How to endure allergy and wildfire season

As much as most of us want to take advantage of the warm weather, spring and summer can be a miserable time for allergy sufferers. Add to that the recurring season of wildfires that can literally smoke us all out of outdoor good times around the Inland Northwest.

Jennifer Watson, F.N.P., nurse practitioner at the Coeur d’Alene branch of Asthma & Allergy of Idaho and Nevada, said different pollens can have an impact on people as the season progresses.

Tree pollen season runs approximately from March to May, Watson said, followed by grass pollen season in mid-May through mid-July. Then comes weed pollen season from mid-July to sometimes October.

Watson also said the pollens we see may not be the ones causing the most trouble.

“When the green and yellow pine pollen is out, so is grass pollen, which is much more allergenic than pine pollen. It’s just that we can see the pine pollen,” Watson said. “Cottonwood seed is also confusing for patients. When the seed is floating around, it’s the grass pollen that is likely bothering the person. There is no cottonwood pollen in the floating seed. Cottonwoods pollinate in March and April.”

Allergy medication is often the savior for those suffering through these various seasons. Consistency, Watson said, is the key to the most effective treatment.

“Starting medications ahead of the season is very helpful,” she said. “For example, starting nasal steroid spray one to two weeks before pollen season, then remaining on it daily through pollen season, may help reduce symptoms and the need for antihistamines.”

“For nasal congestion, use of nasal steroid sprays provide good relief,” Watson continued. “However they don’t work well unless taken daily consistently. For sneezy, itchy and runny nose, antihistamines are helpful. We prefer non-sedating antihistamines over sedating ones.”

A more commonly known antihistamine, Benadryl, can provide relief but also be very sedating and affect cognition, Watson said.

“Benadryl’s effect is only 4-6 hours, so for sustained relief this would need to e taken 4-6 times daily, whereas Claritin, Allegra, Zyrtec and Xyzal are once-daily medications,” she said.

Switching between antihistamines regularly won’t improve symptoms, Watson said, and that people should continue consistently with what has been effective for them.

“If a person initially had improvement from an antihistamine but now it seems to be ineffective, this is likely due to worse allergies more so than lack of efficacy of the medication,” she said. “Changing from one brand of antihistamine to another likely won’t be helpful in this situation.”

Solutions aren’t limited to just daily medication. More and more patients are finding relief with injections designed to train the body to better tolerate allergens.

“Subcutaneous allergen immunotherapy (SCIT) is a series of injections given over time to help desensitize one to the allergies they have,” Watson said. “Tests are needed first to confirm allergies, then an individualized treatment plan is formulated. These take time to provide relief but have long-lasting effect.”

Dealing with the smoke

While those who suffer most from allergies may also suffer greatly from the smoke caused by wildfires, many people with mild or no allergies can also experience just as bad of symptoms or worse.

“Smoke is an irritant to the eyes and lungs, not an allergy, and some people are more sensitive to this than others,” said Dr. Shari Montandon, D.O. of Coeur d’Alene’s Asthma & Allergy of Idaho and Nevada.

The simplest solution is to avoid being outside on days of “unhealthy” and “hazardous” air quality, especially for people with asthma, COPD or other lung conditions. Local news outlets, she said, typically do a good job of warning of these conditions, so people should definitely stay indoors when the warnings are out there.

Even while inside, the smell of smoke is often noticeable, leaving many to wonder whether just being inside is enough.

“Keep windows and doors closed, and use air conditioning to help filter the air into the home,” Montandon said. “The data on air purifiers is poor, so I cannot recommend a specific filter to help.”

Symptoms of smoke-related health problems include shortness of breath, difficulty breathing, chest tightness or any worsening of a current lung condition.

“If symptoms don’t resolve after coming indoors, you should call your doctor,” Montandon said.

More information: AllergyID.com