Wet Winter Blooms Plague Allergy Sufferers
Treatments Include Rinses, Herbs, Medications and More
May 28, 2010 june 10, 2010
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"We're seeing this pattern," says Dr. Daniel Kim, an allergy specialist at Palo Alto Medical Foundation in Santa Cruz. "Several days of rain, then a few dry days, then rain again. So it will be quiet for a day or two when it's raining and then patients will come in very sick or have severe allergy symptoms."
The wet weathers brings blooming grasses, trees and flowers, and with it, high pollen counts. The Weather Channel reported a "high" grass pollen count and "moderate" tree pollen count on Monday, May 24, for Capitola.
Climate change contributes to increased pollen counts as well. Carbon dioxide levels have increased in the past 100 years, meteorologist Carl Parker explained to HealthDay, and plants flourish with higher CO2.
"Some types of pollens have doubled because of climate change," Parker told the news agency.
Pollen counts reaching near-record highs across the U.S. means misery for the some 50 million Americans who suffer from seasonal allergies — including those in Santa Cruz County.
Seasonal allergens are common, and not that different from the rest of the country with grass, tree and weed pollens topping the list. Similarly, local doctors treat symptoms from other environmental allergens like pet dander and dust mites frequently.
Mold allergies, however, particularly during the wet, winter months may be more prevalent under the redwood canopy and in the foggy coastal areas compared to other parts of the nation.
While airborne allergens in Santa Cruz aren't especially unusual, treatment options are more nuanced and run the gamut from acupuncture to steroids.
Traditional Chinese Medicine
"In ancient China, the village doctor was paid throughout the year, when people were healthy," says Eleonor Mendelson, a licensed acupuncturist at Five Branches University. "The moment the people got sick, the doctor was supposed to treat them for free."
Mendelson says that allergies are better prevented than treated.
"Here in Western cultures, you go to the doctor when you are sick, not to prevent a problem that you tend to get on a regular basis." Chinese medicine focuses on preventing illness and disease, and that philosophy extends to allergies.
This is why Mendelson recommends patients receive treatment to strengthen their immune systems several months before allergy season begins — whether that be spring pollen allergies or winter mold allergies.
"In Chinese medicine, if you are balanced, you will not contract diseases or if you do contract diseases, your immune system will be able to kick them out faster," she says.
Treatments include acupuncture and Chinese herbal medicine. Acupuncture focuses on points related to the symptoms, around the nose, for example, or other points located on the same body meridians.
"Let's say someone comes in and has a stuffy nose and doesn't want needles on their face," Mendelson says. "I need to find other points to treat the face that are located on that meridian, for example, large intestine four." Herbal formulas vary based on symptoms, and in addition to Chinese herbs, practitioners may recommend avoiding certain foods like dairy and wheat that can cause phlegm.
Integrative Medicine
"Winter rain and snow is welcome during a drought, and this year, it also has contributed to an explosion of wildflowers and tree blooms — wonderful to look at, but a little hard on the pollen-sensitive," writes Dr. Rachel Carlton Abrams, a holistic medicine and family practice doctor at Santa Cruz Integrative Medicine and Chi Center, in a recent blog posting.
She recommends avoidance for some allergens like dust mites, mold and animals: "Allergy prevention is huge and it's the first thing I talk about."
To avoid and kill dust mites, wash bedding in hot water once a week, use dust covers on pillows, comforters and mattresses and avoid carpet if possible, especially in the bedroom. � Vinegar and water is a fine solution to dust your furniture," she says, adding it's healthy for you and avoids spraying bleach and other toxic chemicals into your environment.
A HEPA-filter vacuum and HEPA air filters also help eliminate floating allergens. "If pollens, grasses and trees are the problems, it's more challenging here because we tend to be a windows-open community," Abrams says.
If possible, keep bedrooms window closed during allergy season — at least overnight — and remember airborne pollen levels are usually highest between 5 a.m. and 10 a.m. Staying indoors during those times and especially avoiding outdoor exercise during those hours can help.
When it comes to treatment, using a saline nasal rinse — like a neti pot or its modern version, sinus rinse — reduces symptoms by flushing allergens from the nasal passage.
Additionally, she recommends quercetin, which is found in apples and onions and acts as an antihistamine to prevent the redness and swelling of allergy season.
"Taken as a supplement, I would recommend one gram, twice daily," she says. Also, she says to consider stinging nettles. "Stinging nettles are the bane of people tromping around in the woods in Santa Cruz, but they are a potent antioxidant and have anti-inflammatory potential for allergies," Abrams says, suggesting 100 to 200 mg twice daily.
Vitamin C and magnesium are also helpful, as are Omega-3 fatty acids, which reduce inflammation. Abrams recommends eating fatty fish or taking a fish-oil supplement. Vegetarians can eat freshly ground flax seed or flax seed oil.
Allergy Specialist
By the time a patient arrives in Dr. Daniel Kim's office, he or she has usually already seen her primary care physician or taken a trip to urgent care for allergies. She's usually tried over-the-counter antihistamines like Claritin.
"If those don't work by the time they see me, I'll put them on a nasal steroid, like the generic Flonase, called Fluticasone," Kim says. "If patients don't want nasal steroids, there are prescription pills and antihistamine nasal sprays as well."
Kim also recommends neti pot or similar nasal rinse for runny noses and avoidance when it comes to allergens like pollen and dust.
Shots, he says, are more of a long-term option.
"It's more for long-term treatment and not really for patients who are having symptoms right now. We give shots of the thing they are allergic to or react to and build their immunity to those things when they are not sick so when the next pollen season comes around, they won't have symptoms. � It's more like an immunization."
Otolaryngology or Ear, Nose and Throat
Some primary care physicians feel comfortable managing basic allergy problems, says Dr. Theresa Gurney, an otolaryngologist with Palo Alto Medical Foundation in Soquel.
And other times, they refer patients to an allergist for testing and treatment or an otolaryngologist, or ear, nose and throat (ENT) doctor.
"One indication that a general practitioner would refer someone directly to an otolaryngologist would be allergies associated with polyps," Gurney says. "In addition to allergy treatment, sometime surgery is needed to treat that disease."
While there's continuing research and discussion about the link between allergies and polyps, "it's thought that in some patients — not all — the development of sino-nasal polyps goes hand in hand with allergies, but certainly not in all patients with allergies," she explains.
Beyond basic medication and helping patients manage allergy symptoms, there's even an opportunity to seek a more direct diagnosis.
Gurney can perform a procedure called a flexible nasopharyngoscopy.
Flexible nasopharyngoscopy is "indirect visualization" of the nasal cavity, Gurney says. "Using a small endoscope about the size of a spaghetti noodle, I can look into the nose and some of the openings of the sinus passageways to see if there is normal anatomy or blockage or infection."
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