Continuing with the series about ignored health problems, this time we focus on allergies. A more accurate phrase might be that the problem is not ignored, but frequently the possible remedies are not pursued far enough. Too often, the sufferers sniff, blow and honk away, while wiping their reddened eyes or scratching at some offending itch.

     An allergy is an exaggerated response of the body’s immune system to a substance that is normally harmless. The most common allergens are: dust mites, eggs, cat dander, pollen, molds, tobacco smoke, certain foods and additives, insect venom, chemicals in plants, cosmetics, perfumes, detergents and soaps. Nasal allergies are the most common. One out of five adults and children suffer from allergies. Since it tends to run in families, there seems to be some inherited disposition. The cost of treatments and absences from work runs into a financial loss of 2.5 billion dollars per year. Allergies can be seasonal—reactions to allergens that are only around at certain times of the year—or perennial—reactions that are chronic to substances that are present all the time.

     Left untreated, allergies can sometimes lead to asthma, sinusitis and polyps. Most commonly, the effects are seen on skin, mucous membranes, eyes, lungs and gastrointestinal tract. The symptoms are usually sneezing, runny nose, itching, teary eyes of hay fever, hives and/or diarrhea. According to Dr. Gary Rachelefsky of the Department of Pediatrics at the University of California at Los Angeles School of Medicine, in a recent article in the Annals of Asthma, Allergy, and Immunology, “…non-nasal symptoms can extend to headaches, thirst, sore throat, plugged or itchy ears, diminished taste, chronic or nonproductive cough, mouth breathing, throat clearing, and snorting. Nasal obstruction and mouth breathing can lead to sleep apnea and sleep disturbances.” Less common, but far more dangerous, is systemic collapse, otherwise known as anaphylactic shock. This is life threatening and requires medical intervention immediately. The signs and symptoms of this may be facial redness and swelling, widespread itching and hives, difficulty breathing and swallowing, cramps, diarrhea and a drop in blood pressure. Unconsciousness may occur. This is a 911 call! Anyone with drug allergies or extreme systemic reactions should wear a Medic-Alert bracelet at all times. There are also special self-injecting pens available by prescription that people with serious allergy reactions can carry with them. They have a medicine in them that can counteract the anaphylactic shock. This is important when one has severe reactions to insect stings. Your doctor can determine if you need those measures.

     In the CBS HealthWatch, by Medscape, website (www.healthwatch.medscape.com), medical writer Michael Rush, states that allergies can “lead to emotional and psychological symptoms that most often go untreated or even unrecognized as related to allergies. He found a 1990 survey published in Psychosomatic Medicine that determined that “allergic rhinitis (nasal inflammation) sufferers have a higher frequency of depression, anxiety, shyness, fearfulness, and fatigue than normal subjects.” According to other studies that he found, sleep disturbance, alone, reduce daily performance and alertness.

     The initial exposure to an allergen may go unnoticed or be mild. Subsequent exposures can cause an increased reaction. Many times in the emergency room, we have heard a patient say that they had taken penicillin (or some other drug) before and did not have a problem, just a little itching, but it did not start until they had taken the prescription for a few days and went away when they finished it. Therefore, they never told their doctor about it. Now their reaction is much more pronounced. It did not occur to them during the first instance that they might be having an allergic reaction.

     Pinning down what could be the offending allergen may not be so obvious. It frequently requires detective work on the part of the patient and the doctor. It is important to find out what has been eaten, touched, in the environment and perhaps if any other family member have had similar reactions. There also other reasons one can have a stuffy nose, itching or rashes. Part of the detective work would be to rule out other causes such as sinus infections, itchiness from systemic causes (inside your body) or other skin conditions such as psoriasis, to name a few.

     Once the allergen(s) have been determined, the best treatment is avoidance. Alas, sometimes this is not possible. Over the counter drugs are available, however most of these cause drowsiness. Other drugs, which can be prescribed, do not cause drowsiness. It is always important to tell you health care provider what other medicines and supplements you take and what other health problems and habits you have. Some of these can have an effect on you and how well your allergy medicine works, be it over the counter or by prescription. Drinking alcohol can interfere or heighten your drowsiness. Some medicines can worsen glaucoma, blood pressure and interfere with other drugs.

     Besides medical interventions, one can intervene in ones surroundings. If pollens are your allergen, stay indoors as much as possible, keep the house closed, use air conditioning, change air filters frequently and wear a filtering mask if you have to do yard work. If pets are your problem, and not having the pet is not an option, keep the pet out of your bedroom—female cats seem to have less dander than males—and bathe the pet weekly. For those that have problems with dust mites and molds, use mold inhibiting paint, remember that wallpaper attracts more molds. Get rid of rugs, drapes and deeply upholstered furniture. If you must have curtains, wash frequently, blinds hold dust more than shades and wear a dusk mask when dusting and vacuuming. Better yet, get some one else to do your dusting and vacuuming for you. Hanging clothes and sheets on the clothesline to dry allows pollens to settle on them. For children, stuffed toys sometimes have fibers in them that are allergens or hold allergens. Damp areas in basements and garages should be treated with an anti-mildew spray.

     While it is not possible to be disease free, one’s health can be optimized by seeking the most comprehensive treatments for whatever are your health problems. Be an active part of your wellness team. Work with your healthcare provider and your family to develop the best treatments, environment, activities and habits. 
© 2001 Joy B. Burch, RN All rights reserved

This is the third in a series of articles about often ignored health problems.