Ragweed and Fall Pollen Allergies

Back to school season is here! Shorter days, crisp, cool evenings, and beautiful fall foliage are on the horizon. This time also marks the onset of weed pollination and the resurgence of allergy symptoms that may have taken a vacation in the hot, dry July heat. The meteorological calendar says fall begins September 22nd, but weed pollen, the main culprit of the sniffles and sneezes during fall allergy season, is already here!

Pollen Offenders

Towards the close of summer, weeds start to pollinate. Weeds grow all summer, but their pollen is usually not released until later in the growing season. This can vary year to year but typically starts mid to late August.  Ragweed, cocklebur, lamb’s quarters, pigweed, dock sorrel, English plantain, and sagebrush can all cause fall allergy symptoms and are widely spread across the U.S.

Specifically ragweed pollen is the predominate culprit of allergy symptoms from August through October, peaking on average in mid-September. Ragweed is one of the major drivers of allergy symptoms and releases huge amounts of pollen each and every day. The pollen produced by ragweed is small and light. It is released in large quantities into the air and carried for miles by the wind. Nasal congestion, runny nose, and itchy eyes are typically caused by wind-blown pollen which is easily spread for miles and miles.

Other Pollen Types

Goldenrod, which blooms at the same time that ragweed does, is instead insect-pollinated and therefore is not a significant allergen for most individuals. Insect carried pollen is produced by plants that have bright and attractive flowers. This kind of pollen is typically large and heavy, sticks to insects, and is transported during flight fertilizing other plants. These bright flowers are commonly thought to be allergy offenders, however because they do not release much pollen into the air they are not as likely the culprit of allergy symptoms.

Ragweed and Fall Pollen Allergies
Ragweed and Fall Pollen Allergies

Manage Symptoms

Checking local pollen counts is helpful to anticipate the level of exposure on any given day. Pollen counts are determined by collecting pollen on special rods. The pollen is then counted under a microscope and calculated in grains per cubic meter of air. Pollen counts tend to be the highest early in the day, or often when the wind picks up just before a large rainstorm. If you like dancing in the fall rain, or jumping in rain puddles, however, you are in luck. During a rainstorm and immediately following, pollen becomes still and dormant because the rain makes it damp and heavy. As the air becomes warmer and drier following the storm, however, the pollen count will rise again.

Pollen Avoidance

Those with weed pollen allergies should try to avoid heavily dense wooded areas or those with brush and shrubbery. These areas should be especially avoided in late August when pollen is the most dense and abundant. Pollen counts are never zero, nor will an allergy sufferer truly be able to avoid weed pollen in the late summer and early fall. However, contact may be lessened by taking simple steps to avoid pollen overload:

  • Utilizing the air conditioner or heater
  • Keeping the windows and doors at home and in the car closed
  • Utilizing the dryer rather than the fresh breeze to dry clothing
  • Changing clothes after coming in from being outdoors
  • Shower prior to getting into bed or laying on upholstered furniture

These easy steps will help to decrease pollen exposures. Also, one benefit COVID-19 may bring allergy sufferers, is that wearing of some masks will help to minimize the amount of pollen reaching the nasal passages if being worn in outdoor settings.

Get Tested

If someone is unsure whether weed pollen is a trigger for their back-to-school nasal congestion, runny nose, post nasal drip, sneezing, and itchy watery eyes, seeing their provider for an allergy test may provide the clarity they are looking for!

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Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, PA. After spending 8 years in clinical practice, she joined United Allergy Services where she is currently the Vice President of Clinical. Amanda is also the past president of the Association of PAs in Allergy, Asthma, and Immunology. 

United Allergy Services is also on FacebookLinkedInor TwitterSee other interesting and related articles on the UAS Blog.


Back to School Action Plan for Allergies and Asthma

Back to School Action Plan for Allergies and Asthma

As the final days of summer break come to a close, families everywhere are preparing for children to return to school. Whether this is the first year a child is heading to school or the last, it is an exciting time for both children and parents. It can, however, also be a time of anxiety for a parent worried about a child’s asthma or allergy conditions. Below are some ways to prepare and communicate these concerns, and  back to school excitement.

Make a Plan

Schedule an appointment with your child’s healthcare provider in the weeks leading up to the first day of school. During this appointment, discuss overall heath as well as specifics regarding allergies, food allergies, or asthma. This is also a great opportunity to request that the healthcare provider refill any asthma or allergy medications. The provider can complete medication permission forms required by the school nurse during your visit. It is important the school nurse can quickly and easily confirm the medication you provide is:

  • non-expired
  • prescribed for your child
  • has clear directions on when, how, and how much to take

This is also the time to request your provider complete any additional forms required by the school. Examples are asthma action plans, anaphylaxis action plans, and food allergy alert plans with avoidance and substitution information. If your child is in their first year or is entering a new school, it is important to contact the school nurse directly. Also, if your child has complex requirements or action plans, you should visit with the school nurse yearly about their daily requirements. The nurse can discuss accommodation options available for children at the school. Other important policies to discuss include asthma inhalers, epinephrine auto injectors, classroom parties, field trips, and cafeteria rules.

Classroom Action

Back to School with Allergies and Asthma
Back to School with Allergies and Asthma

The classroom can be a source of exposure for children with allergies to dust mites, mold, and animal dander. Communicate with your child’s teacher about allergy triggers for their symptoms and what common symptoms to look out for. Don’t forget to ask if the classroom will have a resident pet. If so, what type of animal and any requirements that the pet come home with your child may be important. It is also important to understand if the school has air conditioning or if windows are typically opened on nicer days. If windows must be opened, then you can prepare your child accordingly with additional symptom control medication.

During your initial meeting with the teacher, you can begin setting appropriate expectations. Discuss things such as asthma action plans and any potential limitations for recess or physical education. Also, anaphylaxis action plans for food or stinging insects and any food avoidance requirements should be covered. You will feel confident knowing both the school nurse and teacher are fully informed of your child’s needs. The school nurse and teacher should have a consistent plan for where inhalers and epinephrine auto injectors are stored. Also confirm that there is a plan for administration of medication in a time of need. It is a good idea to ask about substitutes or classroom aides/parent volunteers confirm they are made aware of your child’s needs.

When to Stay Home

During a regular year it is often a challenge to decide when it is or is not appropriate to send a child to school with cold-like symptoms. That can be even more complex for a parent if your child has allergies or asthma. In this unique time when COVID-19 is still a major focus, another layer of complexity is added.

For children with asthma, it is safe to attend school with mild wheezing that occurs infrequently and is quickly resolving with the use of albuterol. However, it is appropriate to keep your child home from school if:

  • they experience difficulty sleeping due to respiratory symptoms
  • require albuterol every 4 hours to relieve them of things like wheezing, shortness of breath, or chest tightness
  • have respiratory symptoms that are failing to resolve with albuterol use

Make sure to always inform the school nurse and the child’s teacher of any recent asthma exacerbations and how it was treated. Communicate any continued treatment if applicable.

If your child has an allergic reaction, make sure to inform the nurse. Also update the nurse on the allergen trigger if known, how the reaction was treated, and any ongoing treatment.

Wishing all the children a safe, healthy, and prosperous new school year!

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Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, PA. After spending 8 years in clinical practice, she joined United Allergy Services where she is currently the Vice President of Clinical. Amanda is also the past president of the Association of PAs in Allergy, Asthma, and Immunology. 

United Allergy Services is also on FacebookLinkedInor TwitterSee other interesting and related articles on the UAS Blog.


Summer allergy avoidance tips

Summer Allergy Travel Tips

School is out, summer is in full swing, and it is prime time for summer vacations and traveling. Summer travel with environmental allergies, asthma, or food allergies may make planning a vacation seem like a daunting task. Not to worry! We can show how to keep summer allergy issues at bay during your staycation, beach trip or wine tour of your dreams.

Summer can be an ideal time to travel. The hot summer months can actually provide relief to some, like those with tree pollen allergies. Unfortunately for others, summer comes with its own allergy triggers. While tree pollen counts tend to be lower, the summer heat pushes grass and mold pollen to be higher. Ragweed begins to appear in the late summer and early fall months to kick off fall allergies. Pollen is not the only trigger you can expect; more stinging insects and hotter temperatures in summer months can complicate matters for asthma sufferers.

Summer Allergy Location Tips

 

Summer allergy travel tips
Tips for summer allergy travel. Paspalum seed heads, filled with seeds, surrounded by grasses and other weeds.

Location is everything! One consideration is that pollen counts tend to be lower on the coast, so beaches may be a good option. The desert, or alternatively snowy mountain tops, can also be ideal for pollen, although maybe not for summer travel. Does your vacation involve hiking or mountain climbing? Dust mites do not prefer elevations above 2,500 feet, so that may be a great choice as well. Wherever you decide to go check the allergen forecasts for that area. You should also check current pollen counts each day there. If high pollen counts are in the forecast, consider planning inside activities during your trip.

Checking pollen counts may not be the only forecast to make sure to monitor. As the temperatures rise, you can expect the humidity to rise as well. Many who suffer from asthma can find their condition aggravated by the high temperatures and humid climate. When planning your time outside during the summer, check the air quality for low humidity and low ozone days. You can also avoid triggers by planning around the heat of the day when possible.

Packing for Vacation

Although your favorite swimsuit may be more fun, allergy control measures should equally be at the highest priority. Staying compliant to your recommended treatment protocol in the days before you leave is crucial. These measures will support well-maintained symptoms while traveling, and for the duration of the trip.

  • Make sure to pack allergy medication and immunotherapy in a carry-on bag if traveling by plane.
    • Try to keep medications in original packaging and pack all medication and allergen immunotherapy in a separate, clear bag.
    • Any liquid or gel medications or immunotherapy will need to individually be 3-4 ounces or smaller. Consider purchasing travel sizes if standard sizes do not meet this requirement.
  • Pack 1-2 days of additional medication or immunotherapy than what will be needed in case of delay when traveling.
  • It may be beneficial to set a reoccurring alarm on a phone before leaving. Normal routines may change with travel and vacation plans.
  • Finally, are you traveling out of the country? If you are traveling to a non-English speaking location, bring a list of your allergies in the native language. You may also learn to say or write  “I’m allergic to _____.” in the local language.

Additionally, do not forget to pack any hypoallergenic hygiene products that you regularly use. Examples might be sunscreen, after sun cream, lotions, ointments, body wash, or laundry detergent. When searching for accommodations, remember that more and more hotels offer items like mattress and pillow covers or hypoallergenic linens so you may not have to pack your own. It may also be helpful to ask about smoke free rooms, away from humid, mold friendly pool areas if possible. If pet dander is a concern, take note of whether the location is “pet friendly”.

Summer Allergy Avoidance Tips

Air in enclosed spaces such as planes and trains can sometimes be extremely dry.  Consider investing in nasal saline spray or washes, as well as portable humidifier. A humidifier will likely also be beneficial if staying in a hotel for more than a night or two. Staying well hydrated with water and non-caffeinated beverages will also greatly help you combat drying out. If traveling by car, considering utilizing the heat or air conditioning and keeping windows closed. Also, turning on the heat or air 10 minutes before departure can help clear vents of any residual allergen particles.

While enjoying your destination, remember that peak pollen times are typically early in the day (specifically 5am 10am). Scheduling desired outdoor activities for later in the day or just before dusk may help to reduce exposures. Similarly to when you are home, a daily shower is helpful for allergen avoidance. Showering before bed will help to wash away allergens that have adhered themselves to your skin or hair. This is especially important to maintain so that your pillow, sheets, and the immediate space you breathe in all night is allergen free.

Insect Allergies

Another aspect of the summer allergy concerns may be insects. If stinging insect allergies are present planning ahead can alleviate a lot of anxiety and allow for a smooth trip. Always make sure to carry a minimum of two epinephrine auto injectors if it has been prescribed to you or a loved one. Make sure the epinephrine autoinjector is carried in a way it can be accessed and administered within 60 seconds of a need arising.

If you or a loved one does have life threatening allergies, it is a good idea to check with your health insurance and ensure you know where to seek medical care should the need arise while you are out of town. You may also consider carrying an allergy identification card. It can be helpful to keep a card in your wallet listing your allergies, and also emergency contact information and your healthcare provider information. This can be especially important for children who may be summer camps or staying overnight with friends or family.

Food Allergies

If food allergies are present, packing your own meals or snacks may make traveling easier. Preparing food yourself is always the safest option. Alternatively, research the local dining hot spots you wish to visit in advance of leaving for your trip. This allows you to identify safe selections from the menu or you can call to request proper menu accommodations. You may still consider packing your own snacks if you have food allergies. While it may be possible to plan meals around food allergies, snacks often present more of a challenge. Pack allergy friendly snacks, especially if lengthy plane rides are involved.

 

Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, PA. After spending 8 years in clinical practice, she joined United Allergy Services where she is currently the Vice President of Clinical. Amanda is also the past president of the Association of PAs in Allergy, Asthma, and Immunology. 

United Allergy Services is also on FacebookLinkedInor TwitterSee other interesting and related articles on the UAS Blog.


Grass Pollen Allergy: Making the Most of Summer

Summer is finally here! Longer days, days spent by the beach or the pool, and late nights catching fireflies are on the horizon. Allergies are usually associated with the spring or fall because pollen is most active during these times. However, summer allergies, especially to grass, are also common. This grass pollen allergy can cause some of the same troublesome symptoms as in other seasons.

Allergy Season

Grass begins to pollinate in the late spring, typically April or May in the northern part of the country. The pollination period in the north will then typically continue through June or July. However, in southern regions, grasses may pollinate throughout many seasons and could trigger symptoms throughout the year. These pollination time periods are when those who suffer from a grass pollen allergy

notice their symptoms at their worst.

Types of Grass Pollen

There are hundreds of different kinds of grasses throughout the United States. Fortunately, not all of them are the source of summer sneezing, congestion, and itchy eyes. Some grass pollen types are small, light, dry and can travel for hundreds of miles by the wind. One group of grasses, referred to as the northern pasture grasses, cause more allergy problems than any others. These grasses include:

  • common timothy grass
  • sweet vernal grass
  • orchard grass
  • perennial rye grass
  • Kentucky bluegrass

Another type of grass, bermuda, is a southern grass and is responsible for many troubling summer grass allergy symptoms. Johnson grass is another main culprit for grass pollen misery.

Grass pollen allergy can make summertime miserable.
Grass pollen allergy can make summer time miserable for many.

Options for Homeowners

While common Bermuda grass usually triggers allergies, some hybridized versions produce little to no pollen. One common type of hybrid Bermuda grass referred to as the "Princess 77" variety is available for homeowners. Other good hybrid Bermuda grass varieties include "Tifway" and "Santa Ana". Buffalo grass may be a good warmer climate option. This warm-season grass survives droughts and requires little supplemental watering, making it ideal for areas with watering restrictions. Types like the "UC Verde" or "609" produces only female plants, eliminating the problems of flowering and producing pollen. Although less commonly found, this is ideal for grass pollen sufferers.

Measuring Grass Pollen Counts

Those that suffer from a grass pollen allergy can benefit from checking their local pollen counts regularly. Pollen counts are determined collecting pollen on special rods. The pollen is then counted under a microscope. The pollen count is then calculated in grains per cubic meter of air. Pollen counts tend to be the highest early in the day, or often when the wind picks up just before a large rainstorm.

If you like dancing in the rain, or jumping in rain puddles, however, you are in luck. During a rainstorm and immediately following, pollen becomes still and dormant due to the rain making it damp and heavy. As the air becomes warm and dry following the storm, the pollen count will become potent again

Manage Your Grass Pollen Allergy

Pollen counts are never zero, nor will an allergy sufferer truly be able to avoid grass pollen in the summer. However, some practices may help decrease pollen exposures. For instance, utilizing the air conditioner while keeping the windows and doors to the home and car closed. Also, utilizing the dryer rather than the fresh breeze to dry clothing will help to decrease pollen exposures. It is especially important to keep windows closed when you or someone close mowing their grass.

Although it may seem like a good idea to avoid cutting the grass as much as possible, mowing grass often and keeping grass short actually causes the grass to release less pollen into the air. If a nonallergic friend or family member isn’t available to assist in cutting your grass, consider wearing a mask. Wearing masks will help to minimize the amount of pollen reaching the nasal passages. It is greatly beneficial for grass pollen sufferers to wear a mask when cutting grass or doing other yardwork.

Other Helpful Tips

Those with a grass pollen allergy should try to avoid heavily dense grassy areas, especially in early summer when pollen is the most dense and abundant. Although summer brings warmer temperatures. when you are out working in the yard, out at a park, or hiking it is recommended to wear long pants or long sleeve shirts in a light breathable fabric. This added layer of protection helps reduce the amount of pollen that comes in direct contact with your skin. Similarly, wearing sunglasses and hats also reduce pollen that contacts eyes or nestles in your hair.

Grass pollen allergy suffers should also make a habit of changing their clothes after coming in from being outdoors, and bathing prior to getting into bed/laying on upholstered furniture. Wash bedding in very hot, sanitizing cycles once a week in peak pollen seasons. It is also beneficial to remove shoes before entering your home. And do not forget your pets! They can be major sources of tracking grass pollen into your home. Make sure to wipes them down with a wet cloth or towel before they enter your home, and make sure to bathe them more frequently in high pollen seasons. And although not always feasible, the ability to keep your pets from sleeping in your bed, in your bedroom, or on your upholstered furniture will also greatly benefit you if you suffer from grass pollen.

Symptom Relief is an Option

If someone is unsure whether grass pollen is a trigger for their troublesome nasal congestion, runny nose, postnasal drip, sneezing, and itchy watery eyes, seeing their provider for an allergy test may provide the clarity they are looking for!

Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, PA. After spending 8 years in clinical practice, she joined United Allergy Services where she is currently the Vice President of Clinical. Amanda is also the past president of the Association of PAs in Allergy, Asthma, and Immunology. 

United Allergy Services is also on FacebookLinkedInor TwitterSee other interesting and related articles on the UAS Blog.


Independence from Summer Allergies

Tips for independence from summer allergy concerns
Summer Allergy relief tips

The Fourth of July is only one week away and that likely means many are making or finalizing plans to be outside. Are you planning to be the grill master? How about the fireworks expert? Maybe you are the ultimate host of the celebration surrounded by family and friends enjoying fireworks, picnics, swimming, and outdoor activities. Here are some of the most common summer allergy tips to for attending Fourth of July celebrations. After all, it is your right to have independence from summer allergies!

Number One Summer Allergy: Grass Pollen 

During the summer months, many allergy sufferers are wary of grass pollen. They are the most common seasonal allergy triggers and are heaviest in May through August. Those that suffer from grass pollen allergies can benefit from checking their local pollen counts daily. Pollen counts tend to be the highest early in the day or as the wind picks up just before a large rainstorm.

Also, try to offer guests an indoor option during your outdoor celebration if possible. Try to offer a portion of the area where guests can sit away from tall/dense grass or shrubbery. Another options would be a non-grass surface like a deck or patio. To avoid bringing those pollens inside after a great celebration, take a shower or bath before hopping into bed. This will help rinse off any sticky allergens stuck to your body or hair before they stick to your bedding.

Summer Skin Allergy: Sunscreen Reactions

Many celebrations occur outside or around the pool, so sunscreen is important to discuss. While sunscreen is a crucial part of summer safety, sometimes it can cause a reaction much worse than a sunburn. A contact allergy to the sunscreen may present as a rash appearing where it was applied. Or it could be a reaction that appears after applying the sunblock and being exposed to the sun.

To avoid a sunscreen reaction, apply a quick and simple patch test before applying the product to your whole body. Decide on a small area, like the wrist, and apply the product. Wait at least 24 hours to make sure the skin does not react.

Summer Venom Allergy: Stinging Insects

Similar to sharing the festive star-spangled celebrations with pollen and sun, consider insects as well. We know stinging insects such as bees, wasps, hornets, and yellowjackets are most active during summer and early fall. Also, fire ants are active all year round in many southern parts of the United States.

For many of us stings and bites can be uncomfortable and painful. However, there are many picnic guests that have life-threatening reactions that can result from a sting or bite. People who know they are at risk should always carry two doses of auto injectable epinephrine. They should have the ability to access it within 60 seconds if necessary. Try to avoid the stings and bites before they occur by refraining from walking outdoors barefoot, especially in grassy areas. Another helpful trick is to skip perfume or sweet-smelling body sprays or lotions. Also, drinking from cans or bottles that have sat open and unattended should be avoided because sometimes insects can be an unpleasant surprise. Finally, when choosing the perfect outfit for the holiday weekend, leave your vivid, floral clothes in the closest.

Summer Asthma Concerns

When we think of the Fourth of July, firework displays lighting up the sky quickly come to mind. Fireworks, although beautiful and breathtaking, can create smoke and small particulate matter. This can trigger asthma for some, taking their breath away in a not so enjoyable way. If you suffer from asthma, consider watching the fireworks from an indoor location. Similar to fireworks, smoke from grills, bonfires, firepits, or outdoor fireplaces can also trigger asthma for some. Try to avoid the direct smoke pathway and leave significant distance between yourself and the source of the smoke.

Other scented products utilized during outdoor gatherings can also contribute to air pollution and can also trigger asthma. If hosting a party, it would be helpful to contact your guests and ask if certain things like scented insect repelling candles, scented tiki torch oil, odor hiding fragrances or air fresheners trigger any negative responses for them.

If there is a swimming pool, remember that while chlorine isn't an allergen, it is an irritant and can cause problems with eye and nose itching. It can also cause breathing problems in people with asthma. If undesired symptoms are occurring while swimming, jump out, take off your suit and washing the affected area with clean water and soap to remove traces of the remaining irritant. You should have a rescue inhaler on hand, if prescribed to you, to calm any respiratory symptoms should they occur.

Summer Food Allergy Considerations

Finally, what would a summer celebration be without all the tasty food and drinks? If food allergies are present, it can make attending picnics and barbeques easier to pack your own meals or snacks to have readily available. Preparing food, yourself is always the safest option, however, it may not be feasible may not allow you to feel you are enjoying all the perks of a summer celebration. It is helpful as a host to ask about any food allergies or dietary restrictions when inviting guests to the event. It is also very helpful to label what individual dishes or offers are and include a high-level recipe or ingredient list. That way guests can privately identify safe selections off the menu in and will allow them to enjoy immersing themselves in the full experience without the worry of unknown exposure.

Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, PA. After spending 8 years in clinical practice, she joined United Allergy Services where she is currently the Vice President of Clinical. Amanda is also the past president of the Association of PAs in Allergy, Asthma, and Immunology. 

United Allergy Services is also on FacebookLinkedIn, or Twitter. See other interesting and related articles on the UAS Blog.

 


how to navigate Easter with allergies

Easter with Allergies

The Easter and Passover holidays are here! Holidays mean family centered fun, festive meals, and usually sweet treats to enjoy. For allergy suffers, however, they can sometimes be challenging to navigate. Aside from the usual pollen and food allergies, brightly dyed eggs, household pets, and sweet baby chicks and bunnies can also wreak havoc on the nose and chest. Here are some tips to navigate the upcoming holidays and ensure that you and your family celebrate safe and happy.

Easter and Food Allergy Considerations

Traditional holiday meals are at the cornerstone of Easter and Passover. Plan the meals out in advance and be mindful of any guests that may have a food allergy. Be flexible and try to switch ingredients for allergy-friendly alternatives, eliminate a recipe from the menu altogether, or take care to prepare allergy-friendly dishes separately from the other meals. If you are not sure if guests have a food allergy, consider printing recipes out for each of the dishes and allow people to determine if it’s a safe food for them to indulge in. Also consider avoiding a buffet style offering, or separating allergen safe foods from allergen containing foods in two different areas or tables.

Sweet Treats

These spring holidays typically mean chocolate and sweet treats to younger members of the family, or those young at heart. Try to again consider those guest and family members that may have allergies to things like chocolate, so they are not left sitting on the sidelines. Allergy to chocolate itself, or the cacao bean, is incredibly rare, however more commonly the offenders are milk, peanuts, tree nuts, soy, and corn. A little research will provide an array of options of dairy free or peanut/tree nut free brands of treats. Always check labels to see if the offending food in contained in the ingredients list, or mentions it was produced in a facility that also processes other allergen containing foods putting your loved one at risk of cross contamination.

Keep in mind most chocolate does contain soy in the form of soy lecithin to keep it solid at room temperature, and white chocolate commonly contains corn in the form of corn syrup. If the treats offered are of the homemade variety, it can be even more challenging for a food allergy sufferer due to lack of label to research ingredients.

If you suffer from food allergies, a good rule to follow if “If you can’t read it, don’t eat it”. Plan to bring some of your own safe snack or goodies, unless you can make sure your host prepared foods allergen free, safely away from other allergen containing food, and on a separate and thoroughly cleaned surface. In lieu of store bought or homemade edible treats, consider offering nonfood items for younger guests such as books, sporting goods, stickers, novelty items, or toys.

Easter Egg Related Allergies

Although the majority of food allergens are most offensive if ingested, it is important to consider that some people do have reactions or develop irritations from contact exposure to egg or the dyes used to make them bold and bright. If colorful dyed egg hunts are part of your spring holiday tradition, there are alternative ways to include everyone on the fun.  Instead of using traditional eggs and egg dye, consider eggs made of wood, ceramic, or plastic, and consider natural dye alternatives. Other options include making gelatin eggs, egg sugar cookies for decorating, or decorating marshmallows in place of eggs. Also, consider replacing the hard-boiled egg on the Passover Seder plate with a ceramic or plastic egg to keep guests anxiety free.

If the above-mentioned allergies are life threatening for you or a loved one, always make sure to carry a minimum of two epinephrine auto injectors if it is prescribed. Make sure the epinephrine autoinjector is carried in a way it can be accessed and administered within 60 seconds of a need arising. If you or a loved one does have life threatening allergies, it is always a good idea to check with your health insurance and ensure you know where to seek medical care should the need arise if celebrating the Spring holidays out of town.

Pollen Considerations

Food allergens typically are the easiest to keep front of mind during the holidays, however equally as difficult for allergy suffers and arguably more difficult to avoid are the tree pollens and mold spores blowing in the air. These unwanted guests can ruin any picnic or outdoor gathering with nasal, sinus, eye, and chest symptoms. If there is both indoor and outdoor venues at the celebration location, try to minimize the time spent outdoors. If you are hosting the celebration, try to offer an indoor haven if planning to spend time outdoors, as well as keep windows and doors closed at the indoor space. Also, minimize the exposure to outdoor allergens while traveling to the destination by keeping windows up in the car and instead using the air conditioning.

Celebration Times

It is a good habit to always check pollen counts for the area where you will be celebrating. If you are planning the celebration, try to have it start mid-day or later due to peak pollen times typically occurring in the first half of the day (specifically 5am 10am). Also, it would be beneficial to plan the event outside of heavily grassy areas or those densely populated with trees. This may help to decrease the concentration of allergens in the air.  If the celebration will be entirely outdoors with no indoor refuge, it is a good idea to make sure you are on top of your allergy medication or immunotherapy regimen before going. It may be wise to pack a few changes of clothing as well as wet wipes for the ability to remove pollen from your immediate environment every few hours.

Once you return home from the festivities, plan to shower or bathe before prioritizing any other activities. It is especially important to bathe before crawling into bed, to remove any allergens that have adhered themselves to your skin or hair. This is especially important before allowing them to have access to your pillow or sheets and being in the immediate space and air you breath in all night.

Easter and Passover Gifts or Decor

Many people choose to show their appreciation to their host or show their love to their family by bringing beautiful spring flowers or plants to the celebration. Unfortunately, people can have severe symptoms such as sneezing, along with nose and eye itching and watering related to the pollen, or just the smell of particular flowers. Even an asthma attack can be triggered from them. According to the American College of Allergy, Asthma and Immunology, there are many flowers you can get at a florist that produce little pollen. Look for tulipsroses, begonia, columbine, crocus, daffodil, and geraniums if you want to be safe.

Pet Allergies

We cannot forget about the cherished furry family members that may be in attendance for the spring holiday celebration. There may also be the propensity to give the give of baby chicks or bunnies this time of year. Dander, saliva, sweat, and urine from adorable dogs, cats, and even bunnies can trigger an allergic response in some people. If possible, try to keep pets confirmed to only a certain area of the celebration so that those that wish to enjoy them can, while those that are unable can find refuge elsewhere.

Make sure to thoroughly wash your hands before returning to an animal free area of the celebration, before partaking in shared food items, or before touching your face, mouth, or eyes. Also, make sure the recipient of a new spring pet is not triggered by them. Although recent literature has shown us a true allergy to bird feathers is rare, there are substantial amounts of dust mites found in feathers that can trigger unwanted allergy symptoms.

Allergy Treatment Options

If you or a loved are unsure whether tree pollen, grass pollen, mold spores, dust mites, or animal dander are potential allergy triggers and the cause of the nasal congestion, runny nose, post nasal drip, sneezing, and itchy watery eyes you have been suffering with, seeing your provider for an allergy test may provide the clarity they are looking for! Some providers may have the ability to access food concerns as well. And if you are already aware of true allergy triggers, but the spring allergy medication and avoidance measures are just not cutting it, there is still time to see your provider and discuss starting allergen immunotherapy.

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Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, PA. After spending 8 years in clinical practice, she joined United Allergy Services where she is currently the Vice President of Clinical. Amanda is also the past president of the Association of PAs in Allergy, Asthma, and immunology. 

United Allergy Services is also on FacebookLinkedIn, or Twitter. See other interesting and related articles on the UAS Blog.

https://unitedallergyservices.com/blog/patients/5-ways-tame-seasonal-allergies/


Baseball season for allergy sufferers

Tips for Balancing Baseball and Allergies

Spring means longer days, warmer weather, and the beginnings of baseball! Unfortunately for some allergy suffers, the start of the long-anticipated baseball season also means the time of year when allergens such as tree pollen are at an all-time high. Sneezing, wheezing, and itchy, watery eyes can make games or practice challenging for you or your little leaguer. Even more concerning? The thought of major league games and contact with baseball’s favorite sidekick...peanuts! You can still enjoy this spring and baseball season with a little planning for your allergies.

Eliminating all outdoor sports and activities may seem like the best decision, and for many, it is. However, if skipping out on baseball or other outdoor sports due to allergies just is not an option, we can help. Here are some tips that will help allergy suffers enjoy watching America’s pastime and PLAY BALL!

Airborne Allergy Tips

Check the weather forecast before heading to the game. When checking out the weather, it is good practice to also check the pollen counts in the area. Keep in mind that peak pollen times are typically in the first half of the day, specifically 5am 10am. Attending practices or games midday or in the afternoon may help to reduce exposures.

Baseball and outdoor allergies don't have to be in competition with one another. If you have a little leaguer, packing wet wipes is good practice. Wiping down their hands, face and neck can be helpful to combat those distracting allergy symptoms when out on the diamond. Also, make sure your favorite player is not relying on allergy medication that could make them drowsy. There are non-sedating medication options, or allergen immunotherapy that are worth discussing with their provider.

After a long practice or game, it is beneficial to change your clothing as soon as possible. Also helpful is an immediate shower, especially before crawling into bed. The shower will help to wash away any allergens that have adhered themselves to your skin or hair. This is especially important so that the allergens aren't transferred to your pillow or sheets, remaining in the immediate space you breathe in all night.

Planning for Stinging Insects and Food Allergies

If your allergies include stinging insects or even food, planning ahead can alleviate a lot of anxiety. Always make sure to carry a minimum of two epinephrine auto injectors if there is a known insect or food allergy. Make sure the epinephrine auto injectors can be accessed and administered within 60 seconds if the need arises.

If food allergies are present, especially peanut, legume, or tree nut, it can make the lyrics “Buy me some peanuts and Cracker Jacks” send shivers down your spine. Fortunately, most large baseball stadiums across the country have become aware of the dangers and distress surrounding food allergies and have started to offer peanut-free games or special accommodations for food allergy families with peanut-free designated seating. The Food Allergy Research and Education (FARE) organization typically releases an annual guide outlining which major league and minor league baseball stadiums offer peanut aware sporting events. Along with utilizing their helpful guide, FARE recommends “to reach out directly to the venue to learn more about their efforts”.

Some suggested questions to have ready when you contact the venue about are:

  • Are there any [peanut] allergy friendly games, sections, or suites available?
  • Does the venue utilize power washing for seating, and traffic pathways at the stadium?
  • Can you find ingredient lists or are they available upon request at the concessions?
  • Do they allow families to bring in their own safe meals and snacks?
  • Are emergency responders available to the public at every game, and are their sections closer to these personnel?

Planning and communication are key to enjoying baseball season and balancing your outdoor allergies. Talk to family, friends, coaches, players, and venues, to create a plan that is right for your family. However, missing out on baseball season does not have to be part of that plan. If you or your loved ones are not quite sure if allergies are playing a role, or if the over-the-counter allergy medication just is not cutting it, you have options. There is still time to see your provider and discuss allergy testing and begin allergen immunotherapy.

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About the Author:

Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, PA. After spending 8 years in clinical practice, she joined United Allergy Services where she is currently the Vice President of Clinical. Amanda is also the past president of the Association of PAs in Allergy, Asthma, and immunology. 

 

United Allergy Services is also on FacebookLinkedIn, or Twitter. See other interesting and related articles on the UAS Blog.

https://unitedallergyservices.com/blog/patients/5-ways-tame-seasonal-allergies/

https://unitedallergyservices.com/blog/patients/versus-fall-alergies-will-win-7-tips-fight-allergies/


Tips for Traveling with Allergies

Summer is here, and for many families that means a much anticipated vacation! A time for overdue rest and relaxation, or maybe some quality time spent away with children and loved ones. While fun can be had at its best during this time, allergies can be at their worst, leaving sufferers to fear their upcoming travel plans. Here are some tips for maximizing enjoyment during travel for allergy sufferers.

Preparing for your trip

Location is everything! Especially when it comes to allergen avoidance and whether the chosen destination will fuel or extinguish allergy symptoms. Keep in mind that pollen counts tend to be lower on the coast, so beaches or cruising can be ideal vacation ideas. The desert, or alternatively snowy mountain tops can also be ideal. Cold temperatures will keep pollen and mold counts low, and dust mites do not prefer elevations above 2,500 feet. Regardless of which destination is desired, it is ideal to check the current weather and allergen forecasts for that area prior to leaving.

What should you pack?

Although your favorite swimsuit, new strappy sandals, or warmest ski jacket may be top of mind when planning and packing, allergy control measures should equally be at the highest priority. Staying compliant with a recommended treatment protocol prior to departure is crucial, as well controlled allergies, asthma, or atopic dermatitis before departing will give the best opportunity for well-maintained symptoms while traveling and for the duration of the trip. Make sure to pack allergy medication and immunotherapy in a carry-on bag if traveling by plane. Try to keep medications in original packaging and pack all medication and allergen immunotherapy in a separate, clear bag. Any liquid or gel medications or immunotherapy will need to individually be 3-4 ounces or smaller, so consider purchasing travel sizes if standard sizes do not meet this requirement. It would be beneficial to pack 1-2 days of additional medication or immunotherapy than what will be needed in case of delay when traveling home. And it may be beneficial to set a reoccurring alarm on a phone before leaving, as it may be more difficult to remember to take medications and immunotherapy regularly while away having fun.

Aside from medications and/or immunotherapy, don’t forget to pack any hypoallergenic hygiene products regularly utilized such as lotions, ointments, creams, body wash, sunscreen, laundry detergent, and/or dust mite encasements for pillows. When searching for accommodations, please also be aware that more and more hotels are offering such things as mattress and pillow covers or hypoallergenic linens so you may not have to pack your own. It is also beneficial to make sure sleeping accommodations are smoke free, away from humid mold friendly pool areas, and are free of “pet friendly” labeling.

Other things to consider

When traveling to or from the destination, the air in enclosed spaces such as planes and trains can be extremely dry. Consider investing in nasal saline spray or washes, as well as portable humidifier. A humidifier will likely also be beneficial if staying in a hotel for more than a night or two. Staying well hydrated with water and non-caffeinated beverages will also greatly help you combat drying out. If traveling by car, considering utilizing the heat or air conditioning and keeping windows closed. Also, turning on the heat or air 10 minutes before departure can help clear vents of any residual allergen particles.

While enjoying your destination, keep in mind that peak pollen times are typically in the first half of the day (specifically 5am 10am), so scheduling desired outdoor activities for later in the day before dusk may help to reduce exposures. And similar to when you are at home, a daily shower, especially before crawling into bed, will help to wash away any allergens that have adhered themselves to your skin or hair and are hoping to enjoy your comfortable accommodations right alongside you. This is especially important before allowing them to have access to your pillow or sheets and being in the immediate space and air you breath in all night.

Tips for travel

Finally, if food allergies or stinging insect allergies are concerning companions, planning ahead can alleviate a lot of anxiety and allow for a smooth trip. Always make sure to carry a minimum of two epinephrine auto injectors if one is prescribed to you or a loved one. Make sure the epinephrine autoinjector is carried in a way it can be accessed and administered within 60 seconds of a need arising. If you or a loved one does have life threatening allergies , it is a good idea to check with your health insurance and ensure you know where to seek medical care should the need arise while you are out of town. Nothing makes returning home even more depressing than unforeseen medical bills.

If food allergies are present, it can make traveling easier to pack your own meals or snacks to have readily available in transit to or from your destination. Preparing food yourself is always the safest option, however, it may not be feasible if staying in a hotel, or may not allow you to feel you are enjoying all the perks of vacation and exploring a new place. Research the local favorites and dining hot spots you wish to visit in advance of leaving for your trip so that you can identify safe selections off the menu in advance or can call and speak with the chef or manager to make reservations and proper accommodations. This will allow you to enjoy immersing yourself in the food culture without the worry of unknown exposure or hassle of having to change restaurants after you have arrived to one.

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Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, PA. After spending 8 years in clinical practice, she joined United Allergy Services where she is currently the Vice President of Clinical. Amanda is also the past president of the Association of PAs in Allergy, Asthma, and immunology. 

United Allergy Services is also on FacebookLinkedIn, or Twitter.


Oral Allergy Syndrome

Spring is just around the corner! Trees, plants, and flowers are beginning to grow and bloom. Fruits and vegetables are light, fresh, and crisp just like the spring air. However, that fresh spring air may carry more than just excitement for the season and oral allergy syndrome may give cause for concern.

Oral Allergy Syndrome

If you have seasonal allergies, spring may be associated with discomfort. Unfortunately, many people with seasonal allergies also suffer from oral allergy syndrome, sometimes called pollen food allergy syndrome. This syndrome occurs when there is a cross-reaction between the similar proteins found within certain types of foods. These foods, such as fruits, vegetables, and some nuts, can have similar allergy-causing proteins on the surface of the pollen grain.

Cross Reactivity

During the spring season, cross reactivity with tree pollen causes oral allergy syndrome. Birch pollen is the most common allergen trigger. According to the American Academy of Allergy, Asthma, and Immunology (AAAAI), oral allergy syndrome can occur in up to 50% - 75% of adults with a birch tree pollen allergy. Symptoms can occur when consuming a wide variety of foods, including those listed below:

  • almond
  • hazelnut
  • carrot
  • kiwi
  • soybean
  • peanut
  • celery
  • potato
  • apples
  • apricots
  • peaches
  • pears
  • plums
  • nectarines

Similarly, another common tree pollen, cedar, can also trigger oral allergy syndrome. Cedar allergy sufferers may have symptoms with several fruits and vegetables, including:

  • apples
  • cherries
  • bell peppers
  • kiwi
  • tomatoes

Symptoms and Treatment

Typically, if you have an oral allergy syndrome reaction you may experience itching in the mouth and throat. Symptoms tend to be more severe when the food is eaten raw or in the purest form. Peeling, cooking, canning, or baking the food can be helpful in reducing or completely avoiding the symptoms in some individuals.

In most cases, symptoms of oral allergy syndrome are localized to the mouth and are uncomfortable or annoying. However, up to 9% of people have reactions that affect a part of their body beyond their mouth. About 1.7% can suffer a life-threatening allergic reaction or anaphylaxis. For this reason, it is crucial for people to determine the cause of their symptoms. Allergy testing and food journals along with medical advice from your healthcare provider are recommended. It is usually best to avoid eating the offending food, especially in that food's peak allergy season. Another consideration would be to treat the underlying pollen allergy with immunotherapy.

 

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Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, PA. After spending 8 years in clinical practice, she joined United Allergy Services where she is currently the Vice President of Clinical. Amanda is also the past president of the Association of PAs in Allergy, Asthma, and immunology. 

United Allergy Services is also on FacebookLinkedIn, or Twitter.


Skin Relief Tips for atopic dermatitis and eczema

Skin Care Tips: Atopic Dermatitis

From Amanda Hofmann, VP Clinical at United Allergy Services:

Earlier this month, the famous groundhog, “Punxsutawney Phil”, saw his shadow and promised 6 more weeks of winter. This past week, Phil showed he was serious about that promise as winter storms swept across most of the US. This recent wintery weather has given us the perfect opportunity to talk about proper skin care, especially if eczema or atopic dermatitis is present.

What is Eczema and Atopic Dermatitis?

Commonly, patients and even healthcare providers use the terms ‘eczema’ and ‘atopic dermatitis’ interchangeably. All atopic dermatitis is a form of eczema, however not all eczema is atopic dermatitis. Atopic dermatitis is the most common form of eczema and typically begins in childhood. This skin condition is typically characterized by dry, itchy skin and rashes that range from red/purple to brown/gray. Skin becomes dry, itchy, and inflamed due to immune system hyper-reactivity and the lack of a protective protein called filaggrin. A key factor in atopic dermatitis is a lack of this protein. Filaggrin allows our skin to produce and maintain a strong skin barrier. Without a strong skin barrier, moisture can quickly escape the skin and bacteria carried by fingernails can easily penetrate the skin after scratching.

Atopic dermatitis is commonly triggered by allergen exposure, stress, infection, or weather changes. Also, combining cold, dry air outside and dry indoor heat causes moisture to escape from the skins surface, leading to dry skin. Layering clothing, blankets, or taking lengthy hot baths or showers can lead to skin dehydration. All of these factors are more present in winter, making this time of year prime for suffering an atopic dermatitis outbreak.

Skin Care Tips: Eczema and Atopic Dermatitis Relief

Here are some helpful hints on how to help the skin survive and get some much-needed relief:

  • Dress in soft, breathable clothing. Avoid itchy fabrics like wool that can further irritate the skin.
  • Despite the persistent itch, try not to scratch or rub the skin. Scratching causes additional skin damage and irritation, as well as causes more heat on the surface of the skin. Skin damage, irritation and heat leads to more intense itching. By refusing to scratch, the itching cycle can be broken and the skin will be protected from virus and bacteria carried by fingernails.
  • For relentless itching sensations, apply cool, damp cloths to affected areas to cool the skin down. Also useful are cold compresses, ice packs, or even that bag of frozen peas in the back of the freezer. Just make sure to always place a towel or barrier between vey cold or frozen items and bare skin.
  • Although hot showers and baths go hand in hand with winter weather, aim for lukewarm water bathing lasting for no more than 10 minutes.
  • When bathing, skip the harsh washcloths and loofahs. Instead use your hands to lather up with a good cleanser. (A cleanser is different than soap or body washes. Soaps and body washes typically contain sodium lauryl sulfate which is a skin irritant, and are not as moisturizing or hydrating as a cleanser)
  • Make sure cleansers, moisturizers, detergents, and skin hygiene products are fragrance free and dye free. (Look for the National Eczema Association Seal of Acceptance on products to guarantee they are free of fragrance, dyes and other common allergens.)
  • After bathing, pat the skin dry rather than harshly rubbing.
  • Replace moisture in the skin by applying a moisturizer immediately after taking a bath or shower. Aim for moisturizing to occur within the first 3 minutes.
  • Moisturizers are classified as an ointment, cream, or lotion based on the amount of oil and water they contain. Higher oil content in a moisturizer is usually better for providing relief and even treating atopic dermatitis. Ointments have the highest oil content and are the best line of defense for atopic dermatitis.
  • Try using a humidifier.  Change the water in the humidifier and clean the machine every three days. Using distilled or demineralized water is recommended.

The National Eczema Association is a great resource for learning more about eczema, atopic dermatitis, causes, symptoms, and treatment options. There is a wealth of information on their website: https://nationaleczema.org/

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Amanda Hofmann, MPAS, PA-C, is a graduate of Duquesne University, in Pittsburgh, PA, and spent  8 years in clinical practice before joining United Allergy Services. She is the Vice President of Clinical at UAS and the past president of the Association of PAs in Allergy, Asthma, and immunology. 

For more interesting insight from United Allergy Services, visit us on FacebookLinkedIn, or Twitter.