Summertime Allergies- It
Posted on: 08/28/2008
Albert S Hartel M.D.
We all look forward to Summertime in Western New York, but while summertime brings with it abundant outdoor activities and hours of enjoyment, it also brings a season of increased pollens, which in millions of allergic individuals, can cause an onslaught of nasal, eye, sinus, and breathing symptoms, as well as potentially life threatening exposures to insects and food allergies.
For pollen allergic individuals, summer doesn’t need to be spent indoors, but measures should be undertaken to decrease pollen exposure. Allergy sufferers should pay attention to the daily local pollen counts, and try to minimize outdoor activity when counts are high. Pollen levels are generally lower on rainy, cloudy and windless days, and reach their peak daily between 10 am and 4 pm. Windows should be kept closed during the pollen season to prevent outdoor pollen from entering homes and cars. Air conditioning effectively filters pollen, and cools and dries the air. After spending time outside, pollen will accumulate on clothes, skin and hair, so it is important to shower and change clothes when coming inside. Hanging sheets or clothing outside to dry will collect pollen on them as well.
Stinging insects place approximately 5% of Americans at risk of a severe life threatening allergic reaction. Anyone who has had a systemic reaction to a sting (such as hives, breathing trouble or throat tightness/swelling) should be tested and properly diagnosed. Carrying portable epinephrine at all times is critical, but not enough, as over 30% of patients will need more than one dose, and all too often these are inaccessible, expired, or the reaction progresses too fast to allow time to administer. Measures which may help decrease insect exposure include avoiding brightly colored clothing and perfume when outdoors, avoiding bare feet, caution when cooking, eating or drinking sweet beverages outdoors, and hiring exterminators to spray and remove nests. Allergen desensitization shots can dramatically decrease risk of a future life threatening reaction in insect allergic individuals, and are the closest thing to a cure to this deadly allergy.
Food allergies are also a summertime concern. Summer vacation is a great time for a picnic, cookout, fair or festival, but for the 8% of children, and 2% of adults who have food allergies, it is critical to know exactly what they are eating. A single bite of the wrong food can induce anaphylaxis, a life-threatening reaction, in severely allergic people. People who suspect food allergies should undergo testing to identify sensitivities, and receive counseling on hidden ingredients and related foods to which a sensitive person also may react. It is important to inform all friends, parents, camps, and restaurants of their food allergies, and make sure they are absolutely certain of ingredients. Make sure the tables are clean, as even the slightest contamination could trigger an attack. Accidents are never planned, so be sure to talk to an allergist about need for injectable epinephrine, which should be available at all times, with multiple individuals properly trained to administer it.
Traveling with allergies this summer means there’s more to worry about than just the price of gas. Make sure all medications are packed and up to date, and if staying in a remote area, know where the closest medical facility is located. Before a lengthy road trip, air out vehicles and travel with the windows rolled up. Plan to drive in the early morning or late evening to avoid high mid-day air pollution, heat, and high pollen levels. When traveling by airplane, pack all medications according to federal security regulations, and keep in a carry-on incase luggage is lost or delayed. Food allergic people should bring snacks onboard and avoid eating unlabeled airline food. Request hotel accommodations in a smoke free room which does not allow pets, and consider bringing a dust mite pillow encasing.
Gardening is a popular summertime activity that provides beauty, and a sense of satisfaction and pride, but also potential allergy trouble. Whenever working around plants likely to cause an allergic reaction, it is important to avoid touching of the eyes or face, and to consider wearing a mask to reduce breathing in pollen spores. Gloves, long sleeve shirts and pants should be worn to minimize skin contact with allergens. When finished, gardening tools and clothing - such as gloves and shoes – should be left outside to avoid bringing allergens indoors. Shower immediately after gardening or doing yard work. People with allergies can also reduce irritation by carefully choosing the plants they include in their landscaping or garden. Certain flowers, trees and grasses are naturally better suited for the gardens of allergic people, (such as Roses, Tulips, and Geraniums), while many others are more likely to produce bothersome symptoms. Testing with an allergist can help identify species to avoid.
Asthma is a chronic disease that kills approximately 5,000 people annually. Not all asthmatics will wheeze, and other symptoms such as cough, trouble breathing and chest tightness that occur with exercise, with infections, at night or when outdoors is suggestive of asthma. Approximately 60-80% of asthma attacks are caused by environmental allergens and irritants such as smoke, pollen and animal dander, but inflammation remains in the lungs occurs even when symptoms are not present. Asthmatic individuals should reduce pollen exposure, and watch for weather changes in temperature, humidity, barometric pressure or strong winds that can aggravate asthma. Make sure all prescribed medications are taken regularly, and monitor usage- using a rescue inhaler such as albuterol more than twice a week means asthma is not well controlled, and puts you at greater risk of attacks, and long term consequences. Even people with mild asthma can suffer a life threatening attack caused by environmental hazards. A proper treatment plan should enable people with asthma to participate in normal activities without limitation in any season.
Summertime in Western New York is a wonderful, but brief time of year. Even people with severe allergies can get the most out of summer by properly identifying sensitivities, educating themselves, and taking necessary precautions to avoid triggers. An appropriate regimen of preventative maintenance medications and a plan for treatment of flares will help minimize suffering. It is even possible to reduce how allergic someone is and how severely they react, through immune modifying allergy shots- which often greatly reduce suffering and the need for long term medication.
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