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

Allergy Capitals

Allergy Capitals

Where you live has a huge impact on those who have outdoor/seasonal allergies. Certain places are notorious for having low allergy levels where as for others, places can be known as allergy capitals.

According to the Asthma and Allergy Foundation of America (AAFA) 40 million have hay fever/nasal allergies and 10 million have allergic asthma. Although not all of these people, and perhaps yourself, have outdoor allergies, a big chunk does.

Fall Allergy Capitals

If you happen to be one of these unfortunate souls you may wonder, am I living in the right place? Or is my residence one of the causes of my worsening symptoms.

The AAFA established the “Most Challenging Cities to Live with Fall Allergies” for 2011.

http://www.aafa.org/pdfs/Public%20LIST%20FALL_2011%20v2.pdf

 High on the list are 1. Knoxville, TN, 2. Dayton, OH, 3. McAllen, TX, 4. Jackson, MS,  and 5. Oklahoma City, OK. Other high contenders were scattered about the eastern states, south and southwest, and some west coast (mostly California).

So what do you do if you live in one of these places?

            If moving is an option and symptoms are severe, that is always a very valid choice. However this may not be ideal for everyone . The next best thing is avoidance. This could be staying indoors, using ventilation[HEPA filter]/ac instead of opening windows, using pharmacologic interventions, checking daily pollen counts (in your local paper or online). Other avoidance ideas are discussed in previous blog entries.

If you are interested in checking pollen counts online, such resources exist such as http://www.pollen.com/allergy-weather-forecast.asp . This website can be used to search different allergy triggers according to city/zip code.

http://www.pollen.com/allergy-weather-forecast.asp

So what are some of the best cities for the seasonal sufferer? This is more subject to change than the most challenging cities. According to the AAFA such “low allergy” cities include Canton, OH, Spokane, WA, Portland, OR, Springfield, MO, and Scranton, PA.

So unless your planning on moving or just trying to tough it out, no city is “free from allergies”, the best you can hope for is less. 

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. 

Cold or Allergies

Cold and Allergies- How do I tell the difference

It’s that time of the year where everything is seeming to bloom and be harvested, but it is also the time where there seem to be more sick friends and coworkers poping up as well. As you start to sneeze and your congestion builds up that tickle in the back of your throat keeps you wondering- am I sick? Or is it just allergies?

Colds are infections caused by viruses and the classical symptoms of the cold are caused by the immune system attack on the contagious pathogens. These symptoms are the occurring because the body is doing what it should be to get rid of this harmful organism invaded.

Allergies on the other hand, and as explained in previous posts, are the body’s hypersensitive response to a harmless stimulus, or allergy, which the immune system recognizes as a danger. Allergies are not contagious and continue as long as the allergen is present.

So how do we know the difference? 

If you are still not sure what you have don’t hesitate to call a physician to check it out. Also, try to avoid possible allergy triggers to see if symptoms improve.  This can even be taken a step further by taking an allergy medication, such as a Claritin to see if symptoms are alleviated. Do you have a history of allergies? Have you had allergies before and does this feel similar or different? These may be signs that you are the allergy sufferer. On the other hand if nothing seems to be helping, the cold is the more likely cause. For colds, also think about anyone you know who has recently fallen ill or that anyone you associate with has after you. Do you work in a place with children, sick people, or just a high volume of public exposure?

Either way symptom relief is the treatment you are most likely to go with for either way. If you suspect a cold, and for just regular health promotion, make sure to wash your hands often, cover your mouth when you sneeze or cough, and carry hand sanitizer around. Also for a cold, get adequate rest, drink plenty of fluids, and possibly try some OTC medications for symptom relief. As for allergies symptom relief can be taken from a variety of medications and avoid the allergy triggers. Make sure that you talk to a doctor before you start any medication regimes or plans. 

Alternative Therapies- Butterbur, Honey, and Acupuncture

Alternate Therapies-

Complementary alternative medicine (CAM) is any healing practice that isn’t part of the practices of conventional medicine. It can range from receiving acupuncture to taking herbal supplements. Because it is alternate however, there is not sufficient evidence to back these treatments as certified but many people vouch for effective results none the less.

Like most conditions, there are “alternate therapies” for Hay Fever. Some of the most common ones include rinsing sinuses (nasal irrigation), which will be discussed in a later blog. Also, common herbal therapies include butterbur, Tinospora cordifolia, cat’s claw, choline, goldenseal, belladonna, bromelian, and honey. Alternate therapies also include hypnosis, acupuncture, and probiotics.

This blog entry will be discussing butterbur, honey, and accupuncture

For information on the other alternative therapies check out http://nccam.nih.gov/ and http://www.rateadrug.com/ for more information and to evaluate your own experiences with these treatments.

Butterbur- (Petasites hybridus) Extracts taken from this shrub-like plant have been used as medicine for for migraines, stomach cramps, coughs, allergies and asthma.

Although how it works is unknown, butterbur is believed to block the action of histamine and leukotrienes resulting in a decrease in inflammatory reactions. There have been studies involving participants with hay fever taking doses of butterbur which had a greater relief in symptoms than those with the placebo. However no studies have been conclusive to classify this as an effective treatment. Side effects include indigestion, headache, fatigue, nausea, vomiting, diarrha, and constipation and is not intended for those who are pregnant, children, and with renal or liver conditions.

Butterbur - Petasites hybridus

Honey- Honey has been studied as a potential therapy for those with pollen senstitive patients. The idea behind it is that the traces of pollen inside the honey desensitizes the body to honey, therefore reducing the hay fever symptoms. This idea is a much like that of immunotherapy.

Honey

Acupuncture- a Chinese healing process which has been practiced for thousands of years, has been studied for the benefit of many diseases. As for hay fever, research suggests that those who receieved accupuncuture with Chinese herbal tea noticed a lessening of hay fever symptoms. But like the other alternate treatments, the study isn’t conclusive.

Acupuncture

Keep in mind with all of these that it is CRUCIAL that you discuss this with your doctor before starting treatment. Herbs and alternative therapies may be harmful to other predisposing medical conditions, need to be taken cautiously, and need to be monitored. Make sure you tell your doctor if you are taking any because although they are not classified as a convention treatment there is still a physiologic impact on the body. Also make sure to by your herbal remedies from safe sources. Herbals are not FDA approved therefore not regulated so doses may be misleading.