allergies, Annapolis Allergy & Asthma
Written by chrissy

Allergies don’t Hibernate

Brrr. Winter has arrived. 2019 brought chilly temps, the worst in years. Colds, viruses and the flu came with it. Sneezing? Sniffling? Probably sick, right? But wait. There’s no fever. You don’t feel sick. And you’ve been congested for a long time. Think again. Naturally, we’re indoors much more of the time these days. And although this increases exposure to viruses, it also means heavier exposure to indoor allergens. Repetitive sneezing and persistent congestion likely is a sign of allergies, or more precisely, allergic rhinitis, the term for nasal allergies.

We all are familiar with windborne pollinating plants releasing pollen during certain times of the year, causing seasonal allergic rhinitis, responsible for the sneezing in parking lots, on athletic fields and during lawn sales. First, it’s the blooming of trees in the spring, then grass going to seed. There’s a brief lull during the heat of the summer, followed by fall weed pollen, until the first frost when these plants become dormant.

That doesn’t mean there aren’t allergies in the winter; they’re just not seasonal. Mold, dust mites, cockroaches and furry pets are here all the time. We’re exposed to these potential sources of allergies every day, making their effect less noticeable. They are sneaky, creeping up on us more slowly, making those with allergies just as miserable. This is why testing for allergies is essential.

Why wouldn’t I know if I have indoor allergies? One reason is the difference in chemistry between intermittent versus daily exposure. Think of the sudden, brief exposure to a dog at a piano teacher’s house versus living at home with a dog. Occasional exposure to an allergen leads to an abrupt release of histamine from mast cells. This causes immediate itching, sneezing, tearing, runny nose, swelling within minutes. Sustained, daily exposure, day in, day out, leads to chronic inflammation over time from leukotrienes, chemokines, interleukins, and other mediators, whose effects occur more slowly over hours and days. There’s less of an obvious histamine response, leading to chronic swelling and inflammation. (That’s also why antihistamines can only do so much, but leave that for another post.)

Reducing allergen exposure isn’t so simple, either. Removing perennial allergens can be difficult. Identify, then remediate mold in basements and damp areas. Repair leaks or moisture may again trigger mold spore following snow melts or with heavy spring rains. Eliminate pests (e.g., roaches). Dust mites cannot survive in air ducts, but prefer bedding and linens, snuggling up to a warm body that also provides their food: sloughed dead skin scales. Wash linens regularly to minimize exposure.

Other allergens may prove more difficult to remove; whether Max is shoved off the bed (again), or Fluffy, the beloved furball simply turns her nose up and moves on to the kitchen, they all leave a trail behind. Tears, saliva, urine skin sweat glands of animals from all contain allergens that stick on surfaces. Several cat allergy proteins, including Fel d 1, actually remain airborne 15-20 minutes after the cat leaves the room. Carpeting, upholstery, draperies, blankets, and pillows act as reservoirs, absorbing allergy proteins. Airborne cat protein even sticks to painted surfaces. Litter boxes, gerbil and hamster cages all are sources of allergens.

Dry winter conditions also exacerbate non-allergic rhinitis. Nostrils act as filters, collecting fine dust particles. Fireplaces and pellet stoves can emit smoke and fine particles, recycling throughout the house through forced air heating. Adding moisture with a humidifier may reduce this, and certainly helps irritated mucous membranes, but be vigilant for mold growth in the base of the humidifier.

Contact us at Annapolis Allergy & Asthma for evaluation and treatment of perennial or seasonal allergens; let us help you enjoy life more fully!

Copyright Duane Gels 2019

Allergies, Asthma, Allergy Injections
Written by chrissy

Asthma and Allergies

When you can’t breathe, nothing else matters.” The American Lung Association

26 million Americans live with asthma, a chronic disease with chest tightness, shortness of breath, and wheezing. It is one of the leading causes of school and work absence. Allergies also can be very disruptive; resultant congestion, itching, sneezing and sinus disease contribute to poor performance, low productivity and overall decreased quality of life. With asthma, constriction and inflammation of the bronchial tubes are present, making it difficult to breathe. These two conditions are often seen together because allergies are a common cause of asthma.   An allergist is a physician who can determine whether asthma is present, and if so, whether allergies are involved. Pollen, mold, dust mites, animals, cockroaches all can act as “allergens”, triggering allergies that can easily lead to life-threatening asthma.

Allergists often act as detectives, analyzing clues. Seasonal allergy and asthma can be triggered by the seasonal variation of tree, grass or weed pollen. Important perennial allergens include mold, dust mites, and beloved household pets. Sometimes symptoms are brought on by non-allergic irritants, such as environmental tobacco smoke, vehicle exhaust fumes, perfumes, candles or changes in temperature. For example, exercise-induced asthma can be triggered by physical activity from rapidly inhaling dry, cooler air. 

Both asthma and allergies can be managed by careful interpretation of individualized allergy tests and applying the results to the specific home and work environment. Identifying and reducing allergen exposure is a good first step. Prudent use of the right combination of medication controls inflammation and usually improves the quality of life. However, in the cases of stubborn symptoms due to obligatory exposure to allergens, patients are looking for a more durable or permanent solution. (such as dogs and cats) Allergy immunotherapy (allergy shots) can provide dramatic, long term relief, often without medication, by eliminating the underlying allergies that cause the problem. Immunotherapy enables those working outdoors on tolerating pollen, K-9 officers to handle their dogs, and families to live with their pets.  

How do allergy injections work?

 Allergies are caused by an overreactive immune system. Harmless particles trigger an overly aggressive response by white blood cells just under the skin and mucous membranes. Injections bypass these cells and deliver harmless allergens to more complex immune cells which regulate and turn off this destructive allergic response. Immunotherapy injections are very precise, safe, and only affect the specific immune response to the ingredients contained in the serum. Evidence-based clinical literature has shown that nuances of dose, frequency, and formulation can make the difference between effective and ineffective allergy treatment. Dr. Duane Gels, a board-certified allergist and director at Annapolis Allergy & Asthma, has successfully treated thousands of allergic patients with customized, effective allergy immunotherapy over 25 years.  The knowledge and experience of his team to appropriately use this technique adjust the immune system and provide long-lasting results. Come be evaluated by the knowledgeable and experienced team at Annapolis Allergy and Asthma and experience relief!

Allergy Tips

A quality, low-allergen lifestyle can be achieved by following your allergist’s action plan.                                       

Asthma and Allergies can be triggered by poor indoor air quality, so change your A/C filters frequently. 

Have your heating/AC ducts cleaned frequently as, over time, dust and other allergens accumulate within the system.

Be aware of environmental weather extremes, as outdoor exercise can trigger asthma and other respiratory conditions

Identify your specific allergies, and minimize exposure in your home. Dust, mold/mildew, animal dander all may contribute.

Use of daily nasal saline rinse, such as a NetiPot can be beneficial to flush out allergens.

Over the counter antihistamines, decongestants and nasal corticosteroids to control nasal congestion and discharge.

Beware of addictive nasal decongestant sprays; after several days of use, rebound congestion often develops. 

Learn your specific allergens: if pollen allergic, stay indoors on dry, windy, high pollen days. Close your windows when the pollen count is high.  Remove and wash your clothes; wash hair before bed, as static can attract pollen.  

In conclusion, there are medical diagnostic and treatment options for asthma and allergies. With patient commitment and confidence with their professional medical doctor, one can resume and enjoy daily activities. Come visit the specialists at Annapolis Allergy & Asthma to determine what allergies you may have. We will help you develop a management plan that works for you. Call us today at 410-573-1600.

Copyright Duane Gels 2019

Asthma, Allergies, ANNAPOLIS, MD
Written by Jenna Simmons

What causes asthma?

The exact causes of asthma aren’t clear, but there are factors that contribute to the development of asthma. According to the American Lung Association, asthma does tend to run in families; however, both inherited and environmental factors do play key roles.  

Risk Factors 

If your parents have or had asthma, you are more likely to have asthma as well. Similarly, if a parent has allergies, their children are more likely to have allergies. Respiratory infections during infancy and early childhood may damage delicate lung tissue, which can have long-term effects on lung function.   Exposure to allergens, irritants and viral infections during infancy or early childhood can compromise the developing immune system. This type of exposure has been linked to asthma. Adults may develop asthma after exposure to chemicals or dust in the workplace. 

You won’t be surprised to learn that smoking and pollution also have negative effects on health and can trigger asthma. You may not be aware of one other contributing factor in the development of asthma: obesity. Both children and adults who are overweight are more likely to suffer from asthma. This group also tends to take more medication and have a more difficult time managing their condition than people of a healthy weight. 

Diagnosis 

Asthma often presents as a nagging cough, periodic shortness of breath or wheezing, but even having these alone doesn’t mean you necessarily have asthma. You need to be diagnosed by a physician to confirm the condition. The doctor will take a complete health history and administer tests such as spirometry. This test measures lung function by measuring how quickly and how much air you blow out.  

Treatment 

Just as types of asthma vary between different people, asthma  treatment needs to be tailored to the individual. There are now a dizzying array of new medications – some in combination, many of which available as inhalers – effective on all types of asthma. They tend to fall into two groups: those used for short-term, quick-relief, and others which provide more long-term control. It’s important to understand why and when to use each.  

Traditionally, fast-acting bronchodilators are necessary to rapidly relax muscle spasms choking your airways from the outside, giving immediate, though temporary, relief. Anti-inflammatory medications work more slowly to cut down the stubborn swelling and mucus  within airways, which builds more slowly from viruses and allergies. Both types of medications are important as part of an overall management plan. 

However, within the last few years, recent advances in technology have led to exciting, new biologic therapies that are now changing the way we treat targeting specific types of asthma.  Come visit the specialists at Annapolis Allergy & Asthma who determine if and which type of asthma you have, and will help you develop a management plan that works for you. Call us today at 410-573-1600.

Written by Jenna Simmons

Heating Sources and Asthma

Indoor air quality is one of the most common triggers for allergies and asthma. Unfortunately in many climates, over 26 million children and adults have no choice but to breathe in recycled air indoors because the climate does not allow for the flow of fresh air through the home. Statistics confirm that asthma attacks peak during the winter months. The reasons are part temperature change and part use of heating systems where dust has been piling up for months.

Temperature drops directly instigate decreased lung function in persons with asthma. Airborne dust and other pollutants in heating ducts are also to blame. Two direct interventions include nose breathing versus mouth breathing and having your home airway ducts cleaned regularly. Let’s consider the latter idea at greater length.

The EPA has weighed in on the best way to ensure your ducts are clean. They suggest you interview several duct cleaning companies prior to choosing a firm. You should be confident that the company you hire meets the National Air Duct Cleaners Association standards. Anyone with asthma or other breathing issues should become familiar with them.
The standards can be found at this website:

https://nadca.com/resources/nadca-standards-publications

According to the Environmental Protection Agency you should insist on a service that uses negative pressure to extract pollutants from the home during the cleaning process. They should also be able to identify ducts that cannot be cleaned and those that may contain asbestos. Fiberglass lining requires special attention during air duct cleaning as well.

Ultimately you may want to consider purchasing and installing a whole-house air filtration system that automatically eliminates dust and other types of particles throughout the entire heating system. These systems have been found to eliminate irritants year-round in all types of weather, addressing a variety of allergens, pollens, and other irritants. There are also a number of room air purifiers that are effective as well.

If you have more questions about allergy and asthma interventions, contact the professionals at Annapolis Allergy & Asthma. Our expert professionals are available to answer your questions and offer advice.