The Typical Costs of Treatment

Depending on the severity of your condition, Hay Fever may end up being a relatively expensive disease with its chronic nature and pharmaceutical symptom management.

Let’s say you take a daily Claritin, Loratadine, 10mg 24 hr antihistamine is taken daily. For a box of 30 tablets, the regular price ranges about $19.89 at Target (and most drug stores). We can round this to about $20 a month for just a daily Claritin tablet and $240 a year.

Now let’s say you have multiple members of the family also taking this medication for their symptoms as well, this price will only go up and possibly double. But of course no medication is perfect and works for anyone. If you have congestion and decide that regular Claritin is sufficient and you need a decongestant, Claritin-D may be a more suitable choice, but with an added price. At Walgreens you can buy Claritin-D (120mg pseudoephedrine with 5mg loratadine antihistamine) 12-hour decongestant with 30 tablets for $29.89. The rounded cost for a day’s use of this drug will then be about $2. This would be $60 a month, and $720 a year if used two times a day, every day of the year.  Claritin-D, and other decongestants, such as Sudafed and Allegra-D are pose additional obstacles because you have to buy it over the counter which is an inconvenience.

Like I said before, Claritin or Claritin-D may not be the drug of choice for a particular user, others may prefer Allegra, Allegra-D, Zyrtec, and generic brands. However these are usually range around the same prices give or take a couple dollars.

Not only can these medications be expensive, but the other interventions taken by many allergy sufferers add up as well. These include things such as immunotherapy and lifestyle changes.

Immunotherapy prices tend to range on a variety of factors. These include length of therapy, type, and whether or not insurance will cover it. In the US, the average cost for immunotherapy ranged from $1,480-$2,500 for six years of therapy. This averaged to about $800 for the first, and most expensive year of therapy, and then dropped down to about $200-$300 dollars a year after that. This is an interesting consideration considering the outcomes of therapy hopefully mean eliminating drug usage for several years and when comparing this to some of the prices above this may be the more fiscally favorable choice.

Lastly, lifestyle changes do have a great financial impact on the hay fever sufferer as well. In previous entries. This includes using the air conditioning instead of opening windows, use of more cleaning products, and a higher quality of filtration system which may all increase electricity and gas bills. A common recommendation to those with hay fever is the use of a HEPA filter. The Envion Therapure Air Purifier for a Medium Room (26x8”) at target is sold online for $139.99. This only works for a room that is about 100-300sq ft. room, which means that multiple may need to be purchased to fulfill the needs of an individual with multiple rooms.

In conclusion, Hay Fever can add up to be a pretty expensive condition to have and something to keep in mind when choosing treatments.  However a combination of one or many may be necessary in order to ensure an improved quality of life which is priceless.

How Big of a Problem is Hay Fever

It’s pretty obvious that Hay Fever is a big problem that affects many people worldwide. We know that it happens to children and adults and that we probably have a little of it (or a lot) ourselves. But really who all is suffering?

According to the CDC, the United States has had 17.7 million adults newly diagnosed with hay fever within the past 12 months and another 7.1 million children have reported having hay fever. The Revolution Health Group reports that hay fever causes about 14 million doctor office visits, 90% of which are seasonal and 70-80% have perennial as well. By the age 6-19, 17% of all children have an allergy to some environmental factor, and the severity and occurrence tend to greatly increase with age with no apparent discrimination to race or gender. Most importantly, the rates in the U.S. have been rising dramatically for unknown reasons.

So what does this even mean? That a significant number of people are suffering from hay fever and that this is an increasing problem. It appears that by this data alone that quality of life for these individuals is also affected. For example; for the doctor’s visits alone take into consideration the time, money (co-pays, medications, transportation etc.) and overall hassle of even getting the visits. This does not even include the symptomatic burdens associated with this chronic condition. Also, because having hay fever puts you at a higher risk for other hypersensitivity conditions from an overactive immune system, there is the increase for food/drug allergies, asthma, and other types of hypersensitivity reactions and the other issues that go along with them.

The most interesting thing about this condition is that even though it affects so many people, leads to so many undesirable effects, symptoms, medication usage, and even possible complications, there is no cure.

http://www.cdc.gov/nchs/fastats/allergies.htm

http://www.revolutionhealth.com/conditions/allergies/allergies-basics/introduction/the-demographics-of-allergies

Is Hay Fever the same as other kinds of allergies?

The term allergies seem to be thrown around a lot. But how do you know the differences between the two and how are they related?

All allergies are technically hypersensitivity reactions in the body. As previously described in the blog entry http://hayfeverinfo.blogspot.com/2011/08/some-of-physio.html it is described that in Hay Fever, the body interprets an innocent particle, such as pollen or dust, as a harmful substance. As a result, the body recognizes the antigen at every exposure and causes an unnecessary immune reaction in order to “defeat” the invader. For nasal allergies, such as Hay Fever, the route of exposure is primarily through the respiratory tract; hence the respiratory symptoms such as nasal congestion, runny nose, and sneezing.

Food allergies, and other forms of allergies (ie drug or insect bites/stings) are also caused by the basic concept of hypersensitivity in the body. They also have varying degrees and severity depending on the body’s amount of exposure and how it interprets the threat. For example, the bee sting. The bee sting’s route of exposure is through a superficial sting, which can actually enter the blood stream. The antigen is first seen through the skin and the hypersensitivity reaction may include symptoms such as pain, swelling, and redness at the site of entry. For those with more severe allergies it can even reach the point of anaphylactic shock which is a life threatening condition where vasodilatation can cause an unsafe drop in blood pressure and airway constriction can inhibit breathing resulting in the body’s loss of oxygen.

The treatment for both of these types of allergies is through the same mechanisms usually centered around anti-inflammatory and antihistamine medications. So if you do suffer from hay fever then you may expect to take a diphenhydramine (Benadryl) for the hay fever symptoms and/or if a bee stung you it would also help in suppressing symptoms of the event.  However not all treatments work the same and this would not be sufficient for an anaphylactic emergency.

Because both of these conditions are both correlating around the body’s hypersensitivity, having one may put you at a higher risk of obtaining more allergies. For concerns feel free to contact a doctor and be aware of what allergies you may have. 

Children and Hay Fever

Hay Fever is a condition that can affect everyone, even the children. Although there are many similarities between children and adults in regards to hay fever, the differences are very important to be aware of, especially if you're a parent. 

So what's similar? 

Well, children often have similar presenting symptoms (rhinitis, sneezing, stuffy nose, sore throat etc). Another thing very important to keep in mind is the similarities of the triggers. For children, often triggers include dust, pollen, mold, pet dander and more. Therefore treatment in avoiding these triggers is the same as for an adult. (for more information on this please see previous blog entry). Pharmacological treatment is very similar as well and most of the same medications have indications for children doses on the backs of the packaging. Common medications recommended for children allergy relief include Claritin and Singulair. Keep in mind that it is important to discuss new medications for a child with a doctor and to ensure accurate dosage.

So what is different?

Many children are often predisposed to other conditions, ie asthma and eczema. Therefore hay fever symptoms may often exacerbate the symptoms of these conditions. This could be especially dangerous with asthma because inadequate oxygenation may occur.

Also, children are at a higher risk for otitis media, also known as a common ear infection. This occurs from the congestion in the sinus passageway. The reason that children have a higher risk of this is because of the passage (Eustachian tube) connects into the nasal passageway. In younger children the tube in more horizontal as opposed to the more diagonal route of an adult Eustachian tube. As a result, it is easier for it to become infected and inflamed.

Lastly, because the development of a child is crucial and much of this is done at school, it is important to address the symptoms of hay fever in a child. Not only are the symptoms bothersome, but also it can actually impede in the learning process and worsen attention. Hay fever can even decrease self-esteem with the constant concern about how their symptoms are affecting their schoolwork and it’s affect on the body.

Final Notes

Like all hay fever sufferers, it is important to address the symptoms and take care of them. With children these this need even increased. Make sure if you think your child has hay fever visit your doctor to have him/her evaluated and see what treatment is appropriate.  

Check out http://www.keepkidshealthy.com/welcome/commonproblems/hayfever.html

When to see a doctor

When to see a doctor

When starting to experience symptoms, questions generally arise about what’s causing this and what can be done to help. Or it could just be that you have had these symptoms for a while now and you just are tired of it. It seems that with a condition like hay fever you don’t necessarily need to see the doctor until you choose to. What may be some things to prompt you though?

One reason to see a doctor is if your hay fever is disrupting your quality of life. This can include a variety of things such as missing work or school, not getting enough sleep, or even just getting in the way of your favorite activities.

Another reason that you should see a doctor is for possible complications or exacerbations of other conditions commonly associated with hay fever. The most common are sinusitis, nasal polyps, asthma, and eczema.

       

     Sinusitis- an inflammation of the sinuses that is associated with infections that can either be bacterial, fungal, or viral. Symptoms are similar to that of the common cold that don’t reside or even worsen after 5-7 days. This can include loss of smell or taste, nasal congestion, headache, sore throat, nasal discharge, fever and fatigue

Sinusitis X Ray

     

    Nasal Polyps- inflammation of tissue lining the nasal passageway causing sac-like growths. Symptoms include similar feelings of a having a persistent cold (up to months or years), mouth breathing, nasal obstruction, loss of smell, runny nose.

Nasal Polyps

    Asthma- a condition where the airways of the lungs can become swollen and narrow, or bronchoconstriction. The most common symptoms are chest tightness, wheezing,  shortness of breath, and coughing. Depending on severity of symptoms, asthma can lead to an emergency situation and you must seek help immediately. 

Bronchiole- Normal vs Asthmatic

    

   Eczema- a hypersensitivity reaction on the skin resulting in itchy and/or scaly rashes.  Symptoms include skin changes resulting in blisters with oozing and crusting, ear discharge/bleeding, itchiness, skin color changes, skin redness/inflammation around blisters, and thickened or leather-like areas on the skin.

Eczema lesion on hand

On your visit…

Make sure you list your symptoms which includes ones that are old and new. Tell your doctor about lifestyle changes you had to make in order to accommodate these symptoms and what you have done to help alleviate. Make sure to include all medications (OTC, prescription, and even herbal remedies). Depending on severity and types of symptoms you may have allergy skin testing or even see a ENT (ear nose and throat) specialists. Also, make sure to write down questions you might have prior to your visit and don’t be afraid to ask. 

Using a Neti Pot for Hay Fever

Neti Pots

What are they?

Neti pots, or nasal saline irrigation is a system of cleansing out the sinus and nasal cavities. in order to help a range of nasal symptoms from colds, allergies, sinusitis or just for hygiene.  Although the idea of the Neti pot has been around for centuries but has recently been increasing in popularity.  This is especially true for those with hay fever because of it acts as effective maintenance of clearing out the allergens with minimal side effects. This especially applies for those year round hay fever sufferers.

How do they even work?

To understand how the Neti pot works, the anatomy and physiology of the sinuses needs to be stated.  Sinuses are air cavities in the cranial bones which help reducing weight of the skull, create resonance in the voice, and most relatable for this, for humidifying the air in the nasal passageway. The paranasal sinuses include the maxillary, frontal, sphenoid, and ethmoid. The body is constantly producing mucus in these cavities which normal works as a protective and lubricating barrier and should just go down the throat as a post nasal drip and be swallowed.  However if  infectious agents, allergens, dirt, dust or other particles are present this mucus can thicken up and have a harder time being removed. This build up causes pressure in the sinuses, worsening symptoms of nasal congestion and rhinitis, and even can lead to cough, sore throat, and hoarseness. With the Neti pot, the solution is designed to thin out the mucus and irrigate it through the sinuses and out the nostrils. Attached is a youtube video of a more in depth explanation.

So do they work?

Studies show that they do help in relieving symptoms. Ear nose and throat  [ENT] surgeons often recommend them to their patients after having nasal surgery because how effective their irrigation works. Research has backed up the claims of both companies and users of the Neti pot. However this may vary from person to person. Don’t start a new regime without constulting your primary care physician. 

My Personal Results

As a fellow hay allergy sufferer I decided to give this device a whirl. I bought the  Neil Med Nasal Flow one at Target for 17.99. When I first started it made my head feel full and I had to make sure my head was tilted just right over the sink otherwise I would taste the salty solution in the back of my throat. However, it didn’t take long and was painless- the best news is I saw results almost instantly. I physically saw mucus in the sink (gross I know, but better out of my sinuses than in!), also I felt better. I was able to breathe better almost instantly. There was the occasional trickle of solution for then next fifteen minutes but nothing bad. I did however feel a little lightheaded for about an hour. I have now tried this regime three nights in a row- deciding I would slow down as soon as I had a successful (little or no mucus left) go around. I have noticed have had little or no congestion in the morning and throughout the day and barely even sneezed. Personally I am loving the Netipot.

Attached are some links you may be interested in about the products.

Check out http://www.amazon.com/Himalayan-Institute-Ceramic-Neti-Pot/dp/B000WJIC3G

http://www.sinucleanse.com/netipotlanding.htm

http://www.neilmed.com/usa/adword_np.php

Allergy Skin Tests

Allergy Skin Tests

With hay fever, the most common thing you are told is to avoid your triggers. But what if you don’t know what the triggers, how are you supposed to avoid them? How do you find out what they are?

Allergy skin tests are designed to help expose whether or not a suspected allergen is actually what is causing the allergic reaction. To gather information on what could be a possible suspected allergen is through the medical history.  During the medical history some questions that may be asked include: How long have you had the allergy? Where do you live? How long do the symptoms last for? Where do you work or what are some environmental exposures?

After gathering the information, the suspected allergen will then be introduced in one of three ways- a skin prick test, skin injection test, and patch test.

            Skin Prick Test- is done with a lancet injected different allergens. The results usually come in about 15 minutes. It can be done with as many as 40 different substances to see if the allergies are from pollen, mold, pet dander, dust and even food allergies. If a skin prick test is positive, there will be a skin response This could be a raised, red itchy lump- somewhat like a mosquito bite.

            Skin Injection Test- a test that, like the skin prick, injects a small amount of allergen extract into your skin. The difference is that instead of a lancet, it is used with a needle to be a little deeper as an intradermal test. In about 15 minutes, there will be signs of an allergic reaction- this test isn’t very common for hay fever like the skin prick test, but more for allergies to venoms or specific medications.

            Patch Test- tests to see if there is an allergic reaction by not injecting an allergen, but instead applying it to a patch, which will be placed on the skin. Like the injection test, this isn’t very common for hay fever, but more for contact dermatitis, such as latex or preservative allergies. The patch will be worn for 2 and irritation will indicated a positive test.  

All of these tests are used in order to pinpoint what your allergies are in order to avoid them. This means may not be necessary for everyone, but more for those who really need to know, are more susceptible, and have very severe allergies. Talk to your doctor about if this interests you to see when/how you can receive this testing. 

What is Hay Fever?

Hay Fever- you or someone you know probably suffers from this condition. For most people, the feeling comes every spring. Do watery itchy eyes, congestion, nonstop sneezing, or just that constant tickle in your throat haunt you as the flowers start to bloom. As unfortunate sounding as this may be, the seasonal hay fever sufferers have it easy compared to the who suffer from perennial, or year round, allergies.  As a fellow "allergy sufferer" I can relate to having the constant wad of tissues secured in my pockets or purse for both the exacerbations in spring and having to be in the presence of mold year round.

However these symptoms are very well known, but the confusion begins with what Hay Fever really is. Hay Fever, or sometimes known as allergic rhinitis, occurs when the presence of an allergen which would be completely harmless, is perceived as being just that opposite and triggers an immune response. This allergen could be from pollen, mold, dust mites, pet dander, cockroaches etc. (The in depth pathophysiologic explanation will be brought up in a future post). The higher levels of these allergens cause a more intense response and sensitization with exposure- that's why for seasonal sufferer's, the very high levels of pollen in the spring can leave some feeling miserable.

The most common symptoms experienced by hay fever include the initial sneezing, watery itchy eyes, altered smell or taste, thin watery nasal discharge, sustained nasal congestion. Throughout chronic exposure there may be headache, congestion, pressure, nasal polyps, post nasal drip (which will exacerbate a cough). The constant congestion may also lead to snoring and daytime drowsiness from difficulty sleeping.

So what can you do? There are plenty of OTC medications (which will be explained more in a future post), such as antihistamines, mast cell stabilizers, intranasal corticosteroids, and leukotriene receptor antagonists (LTRAs). These are all triggered at symptom relief because there is no real "cure" once the antibodies have been made to the specific antigen- however immunotherapy (or allergy shots) can be used if trigger is identified and if medications are not effective. People often do nasal rinses or other alternative methods. The main thing that can be done is to identify the allergen and avoid it.