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Pregnancy and its Effects on Asthma & Allergies

Pregnancy and its Effects on Asthma & Allergies

Pregnancy and its associated changes may affect either your asthma or rhinitis, or both. Should you become pregnant please notify your OAAC physician as soon as possible. This will allow us to work closely with the physician providing your obstetrical care. A team approach to the assessment and care of the pregnant allergic patient will result in the best care for your condition.

Remember, the final decisions on your medications and treatments are always made by the physician providing the obstetrical care. However, your OAAC physician should follow your asthma closely during the pregnancy. We can provide advice about continuation or discontinuation of treatments you are already on for your allergy/asthma prior to the pregnancy.

Allergy Immunotherapy (Shots)

There is no reason to discontinue immunotherapy during pregnancy. It does not pose a risk to the development of your baby. However, we do not want to present an increased risk for systemic reaction during the pregnancy.

Therefore all immunotherapy during a pregnancy must be at a stable or maintenance dose. We do not build or increase the dose of your shots during pregnancy. If you are on build-up of your immunotherapy and you become pregnant, contact your OAAC provider immediately to discuss how to proceed. If you are on your maintenance dose and are having symptoms from the injections or other concerns, contact your OAAC provider.

Rhinitis (Nasal Symptoms)

Your nasal allergy symptoms may improve (15%), worsen (34%) or stay unchanged (46%) during your pregnancy. Some patients develop unrelated non-allergic nasal congestion (rhinitis of pregnancy) during the second half of their pregnancy. If you are having problems please contact your OAAC physician. Some medications are considered safer than others during pregnancy. Non-medical approaches like saline nasal rinses and external nasal dilator strips are very safe.

Asthma

Asthma symptoms during pregnancy appear to worsen, improve or remain unchanged in roughly equal proportions (1/3, 1/3, 1/3). This means that some patients with even very mild asthma may develop more severe symptoms when pregnant. The period of greatest increased incidents of increased symptoms is the third trimester (2436 weeks).

Since the well-being of the baby depends on the severity of the asthma in the mother, close monitoring is necessary. We want to work with your obstetrical physician to maintain your asthma control with the least amount of medications possible. However, because uncontrolled asthma presents the greatest risk to the baby (versus drug side effects) it is imperative not to discontinue or change your asthma medications without the consultation of your OAAC physician. Inhaled steroids for example are considered safe and effective in pregnancy.

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Stinging Insect Allergy Can Ruin Outdoor Activities

When most people get stung by an insect, the sting site gets red, swells and itches. However, for those who are allergic to insect stings, their immune system overreacts to the venom in the sting. For some, a sting might be life-threatening. The reaction – anaphylaxis – is a medical emergency and could be fatal. Symptoms might include two or more of the following – itching and hives, swelling in the throat or tongue, difficulty breathing, dizziness, stomach cramps, nausea or diarrhea. Severe cases could bring a rapid blood pressure fall resulting in shock and loss of consciousness.

“If you’ve ever had a reaction to a sting, you may be allergic,” said OAAC’s Board-Certified Allergist Dr. Dean Atkinson. “If you’ve had an anaphylactic reaction, you should ask for a referral to an allergist to learn how to stay safe in the future.”

Indentifying Stinging Insects

“If you do get stung and have a reaction, pay attention to what the insect was so you can tell your allergist,” Dr. Atkinson said.

Honeybees and bumblebees only sting when provoked. Africanized honeybees also known as killer bees have been found in the Southwestern U.S. are more aggressive and may sting in swarms.  Domesticated honeybees live in man-made hives. Wild honeybees live in colonies or honeycombs in hollow trees or building cavities.

Paper wasps have nests made of a paper-like material that forms a circular comb of cells which open downward. Nests are often located under eaves, behind shutters, or in shrubs or woodpiles.

Yellow jackets have nests made of a paper-mache type material and are usually underground but can also be found in frame building walls, masonry cracks or woodpiles.

Hornets are usually larger in size than yellow jackets. Their nests are gray or brown, football-shaped and made of a paper material similar to yellow jacket nests. Hornets’ nests are usually found up in trees and shrubs, on gables or in tree hollows.

Fire ants build nests of dirt in the ground – sometimes the nests can be 18 inches tall in the right kinds of soil.

“Preventing stings is of upmost importance,” said Dr. Atkinson. “If you find a nest around your home, you should call an exterminator to have it removed.”

Insects usually sting when their homes are disturbed. If you encounter stinging insects flying around you, remain calm and move away. Avoid wearing brightly colored clothing and perfume outdoors.  The smell of food attracts insects. Be extra careful when cooking, eating or drinking sweet drinks like soda or juice. Insects can crawl inside straws or canned drinks. Keep food covered until eaten. Wear closed-toe shoes outdoors and avoid going barefoot.

Treating Stings

If the insect stinger is in your skin, remove the stinger within 30 seconds to avoid receiving more venom. A quick scrape of your fingernail will remove the stinger and venom sac. Avoid squeezing the sac – this will force more venom through the stinger and into your skin.

“Raise the limb and apply a cold compress to reduce swelling and pain,” Dr. Atkinson said. “Gently clean the area with soap and water to prevent secondary infections. Don’t break any blisters. You can use topical steroid ointments or oral antihistamines to relieve the itching.”

Dr.  Atkinson adds that if swelling progresses or the sting site seems infected, contact your physician.

“If you are severely insect-allergy allergic, carry auto-injectable epinephrine,” Dr. Atkinson said.  “Learn how to use it and keep it with you at all times. Also, some patients especially with frequent exposure to the outdoors start venom immunotherapy (allergy shots). It reduces the risk of a future severe reaction to less than 5 percent.”

Epinephrine is a rescue medication and someone will need to take you to the emergency room. Dr. Atkinson also suggests wearing a bracelet or necklace that identifies the wearer as having severe allergies.

“For those who have had a serious reaction to an insect sting, make an appointment with an allergist,” he said. “With proper testing, your allergist can diagnose your allergy and determine the best form of treatment.”

The post Stinging Insect Allergy Can Ruin Outdoor Activities appeared first on Oklahoma Allergy and Asthma Clinic.

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