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Allergic Rhinitis (Nasal Allergies, Hay Fever)

Allergic rhinitis, commonly known as hay fever, is the most common allergic disorder affecting approximately 20% to 25% of the population. The most frequent symptoms are nasal congestion, itchy runny nose, itchy runny eyes, and fits of sneezing. Other frequently accompanying symptoms are headache around the eye area, drainage in the throat, fatigue, and lack of energy. There can also be intense itching of the throat and deep in the ears. The term hay fever is really a misnomer in that it is rarely due to hay, and there is no fever associated with it even though patients feel feverish as the result of the effects of histamine on the blood vessels causing them to dilate and feel warm.

Allergic respiratory symptoms are a result of histamine release along with other chemicals that are either preformed or formed in allergy cells as a result of an antigen antibody interaction.

The job of the allergist is to determine whether the above symptoms are due to allergies or not. Allergic rhinitis is typically classified as seasonal (intermittent) or perennial (persistent), or both. Frequent triggers of true hay fever symptoms include the pollens from grass, tree, and weeds, house dust mite, mold spores, and animal dander. If the above described symptoms are triggered by cleaning one’s home, playing with pets, mowing the grass, etc., then there is high likelihood that symptoms are due to allergies. If your doctor cannot make a correlation of your symptoms with the above triggers, then you need to start thinking outside the allergy box.

The correct diagnostic term for nasal symptoms not due to allergies is non-allergic or vasomotor rhinitis. We don’t understand the mechanism of this condition totally. As the name applies, it is not on an allergic basis, that is to say an antigen antibody interaction. Triggers of non-allergic rhinitis include irritants such as tobacco smoke, chemical odors, cold air, strong perfumes, etc.

Other conditions to consider in people with symptoms of a stuffy nose are hypothyroidism (low thyroid), nasal polyps, tumors (cancer), foreign bodies, infection, and deviated nasal septum. There is also another condition that goes by the acronym N.A.R.E.S. which stands for nonallergic rhinitis with eosinophilia. This means that a person can have all of the symptoms of allergies but are skin test negative, and yet paradoxically have an abundance of allergy cells called eosinophils in their nasal mucus. This condition responds nicely to intranasal steroid sprays.

The nose is the center of the universe to an allergist. If a person does not describe classic nasal symptoms, and for instance only complains that ears or eyes bother them, then the likelihood of symptoms being due to allergies is lessened.

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Back to School with Asthma and Allergies

Back to School

Where did the summer go? It’s almost back to school time for thousands of Oklahoma children. Is your family ready? Are your children starting a new school? Was your child recently diagnosed with an allergy, a food allergy and/or asthma? OAAC will help you be prepared for back to school!

First, if you need birth certificates, they can be ordered online oklahoma.gov/health/services/birth-and-death-certificates.html or by calling 877-817-7364. The cost is $15. Additional copies $15. There is an online/phone convenience fee of $5.

Need immunization records? You can access them online through the Oklahoma Immunization Information System Portal - shotrecords.health.ok.gov

Children with Asthma
Talk to your OAAC provider especially if your child’s asthma is not in control. Update or complete an Asthma Action plan to use at home and at school. You can download a plan from the OAAC website oklahomaallergy.com/wp-content/uploads/521-ASTHMA-ACTION-PLAN.pdf Update any medication orders. If your child is going to a new school, make an appointment to have a conversation with the school staff. Review when your child should take his/her asthma medications. Ensure your child or teen is using daily controller medications on schedule and quick-relief medication as needed.

Visit with the school’s nurse or school administrator about your child’s asthma. Take the medication, forms and supplies to school before or by the first day. For those with children who use a nebulizer, check with the school to see if you need to provide tubing and a face mask and/or the nebulizer itself.

Develop a healthy schedule which includes eating regular, nutritious meals and a set sleep routine.

Check with your child at the end of school day to see if he/she experienced any issues maintaining their asthma at school.

Children with exercise-induced bronchoconstriction may complain about participating in physical activities. However, it is very important for children to stay active, so work with school staff to develop strategies to keep your child symptom-free while exercising. These may include:
•    Using a short-acting inhaler 15 minutes prior to exercise
•    Drinking plenty of water before, during and after exercise
•    Choosing sports that are less likely to trigger symptoms.

Allergies at School

Depending on your child’s allergic condition, you may want to:
•    Tour the school to identify potential allergy triggers
•    Talk with your child’s teacher(s) and other relevant school personnel (such as sports coaches) about your child’s condition and treatment plan
•    If your child is at risk for life-threatening reactions, such as those to food or insect stings, complete an Anaphlyaxis Action Plan and show school staff how to administer autoinjectable epinephrine.

In the Classroom
There are many potential allergy and asthma triggers in schools. It is very important that your child’s allergies have been accurately diagnosed in order to determine what allergens to avoid. If your child has not been tested, make an appointment with the OAAC for testing.

Common asthma and allergy triggers in the classroom include:
•    Dust mites
•    Mold
•    Chalk dust
•    Animal dander

At Recess, Gym Class and After-School Sports
Recess may be the favorite time of the school day for many children, but for those with allergies or asthma, it can be a minefield of potential triggers.

If your child has allergic rhinitis (hay fever), you can view the daily pollen and mold counts (Monday-Friday) on the OAAC website and on social media. When levels are very high, plan accordingly if your child takes medication to control symptoms. When indoors, ask staff to keep windows closed to keep pollen out.

Insect bites can cause severe reactions in children with stinging insect allergy. Explain the symptoms to school staff and make sure your child always carries auto injectable epinephrine in case of an emergency.

Working as a team with your OAAC provider, your school staff and your family, back to school can be an easy transition with proper preplanning.

The post Back to School with Asthma and Allergies appeared first on Oklahoma Allergy and Asthma Clinic.

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