Allergy & Asthma FAQs
20 Tips for Allergy Sufferers
- Keep the grass short, but have someone else do the mowing. If you can’t avoid the yard duty, wear a mask when you mow.
- Don’t rake leaves, because this also stirs up molds.
- Don’t dry clothes outside. Pollen bonds to fabric.
- Allergic to molds? Plan outdoor activities when the weather is hot and dry.
- Ban smoking at home and at work. Smoke only aggravates allergies.
- If you have hay fever, stay indoors when pollen is high. Avoid parks, woods and gardens during the allergy season. Save errands for late afternoon or after it rains. Pollen is worst during early hours and on dry, windy days.
- Wash the pollen right out of your hair; shower and shampoo frequently.
- Consider your allergies when planning a vacation. Ask your doctor to suggest a spot where the source of your allergy isn’t in bloom during your holiday.
- Do not move just to avoid allergies; you may develop new ones in your new home.
- If you garden, avoid choosing plants, trees, grass and weeds with tiny flowers, such as goldenrod.
- Try to keep windows closed at home or in your car.
- When choosing a pet, a dog is safer than a cat, but fish are even better.
- If you must have a dog or cat, choose a shorthaired breed without a thick undercoat.
- Wash animals frequently and try to keep them out of your bedroom.
- Avoid pillows, comforters and other products filled with feathers or down.
- Indoor molds and mildew thrive in humid environments. If mold is found, use a cleaning solution containing 5 percent bleach and a small amount of detergent to easily eliminate molds and mildew once you discover them.
- To reduce humidity in your home, use air conditioning to clean, re-circulate and dehumidify the air in the home. You may also consider using in-home Hepa Filters to help reduce indoor allergens.
- If you are allergic to dust mites, reduce the humidity in your home, remove carpeting as much as possible and replace with hard flooring, such as tile and wood.
- Enclose mattress, box springs and pillows in plastic barrier cloth.
- Change the air filters monthly in heating and air conditioning systems, and/or install an air purifier, preferably with a HEPA filter.
Tips for Children With Seasonal Allergies
For Seasonal Allergies
- Reduce Plant Materials
Pollen is the number one cause of seasonal allergies. Trees account for 10 percent of all allergies in the United States, grasses account for about 30 percent and ragweed accounts for nearly 60 percent of all allergies. Keep trees and shrubs pruned, and eliminate all unnecessary vegetation, including houseplants and decorative bouquets indoors.
- Keep Windows Closed
Because pollen is carried by the wind, it’s in the air everywhere. So keep windows closed even if you have no pollen-producing plants nearby. Air conditioners actually filter pollen and other allergens out of the air as they keep you cool.
- Change Filters Regularly
Furnace and air conditioning filters take many allergens out of the air. However, they build up on the filters. To filter them out and keep them out, change filters once a month.
For All Other Types of Allergies
- Eliminate “Dust-Collectors”
Knickknacks and clutter collect dust and are hard to clean. Get rid of unnecessary objects and display valuables in a glass case that’s easier to clean.
- Keep Bedding Clean
Over one-third of your child’s life is spent in the bedroom, so keep it clean! Wash bedding in hot water every week, use allergen-proof cases for pillows and mattresses, and consider getting rid of wall-to-wall carpeting. Minimize use of heavy draperies or Venetian blinds, which catch a lot of dust.
How do I know I am allergic to a certain food?
- What are the symptoms of asthma?
A: Typical symptoms include chest tightness, shortness of breath, coughing and wheezing. The symptoms can be brought on by certain exposures (irritants, allergens, exercise) or they can be persistent.
- How is asthma diagnosed?
A: The diagnosis is best done by a visit to the doctor. The diagnosis is based on typical symptoms, the patient’s medical and family history, physical exam and often with breathing tests.
- What causes asthma?
A: We know that allergies (mostly to things in the air like pollens and dust mites) contribute to the asthma of many children and young to middle-aged adults. But there are many people who have asthma and no allergies at all. Although we are not sure of all the fundamental causes of asthma, we believe that both environmental and genetic factors play a role in the inflammation of the airways typical of asthma.
- Is asthma a serious disease?
A: Yes, it can be. Asthma is unique because the intensity of disease varies widely. Asthma can be merely an inconvenience in one person, and it can be a potentially life-threatening disease in another. A given individual may fall anywhere between these two points. Also, an asthmatic may move up or down this scale during the course of a lifetime – with lucky patients going into remission as they age. The overwhelming majority of asthmatics can be treated effectively with medications (as well as anti-allergy measures) with minimal, if any side effects.
- What different kinds of asthma medications are used?
A: There are many different types and brands of asthma drugs on the market. We believe it is helpful to classify the drugs to help understand how they are used. The two main types are bronchodilators and anti-inflammatory medications (steroids/cortisone-type medications and cromolyn-type medications). Two other types of medications – Leukotriene modifiers (e.g., Accolate and Zyflo) and phosphodiesterase inhibitors (e.g. theophylline) – are difficult to classify since they seem to have properties of both bronchodilators and anti-inflammatory medications.
- What are bronchodilators?
A: Bronchodilators are medications that dilate (open up) the bronchial tubes to permit easier breathing and relieve symptoms. There are short-acting bronchodilators that are used for quick relief of asthma symptoms (e.g., albuterol and trade names, including Ventolin and Proventil HFA.) Most doctors instruct patients to use them as needed – the moment that asthma symptoms arise. In children, bronchodilators are sometimes used on a regular basis, because kids may not let their parents know when they are having symptoms.
Long-acting bronchodilators (serevent) keep the bronchial tubes dilated over many hours. Important to know, however, is that these medications may take a while (maybe an hour or so) to start working. They should never be used for quick relief of asthma symptoms. That is, they are prescribed as maintenance medications – they are taken daily without regard for the symptoms the patient is having at that particular moment. Most of the asthma experts believe that this type of long-acting bronchodilator should be used in conjunction with daily anti-inflammatory medications, as well as a short-acting bronchodilator for quick relief.
Theophylline and leukotriene modifier are considered by some to be long-acting bronchodilators also, but have been used as the sole medication in some patients.
- How are anti-inflammatory drugs used in asthma?
A: The two main types of anti-inflammatory are steroids (oral [pill or syrup] and inhaled forms) and cromolyn-type mediations. Both of these drugs, in the inhaled form, are safe and effective in asthma. They should be used as daily maintenance medications as they do not result in immediate relief of symptoms. These anti-inflammatory medications may prevent the permanent damage to the lungs that experts believe is occurring over many years in the uncontrolled asthmatic. Examples of inhaled steroid medications are flovent, vanceril, azmacort and pulmicort. Examples or cromolyn-type inhaled medications are intal and tilade.
Consequently, national expert guidelines for the treatment of asthma recommend that any asthmatic experiencing symptoms more than twice a week should be treated with maintenance medications like inhaled steroids or cromolyn-type medications. These recommendations also apply to children and pregnant women. In children, the cromolyn-type is usually the first choice, with inhaled steroids being used in more persistent cases. For most adults, inhaled steroids are much more effective than cromolyn-type medications, and they are considered to be extremely safe drugs when given in low to moderate doses.
There is little concern about long-term inhaled steroids in children because of possible growth delay. However, most of the experts believe that if the asthma is serious enough, it’s well worth the small risk of treating with inhaled steroids.
The oral form of steroids (e.g. prednisone) should be reserved for two situations, because long-term use is fraught with serious side effects.
- For short courses (5-14 days) used in asthma exacerbations – when a patient is having to use their bronchodilator very frequently or when the asthma is interfering with their daily routine (nighttime awakenings, missing work or school).
- Chronic, daily use of oral steroids is reserved for the most severe asthmatic when all other types of asthma drugs have been tried. I believe that any asthmatic taking chronic, daily oral steroids should definitely be followed by an asthma specialist (allergy/immunologist or pulmonary specialist).
- Should I continue to take asthma medications during my pregnancy?
A: Yes! Although your doctor may want to switch which drugs you are taking, you must continue to take appropriate treatment during pregnancy. Very effective anti-asthma drugs are available that are considered to be safe for pregnancy. The fetus depends on his mother’s lungs for oxygen. If your doctor refuses to put you on medications to control your asthma during pregnancy, find another doctor willing to do it.
- Should I limit my activity because I have asthma?
A: No and yes. First of all, asthma is very treatable. If you can’t do your normal activities or are unable to exercise as much as you want, then there is something wrong with your asthma treatment program. There are Olympic athletes (e.g., Jacki Joyner-Kersey) who have significant asthma! In general, there are very few activities that asthmatics need to avoid.
So, having asthma is no excuse for being a couch potato. It is a shame that some asthmatic children are kept from physical education classes or recess, because they are not being treated appropriately for their asthma. In fact, some experts theorize that inactivity can, over the long run, worsen asthma.
If your asthma is not under control, then you should limit your activity briefly until you can meet with your doctor. It is the rare asthmatic who has such severe symptoms that they must limit their activity despite maximal medical treatment.
- How do I know if my asthma is serious?
A: Most agree that you should consider getting specialist care for your asthma with an allergy/immunology in the following instances:
- You have been hospitalized (kept overnight in the hospital) for your asthma in the recent past.
- You are chronically taking oral steroids (pills or syrup) for your asthma.
- You are chronically taking more than two different types of medications for your asthma.
- You have been to the emergency room for asthma more than once or twice in the past year.
- You are going through more than one bronchodilator inhaler each month.
- You are missing work, school or not sleeping well regularly because of asthma.
- Do allergy injections (allergen immunotherapy) work for asthma?
A: Scientific evidence shows that immunotherapy does improve asthma n allergic patients, as shown in a recent meta-analysis (a statistic analysis of many studies pooling all the information from hundreds or thousands of patients) in the pulmonary journal The American Review of Respiratory and Critical Care Medicine. Although some recent studies have shown that immunotherapy is not necessarily better than full medication treatment for asthma, these allergen injections will often lessen the amount of medication needed to control asthma. These injections are a great choice for those patients who don’t comply well with medications, those who don’t want to rely too much on medications and especially for those patients who also have allergic rhinitis (“hay fever”). Allergen immunotherapy in appropriately selected patients should improve allergic rhinitis and asthma symptoms, and decrease the requirement for medicating both conditions.
- I’ve heard that antihistamines are bad for asthmatics. Is this true?
A: I consider this an “old doctor’s tale.” Some of the newer prescription antihistamines (Zyrtec, Claritin) have been shown in studies to be very safe in asthmatics – perhaps even making asthma improve. There were studies done many years ago that suggested that older antihistamines (like some of the over-the-counter drugs available today) could worsen asthma. A recent meta-analysis showed that antihistamines do not increase asthma symptoms or decrease lung function in asthmatics. Indeed, many asthmatics have allergies, and I don’t believe that they should be denied the newer prescription antihistamines.
- What is the treatment for exercise-induced asthma?
A: Two prescription medications, albuterol and cromolyn (see above), are recommended for the prevention of exercise-induced asthma symptoms. Usually, they are taken 15 to 30 minutes before exercise. Albuterol is thought to be the most effective in this regard. Long-acting bronchodilators are also thought to be helpful for prolonged exercise (e.g., more than four hours).