— For Dawn Quiett of Dallas, springtime is guaranteed to bring sneezing, a runny nose, an itchy throat and especially congestion. But this year’s allergy season has been so “brutal” that her usual armamentarium just isn’t winning the battle.
“I would give a million dollars to breathe through my nose for 10 minutes,” says Quiett, 39. “I think I have bought enough Sudafed in the last month that the feds might think I am making meth.”
She’s far from alone in her suffering. Doctors say spring allergies are wreaking exceptional havoc in many areas of the United States this year.
“Every report I’ve heard around the country is that it’s pretty bad,” says Dr. Richard Gower, president of the American College of Allergy, Asthma and Immunology.
Gower, an associate professor of medicine at the University of Washington who practices in Spokane, says late snowfalls — the city broke a record with nearly 100 inches of snow over the winter — meant that trees didn’t start blooming until recently. That, in turn, led to a dramatic release of pollen all at once, sometimes called “super bloom,” rather than the more typical steady release spread out over time.
Now that it’s warming up, he says, “it’s beginning to hit the fan.”
Dragging out the misery
The spring allergy season starts when trees and plants begin blooming, which can be as early as January and February in traditionally warmer areas such as California and Arizona, and late February and March across the South. In colder parts of the country that may still be having snow into March or after, plants usually start blooming later. All this generally means more and longer suffering in the warmer areas, although as Gower notes, late snowfalls can spell their share of misery when they lead to a burst of all kinds of pollen at once.
Overall, experts say, global warming trends that lead to unusually mild winters are taking their toll in various areas around the country.
“In general we’re seeing warmer weather earlier,” says Dr. Stanley Fineman, an allergist at the Atlanta Allergy and Asthma Clinic and a spokesperson for the American Academy of Allergy, Asthma and Immunology. “Because of this warming trend, we’re seeing higher pollen counts sooner, more difficulty and longer seasons.”
Of the top 10 “spring allergy capitals” for 2009, named by the Asthma and Allergy Foundation of America, seven are in the southern U.S.: Louisville, Ky.; Knoxville, Tenn.; Charlotte, N.C.; McAllen, Texas; Greensboro, N.C.; Little Rock, Ark.; and Augusta, Ga. The list, which identifies the “most challenging places to live with spring allergies,” is based on tree pollen scores but also the number of allergy medications used per patient and the number of allergy specialists per patient. The other cities on the list are Madison, Wis.; Wichita, Kan.; and Dayton, Ohio.
“In Atlanta, it’s definitely worse than it has been in previous years,” says Fineman. While the typical allergy season in Atlanta is from mid-March through May, he says, both this year and last year warm weather has meant surges of tree pollen in February. Quiett says Dallas, too, was having hot days in February — up to 90 degrees Fahrenheit.
This causes a double-whammy when the rest of the plants bloom later in spring because allergy sufferers have already been “primed” earlier in the season, he says. When people are primed and then re-exposed to pollen, their symptoms can be worse because a smaller amount of pollen triggers even more misery than normal. “Your allergy cells are ready to fire when you’re primed, so you fire quicker,” he says.
Oklahoma also saw trees blooming earlier than usual this year, says Dr. Warren Filley, an allergist and professor of medicine at University of Oklahoma Health Sciences Center in Oklahoma City.
“It’s been on average a worse season than we often see,” he says.
Last year in Oklahoma City, spring allergies weren’t as bad because ice storms during the winter took trees and branches out meaning less pollen come spring, says Filley. But this past winter was milder, leading to many cedar trees blooming a little earlier than usual, in February. There also has been less rain to wash the pollen out of the air, he says, and more wind “throwing pollen around.”
On the other hand, Dr. David Rosenstreich, chief of allergy and immunology at Montefiore Medical Center in New York City, says his practice isn’t as busy so far this year as last. The season there usually doesn’t peak until between mid-April and mid-May, so it may be that this year is not so bad, or it may be that it just hasn’t reached it’s peak yet. It’s also possible, he says, that fewer people are seeing doctors because of the economy.
Brad Carr, 59, found that his allergies worsened dramatically when he moved a few years ago from Albany, N.Y., to Montgomery, Ala., and they are particularly bad this year. “My eyes constantly tear up and the scratchy throat feeling doesn’t dissipate, so that makes swallowing foods a real treat,” he says. “My nose runs 24/7.”
Like Quiett, his usual medications, the antihistamine Claritin and the decongestant Sudafed, aren’t doing the trick this year. So his doctor recently prescribed Flonase, a steroid nasal spray, and Zyrtec, another antihistamine.
“Sometimes I feel like I am walking around with a CVS in my pocket,” says Carr, who’s getting “a little” better relief now and anxiously awaiting the end of spring so that he can once again enjoy a game of golf.
Vary your battle plan
If you suffer during sneezing season, there are several effective treatment options but you may need to experiment to find which approach, or combination of approaches, works best.
“Everybody responds to the medications differently,” says Gower. “Sometimes you have to keep trying and vary the medicine and the regimen.”
So don’t just give up and stop seeking medical care because one approach isn’t working.
For people with milder allergies, experts say, it’s reasonable to start with over-the-counter (OTC) antihistamines and decongestants. Claritin and Zyrtec, antihistamines once sold only through prescription, are now available off the shelf. Older antihistamines such as Benadryl also can help but they may cause significant drowsiness, which is why some allergy sufferers prefer to take it at night. Zyrtec, too, may cause some sleepiness.
If these medications aren’t spelling relief, consult your primary-care doctor or allergist about stronger prescription options. These include prescription antihistamines, and steroid and antihistamine nasal sprays. Patients may have success with one of these, or they may need some combination of prescription and OTC medicines. Doctors say steroid nasal sprays can be particularly effective, although some patients may not like to use a spray, or they may experience side effects such as irritation or bleeding that they don’t tolerate well.
Allergy shots, known as immunotherapy, are another treatment option that’s usually reserved for more severe, persistent allergies. But it’s too late to start them for spring (but not fall). They work by increasing the body’s tolerance to an allergen, and it usually takes about two months for them to start working, says Fineman.
Self-help measures also are important.
A key step is avoid allergens by staying indoors as much as possible (and tolerable), particularly in the afternoon when pollen counts tend to be highest. Also keep windows closed and run the air conditioner instead. And after being outdoors, it’s a good idea to take a shower, wash your hair and change clothing to get rid of pollen that’s on your body.
Nasal irrigation with a saline solution also can help by clearing mucous and allergens from the nasal passages, experts say. Patients use a device such as a squirt bottle, bulb syringe or neti pot (a ceramic container that resembles a small tea pot) to get the salt-water solution in one nostril and out the other. Commercial nasal wash kits and preparations are available at the drugstore, or you can make a solution at home. Here’s one recipe: http://www.aaaai.org/patients/publicedmat/sinusitis/rinse.stm.
Bear in mind that medications that worked in the past may not work so well this year. One possible explanation is that pollen counts are especially high. Another is that your allergies may have worsened since last year, which is not uncommon from one year to the next, says Gower. If this is the case for you, talk to your doctor about how to get better relief.
Then mark your calendar to stock up on your medications early next year so that you’re armed and ready before allergy season starts. Filley emphasizes that hay fever can be much harder to treat “when it gets rolling.”