Vail health: Coughing, sneezing and itchy eyes
May 21, 2012
If you rarely suffer from sneezing fits, a nose that runs like the Colorado River in spring or itchy eyes with the texture of coarse sandpaper you may not appreciate what it is to truly suffer from allergies. If your dream is to reinvent Kleenex with the strength of steel and softness of goose down, then you probably know what I mean.
So, why do allergies seem to come and go? What can you do for them? Will they ever go away?
First, whatever causes an allergy is called an allergen. There three basic types of allergies – inhaled (pollens, dusts, grasses, etc.), ingested or injected (food, medicines, bee stings, etc.) and topical (poison ivy, chemicals, etc.). Each of these can come in various strengths. Some things are absolute allergens. That is anyone exposed to them will have a reaction. Most are relative allergens. These are the allergies that increase as the degree of exposure goes up. Thus, we have good and bad days, seasons or years depending on how much of the allergen we’re exposed to. For example, someone with mild grass allergies might be able to sit comfortably on a deck, but would suffer if they mowed the lawn (good excuse to get out of that job!). Conversely, someone with severe grass allergies might start sneezing if the person at the end of the street just mowed their lawn. That helps explain why some people have allergies one year and not the next. Their exposure changes and so does their symptoms.
Different types of allergies result in different symptoms. Inhaled allergies causes a person to suffer from sneezing, itchy, watery eyes, runny nose and just generally feeling under the weather. Ingested allergies most commonly cause hives, skin itching and swelling. Topical allergies may cause a very itchy rash with swelling, redness and small vesicles (like blisters). If severe enough, all three types of allergies can cause wheezing, shortness of breath, airway swelling and a trip to the emergency room.
Relief is available
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Despite these miserable symptoms, relief can be found. Avoidance is the best means of prevention – especially for ingested/injected and food allergies. When you need to reach for therapy, antihistamines are a good first choice. These come in two flavors. Traditional antihistamines, like Benadryl, are sold over the counter. They work well, but can be quite drying and often sedating. The newer antihistamines are very well tolerated and include both prescription and over-the-counter medications such as Allegra, Claritin, Clarinex and Zyrtec.
The advantages of these newer antihistamines are fewer side effects and they keep your sympotoms at bay much longer – up to 24 hours. Other medications include different types of prescription nasal sprays, an asthma drug called Singulair, topical creams, and pseudoephedrine hydrochloride, commonly known as Sudafed. Generally avoid sedating antihistamines in children when it might affect school performance or in yourself if you’re driving, operating machinery or just need to be at your best. Sudafed needs to be used with caution if you have heart problems, high blood pressure, heart palpitations, difficulty sleeping or thyroid disease. It is also the base ingredient in the production of Methamphetamine so it is controlled through the need to sign for it when purchased. If you are pregnant, you should always check with your doctor before taking anything.
Sprays, drops, shots
Recently approved by the FDA is a new dual-ingredient nasal spray that may be very promising. For those with severe eye symptoms, drops may be your best bet and prescription choices include an excellent generic twice-a-day drop called Patanol as well as its once-a-day, non-generic equivalent, Pataday.
While ingested/injected and topical allergies are generally with us forever, inhaled allergies wax and wane with time and exposure. Avoidance comes first, but when that is impossible, medications are safe and well tolerated. Whatever you try, follow the directions! Do not take more medicine than recommended as the risks are greater than your allergy sympotoms.
The last – but for many the best – option may be allergy shots. Known as desensitization, an allergist will carefully determine what you are allergic to, as well as the severity of that allergy. Special shots are then developed specifically geared to desensitize you by administering those allergies in miniscule but gradually increasing doses until your symptoms improve. It is a process that takes months to years but may allow you to fully enjoy our great outdoors.
Dr. Drew Werner is a medical staff leader at Valley View Hospital in Glenwood Springs, a family physician at TotalHealth Care and the Eagle County health officer. He lives in Eagle with his family. Email comments about this column to firstname.lastname@example.org.