Wheezes and Sneezes: Are Your Allergies Out of Control?
August 2002 — Amy Weinberg has had allergies for as long as she can remember.
"I'm very allergic to cats, to most grasses, to queen palms and to live oaks," says Weinberg, director of business operations at a Broward County law firm. "I have queen palms all over my front yard and live oaks all over my backyard, so I'm surrounded by things I'm allergic to."
Growing up on Long Island, New York, Weinberg could breathe normally in winter, but that ended when she moved to Plantation, Florida, with her family in 1974. Because pollen and other atmospheric allergens are present all year in Florida, Weinberg's allergies got worse.
"We have some of the biggest mold counts in the country, and that's all year round," says Neil Gershman, MD, an allergy/immunology specialist on the medical staff at Memorial Regional Hospital. "We also have some really bad dust mite problems, and although we have very little pollen, it's year-round. So, symptoms here tend to be more insidious and chronic than up north."
Weinberg suffered through, living on decongestants and tissues, until two years ago when someone suggested that she visit an allergy specialist. She made an appointment with Dr. Gershman, who pinpointed her problems and Weinberg began immunotherapy (allergy shots). Today, she sees Dr. Gershman monthly for a series of shots.
"I rarely take anything else now," Weinberg says. "Since I have been taking the allergy shots, I have had clear breathing. I still try not to be around things I'm allergic to. But my best friend has two cats, and I can go over there and stay now. I was never really able to do that before."
The Anatomy of an Allergy
Allergies almost always show up during childhood. If your hay fever didn't appear until you were 25, you were probably always predisposed to a reaction. You were just lucky up until that point.
"In most cases, I think it's truly a children's disease or that it starts in childhood," says Dr. Gershman, who is himself allergic to dust mites. "You'll see hormonal changes during adolescence sometimes and the child may get better. But when he or she gets to be 25 or 30, the allergies may come back. That's a pretty common story."
Symptoms vary greatly and depend on the allergen, the area of the body exposed and the severity of the reaction. Common signs are a runny nose, watery eyes, clogged sinuses, coughing and sneezing.
Treating the Problem
Two tests are available to detect allergies. Skin tests, in which small amounts of likely allergens are injected into the skin, are about 95 percent accurate. Traditionally, blood tests have not been nearly as precise, but they are rapidly improving.
Some allergy sufferers have mild reactions that can be prevented by simple precautions, such as avoiding the allergen. Weinberg, for example, can't get rid of every tree in her yard, but she can easily stay away from horses and feather pillows.
Other allergy sufferers need additional help because preventive measures are not effective or feasible. Nasal steroids and oral antihistamines are usually effective. More severe cases can be treated with a regimen of shots. Allergen immunotherapy is like a vaccine: Gradually increasing the dose of allergens helps to build a type of immunity. It relieves symptoms and may alleviate the need for medication.
Nasal steroids — not to be confused with the anabolic steroids some bodybuilders use — are very safe and are probably the most effective medications for treating nasal allergies, Dr. Gershman says. Non-sedative prescription antihistamines are effective, have little or no side effects and may be safer for many people than over-the-counter antihistamines.
About 40 percent of people have an allergic predisposition, between 15 percent and 20 percent have symptoms of an allergy and about 5 percent seek professional medical help for the problem.
"Only a small proportion of patients see a doctor, because most people use over- the-counter medication," Dr. Gershman says. "More people should see a doctor and not treat the problem with over-the-counter drugs that are sedating."
With advancements in testing and treatments, allergy sufferers shouldn't wait as long as Weinberg did before being treated. "If it's bothersome enough to affect your quality of life, then it's worth seeing a doctor about it," Dr. Gershman says, adding that most primary care physicians can treat common allergies.
Allergies were certainly affecting Weinberg's life, and her first visit to an allergy specialist marked a turning point.
"I spent my whole life stuffed up. I lived like that," she says. "When I see people like that now, I tell them to see a doctor and get better."
If allergies affect your quality of life, call your doctor. For a referral to a physician in your area, please call the Memorial Healthcare Sytem Physician Referral Service at (800) 944-DOCS.