b'not necessarily what youre allergic to.Take, for example, thoseDESENSITIZATION(ALLERGENIMMUNOTHERAPY): cottonwood fibers that you see floating around in May and June.Formorethan100years,allergistshavesuccessfullytreated These fibers may clog your pool filter, but they do not containallergysuffererswithinjectionsofallergenicextractsfora pollen and thus are not responsible for your misery.Grass pollen,variety of common aeroallergens, including tree, grass and weed whichisinvisiblebutabundantinbright,breezyconditionspollens, dust mites, molds, cat and dog dander. The treatment during the months of May and June, is the real villain. coursetypicallyinvolves6monthsofweeklyinjectionsto So,whatcanbedonetoalleviatethemiseryofspringbuild up to maintenance doses (escalation phase) followed by pollenallergies?Thereareonlythreetreatmentstrategies:maintenanceinjectionsadministeredevery2-4weeksfor3-4 allergenavoidance,medications,anddesensitization(allergenyears (maintenance phase). Significant improvement in allergic immunotherapy). symptomsandmedicationrequirementsistypicallyseen3 months after achieving maintenance doses and may persist for POLLEN AVOIDANCE:Easier said than done! As noted above,5 or more years beyond the completion of maintenance therapy. removing pollinating plants from your property wont help a bit.Rapid escalation protocols are available, but the recommended Even if you decided to move to a different part of the country,duration of maintenance injections remains 3-4 years.Because SPRING POLLENyou would simply take your allergic tendencies with you andallergyshotsmayoccasionallycauseseriousallergicreactions soon become sensitized to native pollinating plants that youve(anaphylaxis),injectionsshouldbeadministeredinamedical not previously encountered.Mars and Antarctica are the onlysettingsupervisedbyamedicalprofessionaltrainedand ALLERGIES safe bets that come to mind. The most effective pollen avoidanceexperiencedintherecognitionandmanagementofsuch method on planet Earth involves staying indoors and keeping yourreactions.Homeadministrationofallergyshotsarealmost windows closed on some of the most beautiful days of the year.never recommended by board certified allergists.During the lastIN NORTH TEXAS For a number of health and social reasons, I do not recommend10 years or so there has been a trend toward use of commercial thisapproach.Youmay,however,benefitsubstantiallyfromallergenicextractsadministeredsublingually(allergydrops washing your face and rinsing your nose with saline immediatelyunder the tongue) on a daily basis at home.The doses of sublingual after outdoor activities during high pollen conditions.If you doallergy drops required to achieve a degree of clinical effectiveness not plan to shower that evening, wipe your hair with a damp towelapproaching that of allergy shots are typically 10-50 fold greater before going to bed in order to avoid tracking pollen into yourthan doses used in injection therapy.Because sublingual allergy pillow.drops involve off-label use of extracts formulated for injection, insurance cannot be billed for this therapy. There are currently MEDICATIONS:Fortunately,someofthemosteffective4 FDA approved sublingual allergen tablets on the market that medicationsforalleviatingandpreventingallergicsymptomsspecifically treat allergy to dust mites, ragweed, and northern canbepurchasedinexpensivelyoverthecounter,andmostpasture grasses (but not our regional southern varieties).These aresafeforlong-termuse.Unfortunately,theOTCstatusofprescription products, which are intended to be taken at home, Flonasecomeswitharequiredwarningtolimittheuseofneed to be taken on a daily basis for 3 months prior to the start this medication to no more than 2 weeks. In truth, when takenand continued for the duration of the specific pollen season.properlythesemedicationsrarelycauseanysideeffectswithIf allergy symptoms are interfering with your sleep or activities longtermuse,nosebleedsbeingthemostcommonproblem.and not satisfactorily managed with judicious use of medications, Other topical corticosteroid nasal sprays available OTC includeyou should consider seeing an allergist for additional evaluation NasacortandRhinocort.Thesemedications,whentakenand consideration of allergen immunotherapy.routinely, reduce allergic inflammation in the nasal membranes that gives rise to most of the symptoms of nasal allergies.Newer,Editors Note: For more information, contact Robert W. Sugerman, MDat non-sedating antihistamines (e.g., Claritin, Zyrtec, Allegra)Allergy Partners of North Texas. www.allergypartners.com/northtexasand their respective generic equivalents (loratadine, cetirizine, fexofenadine) can be purchased in bulk without a prescription. Ideally, antihistamines should be taken before anticipated allergen exposuresinordertoblocktheeffectsofhistaminerelease. TheverylowrateofsedationassociatedwiththeseproductsEVEN IF YOU DECIDED TO MOVE TO A permits morning dosing before you go outdoors to meet and greet the pollens. Older antihistamines (e.g., Benadryl, Chlor- DIFFERENT PART OF THE COUNTRY, Trimeton) are highly effective in alleviating allergy symptoms, but at the expense of sedation.Plan to go to sleep after takingYOU WOULD SIMPLY TAKE YOUR thesemedications.Combinationantihistamine-decongestant products (any of the above followed by D) are considerablyALLERGIC TENDENCIES WITH YOU AND more expensive and may be purchased only in limited quantities with a government I.D. (because pseudoephedrine is the startingSOON BECOME SENSITIZED TO NATIVE material for crystal meth).The decongestant component alleviates nasalcongestion,whereasantihistaminesdonotaddressthisPOLLINATING PLANTS THAT YOUVE symptom.Sideeffectsincludeinsomnia,aggravationofhigh blood pressure, and impairment of urination in older men withNOT PREVIOUSLY ENCOUNTERED.enlarged prostates.GoodLifeFamilyMag.comMARCH 202033'