If you suffer from seasonal allergies, you do not want to miss this interview with otolaryngologist, Dr. Daniel Fox. He gives us some great advice on how to prevent the symptoms of seasonal allergies and what to do if your prevention fell by the wayside and you find yourself in the middle of a nasty allergy attack.
Shelby Stockton: Welcome to the Texas ENT audio blog. I'm Shelby Stockton. If you suffer from seasonal allergies, you do not want to miss my interview with otolaryngologist, Dr. Daniel Fox. He gives us some great advice on how to prevent the symptoms of seasonal allergies and what to do if your prevention fell by the wayside and you find yourself in the middle of a nasty allergy attack.
Shelby Stockton: Dr. Fox, thanks so much for spending some time with me today to talk about seasonal allergies.
Dr. Fox: I'm happy to be here. It's good to be with you, Shelby.
Shelby Stockton: November is upon us, and I believe that's the beginning of allergy season. Am I correct?
Dr. Fox: Well, in Houston, allergy season is pretty much 365 days a year. But yes, allergies are bad in November like every other month.
Shelby Stockton: Dr. Fox, can you explain to us, exactly what are seasonal allergies?
Dr. Fox: Seasonal allergies refer to the variation in allergic symptoms that generally correspond to fluctuations and allergen levels. The classic examples are trees are worse in the Spring. So for example, in Houston oak is terrible in February and March. And then your grasses are generally the dominant allergen in the summer, and then the weeds are dominant in the fall. Ragweed is particularly bad in Houston right now. That's in contrast to your perennial, for all year-long allergens. Those are your dust mites and your molds and your animal danders that don't really fluctuate throughout the year.
Shelby Stockton: Why is it that some of these seasonal allergies affect some people, but not others? Because when I was growing up in Houston, I didn't have seasonal allergies. And then I moved to Austin, and within a year I was going through these attacks.
Dr. Fox: Well, it depends a lot on each individual patient's immune system. So some patients are more geared toward an allergic response. You can think of this in a simplistic way as a pendulum, where one side of the pendulum is autoimmune disorders. And the other side of the pendulum is allergic disorders. Now that's a little bit too simple, but it's a good way to think about it. If your immune system is slanted more toward the allergic response, you're more likely to have an allergic rhinitis or an allergy problem. If your immune system's more slanted toward the autoimmune response, you're more likely to have issues with rheumatoid arthritis or maybe multiple sclerosis or Crohn's or disorders that are in that type of category.
Shelby Stockton: Oh, wow. That is so interesting. What can people do to help prevent seasonal allergies?
Dr. Fox: Well, avoidance is obviously a great way to prevent seasonal allergies. The difficulty is, it's not very practical. You can't really avoid the grass pollens and the tree pollens and the weeds, unless you hunker down inside, which nobody wants to live like that. Some simple preventative ways of addressing allergies are using nasal saline irrigations. Those are tried and true for the past 5,000 years. And as long as you follow the directions appropriately, they're very safe. They actually wash allergens out of your nose. So that there's less time for your body and your immune system to generate an allergic response.
Shelby Stockton: You just piqued my interest in something when you said that nasal sprays have been proven for the last 5,000 years. Do we have proof that people have been using nasal sprays that long?
Dr. Fox: Yeah, we actually do. So going back to about 3000 BC archeologists have found rudimentary Netty pots in India. And so we think that at least since 3000 BC, there were nasal irrigations on the Indian subcontinent.
Shelby Stockton: Wow. That is fascinating. Let's say I forgot my Netty pot. I forgot my nasal spray. I'm having a full-on allergy attack. What's the best course of action I could take?
Dr. Fox: So it depends on where you are and if you have access to an ENT. In terms of over the counter medications, your fast-acting medicines like antihistamines, so your Claritins, your Zyrtecs, your Allegras, those will work pretty quickly. And they'll work well on itching, sneezing, drainage. They don't work very well for decongesting. Another class of medications are your oral decongestants, so your Sudafeds, your phenylephrines that come in a lot of common cold allergy and sinus remedies. Those will work pretty quickly and do a good job decongesting. The problem is, those are not meant to be longterm medicines, and so they should only be used for a few days. And not all patients can use those, especially those that have blood pressure issues.
Shelby Stockton: What kind of potential patient would you tell, "Okay, it's time for you to come see me. Enough is enough. Come see a doctor about this"?
Dr. Fox: If a patient is regularly having to use non-prescription, over-the-counter medications, they need to come see an ENT. The only way to actually fix allergy problems is to test patients, figure out what they're allergic to, and then desensitize the individual patient to the allergens that we find are dominant. We have two general ways to do that. We can do allergy drops, which is known as sublingual immunotherapy, or allergy shots, which is known as subcutaneous immunotherapy. There's some newer options that are not widespread and are not covered in any fashion by insurance. Those include a technique called intralymphatic immunotherapy. That is not something that is mainstream and is also extremely expensive at this point.
Shelby Stockton: All right. Well, thank you so much. Dr. Fox, I really appreciate you taking time out of your day to talked to us about seasonal allergies.
Dr. Fox: Happy to, thanks, Shelby.
