Asthma & Spring Allergies

By Sara Hodon

Springtime means warmer temperatures and more quality time outdoors, but it also means the start of allergy season.

While any number of things can aggravate an allergy inside a person’s home—dust and pet dander among them—the great outdoors are chock-full of allergens that compromise respiratory systems.  According to Eric Schenkel, MD, Director of Valley Asthma and Allergy Center in Bethlehem Township and Director of the Department of Allergy at Easton Hospital, trees are the biggest culprit. “There are over 20 types of trees with high pollen content,” Dr. Schenkel explains. “In the first part, or ‘first act’ of spring, you have birch pollen and hickory pollen. In the ‘second act’, you have oak pollen,” he says. Besides tree pollen, grass and ragweed are also problematic.

Allergy symptoms can vary from person to person, but for springtime allergies, Schenkel says, the most common signs are itchy, watery eyes. More severe allergy symptoms are sneezing and stuffy or runny nose. Serious allergies can lead to asthma, a respiratory condition in which the bronchial tubes become inflamed.

If you suspect you or someone in your family may have allergies, schedule an appointment with a board-certified allergy specialist who can make a definite diagnosis. “The specialist will take a history and discuss the patient’s condition, and may get into other possibilities, such as skin allergies, lower respiratory tract, and food allergies,” Schenkel explains. He says the easiest way to diagnose allergies is with a skin test. For this procedure, the skin is either scratched or a small amount of the allergen is injected under the skin. If the patient has a positive reaction, a small wheal, or hive, will develop, and the surrounding skin will turn red. “It is relatively painless, but difficult to do properly, and it should only be performed by a board-certified allergist,” Schenkel says. “If positive, it indicates an allergic sensitivity, but the results need to be interpreted in a clinical setting.” He also adds that skin tests are much more accurate than blood tests for diagnosing an allergy.

Once the allergy is diagnosed, the specialist can suggest the best course of treatment. As Schenkel points out, there are a few measures you can take to prevent reactions. One is fairly obvious—“If you’re allergic to something, avoid it,” Schenkel says. He also suggests tackling outdoor activities later in the day, as pollen counts are higher in the mornings, and showering immediately after coming inside to wash off any lingering pollen residue. Running the air conditioner in the house, rather than a fan that can blow around pollen, dust, or dander, can also help to keep reactions to a minimum. If preventative measures don’t work, Schenkel says, there are a number of over-the-counter medications on the market that may help. “The best medications are nasal steroids,” Schenkel says. “The sprays are very safe when used properly and they’re even better when taken before the [allergy] season.” Oral anti-histamines and allergy shots, in which the patient is injected with small doses of the substance they’re allergic to in order to build up a tolerance, can also be effective. Schenkel says that many allergy specialists offer their patients the opportunity to try new medications on the market, and they may help to alleviate some of their symptoms.

Spring is also peak time for asthma flare-ups, which can be triggered by allergens like grass and pollen but also fumes, pollutants, and sprays. The condition is usually
genetic, says Mark P. Shampain, MD, of Shampain and Associates, Allentown and on-staff physician at Lehigh Valley Health Network and St. Luke’s Hospital, Allentown Campus. “If one parent has asthma, 50 percent of kids have asthma; if both have it, approximately 75 percent of children have it,” he says. Asthma symptoms usually include wheezing, shortness of breath, and coughing, and sufferers often contract upper respiratory infections. According to Jameel Durani, MBBS MD, FACP FCCP, Westfield Hospital, Allentown, asthma is the most common lung disease in children.

“Asthma can begin at any age in life, but most commonly, onset occurs in children younger than six years of age. When asthma begins later in life, the diagnosis is often delayed,” Dr. Durani explains. Commonly, these patients are misdiagnosed as having recurrent bronchitis and initially treated with antibiotics. In addition, when the onset of pulmonary symptoms begins later in life, a diagnosis of chronic obstructive pulmonary disease (COPD) is often made, even in the absence of smoking.” Shampain says that using less acetaminophen as a treatment for asthma, which has the opposite effect of ibuprofen’s anti-inflammatory properties, has also been a huge help in keeping asthma under control.

Asthmatics can still enjoy full, active lives. “It can absolutely be controlled, but many asthmatics walk around not knowing that,” Schenkel says. “Many sit around on the sidelines of life rather than participating.”  Asthma can be kept in check with two categories of medications—relievers and controllers. According to Dr. Durani, “‘Relievers’ are medications designed to give quick relief. They can also be used to prevent symptoms associated with exercise or to give quick relief from acute airflow obstruction. ‘Controllers’ are used long term to maintain control, usually by reducing airway inflammation. The most commonly used controller is inhaled corticosteroids.”

Two factors have caused an uptick in both asthma and allergy diagnoses in recent years. “The first is global warming, because each pollen plant produces more than they used to and there are more plants out there,” Schenkel says. The other is the “Hygiene Hypothesis.” “Because we’re keeping kids indoors more and keeping them cleaner, the hygiene may be keeping them more susceptible.” “For the most part, people should improve with the right treatment and consultation,” he says.

Dr. Jameel Durrani, MD
Pulmonology & Sleep Specialist; Director, ICU, Westfield Hospital

4825 W. Tilghman Street
Allentown, PA 18104

Dr. Eric Schenkel, MD
Director, Valley Asthma and Allergy Center

3101 Emrick Blvd., Suite 211
Bethlehem Twp., PA 18020

Dr. Mark P. Shampain, MD
Shampain and Associates
3131 College Heights Blvd. #200
Allentown, PA 18104

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