July 2016- Surviving Allergy Season

A word from the author— For the Health Ministry page this month, I have decided to feature a topic that many are talking about, including myself: how bad my allergies are this year. According to many allergists across the country, each year, allergy season seems to be getting worse and worse, with an increase in the amount of weed spores and pollen in the air. Even people that report, “they don’t have allergies” seem to be suffering from runny noses, uncontrollable sneezing and congestion, and itchy, watery eyes, the classic “allergy trifecta.” I have included some of the most recent information about this year’s allergy season below, including tips about, “how to survive allergy season.” Enjoy!

The Truth about Allergies More than 50 million Americans are living with seasonal nasal allergies. AAFA’s annual Spring Allergy Capitals report provides insights into cities where people are most affected by seasonal symptoms. Allergies are getting worse, and climate change may be a factor. Today, 50 million Americans suffer from nasal allergies.9 Studies say that climate change may be to blame. With plants producing more pollen per year, sending more allergens into the air we breathe, our immune systems are working overtime.

What were the Allergy Capitals this Spring (2016)? The top 5 most challenging place to live with spring allergies this year are:

1. Jackson, MS 2. Memphis, TN 3. Syracuse, NY 4. Louisville, KY 5. McAllen, TX

The report looks at 3 important factors:

Pollen score Allergy medication usage Availability of Board-certified allergists

This year’s report named Jackson, Mississippi, as the top Spring Allergy Capital due to its:

Higher than average pollen Higher than average medicine use

How does your city rank on the allergy charts by Region? The 2016 Spring Allergy Capitals also ranks cities by regions to provide a closer look into how each city stacks up against surrounding areas. 2016 Regional Rankings No. 1 in the Midwest- Wichita, Kansas No. 1 in the Northeast- Syracuse, New York No. 1 in the South- Jackson, Mississippi No. 1 in the West- Tucson, Arizona

The Worst Allergy Season Ever Below, I have copied the text of a great article from the NY Post released on April 12, 2016 entitled, “Four ways to fight the worst allergy season ever.” This article has a lot of great information from a local allergist and helps to explain some simple ways to help allergy sufferers. Article by Dana Schuster: April showers bring May flowers — and a whole lotta sneezing and itchy eyes. And this year, according to experts, allergies are going to be worse than ever. “We’re seeing allergy symptoms become more severe and start earlier,” says Dr. Neeta Ogden, an NYC-based allergist. She and other doctors attribute this to environmental shifts and climate change. “What determines if there is more or less pollen is temperature, humidity or rainfall,” says Dr. Darryl Zeldin, scientific director at National Institute of Environmental Health Sciences. “This year is predicted to be very bad,” he adds, noting that the mild, wet winter caused premature blooming. “Typically in New York, pollen season doesn’t start until June, so this means a longer [allergy] season and more suffering.” And it’s only going to get worse: Ogden cites a 2012 study indicating that in the year 2040, “pollen counts will be double what they were in 2002.” Luckily, we’ve rounded up tips from top professionals to keep your eyes dry and nasal passages clear.

See your allergist before the sneezing starts Dr. Clifford Bassett, founder of Allergy & Asthma Care of New York, says it’s best to seek out care before scratching your eyes out. Your doctor can introduce you to new treatments, like sublingual immunotherapy — small doses of allergens in tablet form that the patient keeps under the tongue for one to two minutes before swallowing. It’s a less painful, more convenient alternative to shots, though the tablets currently approved by the FDA are to combat only ragweed and grass pollen. Ditch the pollen-ridden clothes ASAP “When the season starts, have an allergy basket where you dump everything that’s been outside, and throw it in the wash immediately,” says Ogden.

Dr. Jordan Josephson, a nasal and endoscopic sinus surgeon in Manhattan, advises patients to shower before getting into bed — even if it’s just a quick nap: “A lot of people go out on the golf course and take a nap in their clothes, and then go to bed later and are rolling around in pollen,” Josephson says. Thoroughly clean your face “Use baby wipes to clean your eyes and eyelashes, where you can have microscopic grains of pollen sitting,” says Ogden. She also suggests using a saline spray to clean out the nose. The salt water restores moisture to dry nasal passages and lessens the inflammation of mucous membranes.

And when all else fails, stick some needles into your skin While Bassett thoroughly recommends the care of allergy professionals, he says there have been several studies that recommend acupuncture as “an adjunctive treatment.” Josephson, meanwhile, is “a big proponent of a neti pot. “I really like the Grossan Hydro Pulse, which is [like a] Waterpik to wash out your sinuses. It makes people feel great. I always tell my golfers who have allergies or sinus problems to use it right after they get off the golf course.”

What are allergies? Allergies are the result of an over-reactive immune system. When allergies occur, the immune system mistakenly identifies an allergen (pollen, pet dander, mold, and dust mites) as an “invader.” In response, the body mounts an inappropriate immune response—similar to one that it would launch against something much more harmful, such as the cold virus. To rid itself of the “invader,” the immune response triggers a response that results in you experiencing symptoms—such as sneezing, runny nose, and itchy, watery eyes.

What causes our allergy symptoms? Allergens are allergy-causing particles that travel through the air. Below are the most common types of allergens.

ANIMAL ALLERGENS- Minute airborne particles produced by pets like dogs or cats are called “pet dander.”

INDOOR ALLERGENS- These include mold and particles from dust mites. These allergens are with us all year long.

TREE POLLEN- Occurs at certain times of the year and is especially prevalent in the fall.

OUTDOOR ALLERGENS- These are the seasonal allergies that include pollen from grass and weeds.

Allergens enter our bodies through our nose. Once allergens enter, they trigger a response from our immune system. Inflammatory substances are released, causing your allergic symptoms.

Allergies are much more than a nuisance… Studies show allergies also have an impact beyond symptoms alone.

57%SLEEP DISTURBANCES

60%FEELING MISERABLE

67%IRRITABILITY

85%TIREDNESS

Allergies Impact Your Quality Of Life

Nasal allergy symptoms can negatively affect our lives and many aspects of our personal and professional activities.

Limit social activities

Are unable to enjoy pets

Limit outdoor activities

Medical costs and doctor's visits

Workdays lost

Loss in work productivity How to Prepare for Allergy Season The first step is to know what you’re allergic to. Next, it helps to minimize your exposure to those allergens—whether that means cleaning your home in a certain way to reduce indoor allergens or keeping an eye on your local allergy forecast.

Once you start suffering from seasonal allergy symptoms, figure out which allergy medicine is right for you and start treating as soon as your allergy symptoms start. Taking your medicine before peak allergy season can help alleviate symptoms like nasal congestion, runny nose, itchy nose, sneezing, and itchy, watery eyes.

What are the different types of allergies? An allergy occurs when your body’s immune system sees a certain substance as harmful. It reacts by causing an allergic reaction. Substances that cause allergic reactions are allergens. There are many types of allergies. Some allergies are seasonal and others are year-round. Some allergies may be life-long. It is important to work with your health care provider to create a plan to manage your allergy. Avoiding your allergens is the best way to prevent an allergic reaction.

There are many different types of allergies, including: drug, food, insect, latex, mold, pet and pollen. If you have seasonal allergies, you are likely allergic to mold or pollen, or both. For this article’s purpose, I have only included more in-depth information on the mold and pollen allergies below.

What Is a Mold Allergy? If you have an allergy that occurs over several seasons, you may be allergic to the spores of molds or other fungi. Molds live everywhere. Upsetting a mold source can send the spores into the air.

Mold and mildew are fungi. They are different from plants or animals in how they reproduce and grow. The “seeds,” called spores, travel through the air. Some spores spread in dry, windy weather. Others spread with the fog or dew when humidity is high. Inhaling the spores causes allergic reactions in some people. Allergic symptoms from fungus spores are most common from July to early fall. But fungi grow in many places, both indoors and outside, so allergic reactions can occur year round. Although there are many types of molds, only a few dozen cause allergic reactions. Many molds grow on rotting logs and fallen leaves, in compost piles and on grasses and grains. Unlike pollens, molds do not die with the first killing frost. Most outdoor molds become inactive during the winter. In the spring they grow on plants killed by the cold. Indoors, fungi grow in damp areas. They can often be found in the bathroom, kitchen or basement.

What Are the Symptoms of a Mold Allergy? The symptoms of mold allergy are very similar to the symptoms of other allergies, such as sneezing, itching, runny nose, congestion and dry, scaling skin.

Outdoor molds may cause allergy symptoms in summer and fall (or year-round in some climates)

Indoor molds may cause allergy symptoms year-round

Mold spores get into your nose and cause hay fever symptoms. They also can reach the lungs and trigger asthma. A chemical released by allergy cells in the nose and or lungs causes the symptoms. Sometimes the reaction happens right away. Sometimes a mold allergy can cause delayed symptoms, leading to nasal congestion or worsening asthma over time. Symptoms often get worse in a damp or moldy room like a basement. This may mean you have a mold allergy.

Rarely, some patients can have a more serious illness called allergic bronchopulmonary aspergillosis. In this condition, there is both an allergic and an inflammatory response to the mold. Symptoms may include severe wheezing, coughing and shortness of breath, much like asthma. Food fungi, like mushrooms, dried fruit, or foods containing yeast, vinegar or soy sauce, usually don’t cause allergy symptoms of the nose, eyes and lungs. It is more likely that reactions to food fungi are caused by the food's direct effect on blood vessels. For example, fermented foods (like wine) may naturally contain a substance known as histamine. Histamine is also a chemical your allergy cells release during an allergic reaction. Foods that contain histamines can trigger allergy-like responses when you consume them.

How Do Doctors Diagnose Mold Allergy? To diagnose an allergy to mold or fungi, the doctor will take a complete medical history. If they suspect a mold allergy, the doctor often will do skin tests or allergen specific IgE blood tests. Extracts of different types of fungi may be used to scratch or prick the skin. If there is no reaction, then you probably don’t have an allergy. The doctor uses the patient's medical history, the skin testing results and the physical exam to diagnose a mold allergy. How Can I Prevent an Allergic Reaction to Mold? There is no cure for allergies. But you can reduce your allergy symptoms by avoiding contact with the mold spores. Several measures will help: Reduce Your Exposure to Mold Spores Outside

Limit your outdoor activities when mold counts are high. This will lessen the amount of mold spores you inhale and your symptoms.

Wear a dust mask when cutting grass, digging around plants, picking up leaves and disturbing other plant materials.

Reduce Your Exposure to Mold Spores Inside Use central air conditioning with a HEPA filter attachment. This can help trap

mold spores from your entire home. Freestanding air cleaners only filter air in a limited area. Avoid devices that treat air with heat, electrostatic ions or ozone.

Lower your indoor humidity. No air cleaners will help if excess moisture remains. If indoor humidity is above 50 percent, fungi will thrive. A hygrometer is

a tool used to measure humidity. The goal is to keep humidity below 45 percent, but below 35 percent is better. If you have to use a humidifier, clean the fluid reservoir at least twice a week to prevent mold growth. Air conditioners and dehumidifiers can also be a source of mold.

Prevent mold and mildew build up inside the home. Pay close attention to mold in bathrooms, basements and laundry areas. Be aggressive about reducing dampness.

To Reduce Mold in Your Bathrooms: Use an exhaust fan or open a window in the bathroom during baths and showers. Remove bathroom carpeting from places where it can get wet. Scour sinks and tubs at least monthly. Fungi thrive on soap and other films that

coat tiles and grout. Quickly repair any plumbing leaks. To Reduce Mold in Your Kitchen: Clean garbage pails frequently. Clean refrigerator door gaskets and drip pans. Quickly repair any plumbing leaks. Use an exhaust fan when you are cooking or washing dishes.

To Reduce Mold in Your Laundry Area: Remove clothes from washing machine promptly. If you have a front-loading washing machine, clean the rubber seal and inside of

the door. Leave the door cracked open when the machine is not in use. Don’t leave wet, damp clothes sitting around. Make sure your laundry area has good air circulation. To Reduce Mold in Your Bedrooms: Polyurethane and rubber foams seem especially prone to fungus invasion. Use

plastic covers on bedding made from these foams. Throw away or recycle old books, newspapers, clothing or bedding. Check windows for condensation (water droplets or mist).

Improve air flow through your bedroom. If your closet is colder than the rest of your room, leave the closet doors open.

To Reduce Mold in Your Basement: Quickly repair any plumbing leaks. Promote ground water drainage away from a house. Remove leaves and dead

vegetation near the foundation and in the rain gutters. To Reduce Mold in Your Whole House: Use an electric dehumidifier to remove moisture and keep humidity in your house

below 45 percent. Drain the dehumidifier regularly and clean the condensation coils and collection bucket.

Increase air flow in your home. Open doors between rooms, move furniture away from walls and use fans if needed.

Repair roof leaks and roof gutters. Clean out your gutters to remove leaves and debris. When gutters are full or damaged, it can cause leaking.

What Are the Treatments for Mold Allergy? In some cases, there may be ways to reduce or remove mold exposure. This may not always be possible and you may need medications.

Avoid contact with mold. Take medications for nasal or other allergic symptoms. Antihistamines and

nasal steroids are available over the counter without a prescription. If you have allergic asthma, talk to your doctor about which medicines may be best for you. You might also be a candidate for allergy shots. Allergy shots may help reduce symptoms and medications. Learn more about allergy treatments.

What Is a Pollen Allergy? Pollen is one of the most common triggers of seasonal allergies. Many people know pollen allergy as “hay fever.” Experts usually refer to pollen allergy as “seasonal allergic rhinitis.” Each spring, summer and fall, plants release tiny pollen grains to fertilize other plants of the same species. Most of the pollens that cause allergic reactions come from trees, weeds and grasses. These plants make small, light and dry pollen grains that travel by the wind.

Grasses are the most common cause of allergy. Ragweed is a main cause of weed allergies. Other common sources of weed pollen include sagebrush, pigweed, lamb’s quarters and tumbleweed. Certain species of trees, including birch, cedar and oak, also produce highly allergenic pollen. Plants fertilized by insects, like roses and some flowering trees, like cherry and pear trees, usually do not cause allergic rhinitis.

What Is a Pollen Count? A pollen count is how much pollen is in the air. This is often reported during pollen season on local weather forecasts. Sometimes the main types of pollen are also reported.

What Are the Symptoms of Pollen Allergy? People with pollen allergies only have symptoms when the pollens they are allergic to are in the air. Symptoms include:

• Runny nose and mucus production • Sneezing • Itchy nose, eyes, ears and mouth • Stuffy nose (nasal congestion) • Red and watery eyes • Swelling around the eyes

How Do Doctors Diagnose Pollen Allergy? Doctors use two tests to diagnose a pollen allergy. Skin Prick Test (SPT) In prick/scratch testing, a nurse or doctor places a small drop of the possible allergen on your skin. Then the nurse will lightly prick or scratch the spot with a needle through the drop. If you are allergic to the substance, you will develop redness, swelling and itching

at the test site within 20 minutes. You may also see a wheal. A wheal is a raised, round area that looks like a hive. Usually, the larger the wheal, the more likely you are to be allergic to the allergen. A positive SPT to a particular pollen allergen does not necessarily mean that a person has an allergy. Health care providers must compare the skin test results with the time and place of a person’s symptoms to see if they match.

Specific IgE Blood Test Blood tests are helpful when people have a skin condition or are taking medicines that interfere with skin testing. They may also be used in children who may not tolerate skin testing. Your doctor will take a blood sample and send it to a laboratory. The lab adds the allergen to your blood sample. Then they measure the amount of antibodies your blood produces to attack the allergens. This test is called Specific IgE (sIgE) Blood Testing. (This was previously and commonly referred to as RAST or ImmunoCAP testing.) As with skin testing, a positive blood test to an allergen does not necessarily mean that an allergen caused your symptoms.

How Can I Prevent an Allergic Reaction to Pollen? There are actions you can take to reduce allergic reactions to pollen:

Limit your outdoor activities when pollen counts are high. This will lessen the amount of pollen allergen you inhale and reduce your symptoms.

Keep windows closed during pollen season and use central air conditioning with a HEPA filter attachment. This applies to your home and to any vehicle (car, bus, train, etc.).

Start taking allergy medicine before pollen season begins. Most allergy medicines work best when taken this way. This allows the medicine to prevent your body from releasing histamine and other chemicals that cause your symptoms.

Bathe and shampoo your hair daily before going to bed. This will remove pollen from your hair and skin and keep it off your bedding.

Wash bedding in hot, soapy water once a week. Wear sunglasses and a hat. This will help keep pollen out of your eyes and off

your hair. Limit close contact with pets that spend a lot of time outdoors. Change and wash clothes worn during outdoor activities. Dry your clothes in a clothes dryer, not on an outdoor line.

What Is the Treatment for Pollen Allergy? Certain over-the-counter and prescription medicines may help reduce pollen allergy symptoms.

Antihistamines come in pill, liquid or nasal spray form. They can relieve sneezing and itching in the nose and eyes. They also reduce a runny nose and, to a lesser extent, nasal stuffiness.

Decongestants are available as pills, liquids, nasal sprays or drops. They help shrink the lining of the nasal passages and relieve nasal stuffiness. Use decongestant nose drops and sprays only on the short-term.

Nasal corticosteroids are a type of nasal spray. They reduce inflammation in the nose and block allergic reactions. They are the most effective medicine type for allergic rhinitis because they can reduce all symptoms, including nasal congestion. Nasal corticosteroids have few side effects.

Leukotriene receptor antagonists block the action of important chemical messengers (other than histamine) that are involved in allergic reactions.

Cromolyn sodium is a nasal spray that blocks the release of chemicals that cause allergy symptoms, including histamine and leukotrienes. This medicine has few side effects, but you must take it four times a day.

Many people with pollen allergy do not get complete relief from medications. This means they may be candidates for immunotherapy. Immunotherapy is a long-term

treatment that can help prevent or reduce the severity of allergic reactions. It can change the course of allergic disease by modifying the body’s immune response to allergens. Allergy Shots - Subcutaneous Immunotherapy (SCIT) has been around for more than 100 years and can provide long-lasting symptom relief. SCIT is a series of shots that have progressively larger amounts of allergen. An injection of the allergen goes into the fat under the skin. Over time, allergic symptoms generally improve. Many patients experience complete relief within one to three years of starting SCIT. Many people experience benefits for at least several years after the shots stop. Sublingual Immunotherapy involves placing a tablet containing the allergen under the tongue for 1 to 2 minutes and then swallowing it. In 2014, the FDA approved three types of under-the-tongue tablets to treat grass and ragweed allergies. More are in development. You take SLIT tablets daily before and during grass or ragweed season. This treatment offers people with these allergies a potential alternative to allergy shots. Discuss your allergy symptoms and your allergy treatment plan with your health care provider.

Resources: https://www.flonase.com/news/allergies/allergy-season/ https://www.pollen.com/ http://nypost.com/2016/04/19/four-ways-to-fight-the-worst-allergy-season-ever/ https://www.washingtonpost.com/local/pollen-misery-and-the-allergy-afflicted-our-season-of-suffering-has-arrived/2016/04/20/143a3a42-066a-11e6-a12f-ea5aed7958dc_story.html http://www.cnn.com/2016/03/24/health/allergy-season-survival-guide/ http://www.accuweather.com/en/weather-news/spring-allergy-forecast-2016-early-eastern-us-warmup-may-jumpstart-season/55920967 http://www.aafa.org/page/allergy-capitals.aspx