AUAA… Episode 14 Seasonal Allergies – Penn State Health Milton S. Hershey Medical Center

From Penn State Health this is ask us anything about seasonal allergies. I’m Scott Gilbert thanks for watching today. You see the trees, the grasses is the flowers behind us. A sure sign of spring. It’s also a sign of spring and seasonal allergies for a lot of people so here to sort out what allergy sufferers can expect this season, is Dr. Faoud Ishmael. He’s an hour just here at Penn State Health Milton Hershey Medical Center. Dr. Faoud Ishmael, thanks for being here today. Thank you for having me. So let’s talk a little bit about this season and what we’re seeing in terms of allergens. I know it’s been a little bit of a wacky season weather-wise how does that play into it as well. Yeah, it’s correct so I here in Pennsylvania we typically expect their preseason which is what that springtime is. Probably start as early as the first week of March usually peaking within the first couple weeks so in that sense we’ve had we’ve actually had a pretty decent season so far. With some of the cold weather some of the snow we’ve had we haven’t had a sustained increase in the pollens like we expect now we’ll see what happens moving forward as the weather’s been warming up a little bit especially as we get into April things may change. The tree pollens are going to come out a little bit more as the weather warms up. And so, I think we’re going to be seeing some symptoms within the next week or two. So that late March snowstorm is going to have an impact, it’s just not clear exactly what type of impact. Yeah absolutely you know there are a couple things to consider. One of those is many people out there are not allergic only the tree pollens they may be allergic to grasses or weeds and as we go through April as we get it to May grass is going to come up. So people may not be completely out of the woods. For those for a tree allergic, one of the things that remains to be seen is whether, what will get a rapid increase and then tree pollens that kind of merges into the grass season and maybe symptoms are going to start developing about pretty quickly. So it’s going to have to see which allergens emerge at what time then. Very interest. Exactly. You’re watching ask us anything about seasonal allergies from penn state health and Scott Gilbert along with Dr. Faoud Ishmael, we welcome your questions feel free to type them into the comment field below this Facebook post whether you’re watching the video live with us here on Monday or if you’re watching on playback, we can still track down some answers to those questions and get those to you. You know Dr. Ishmael, here in central Pennsylvania it seems like we have a lot of allergens in this area how does this area stack up compared with, say other parts of the country? Yes, so we definitely are in a hot spot when it comes to allergies and when we think about outdoor allergies you know under a few things we think about so in general we have four main seasons we have the springtime which are primarily tree pollens we have the the summer which is primarily grass and a few weeds and then ragweed starts early fall kind of going into the first frost and actually once we’ve strop and get to get a little wet, we start to get molds to come up. So we’re in the area it’s really prevalent in all of those things so some people may have allergies starting beginning the March and actually going all the way through the end of fall or going into winter . So yeah we’re circling in an area with with all of those things. I feel it as well every spring time I’m among those who always know when it’s springtime based on the allergy symptoms. Talk a bit about avoiding those triggers it seems like that’s a good important first step is to try to avoid them things like you know staying indoors when you can but that’s also tough because you want to get outside and enjoy the summer. Yeah absolutely, so really the first step is avoiding allergens reducing the exposure. That’s you know, that’s kind of cornerstone and where we start. Outdoor allergens there are a few things that you can do. You know, one of the common things I think is you know weather starts to warm up a little bit in the spring people have a desire to open up the window get some fresh air the problem is all those columns come in and now you have a pretty high exposure especially when you’re sleeping. So those are certainly the first thing. Avoid sleeping with your windows open. Some people will try to close outside especially the weather warms up so that’s another thing to keep an eye on because the pollens flying through the air – the pollens will deposit on the clothing and you know when you bring it in you may have another source of exposure. You know there are few other things that may, may help pollens tend to be highest in the morning so if you’re going to go out for a run or walk or spend some time outside. Doing the towards the end of the day might actually be a little bit better than the beginning of the day. And when you come in from the outside you have to be aware the pollens are going to deposit and your skin your here your clothing so it’s a good time the three clothes in the hamper maybe maybe have a shower to get those off. Outside of that, you know there’s not a whole lot you can do you know it’s probably better to go outside and get some exercise and completely avoid it. You know a few important things to that they may be helpful. When you’re indoors especially as the weather gets warmer running your air conditioning might help. The AC filter is sufficient to filter out most of the pollens were exposed to and if you have central AC changed and filtering a regular basis is also something else that can be really key. Good advice. You’re watching, ask us anything about seasonal allergies from Penn State Health I’m Scott Gilbert along with Dr. Faoud Ishmael and we welcome you to share this interview. If you find this information useful, feel free to share it right now live while we’re doing this interview or even again if you’re watching after the fact of course feel free to ask your questions as well and will track down some answers for you from dr. Ishmael boy there’s a [NO AUDIO] watch for some of the more severe symptoms. Things like lots of mucus produce post nasal drip, congestion, so that’s really when we think about going to the next step which would be intranasal steroids. Now even though these are steroid medications are actually a safe kind of a steroid these are you know and what do you think about if you have a swollen joint you get a cortisol shot that those are in those ends. The nose spray forms are even safer because it’s topical. It’s really going to the nose only. So those are anti-inflammatory medications and those really will treat the vast majority of allergy symptoms. Both nasal and it turns out eye symptoms as well. One of the key things to remember with the intranasal steroids is they don’t act right away you need to use them everyday probably for a good week maybe two weeks from to really build up. So as you think about your springtime allergies you may actually want to start to add a week or two before when your symptoms normally would occur and usually will tell people continuum daily through at the end allergy season or at least their allergy season. Now you know there are a few medications are we in general tell people to avoid and those are decongestants. They can be the oral decongestants topical decongestants either in nose spray or eye drop form. Why is that? Because I was on a decongestant for a while and it seemed to handle the symptoms but that’s not optimal. Yeah exactly, so the way to decongestants work is they they constrict blood vessels which reduces swelling in the nose and can actually do the same thing in the eyes. The problem is your nose gets used to that medication and after using it maybe for about three days in a row it turns out that your nose will be so used to with it if you stop it you may get a rebound in the symptoms. The other big thing that we worry about is that this effect on the blood vessels can occur through out your body. [NO AUDIO] … option is that kind of a resort when the other medications you talked about don’t work. Yeah, absolutely so we think a bit shots in a few different settings. One would be when someone’s tried all of those options, they’ve tried the oral antihistamines that tried to no spray and they still contain you have symptoms that would be sending where we probably want to see someone like that in our office. A few things we’d be thinking about would be allergy testing you know what are you allergic to a lot of times there may be a combination of indoor things and outdoor things are causing allergies. People have allergies in different seasons were maybe nine months out a year you’re going to be miserable that would be another indication for someone to think of it shots. There are some downsides with shots the main issue is… [NO AUDIO] probably for at least three years to get benefit. Now the upside of shots is, that effect may be permanent and that’s the hope is that people have long lasting benefit after completing corset shots. So you know kind of in summary it’s a good way to potentially reduce the need for medications treat symptoms when other things aren’t working and maybe a long-term therapy to hopefully take allergies away or at least reduce the symptoms quite a bit hopefully forever. We welcome your questions for Dr. Faoud Ishmael in this edition of ask us anything about seasonal allergies from Penn State Health some really interesting information so far here you know I would like to ask you a bit about children versus adults it seems like, i mean, I know for one I knew very early on in life that I was going to have seasonal allergies and they’ve stuck with me ever since is that typical. Yeah, so that’s typical some children especially with the outdoor allergens we tend to see it starting maybe around a just four, five, six or so in general we need children need probably a few years of seeing pollens to start becoming allergic. The problem with allergies is once you have them they typically don’t go away so they typically start and childhood and persist throughout adulthood and so they are pretty bothersome in that sense. So when it comes to allergy season for asthma sufferers are there some additional issues there that those people need to worry about? Yeah, absolutely so we tend to think about allergies as things evolving the upper airway the nose the eyes, asthma is a disease of the lower airways but actually can be triggered with the same things. So allergies are a major trigger for asthma. So people who have asthma and allergies they’ll have symptoms like wheezing, coughing, shortness of breath, chest tightness and essentially the same things happening as someone with these allergies you’re getting swelling in your ways you’re getting mucus production. It’s a little bit more dangerous though we think about allergies really is more being an issue with quality of life people are miserable, asthma really can be something a little bit more severe you worry that people may end up in the emergency room if they’re it’s not controlled. So it’s one of those things that we like to keep a close eye on if we have asthmatic patients who are allergic we like to counsel them a little bit to some of these triggers might also worsen the asthma. Some of them may need to be on a daily inhaler at least during the allergy season. And so, if someone notices those types of symptoms it’s a good idea to contact your physician. You’re watching ask us anything about seasonal allergies from Penn State Health I’m Scott Gilbert alongside Dr. Faoud Ishmael, giving us some great information, we welcome your questions as well. Say you suffer seasonal allergies every spring what are some of the issues you deal with? Here’s a chance for you to get some advice straight from a physician. You know, it seems like it never fails any time the symptoms [NOAUDIO] but be persistent usually throughout the course of that season most viruses tend to last a few days and then they start to get better. But in the end, they can’t be a little difficult to sort out so luckily a lot of the lot of the allergy medicines really work very well for colds as well things like antihistamines can help sneezing regardless of the cause. If symptoms keep persisting that’s a sign that it’s it’s more likely to be allergy driven. You know we’re talking a lot about outdoor allergens that’s our focus today but there’s a whole different set of allergens that affect people indoors all year round can you talk it just briefly about those and with and how those compared to outdoor allergies? Yeah absolutely, in fact many people have both indoor and outdoor allergies so people may have symptoms year-round and then get worsening during the seasons. So the main indoor allergens are dust mites that’s a big one in this area. Dust mites live in fabric actually so they’re in your bedding your pillows they may be carpets. So people may have symptoms even during the winter if you’re allergic to dust mite. Animals are another major source allergens things like cat and dog typically furry animals are ones we think about. You know this part of Pennsylvania we don’t we don’t think about this a whole lot that there may be things like cockroaches there may be may be issues those tend to be more in inner city type environments rodents me also be sources of allergens and you know here we see most often or lab workers where we use some of these as models to study disease. So quite often people have may have both. So when it comes to allergy testing who should consider that you know given all these allergens that are out there I mean at what point do you suggest that for patients as a way to sort out what are and aren’t triggers for that individual. Yeah, so first of all really anyone just want to know what they might be allergic to even if they have symptoms, just at one particular time of year that might be helpful because we can potentially make better recommendations about how to avoid things. Certainly people have tried the medications and it’s not helping we’d want to think about testing. And then someone who has symptoms you know as we talked about multiple seasons of the year maybe year round they might be considering stuff like allergy shots that would be a key step is determining when they’re allergic to. Good advice Dr. Faoud Ishmael thanks for your time today. Thank you. And thank you very much for watching again we welcome you are your questions and your comments even after the fact if you add your questions to the comment field below this Facebook post will make sure to get those to Dr. Ishmael and get a answer posted for you and please feel free to share this post if you found this information helpful and thank you again for watching ask us anything about seasonal allergies from Penn State Health.

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