for your allergy treatments. “If you have a seasonal allergy, you could start your OTC medication three or four weeks before your allergen hits its peak season, and that can be helpful,” Mirmanesh concludes.

Resources

Advocare Pediatric & Adult Medicine
Locations in Marlton, Sicklerville and Voorhees
(856) 985-8100; (856) 728-7900; (856) 753-7374
AdvocareDoctors.com/docmir

Cavallaro Family Practice
701 White Horse Road
Voorhees
(856) 344-7916
CavallaroFamilyPractice.com

Deborah Heart and Lung Center
200 Trenton Road
Browns Mills
1 (800) 555-1990
Deborah.org

Published (and copyrighted) in the Art of Living Well pull-out section of Suburban Family Magazine, Volume 5, Issue 3 (May, 2014).
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