NOTHING TO SNEEZE AT

WRITER: MICHAEL FREEDMAN, D.O.

It will soon be that time of year again when trees begin to bloom, grass begins to grow again, and the end of our Florida winter means warmer weather once again. For some that means the beginning of allergy season, and for others, the end of the winter colds and sinus infections. Still, some people have significant issues that affect the quality of their lives. So how can we tell whether their symptoms are part of a springtime cold or an allergy since some of the symptoms overlap, making it difficult to determine what the proper diagnosis is and which treatment to recommend?

Patients with both allergies and colds can have nasal stuffiness, a clear runny nose, sinus pressure, or a sore throat. What usually distinguishes someone who has allergies are symptoms of itchy or watery eyes, an itchy nose or throat, and other symptoms such as a rash or body itching. Also, the timing of symptoms can help. If symptoms begin immediately after exposure to an allergen, such as dust, mold, or other environmental stimuli, then allergy is most probable. Many allergies also occur in a seasonal pattern, although some can be year-round. Cold symptoms usually take a few days to develop and can include discolored nasal drainage and fever, which are uncommon with allergy.

Treatment of allergies begins with avoidance. If a known allergen can be avoided, this can go a long way to minimize symptoms. Frequent dusting of furniture and hardwood or tile floors instead of carpeting can minimize dust allergy, as well as HEPA filters and regular duct cleaning. Dust mite allergies can be minimized by washing bedding in hot water and using dust covers. Mold allergy occurs in damp places and the use of bleach can help decrease mold spore colonies.

After avoidance, medical therapy of allergy is the cornerstone of treatment. Allergies occur because of the release of a chemical called histamine. Therefore, antihistamines, which block the effects of histamine, are a major part of allergy treatment. They come in both oral and spray forms and can be combined with decongestants or nasal steroid sprays.

Also, allergy testing can identify what someone is allergic to and depending on the severity of symptoms and testing results, immunotherapy, or allergy shots, can be very helpful as this is the only treatment that can change someone’s allergies. Allergy shots are usually administered weekly over a period of two years and can desensitize or vaccinate someone from their allergies,.

Treatment of upper respiratory infections also begins with avoidance via prevention. Hand washing and use of hand sanitizers can help prevent many infections, as can strengthening our immune system by exercise, eating a healthy diet, and getting enough sleep. Treatment of upper respiratory infections is largely supportive. Vitamin C, zinc supplements, saline irrigation, steam inhalation, rest, and fluid intake can certainly make a difference in the severity and duration of cold symptoms. Since viruses cause most of these infections, antibiotics are not helpful.

Most viral upper respiratory infections will improve within seven to ten days. If symptoms persist beyond that period, it is likely that a bacterial sinus infection has developed, especially if discolored drainage, facial pain, or fever is present. If this occurs, a physician may prescribe antibiotics. Fortunately, most sinus infections will improve with medication. However, if someone has more than four infections per year or has symptoms that persist despite medication, a chronic sinus infection may be present and surgery may be necessary.

Traditional sinus surgery involves using special telescopes and instruments to open and clean infection from the sinuses. Over the past five to seven years, a more minimally invasive procedure called balloon sinus dilatation has been developed, allowing physicians to open the sinuses with small balloons much like angioplasty does with blood vessels.

Many people feel they have to live with their allergy or infection symptoms but they do not. With the proper diagnosis and treatment, they can quickly return to smelling the roses once again.