ALLERGY TREATMENT

Spring Allergies Have Sprung

By Russell Traister, MD – AHN Pediatrics Bloomfield

While for many, the arrival of

spring means a thaw from a frigid winter and the sight of daffodils popping out of the ground, for allergy sufferers, spring can be a harbinger of worsening allergy symptoms. When trees start blooming, tree pollen becomes abundant triggering allergy symptoms in affected individuals. The range and severity of symptoms can differ dramatically from patient to patient. While some may be affected by a mild itchy nose easily remedied with and over-thecounter antihistamine, some are afflicted with intractable itchy, watery eyes and nose immune to medication. Contrary to popular belief, spring flowers are not a cause of seasonal allergies. Flowers are pollinated by insects, not the wind. While the smell of flowers may serve as an irritant to some leading to sneezing, they are not true allergens. Tree pollen, however, is wind pollinated and can travel far distances in the air and lead to allergic symptoms in sensitized individuals. Tree pollen counts have been increasing in recent years, likely leading to more or prolonged allergic symptoms. Grass and weed pollen counts can also start to rise later in spring and can contribute to allergy symptoms as well. Other allergens such as cat, dog, and dust mite are considered perennial, or year round allergens, and would be expected to cause symptoms throughout the year instead of seasonally. The number one goal in allergy treatment is avoidance of triggers. Unfortunately, when it comes to tree, grass, and weed pollen, that can be difficult given they are spread widely throughout the air. Keeping home and car windows closed can help, but not eliminate, exposure. Given that pollen can travel miles through the air, it is not just about the vegetation in your local neighborhood.

Treatment approaches should be discussed on an individualized basis with each patient. Medication options include intranasal steroids, antihistamines, allergy eye drops, and nasal saline irrigation. However, if those medications are not sufficient, or the frequent need for medications is bothersome, allergy shots are a potential treatment option. While medications may suppress allergy symptoms, allergy shots

have the potential to cure your allergies. Allergy shots are a big commitment, but can have long lasting benefits. The biggest commitment is in the first 3-6 months of treatment, as shots are required 1-2 times weekly in the office, followed by a mandatory 20-30 minute waiting period to ensure no reaction to the shots occur. After about 6 months the shots are spread out to once monthly injections, and shots are continue for a period of about 5 years, when they are generally stopped, ideally with a long lasting beneficial affect on allergy symptoms. It should also be noted that after starting shots it can take 6-12 months to start seeing symptom benefit. Additionally, if someone has asthma, the allergy shots may have a beneficial effect on that condition as well.

When you visit your allergist, they may perform skin or blood testing to determine which allergens you might be sensitized to. Both tests are adequate for determining your allergies, but skin testing is more sensitive, and if you are considering allergy shots your allergist

may suggest this route. Skin testing is a safe and nearly pain free procedure that involve a prick of the skin with various allergens. A typical environmental allergy panel consists of around 40 pricks, typically placed on the arms or back. The results can be read in about 20 minutes. Your allergist will use this information to provide guidance on treatment, avoidance measures, and to determine which allergens should be placed in allergy shot mixes, should that be the best route of treatment.

Dr. Traister attended The University of Pittsburgh School of Medicine and received his MD and PhD (Immunology) in 2008. After finishing residency training in internal medicine and fellowship training in allergy and immunology, he worked part-time at UPMC, Children's Hospital of Pittsburgh, and Pediatric Alliance. Subsequently he was employed at Wake Forest Baptist Health in Winston-Salem, NC. His research interests include vocal cord dysfunction, hypogammaglobulinemia in lung transplant patients, and rush immunotherapy. He is an author on over 20 peer-reviewed publications and over 25 abstracts. He currently resides in Blawnox with his wife and two children. Moving back to the area allows Dr. Traister to be closer to his extended family, who also reside in Western Pennsylvania.

The number one goal in allergy treatment is avoidance of triggers. Unfortunately, when it comes to tree, grass, and weed pollen, that can be difficult given they are spread widely throughout the air.