Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, April 11, 1995 TAG: 9504120022
SECTION: EXTRA PAGE: 1 EDITION: METRO
SOURCE: JANE BRODY
DATELINE: LENGTH: Long
But while pollen (the plant's male ``seed'') prefers to land on the sticky, moist stigma (female sex organ) of a plant of the same species, it unfortunately lacks self-direction. At the mercy of wind and weather, pollen will settle on any sticky, moist surface, including the lining of the human nose and throat. Once there it will make a tentative overture, sending out a protein signal that in effect asks, ``Are you the one for me, and are you receptive?''
Rather than remain silent, the nose and throat of an allergic person respond as if attacked and start an antibody counter-attack that releases the chemical cascade responsible for the sneezing, runny nose, itchy eyes, stuffed head and fatigue that are the hallmarks of a pollen allergy. Feeling defenseless against pollen, the person then may search for symptomatic relief in the drugstore, where a bewildering array of products beckons.
But experts on allergy and pollen insist that allergic people need not become hapless victims of the bearers of male plant genes or the mold spores that often add to allergic miseries. Knowing how to minimize exposure and how to treat symptoms most effectively can greatly reduce the annual discomfort of seasonal allergic rhinitis, the medical name for ``hay fever.''
The best defense against pollen, as with most aggressors, is to stay away from it as much as possible. Try to schedule your outdoor activities when the air is relatively free of pollen, which is at night, at daybreak when plants are still covered with dew, during and after a steady rain, and on cloudy, humid, windless days. Surprisingly, a thunderstorm does not help, because large raindrops are inefficient at washing pollen from the air.
The best hours for outdoor exercise in springtime are very early, from 6 a.m. to 8 a.m., before the sun is high and hot enough to dry the pollen-bearing anthers. Contrary to popular belief, midafternoon on a hot, sunny day, can also be relatively comfortable for allergy sufferers because hot air currents carry pollen high into the air, noted Dr. Yalamanchi K. Rao, an allergist associated with New York-Methodist Hospital in Brooklyn.
``However, if you open an office window on the 20th floor at 2 p.m., you'll be likely to feel allergy symptoms,'' Dr. Rao cautioned. He added that pollen counts at ground level generally peak between 8 a.m. and noon, as pollen starts to rise, and again between 5 p.m. and 9 p.m., as the air cools and the pollen falls back to earth.
Indoor air is relatively free of pollen if windows are kept closed. For ventilation and cooling, allergists uniformly recommend air-conditioning in cars as well as in homes. Ultrasensitive people might also use an air-cleaning machine with a high-efficiency particle air filter in one or two rooms where a lot of time is spent, like the bedroom.
``Irritants like tobacco smoke, automobile exhaust, hair spray, perfume, insecticide sprays and laundry detergent are best avoided because they can enhance allergy symptoms, especially in a person with asthma,'' Dr. Rao said. Though not terribly fashionable, it would also help to wear a nasal mask and goggles, or at least wrap-around glasses, when pollen is most bothersome.
Allergic people would be wise to plan vacations carefully. Generally, the beach and seashore are the safest bets for people with pollen allergies. Allergy season is year-round in subtropical and tropical areas, and leaving the cool Northeast for warmer climes in the South could trigger a major allergic attack.
For those who cannot or will not spend the nicest time of the year holed up in an air-conditioned building, there are various treatment options. Most widely used are over-the-counter antihistamines, usually in combination with a decongestant. Antihistamines are most effective if taken before symptoms are well established, since they work to block histamines, which initiate the allergic response. They will not, however, relieve established congestion; for that, a decongestant may help. If nothing else, the decongestant will help to counter the drowsiness often induced by nonprescription antihistamines.
In recent years, costly but effective nonsedating antihistamines have become available as prescription drugs. These include Seldane (terfenadine), Hismanal (astemizole) and Claritin (loratadine), all of them tablets. These are unlikely to cause the drowsiness, dizziness, impaired coordination, and dryness of the mouth, nose and eyes associated with over-the-counter antihistamines.
For itchy eyes, there are saline washes and prescription drops containing antihistamines. And for the nose, in addition to cleansing saline drops, there are prescription nasal sprays and inhalers containing steroids, like Vancinase (beclomethasone), Nasacort (triamcinolone), Flonase (fluticasone) and Rhinocort (budesonide). These sprays are generally considered the the most effective treatments of allergy symptoms because they suppress inflammation and other allergic symptoms where they start - in the nasal airways and throat.
People who are severely allergic to pollen and who do not get adequate relief from medication are usually advised to consider immunotherapy: allergy desensitization shots, which induce a form of tolerance to pollen allergens. Severe uncontrolled allergies can progress to asthma.
With immunotherapy, a person gets injections containing progressively higher doses of the allergens in question once or twice a week until he or she no longer reacts when exposed to the real thing. The success of immunotherapy depends on a proper and thorough diagnosis of the person's sensitivities and exposures. A positive reaction to a skin test does not necessarily mean a person would react to the same pollen encountered in the air. Therefore, the diagnosis must take into account the person's symptom when exposed to particular kinds of pollen.
Immunotherapy can involve a long-term commitment, often years, especially for people with severe, multiple sensitivities. Even after completing the treatment, periodic booster injections are often needed to maintain the immunity.
For more information:
The American Academy of Allergy Asthma & Immunology operates a toll-free referral and information line - (800) 822-2762 - for consumers seeking the names of nearby qualified allergists and facts about allergies and asthma. The academy has also prepared a consumer pamphlet, ``Understanding the Pollen and Mold Season.'' Call the information line or write to the academy at 611 East Wells Street, Milwaukee, Wis. 53202.
by CNB