Healthy Living for Life – Seasonal and Indoor Allergies (Full Version)

– [Narrator] Living longer, living healthier, living better than ever before Welcome to Mountain-Pacific's Healthy Living for Life, – Welcome back, today I'm talking to Dr

David Kluge about air and seasonal allergies Dr Kluge is a specialist in ear, nose, and throat with an allergy practice as well Thanks so much for being here today – Thank you

– So let's start out talking about seasonal allergies Is there a peak time when these allergies flare up? – Seasonal allergies will start usually in the spring time which can be as early as March And that's usually with trees in March, and the trees will peak for a few months and then beginning around June or even late May you can have some grasses which will start to come out and you'll have grass pollen which causes a lot of problems for people and then towards late June and early July then a lot of the weeds pollen will come out as well and that'll persist until we have a couple hard freezes so even almost as long as Thanksgiving people can still suffer from seasonal allergies – [Beth] Wow, okay, and so what are some of the common symptoms that people experience when it comes to seasonal allergies? – So sneezing, itchy eyes, itchy nose, nasal congestion, nasal drainage, eye watering, all of those things happen when people are outside, about, and working outside or just even walking to and from their cars sometimes – So what exactly is in the air that causes these seasonal allergies and for people to experience those kinds of symptoms? – So outside seasonal allergies are gonna be pollens for the most part, and that's gonna be tree, grass, or weed pollens which are floating around and you can kinda determine based on what time of the year it is what kind of pollen you might have around

– [Beth] So why do people react to pollen? What's the science there, I guess, that causes people to react to those things in the air? – So the pollen is floating around in the air all the time, you can't usually see it, some pollen you can actually see like on your car you'll see a coating of pollen sometimes in the morning, that's usually a bad sign But in general you don't really see it, but you do breathe it in all the time and you get it on your skin and your clothes so you can get it in your eyes if you itch your eyes and you're breathing it in all the time so it causes a lot of nasal symptoms with swelling, congestion, runny nose It can cause eye swelling, people's eye can actually swell shut sometimes almost But a lot of eye drainage or itchiness because they're itching their eyes or they're just getting the wind blowing in their eyes and also getting the pollen that way – Okay sure, and so how many people would you say in the U

S are affected by seasonal allergies? – Probably almost half the United States is affected at some time or the other with some kind of allergies, either indoor or outdoor allergies Half the US will have some sort of allergy reaction at some time in their life

– [Beth] Are there more common allergies or common symptoms that people in our area, Montana and Wyoming would experience compared to other parts of the United States? – I think that allergies are pretty universal as far as symptoms go, it's gonna be just the allergic rhinitis symptoms with the sneezing, itchy eyes, itchy nose, or the allergic conjuctivitis symptoms with the itchy eyes, runny eyes, swollen eyes Those are pretty universal throughout no matter where you live with pollens or even indoor allergens as well cause similar symptoms – Okay, and what about hay fever, what exactly is that? – Hay fever is just a slang term that people use for allergic rhinitis Usually seasonal allergies because they experience it when they're around hay, traditionally, and that was back maybe in the 1800s, 1700s, where people were out in the fields cutting hay, out in the grass and so they experienced very intense symptoms in that time because they had very intense exposure They're out working in the grass, working in the hay, around those kinds of things that might be exposing them to allergens to make them have symptoms

– Okay, so I would imagine that would still affect farmers in agricultural areas today – Yes, absolutely, I have a lot of farmers and ranchers at my practice, and they say that when they cut hay, or they're in hay barns or grain bins, they'll have significant allergy symptoms – Sure, okay, so can hay fever impact people more than just sneezing and coughing, or is that generally what they experience? – So yeah, that's how it starts usually, and then it can develop into ocular symptoms where they have issues with their eyes It can develop into swelling where they can get swelling in their nose, causing congestion, or swelling in their eyes, and it can even go into an asthma type reaction where they can have some shortness of breath – [Beth] Okay and so you just mentioned asthma

Do allergies cause asthma? – Allergies can trigger asthma for sure, yes Adult onset allergies and asthma is a major issue with exposures You could not even know you really have any reactive airway problems and get exposed to something that you're allergic to and then develop asthma type symptoms – Okay, so can you talk a little bit more about what exactly happens there, what happens in your lungs or in your body where allergies become asthma? – So, similar to breathing in the pollens or breathing in things that we're allergic to into your nose, they cause nasal symptoms, but also, they're going into your throat, and down in your throat, into your windpipe, and into your lungs where they can cause similar inflammation and so cause the muscles in the lungs to constrict which is what an asthma attack really is, can cause you to make more mucous in your lungs, and have you cough and have more stuff that you're coughing out of your lungs – Okay, and so just how dangerous is asthma? Can asthma lead to death, especially if it's not treated? – Absolutely, yes, asthma is, for sure definitely can be life threatening

It's fairly easy to treat and so it's a silly way to be sick, but yes if you ignore it or if you don't know if you have a certain allergy that might set you off and you get exposed to that in a sever magnitude, you can have a severe life-threatening reaction – Okay, can you talk a little bit about when someone should definitely consider seeing a doctor if they're experiencing those kind of breathing issues – For anytime, any kind of shortness of breath which can't be explained due to working out in a gym that you're short of breath or going up a flight of stairs and you're just out of shape and short of breath, if you really are feeling you can't catch you air and you can actually hear yourself or somebody else can hear you wheezing then you should be seen in the ER right away

– Okay, great, and you said that it was easy to treat Can you talk a little bit about some of the treatments people can do for asthma? – Sure, so you can do treatments as easy as avoidance, avoiding what might set off your asthma if you have allergy-induced asthma then you can just try to avoid those triggers You can take traditional allergy medications which would treat your allergies and in so would also treat you asthma as well in that case And then you can go into inhalers which would be either emergency inhalers that you would take several times a week at the most if you had to Or you could take a daily inhaler which is a different kind of inhaler which you would take everyday to avoid the symptoms altogether

– Gotcha, okay great, thank you so much Dr Kluge We're gonna pause here for just a quick break, But coming up after these messages we're going to continue our discussion on allergies Don't go away, we'll be right back in just a couple of minutes, stay tuned – Welcome back, we're talking about seasonal allergies with Dr

David Kluge, thanks for staying with us, doctor So can you talk about, some people develop seasonal allergies later in life, why does that happen? – That can happen for several different reasons, and it's actually kind of controversial and not really well understood at all But it can go both ways, people can develop allergies as they get older and they could have had severe allergies when they were younger and then kind of grow out of them as they get older as well And that can happen with asthma as well You could have severe asthma as a child and then grow out of it as a teenager or never have asthma at all in your life and then have it when you turn 30 or 40 years old

Some of the mechanisms are understood a little bit and one of the mechanisms that I've noticed a lot is hormonal changes and that affects men only once in their life when they go through puberty and their allergies and asthma can change significantly at that time in their life And then over the course of their life over usually years or decades can also change but usually much more slower But the hormonal changes can happen rapidly in the period of months or even a year And then for women, they have the same thing, you know with puberty, but then every time a woman gets pregnant of course her hormones are gonna be in a state of flux, and so that can change her immune system, and she can go from having no allergies to having severe allergies or again the other way around She can develop food allergies

Sometimes the food allergies will be permanent, sometimes the food allergies will go away after she gives birth, it's very interesting because then the child could go on to develop allergies that were similar to the mother's when she was pregnant, so it's very interesting And then finally with woman with menopause, their allergies can also change one more time, again in a rapid, fairly rapid, menopause is a fairly lengthy period, but still it can over a period of a short couple years it can change pretty remarkably that way And again asthma can do the same thing So that's one main mechanism that we do understand, but lots of other mechanisms do exist for adult-onset allergies, some of those can also have to do with exposures, moving to a different area of the country, having a new house, having had an incident in your house with water or flooding or mold in your house, new animals in the house, all of those things can trigger allergies as the adult-onset A lot of them can be figured out, but a lot of them cannot

– Okay, are there times that someone might have an allergic reaction, especially to seasonal allergies for example, that is so bad, they would need to seek out emergency help? – Typically with traditional allergic rhinitis and allergic conjuctivitis which is the nasal and eye symptoms, those are just very inconvenient but not necessarily life-threatening As we've spoke about before though, when the allergies can trigger an asthma reaction or a lung issue then that can become life-threatening and have to be seen in an emergency setting, yes – Okay, are there some things that folks can do to sort of keep control of those symptoms related to seasonal allergies? – So avoidance is the key, you know, if you know what triggers you, if you know what you're allergic to, then trying to avoid those particular things is the number one thing to do If you do have exposure, then trying to basically decontaminate yourself as fast as possible after the exposure So let's say that you know that when you mow the lawn that you're eyes are gonna swell up and you're gonna have trouble breathing so then, you can mow the lawn, you might wanna wear a mask if you're very severely affected as soon as you get done mowing the lawn though, you'd wanna come inside, take your clothes off, put them in the wash, get in the shower, and then something that people don't usually think about is your nose filters all that air that you're breathing and so getting your nose washed out just like your body washed off is important, so using nasal saline spray, Ocean spray or Simply Saline, some form of a generic of that is also great to wash out your nose and get it cleaned out

– Okay, those are great tips, can someone get tested to find out what allergies they have? – Yes, that's the purpose of the first step of allergy treatment is if you have symptoms that are not controlled with traditional medications then going and getting seen by an allergist and getting tested, so we can find out almost exclusively what you're allergic to, yes – Okay, are there potentially any side effects to those test? – The test can cause typical allergic reactions so if you're very uncontrolled, the test can put you into an asthma reaction which would be very rare, but can occur Testing is occurred in two different ways We do skin testing which we actually put a little piece of what we think you might be allergic to under your skin as a scratch test or as an intradermal test, those tests are anywhere from not uncomfortable at all to being moderately uncomfortable, not really painful, but they can be a slightly uncomfortable test Most of the testing does not even involve needles, though, but some testing sometimes does involve needles, and that testing can be very minimally dangerous, but again we're trained to, we're allergists, so we're trained in allergy reactions and we're set up for those kinds of reactions in the office if anything happens

The other part of testing that can be done is blood testing which is where your blood is drawn and they test your blood for different antibodies for things that you might be allergic to as well Of course that test is just as dangerous as getting your blood drawn which isn't really dangerous at all But those are the two different ways Skin testing is considered much more accurate in general, so we try to do skin testing if we can – Okay, does insurance typically cover those types of tests? – Insurance usually, almost universally, insurance covers those tests, either the skin testing or the blood testing and it just depends on what your insurance co-pays might be or deductibles to be met but otherwise it's very well covered

– Okay great, are there prescription medications that people might get prescribed if they find out they're allergic to something? – So there are, at this time most of the medications that we had in our tool bank of medications, tool box of medications are over the counter, which is very convenient for patients But there still are some prescription medications and those include medications that we'd use for asthma as we talked about before with either a rescue inhaler or daily inhalers or medication such as Singulair or montelukast that's one of the only prescription medications left that we can prescribe patients and that works for allergies and asthma and when it does work it works very well, but sometimes it doesn't work at all for some patients – [Beth] Okay so you mentioned prescription, over the counter meds, any side effects that people should be aware of when taking those kind of medications? – So the over the counter medications which used to be prescription which are now over the counter would include Flonase or Nasonex or Rhinocort, nasal sprays, and those are steroid based nasal sprays, they work very well for nasal congestion and nasal drainage and sneezing, but mainly congestion and drainage The number one side effect for any of those nose sprays is gonna be nose bleed, second most common side effect is gonna be headache, they're not addictive nose sprays, there are some nose sprays over the counter which I do not recommend which are addictive, and basically your nose gets addicted to those nose sprays, and those are awful and those are the afrin or the nasal 4 Way nose sprays which should be avoided unless you're sick and only should be used for a couple days in a row But the Nasonex, the Flonase, the Rhinocort, and those ones are great to use long term and not addictive

Other class of medications over the counter would be the antihistamines and that includes the old-fashioned Benadryl which works great, everybody's taken Benadryl, it makes most people very sleepy only lasts for four hours, but it works very well It's the most potent antihistamine that really we have If you go to the ER with an asthma attack they're gonna give you Benadryl

So it works great and I recommend if you're having a severe attack to use a liquid Benadryl like a children's Benadryl or a liquid gel Benadryl because it's absorbed faster in your body But other antihistamines which are newer than Benadryl which don't cause as much sedation would be Claritin, Zyrtek, Allegra, or Xyzal which is one of the newer ones as well Zyrtek and Xyzal can cause some sedation but typically Allegra and Claritin do not cause much sedation Unfortunately though, Claritin and Allegra don't seem to work as well as Zyrtek and Xyzal Xyzal and Zyrtek seem to be stronger but they can cause about 10% of people to be sleepy

– Okay perfect, alright doctor thank you so much We're gonna take another break, but we'll be back right after this, stay tuned – Welcome back to Healthy Living for Life We're continuing our discussion with Dr David Kluge on allergies, so I understand as we age our body changes, obviously, and that we may produce, or that may cause more air borne allergy problems

So can you talk a little bit about the changes in our body, I know you mentioned hormones earlier, but what happens that can make allergies worse? – Well for some reason as we get older everything gets worse it seems like But, one thing that we do see is that the nose continues to get more plugged and congested and our throat also tends to get more constricted and just the way of aging and so one thing that we do see is more sleep apnea as we get older because our muscles tend to be more relaxed and our nerves don't seem to work as well, and so our whole upper airway system kind of just gets worse as we get older and so the allergies that may have caused nasal obstuction and some drainage when we were younger may now cause sleep apnea and collapse of the upper airway completely as we get older which would have to be treated in a whole different way than just with allergy medication – [Beth] Okay, let's talk a little bit about indoor allergies, what are some of the more common indoor allergies? – So indoor allergies are gonna be limited just to what's inside the house or what can be inside the house and that's gonna be dust mites, cats, dogs, or other animals if you have other animals in there such as birds or other rodent type animals and also molds and molds are really underappreciated as far as how bad they cause severe allergy symptoms – Okay, can a doctor like you, an allergist, help identify what is causing people to have symptoms that's inside their house? – We can help, we can give them ideas to look for, and we can also tell by when the patients have symptoms As we talked about earlier, some people have symptoms that peek in the summertime, such as hay fever, where they get outside and they work around and they get worse, some people will have symptoms that get worse in the wintertime

They do fine all summer long and then as soon as they button up their house for the winter, then they get worse And those are gonna be people that have indoor allergies Another thing about indoor allergies is that they can affect you all year around So you can have symptoms all year around, spring, summer, fall, winter, all the time, maybe worse in the winter, but they can also still affect you the summertime as well And they can still be indoor allergies that are getting you

– Okay, if somebody brings something new into their house, a new piece of furniture or carpet, can that cause allergies? – It can cause allergy-type symptoms The chemical released from new furniture or new carpets or chemicals released in smoke or in perfume or in household cleaners can cause allergy-type symptoms It's hard to say that they're really allergic to it, but as far as the patient perceives, what they notice, what they feel, they feel that they get congested, they feel that they can't breath, they feel their nose runs, that their eyes might get swollen or their eyes might run, but inside their body, it's a different reaction that's happening, but what the patient perceives is still the same – Okay and you just mentioned cleaners, what about those and air fresheners? – So anything with a strong odor, cigarette smoke, car exhaust, forest fire smoke, you know volcano smoke for folks in Hawaii right now, all those can basically irritate an already irritated system so if the system is revved up due to an allergy-type system reaction already then those other irritants can make that reaction worse – [Beth] So if someone is buttoned up, as you said, for the winter, what can they do to lessen those symptoms? – Keep the house as clean as possible

Of course, they probably know, whether or not they want to know or want to think about it, they might be allergic to their animals or not, so minimizing exposure to the animals that they may have in their house also is useful, keeping the house as clean as possible, keeping the animals out of your bedroom, you spend eight hours a day or more in your bedroom and so that's eight hours you could have as a clean space for you if you can keep the animals out of there if you're allergic to the animals Also changing your sheets often, vacuuming frequently, using a hepa filter, using an air freshener in your house It helps if you know what you're allergic to as well, so if you've seen an allergist and you've been tested and you know that you're allergic to dust mites but not your dog then that's useful because you know how to treat that in your house differently than somebody that doesn't know what they're allergic to – Sure, okay and what if you clean all the time and you're still experiencing symptoms, what do you do then? – So then you would take medications over the counter which we talked about before which would be antihistamine and maybe a nasal steroid spray and if those are not affective enough then you probably need to see an allergist to find out what is setting you off to see if you can avoid it or if you need to take the next step in treatment – [Beth] Okay would you recommend an air purifier? – Absolutely, yes, and I would keep that in places where you sit more often, so in your bedroom having it on your night stand would be nice or in your bedroom as well, just close to where you breath and if you have a place where you sit and read or watch tv in the living room all the time having one out there, again to keep the air clean by where you're sitting

Something that I wanna mention really quickly though, is that house plants can be a big source of indoor mold Keeping house plants away from your bedroom completely and away from your sitting areas can be a good way to avoid that source of mold in your house – [Beth] Okay so we're almost out of time doctor, but really quickly, smoking, does that make allergies worse? – Smoking, again is like an irritant, so of course, and it always surprises me people that have asthma and they smoke But yes, it basically takes a system that's already irritated and then you're just adding another layer of irritation on top of it – [Beth] Okay and then again just really quickly, medications for indoor allergies

– They would be exactly the same as the outdoor allergy medications I know the drug companies want you to think that some medications are approved for indoor or outdoor allergies, really all the medications are almost all the same The antihistamines are almost the same The nasal sprays are almost all the same Just use them as you think you should use them

– Okay perfect, thank you so much great information and expertise, so thanks for being on the show today and thank you for joining us, we hope you'll come back again next week, until then, stay fit, stay well, and stay healthy for life with Healthy Living for Life – We'd love to hear from you If you have suggestions for future programs, visit our website at MPQHForg or call us at 406-443-4020 You can also catch us on youtube by visiting our website and clicking the youtube icon

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