Ahhh, springtime. You can feel it in the air. Do you feel it in the form of sniffing, sneezing, wheezing, coughing, itchy eyes, and occasional hives? Allergies are present in many forms ranging from mild to severe. With the recent rainy winter in California and the subsequent super bloom, many Californians are experiencing worse than normal allergies. My poor husband, who is allergic to grass, is struggling right now because of all the people cutting their lawns. He will only have to struggle for another month or two, whereas I struggle year round due to allergies to dust mites.
What Causes Allergies?
Allergic reactions, colloquially “allergies,” are a result of the immune system exaggerating a reaction to specific “allergens,” which are specific molecules that initiate an immune response. Some common allergens include: pollen, grass, dust, pet dander, certain foods, and latex. The immune reaction involves “histamines” which are molecules that help the body in getting rid of the allergen. Histamines are released and attach to cell receptors in the area of where the allergen is detected. This promotes blood flow which then causes inflammation, which then causes another immune reaction. Depending on where the histamines and subsequent inflammation target, a variety of symptoms will result.
Some allergic reactions are relatively minor and others can be life threatening. Symptoms of allergies can vary widely and include
- Runny nose
- Irritated eyes
- Cognitive difficulty
- Joint pain
- Hypotension (low blood pressure)
Grgh, I hate hay fever, which is also known as allergic rhinitis. Hay fever is not specific to hay, but can be caused by a variety of airborne particles such as pollen or dust. The common symptoms include sneezing, runny nose, irritated eyes and itching of the ears.
Staying inside in the morning is helpful for those that are allergic to pollen, as pollen is higher in the morning. Also, hot, dry, and windy days stir up pollen and other allergens, so stay inside during those times. For people with “outside” allergens, it is a good idea to immediately take off the clothes you were wearing outside and put them in the washer. This will reduce the amount of outside allergens present in the house. Keeping your windows closed and air filters cleaned will also help reduce the amount of allergens floating around in your inside air.
For the longest time, I thought I was “allergic to night air” because I always got super sneezy and had a hard time breathing all night long. When I offhandedly mentioned this to a doctor, he educated me about dust mites, and that is when I finally found relief. I bought anti-allergen pillows (affiliate) and pillowcases (affiliate) which made a big difference. I wash the sheets regularly, and use the dryer to dry the sheets. Using the dryer is an important step as the dryer will cook/kill whatever dust mites managed to make it through the washer. I take allergy pills before going to bed every night. Keeping the floors and other surfaces in the room dustfree helps too. Typically, after I have a rough night of breathing, I change the sheets and throw my comforter in the dryer as a quick fix (actually washing the king sized comforter is an involved task and sometimes I just don’t have time for it). The extreme heat kills the dust mites and buys me another couple weeks of relief.
Anaphylaxis and Epipens
Some people have severe reactions to specific antigens, like antibiotics, latex, insect stings, and foods. The first exposure to that allergen may not cause significant alarm, but after subsequent exposures the reaction builds. Anaphylaxis is characterized by both swelling at the site of exposure and systemic swelling of the body’s tissues. If the swelling affects face and throat and ultimately the flow of air to the body, the reaction can be fatal. The anaphylaxis reaction can develop in as little as 3-4 minutes.
After my fourth bee/wasp sting, I realized that I have a growing allergy and am likely now severely allergic to bees and wasps. Basically, I need to have my epipens anytime I leave the house, which is super annoying. I have gotten used to it though, carrying them in a running belt like this one (affiliate) whenever I want to do something without my purse. Epipens used to be quite expensive (in 2013, the highest I was quoted was $768 for the twin pack, but most were around $400) and most expire in about a year (although recently the press announced that the expiration date is actually about 4 years). But, with the recent hullabaloo about the price of Epipens, I got two off brand epinephrine auto-injectors (in my experience, they are always distributed in two doses) completely covered by insurance! I used to only carry one autoinjector with me, but after researching for this blog post, I realized the importance of carrying both. The dose of epinephrine delivered only lasts about 15-20 minutes. If I am out on a run in the wilderness, it will take me longer than 15-20 min to get to medical care. Even if I am close to medical attention, having the second dose available is a small hassle to pay when the alternative is death.
If you have to carry epipens, carrying benadryl is also recommended. A doctor told me if I get into a situation where I need my epipen, that I also need to be taking benadryl to help curb the reaction. He recommended to use the Epipen and then to bite and crunch the first benadryl that I take and to put a second benadryl under my tongue. While I don’t have the education or degree to confirm this to be medically sound advice, this is my personal plan for the next time I get stung.
How to Manage Allergies
One way to fight allergies is with antihistamine. Antihistamines work by coating the histamine receptors, which prevents the histamine from binding causing the subsequent effects. There are a variety of antihistamines available over the counter in pill form, and talking to a pharmacist will help you narrow down which is best for you. Benadryl (which is the brand name for diphenhydramine) can be taken once every 4-6 hours, but has drowsy side effects. There are non drowsy 24 hour options available–Claritin, Alavert, Allegra, and Zyrtec are recognized name brands. Claritin and Alavert are both brand names for loratadine, Zyrtec is cetirizine, and Allegra is fexofenadine. Taking these 24 hour pills does not have an immediate effect as it only prevents more histamine from binding but can’t stop or remove the current histamine already bound to the receptors. The effectiveness of the medication needs to be judged after about a week of consistently taking the pills. Different people respond better to loratadine, cetirizine, or fexofenadine. If one doesn’t work, maybe try another (as recommended by your doctor, of course).
Another solution that I am fond of is the nasal corticosteroid spray, not to be confused with a nasal spray used with cold symptoms. This corticosteroid nasal spray works by reducing swelling and mucus in the nasal passageway. Nasal sprays put the medicine right where I need it–in my nose. It may take up to two weeks for symptoms to improve, so wait two weeks before judging its effectiveness. There are a variety of nasal corticosteroid sprays available, some with a prescription and some without.
Allergy shots are a long term solution to your allergies. They are a form of immunotherapy designed to decrease the symptoms of specific antigens. Unfortunately allergy shots are not available for food allergies and are typically used for environmental allergies, insects, and asthma. Allergy shots require a significant time investment. Initially, shots are given once or twice a week for 3-6 months and then stretched out to longer, once every 2-4 weeks for 3-5 years.
Allergy shots work like a vaccine. Small amounts of the allergen are injected and your body develops an immunity or tolerance to the allergen. Noticeable improvement may take up to 12 months. After finishing allergy shots, patients typically experience a general decrease in sensitivity to the allergen and lasting relief from the symptoms. While it is a significant investment of time and money (if insurance doesn’t cover it), reducing allergic reactions may be worth it for some people.
Allergies are part of life for many people. By taking appropriate steps, you can reduce the symptoms of your allergies and live a little bit more comfortably.
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