welcome spring and all those beautiful flowering plants and trees ACHOO!

As the cold, damp winter finally turns into spring, we all want to get outside to enjoy the longer hours of sunshine and milder weather. For seasonal allergy sufferers, however, this time of year turns them into a sneezing, coughing, itchy-eyed miserable mess. Since staying inside and hiding from the pollen-filled outside air is not an option, what can the allergic do to improve their quality of life?

The first step, according to nurse manager Jutta Harvey, R.N., B.S.N., of the Allergy Clinic of Bermuda, is to be tested to find out what the specific allergies are so they can be effectively treated.

“Here we do a combination of skin-prick testing and a blood test,” says Harvey. “The skin-prick testing is what we do most of. A person comes in and we prick their skin with all of these items that are known to cause allergies most frequently, and then we watch for any swelling, redness or itching to occur – signs of inflammation. The skin is useful for testing because the same cells that are in the skin line the nose, sinuses, throat, lungs and digestive tract. So if the skin testing shows inflammation in that spot on the skin, it may well mirror the inflammation that is going on elsewhere.”

The skin-prick test consists of a small plastic device that picks up a drop of weak solution containing the allergy for which they are testing. The device is then pushed on to the skin, held for a second and released. The patient being tested waits for 20 to 30 minutes for a reaction to develop; this gives a good idea of what the patient might be allergic to, depending on the speed and size of the response.
The Allergy Clinic tests for allergies to grasses, trees, weeds, mold spores, dust components, insects, animals and some basic foods. Depending on the results, patients often return for more in-depth testing, which often includes a blood test. Blood testing is also useful for anyone whose skin is not in optimal condition for skin testing. For example, patients who have continual hive breakouts, those who are very young or very old and those who must stay on their prescribed medications are good candidates for blood testing.

In Bermuda, people with common seasonal allergies tend to feel worse during the change of season that occurs from March to May and again from October to November. The main culprits in spring are cedar trees, casuarina trees and rye grass, while Mexican pepper is the main fall pollinator. Compounding the problem is that these allergens overlap with long-season grasses like Bermuda grass and English plantain, which pollinate all year around.

“Plants pollinate in two ways,” says Harvey. “The flowering plants, like the beautiful hibiscus or the fragrant freesias, attract birds and bees. Their pollen is very heavy, and it needs a bird or bee to carry it around and drop it in another location. Those are not usually the plants that cause allergies because the pollen is not blowing around so much. Nondescript plants like grasses, trees and weeds make up for the fact that they don’t attract the birds and the bees by putting out large amounts of tiny, wind-borne pollen, and that is what is problematic. It is small enough to get into the wind and small enough to get into the nose, eyes and on the skin.”

According to Harvey, the first step is avoidance measures. “If you can avoid what you are allergic to, then that’s the game,” says Harvey. “But if not – truthfully most of these things can’t be avoided 100 percent –  medication or allergy vaccinations can help. After in-depth testing, we find out exactly what a person is allergic to, how allergic they are and then that determines the dose to start their desensitization shots with. It is not a one-off; it is a long-term treatment, but it also gives long-term results.

“Medication can help relieve the symptoms of allergies, but it doesn’t make anybody less allergic, which is where immunotherapy comes in. But if the problem is not so bad that it needs immunotherapy, then medication is a good stopgap measure. Antihistamines are usually tablets or liquids that go through the whole body and address whatever is the symptom. Then there are specific medications like sprays for the nose, drops for the eyes and creams for the skin that can be helpful, depending on what exactly the allergies have targeted.”

If an allergy sufferer wants a long-term treatment option, allergy vaccinations – otherwise known as allergy immunotherapy or allergy shots – can considerably reduce or even remove allergy symptoms and the need for traditional, symptom-relieving medication. The process begins with an injection of a weak concentration of an allergen extract followed by injections of increasingly stronger concentrations until the patient reaches the top or “maintenance dose.” Most patients must be treated for three to five years, sometimes longer, but drastic improvements in allergy symptoms can usually be seen within the first few months of treatment. Studies have shown that 80 to 90 percent of patient allergies improve and that the treatment remains effective for at least six years after the immunotherapy has been discontinued. There are some possible side effects, including irritation at the injection site and rarely serious systemic reactions.

“If your allergies are a prolonged and recurrent problem, it is wise to address them more specifically, find out what you are allergic to and then fine tune your lifestyle and your medication to get a better result,” says Harvey.

For more information or to be tested, contact the Allergy Clinic of Bermuda at 292-3230 or e-mail allergy@tbinet.bm. The Allergy Clinic is located at Healthways in the Park Place Medical Centre on Cedar Avenue, next to the tennis stadium. 

Allergic Rhinitis
Allergic rhinitis is the set of symptoms that occurs when you breathe in substances to which you are allergic. These substances are called allergens; they are small proteins.
Seasonal (intermittent) allergic rhinitis, sometimes called hay fever or rose fever, occurs during times of the year when allergens are in the air, most commonly spring, summer and fall. The most common allergens are tree, grass or weed pollens.
Perennial (persistent) allergic rhinitis is caused by allergens that may be present year-round. These may include chemicals, dust, dust mites, cockroaches, animal dander or mold spores. Symptoms may be present any time of year.
An allergic reaction occurs when your body’s immune system overreacts to an allergen. When you breathe in an allergen, cells in your nasal passages release a chemical called histamine. Histamine causes your nose to feel itchy. Histamine also causes swelling and mucus production in the nasal passages.
Risk factors that increase your chance of developing allergic rhinitis include family members with allergic rhinitis, eczema or asthma; eczema; asthma; and food allergies.
Allergic rhinitis can cause the following symptoms: sneezing; itching in the nose, eyes, throat and ears; red, watery eyes; runny nose; nasal congestion; sinus pressure; postnasal drip and cough; headache; and dark circles under your eyes.

Tips from the Allergy Clinic
1. Keep at least one room in your house allergy free, the best being your bedroom.
2. Change your clothes as soon as you get home.
3. Wear a hat when outdoors.
4. Take off your hat, shoes and coat as soon as you get indoors.
5. Wash your hair before bedtime.
6. Use a dryer instead of a clothesline, as clothes and sheets hanging on a clothesline will collect airborne pollen.
7.  If possible, close your windows and have your home climate controlled.
8.  Dust your house regularly. One third of all household dust is pollen.
9.  Use a damp cloth
to wipe your pets fur when it comes inside as fur can collect airborne pollen.
Source: Bermudahospitals.com