Spring Respiratory Allergies in Tulsa

Every parent has pondered why some kids have spring respiratory allergies and others do not. This time of year, it seems like every other person you meet has allergy problems, and that may not be an exaggeration. Allergies often trigger asthma in both children and adults. According to AsthmaCapitals.com, Tulsa ranked #5 in the top 10 Asthma Capitals for 2011. According to Asthma Capital’s statistics, Tulsa rates “worse than average” in annual pollen score, air quality, 100% public smoke-free laws, and the rate of uninsured.

“I see a lot of kids with respiratory problems triggered by spring allergies, especially in the school age, and this year I expect them to be worse than normal because of the milder winter,” said Dr. Joseph Walter, pulmonologist at St. Francis Children’s Hospital.

It all starts with the first spring pollens. “Cedar levels have started to become measurable and are increasing, and other trees usually start at the end of February and go until April,” Dr. Walter said.

When one struggle ends, another begins. “In April or late spring we start to see grass levels increase throughout the summer,” Dr. Walter explained. Pollen levels are not at their lowest until the peak of summer or July, so it is important to partner with your child’s doctor to develop the best coping strategy.

The cause of allergies is both familial and environmental. While you cannot pick your relatives, you can choose the times you go outside. “Pollen levels tend to be at their highest early in the morning and in the evening, so those are times when people with severe allergies should limit outdoor exposure,” Dr. Walter said.  Preventive measures are limited. “Basically, your body is reacting to the abnormal proteins in the allergen, so your body, as part of its defense mechanism, is trying to fight off that abnormal allergen and it causes a reaction that triggers inflammation,” he explained. This is what occurs in the nasal airway. “You inhale the pollen and your body starts to try to fight the pollen and get rid of it which causes your nose to become swollen, you get more blood supply and then you secrete more mucus and have symptoms including sneezing or itching.”

Most children with allergies can be recognized because of the hallmark signs.  “The most common with nasal allergies are runny or stuffy nose, sneezing and itchy and watery eyes,” Dr. Walter said. A significant subgroup will have asthma-type symptoms. “Airways become swollen, you make more mucus and it causes coughing and wheezing problems.”

There are good medicines available to treat both. “For nasal allergies, there are good, long-acting antihistamines available over-the-counter with low risk of side effects,” Dr. Walter said.

Parents can also look at the environment to figure out if there are some easy fixes at home. “Dust mites are present primarily in bedding, mattresses, pillows and box frames, so you should use encasements, pillowcase covers, mattress covers and box spring covers,” he advised. Pets are another source of allergies.  “What kids react to is primarily the dander, which is the flakes of skin pets leave behind,” Dr. Walter said, “so you should limit where the pet can go, such as  the bedroom and rooms with carpeting or upholstered furniture.”

Mold levels fluctuate throughout the year and often cycle with weather changes.

While you may temporarily be able to get your child’s allergies under control, it is important to get to the bottom of things. “Ideally you want to identify what he is allergic to,” Dr. Walter said, “and most people who are allergic are not allergic to a single thing; they have multiple allergies like dust mites and also seasonal allergies.”

In severe cases, shots or allergy immunotherapy can be effective. “They are injections of what you are allergic to,” he said, “so over time your child becomes desensitized and no longer reacts to the allergen.” It is a long-term commitment with great benefits, while the drug therapies are short-lived. “Antihistamines treat symptoms but when you stop taking them and are still exposed, you will continue to react.”

However, there has been an evolution in medicines over the last 20 years. “Antihistamines we used even 30 years ago had more side effects and were less effective,” he said. There are new medication options including multiple nose sprays for nasal allergies, nasal steroid medicines and nasal antihistamines.  “They work in the nose at decreasing the allergy reaction without causing systemic side effects,” Dr. Walter said. Asthma options have improved as well, with more inhaled medicines. “Oral antihistamines can be effective for eye symptoms and there are eye drop antihistamines, but kids do not tolerate them well.”

Know when to see the doctor. “If your child has lung symptoms, meaning coughing, wheezing or shortness of breath triggered by allergies, those are signs of asthma and he should see a physician,” Dr. Walter said. The doctor will take a history, which will help assess what is happening, and will examine the child.  “When I see kids over age five, we are able to do lung function testing where we have them blow into machines and it allows us to objectively measure how the lungs are doing and look for signs of asthma.” Often allergy testing, like blood or skin testing, can be useful as well. With a little knowledge and an action plan created with your family’s physician, your child will likely breathe easier this spring.

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