It’s easy to spot the veterans. They know the lingo and readily identify themselves by their attackers. “I’m a pollen and grass,” says one patient in the allergist’s waiting room. “Me too! Plus I’m a cat dander and mold,” shares another enthusiastically.

In San Antonio, you don’t exchange astrological sign information. That’s so 1974. Instead, it’s all about allergies. As with the weather, almost everyone can relate on some level to this topic.

Unlike the rest of the nation, where ragweed is the main seasonal culprit, the Hill Country counts mountain cedar as public enemy No. 1. It’s estimated that one person out of 10 is allergic to the pollen shed by this juniper tree (Juniperus ashei). The fiery red granules take flight starting in mid-December and don’t abate until early February. That’s when oak, Arizona ash and pecan take the pollen count baton.

According to the American Academy of Allergy, Asthma & Immunology (AAAAI), nearly 36 million Americans suffer from seasonal allergic rhinitis, commonly called “hay fever” or, in San Antonio, “cedar fever.” Once exposed to an airborne pollen like cedar, allergy sufferers often experience sneezing, runny noses and swollen, itchy, watery eyes. Symptoms of allergic rhinitis can have a major impact on a person’s quality of life, including the ability to function well at school or work. Some estimates tag it as a $6 billion-a-year problem when you take into account medications, hospitalizations, doctor visits and lost productivity.

Seeking treatment

Many people suffer in silence year after year. Stoicism won’t help your itchy eyes or prevent a sinus infection. A visit to your doctor can confirm a diagnosis and start you on a management plan to help ease your symptoms and begin to improve your quality of life. Allergists/immunologists are pediatric or internal medicine physicians who have trained an additional two years to become specialized in the treatment of asthma, allergy and immunologic diseases. You might opt to see one of these specialists when dealing with allergies or complications resulting from allergies, such as asthma, otitis media (ear infection) or sinusitis (sinus infection).

Many treatment options are available. In some cases it may be as simple as limiting your exposure to the allergen. For others, over-the-counter antihistamines, decongestants, nasal sprays and/or eye drops may be the answer. Your doctor may prescribe steroids to combat inflammation and for more severe cases, immunotherapy. Allergy shots, also known as immunotherapy, help your body build up antibodies so that over time allergic reactions are lessened or prevented.

Can you do anything before allergy season hits? Dale Wood, M.D., at the Southwest Asthma and Allergy Clinic says yes. A board-certified allergist for 25 years and associate professor of pediatrics at the University of Texas Health Science Center at San Antonio, Dr. Wood encourages people to see their family doctor. “Taking an antihistamine will usually decrease your reaction when heavy pollen hits,” says Dr. Wood. “You’ll likely avoid getting an infection too.”

If you haven’t sought treatment because you think medication will make you a zombie, now is the time to revisit that assumption. Gone are the days of drowsy Benadryl dozing. The new-generation antihistamines and decongestants have non-drowsy formulas. A daily squirt of a steroid nasal spray, such as Flonase or Rhinocort, can also be a powerful way to combat inflammation.

“If the inflammation is not addressed, the message is sent to make more allergy antibodies the next year,” says Dr. Wood. “That is why over time pollen allergy worsens. The nasal steroids do many things. They address acute allergy symptoms and may reduce asthma risk, but they also keep allergies from getting worse year after year.”

New treatments

Although there is no cure for allergies, there are some promising new treatments on the horizon. Dr. Wood has seen good results with a new anti-IGe shot that renders some people almost allergy free by helping the immune system build up antibodies against the offending allergen over a period of one to three years. “It’s been used in San Antonio for the past 12 months,” says Dr. Wood. “It also appears to provide some relief for those with peanut allergies.” The anti-IGe shot isn’t for everyone and is costly — about $1,000 per month. Insurance companies are just beginning to cover the cost.

European scientists are working on an allergy vaccine that is genetically engineered and based on material found naturally in pollen. Although not currently available, the vaccine seems to have fewer side effects than allergy shots used today and may help reduce allergy symptoms in hay fever sufferers.

Studies show a new antihistamine nasal spray called Astelin (azelastine) appears to be a cost-effective single treatment for seasonal allergies. It can be used as a first drug for treatment or as an alternative therapy when antihistamine pills, such as Allegra or Claritin, fail to relieve symptoms. Another boon for Astelin is that it also seems to relieve nasal stuffiness, like a decongestant. Currently Astelin is the only nasal antihistamine approved for use in the United States.

Pay special attention to children

Although the more callous among us (usually those who don’t have allergies) may chide our family, friends and colleagues for their foggy-headed malaise, allergic rhinitis is not a trivial disease — especially for children. According to the AAAAI, treating seasonal allergies as soon as symptoms occur helps children do better in school and could prevent long-term complications, such the development of asthma or earaches.

In addition to irritating symptoms, such as sneezing and a runny nose, performance and behavior problems at home and school can also crop up. Some of these problems might include irritability, temper tantrums, decreased concentration and overactive behavior. Because allergic rhinitis interferes with learning, proper treatment can improve behavior and school performance.

“Children ages three to seven are by far some of the sickest patients I see,” says Dr. Wood. He’s seen his share of raccoon-eyed kids who can hardly breathe, much less pay attention in school. “It’s especially crucial for parents to get asthmatics into a doctor at an early age to prevent lung remodeling,” says Dr. Wood. “You can’t wait until they’re six or seven years old to address allergies. The capacity and function of a child’s lungs can be forever altered without treatment.”

Practice avoidance

If you plan to be outdoors, check the pollen counts in the newspaper or on the news to avoid exposure when counts are high. Peak pollen production is between 5 a.m. and 10 a.m. Pollen is highest on warm, sunny days.

Wearing disposable painter’s masks to cover your mouth and nose is also helpful, especially when doing yard work.

With seasonal allergies, staying indoors as much as possible is the best way to avoid pollen exposure. Here are some additional precautions:

Keep your doors and windows closed. Turn on the air conditioner when pollen is extremely high.
Cover your air-conditioning vents with cheesecloth to help filtrate the pollen. Change your filters often. You may want to use a HEPA (high efficiency particulate air) filter to filtrate the pollen even more.
Dust your home with a damp cloth. Vacuum your carpets with a vacuum equipped with a HEPA filter each week. Go over the carpet six to eight times for maximum effectiveness.
When driving, keep your windows closed and set your air conditioner on recirculate.
Take a shower and change your clothes after being outdoors for a long period. This will protect you from pollen that lands on your clothes and in your hair.
Bathe pets often, even if they live indoors.
Take your medicine exactly as prescribed. If you know cedar will be a problem for you each winter, see your doctor in early fall to update your treatment plan and stock up on allergy medications.
In lieu of a cure, minimizing exposure to pollen and visiting your doctor are your best defenses for combating midwinter allergies. Stocking up on super-soft, lotion-infused tissue might not be a bad idea. Bless you!

Author: Kelly A. Goff