From Penn State Health this is ask us
anything about seasonal allergies. I'm
Scott Gilbert thanks for watching today.
You see the trees, the grasses is the
flowers behind us. A sure sign of spring.
It's also a sign of spring and seasonal
allergies for a lot of people so here to
sort out what allergy sufferers can
expect this season, is Dr. Faoud Ishmael.
He's an hour just here at Penn State
Health Milton Hershey Medical Center.
Dr. Faoud Ishmael, thanks for being here today.
Thank you for having me. So let's talk a
little bit about this season and what
we're seeing in terms of allergens. I
know it's been a little bit of a wacky
season weather-wise how does that play
into it as well. Yeah, it's correct so I
here in Pennsylvania we typically expect
their preseason which is what that
springtime is. Probably start as early as
the first week of March usually peaking
within the first couple weeks so in that
sense we've had we've actually had a
pretty decent season so far. With some of
the cold weather some of the snow we've
had we haven't had a sustained increase
in the pollens like we expect now we'll
see what happens moving forward as the
weather's been warming up a little bit
especially as we get into April things
may change. The tree pollens
are going to come out a little
bit more as the weather warms up. And so, I
think we're going to be seeing some
symptoms within the next week or two. So
that late March snowstorm is going to
have an impact, it's just not clear
exactly what type of impact. Yeah
absolutely you know there are a couple
things to consider. One of
those is many people out there are not
allergic only the tree pollens they may
be allergic to grasses or weeds and as
we go through April as we get it to May
grass is going to come up. So people may
not be completely out of the woods. For
those for a tree allergic, one of the
things that remains to be seen is
whether, what will get a rapid
increase and then tree pollens that kind
of merges into the grass season and maybe
symptoms are going to start developing
about pretty quickly. So it's going to
have to see which allergens emerge at
what time then. Very interest. Exactly.
You're watching ask us anything about
seasonal allergies from penn state
health and Scott Gilbert along with
Dr. Faoud Ishmael, we welcome your questions
feel free to type them into the comment
field below this Facebook post whether
you're watching the video live with us
here on Monday
or if you're watching on playback, we
can still track down some answers to
those questions and get those to you. You
know Dr. Ishmael, here in central
Pennsylvania it seems like we have a lot
of allergens in this area how does this
area stack up compared with, say other
parts of the country? Yes, so we
definitely are in a hot spot when it
comes to allergies and when we think
about outdoor allergies you know under a
few things we think about so in general
we have four main seasons we have the
springtime which are primarily tree
pollens we have the the summer which is
primarily grass and a few weeds and then
ragweed starts early fall kind of going
into the first frost and actually once
we've strop and get to get a little wet, we
start to get molds to come up. So we're
in the area it's really prevalent in all
of those things so some people may have
allergies starting beginning the March
and actually going all the way through
the end of fall or going into winter . So
yeah we're circling in an area with with
all of those things. I feel it as well
every spring time I'm among those who
always know when it's springtime based
on the allergy symptoms. Talk a bit about
avoiding those triggers it seems like
that's a good important first step is to
try to avoid them things like you know
staying indoors when you can but that's
also tough because you want to get
outside and enjoy the summer. Yeah
absolutely, so really the first
step is avoiding allergens reducing the
exposure. That's you know,
that's kind of cornerstone and where we
start. Outdoor allergens there are a few
things that you can do. You know, one of
the common things I think is you know
weather starts to warm up a little bit
in the spring people have a desire to
open up the window get some fresh air
the problem is all those columns come in
and now you have a pretty high exposure
especially when you're sleeping. So
those are certainly the first thing. Avoid
sleeping with your windows open. Some
people will try to close outside
especially the weather warms up so
that's another thing to keep an eye on
because the pollens flying through the
air - the pollens will deposit on the
clothing and you know when you bring it
in you may have another source of
exposure. You know there are few other
things that may, may help pollens tend to
be highest in the morning
so if you're going to go out for a run
or walk or spend some time outside. Doing
the towards the end of the day might
actually be a little bit better than the
beginning of the day. And when you come
in from the outside you have to be aware
the pollens are going to deposit and
your skin your here your clothing so
it's a good time the three clothes in
the hamper maybe maybe have a shower to
get those off. Outside of that, you know
there's not a whole lot you can do you
know it's probably better to go outside
and get some exercise and completely
avoid it. You know a few important things
to that they may be helpful. When you're
indoors especially as the weather gets
warmer running your air conditioning
might help. The AC filter is
sufficient to filter out most of the
pollens were exposed to and if you have
central AC changed and filtering a
regular basis is also something else
that can be really key. Good advice.
You're watching, ask us anything about
seasonal allergies from Penn State
Health I'm Scott Gilbert along with
Dr. Faoud Ishmael and we welcome you to
share this interview. If you find this
information useful, feel free to share it
right now live while we're doing this
interview or even again if you're
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free to ask your questions as well and
will track down some answers for you
from dr. Ishmael boy there's a
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watch for some of the more severe symptoms.
Things like lots of mucus produce post nasal drip,
congestion, so that's really when
we think about going to the next step
which would be intranasal steroids. Now
even though these are steroid
medications are actually a safe kind of
a steroid these are you know and what do
you think about if you have a swollen
joint you get a cortisol shot that those
are in those ends. The nose spray forms
are even safer because it's topical. It's
really going to the nose only. So those
are anti-inflammatory medications and
those really will treat the vast
majority of allergy symptoms. Both nasal
and it turns out eye symptoms as well. One
of the key things to remember with the
intranasal steroids is they don't act
right away you need to use them everyday
probably for a good week maybe two weeks
from to really build up. So as you think
about your springtime allergies you may
actually want to start to add a week or
two before when your symptoms normally
would occur and usually will tell people
continuum daily through at the end
allergy season or at least their allergy
season. Now you know there are a few
medications are we in general tell
people to avoid and those are
decongestants. They can be the oral
decongestants topical decongestants
either in nose spray or eye drop form. Why is
that? Because I was on a decongestant for
a while and it seemed to handle the
symptoms but that's not optimal. Yeah
exactly, so the way to decongestants work
is they they constrict blood vessels
which reduces swelling in the nose and
can actually do the same thing in the
eyes. The problem is your nose gets used
to that medication and after using it
maybe for about three days in a row it
turns out that your nose will be so used
to with it if you stop it you may get a
rebound in the symptoms. The other big thing
that we worry about is that this
effect on the blood vessels can occur
through out your body.
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... option is that kind of a resort when the
other medications you talked about don't
work. Yeah, absolutely so we think a bit
shots in a few different settings. One
would be when someone's tried all of those
options, they've tried the oral
antihistamines that tried to no spray
and they still contain you have symptoms
that would be sending where we probably
want to see someone like that in our
office. A few things we'd be thinking
about would be allergy testing you know
what are you allergic to a lot of times
there may be a combination of indoor
things and outdoor things are
causing allergies. People have allergies
in different seasons were maybe nine
months out a year you're going to be
miserable that would be another
indication for someone to think of it
shots. There are some downsides with
shots the main issue is...
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probably for at least three years to get
benefit. Now the upside of shots is, that effect
may be permanent and that's the
hope is that people have long lasting
benefit after completing corset shots. So
you know kind of in summary it's a good
way to potentially reduce the need for
medications treat symptoms when other
things aren't working and maybe a
long-term therapy to hopefully take
allergies away or at least reduce the
symptoms quite a bit hopefully forever.
We welcome your questions for Dr. Faoud Ishmael
in this edition of ask us
anything about seasonal allergies from
Penn State Health some really
interesting information so far here you
know I would like to ask you a bit about
children versus adults it seems like, i mean,
I know for one I knew very early on
in life that I was going to have
seasonal allergies and they've stuck
with me ever since is that typical. Yeah,
so that's typical some children
especially with the outdoor allergens we
tend to see it starting maybe around a
just four, five, six or so in general we
need children need probably a few years
of seeing pollens to start becoming
allergic. The problem with allergies is
once you have them they typically don't
go away so they typically start and
childhood and persist throughout
adulthood and so they are pretty
bothersome in that sense. So when it
comes to allergy season for asthma
sufferers are there some additional
issues there that those people need to
worry about? Yeah, absolutely so we tend
to think about allergies as things
evolving the upper airway the nose the
eyes, asthma is a disease of the lower
airways but actually can be triggered
with the same things. So allergies are a
major trigger for asthma. So people who
have asthma and allergies they'll have
symptoms like wheezing, coughing,
shortness of breath, chest tightness and
essentially the same things happening as
someone with these allergies you're
getting swelling in your ways you're
getting mucus production. It's a
little bit more dangerous though we
think about allergies really is more
being an issue with quality of life
people are miserable, asthma really can
be something a little bit more severe
you worry that people may end up in the
emergency room if they're
it's not controlled. So it's one of those
things that we like to keep a close eye
on if we have asthmatic patients who are
allergic we like to counsel them a
little bit to some of these triggers
might also worsen the asthma. Some of
them may need to be on a daily inhaler
at least during the allergy season. And
so, if someone notices those types of
symptoms it's a good idea to contact
your physician. You're watching ask us
anything about seasonal allergies from
Penn State Health I'm Scott Gilbert
alongside Dr. Faoud Ishmael, giving us some
great information, we welcome your
questions as well. Say you suffer
seasonal allergies every spring what are
some of the issues you deal with? Here's
a chance for you to get some advice
straight from a physician. You know, it
seems like it never fails any time the
symptoms
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but be persistent usually throughout the
course of that season most viruses tend
to last a few days and then they start
to get better. But in the end, they can't
be a little difficult to sort out so
luckily a lot of the lot of the allergy
medicines really work very well for
colds as well things like antihistamines
can help sneezing regardless of the
cause. If symptoms keep persisting that's
a sign that it's it's more likely to be
allergy driven. You know we're talking a
lot about outdoor allergens that's our
focus today but there's a whole
different set of allergens that affect
people indoors all year round can you
talk it just briefly about those and
with and how those compared to outdoor
allergies? Yeah absolutely, in fact many
people have both indoor and outdoor
allergies so people may have symptoms
year-round and then get worsening
during the seasons. So the main indoor
allergens are dust mites that's a big
one in this area. Dust mites live in
fabric actually so they're in your
bedding your pillows they may be carpets.
So people may have symptoms even during
the winter if you're allergic to dust
mite. Animals are another major source
allergens things like cat and dog
typically furry animals are ones we
think about. You know this part of
Pennsylvania we don't we don't think
about this a whole lot that there may be
things like cockroaches there may be may
be issues those tend to be more in inner
city type environments rodents me also
be sources of allergens and you know
here we see most often or lab workers
where we use some of these as models to
study disease. So quite often people have
may have both. So when it comes to
allergy testing who should consider that
you know given all these allergens that
are out there I mean at what point do
you suggest that for patients as a way
to sort out what are and aren't triggers for
that individual. Yeah, so first of all
really anyone just want to know what
they might be allergic to even if they
have symptoms, just at one particular
time of year that might be helpful
because we can potentially make better
recommendations about how to avoid
things. Certainly people have tried the
medications and it's not helping we'd
want to think about testing. And then
someone who has symptoms
you know as we talked about multiple
seasons of the year maybe year round
they might be considering stuff like
allergy shots that would be a key
step is determining when they're
allergic to. Good advice Dr. Faoud Ishmael
thanks for your time today. Thank you.
And thank you very much for watching again
we welcome you are your questions and
your comments even after the fact if you
add your questions to the comment field
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again for watching ask us anything about
seasonal allergies from Penn State
Health.