Allergy Attack
Pick the best approach to save yourself from threats to eyes, sinuses and lungs.
June 18, 2008— -- Allergies are life's medical traffic jam. Whether you're in the middle of major congestion or a 14-symptom pileup, this time of year is as annoying and painful as it is disruptive and frustrating.
What's worse, no matter what's causing your coughing/sneezing/head-exploding chaos, you can feel lost when it comes to knowing how to eliminate all the stuff, gunk, and goop that's darting through your head. So if you feel stranded on the painful road of allergic symptoms, use this primer to get to the closest exit.
Your Allergy Situation: You have a runny nose and you-ou-ou-ou-ou sneeze! all the time.
Like Cameron Diaz movies, all prescription antihistamines are not made alike. Although they all work by stopping histamines (the things your body releases when you're allergic) from getting to their receptors, Zyrtec (cetrizine) has been shown to be more effective than other prescriptions. With over-the-counter (OTC) medication, the antihistamine diphenhydramine (found in Benadryl) is most effective for quelling an allergy attack.
"It works within a couple of minutes; [other antihistamines] work within a couple of hours," says Dr. Beth Eve Corn, chief of Mount Sinai School of Medicine's allergy clinic. The trade-off for fast action is that Benedryl hits you like a Mack truck -- and puts you to sleep fast. You can take loratadine (found in Claritin) to avoid the drowsy effects.
Tip: If you know you're going to be exposed to allergens (being outside or around a neighbor's pet, for example), take some loratadine several hours before you go. It's also been shown to have a preventive effect.
Your Allergy Situation: Your eyes are as red as the Oscar night carpet.
This time of year, you don't have to travel from LA to NYC to know the meaning of red-eye. While OTC antihistamines can help relieve redness, you're better off with prescription antihistamine drops because they're more effective than the OTC ones and last twice as long -- half a day compared with a few hours. (A 24-hour formula is awaiting FDA approval.) By blocking allergy-causing histamines from their receptors, antihistamines like olopatadine and levocabastine eliminate your au naturel red eyeliner and immediately calm swollen blood vessels in the eye.
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The Secret Life of Germs"I rarely use it on a regular basis," says Dr. Timothy Craig, an allergy expert at Pennsylvania State University. "I use it on a rescue basis."
Tip: If you wear contacts, take them out and wait five minutes after using any antihistamine drop before popping them in. The lenses can absorb the drop, preventing the medicine from working properly, says Dr. Robert Cykiert, a professor of ophthalmology at New York University.
Your Allergy Situation: Your nose feels clogged and drier than an Arizona desert.
For severe nasal-allergy symptoms, nasal steroids are the first-choice drugs. Imitating the cortisone and hydrocortisone made by your adrenaline gland, they help suppress nasal inflammation by decreasing the production of inflammation-causing cells, says Dr. David Bernstein, professor of clinical medicine at the University of Cincinnati.
It may take longer for your symptoms to go away, but try an OTC first. Combine an antihistamine with a decongestant that contains pseudoephedrine, which makes breathing easier by shrinking the blood vessels in your nose. Test drive the 12-hour OTC decongestants before you swallow the 24-hour formula, because the decongestants can have a stimulating effect, says Dr. Don McNeil Jr., an allergy expert at Ohio State University.
Tip: Nasal saline -- a combo of salt and water -- is an all-natural decongestant that won't cause rebound congestion, a potential side effect of oxymetazoline, which is found in popular OTC decongestants. It clears out allergy-causing debris and relieves dryness by misting the nostrils with moisture, says Corn.
But use a preservative-free formula like Simply Saline Sterile Saline Nasal Mist. A study at Eastern Virginia Medical School found that benzalkonium chloride, the most common nasal saline preservative, kills infection-fighting cells in the nose.
Or make your own. Combine 1/8 teaspoon iodine-free salt with eight ounces warm water and a sprinkling of baking soda to neutralize the pH. Using an ear syringe, squirt water up one nostril until it comes out the other. Make a new solution for each use to avoid sending bacteria into your nose.
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The Secret Life of GermsYour Allergy Situation: You're getting desperate.
Generally, we avoid needles unless we need blood to come out or a flu vaccine to go in. But if you've reached the point at which meds are about as effective against your allergies as water pistols are against a volcano, then you might consider allergy shots.
Allergen immunotherapy works by decreasing sensitivity to allergens through shots. Although no official stats on the procedure's success rate exist, doctors throw around 50 percent as an unofficial estimate.
"If an antihistamine is not working, then allergy shots are a great option," Corn says. Treatment begins with an allergy test. Once your doctor finds out what you're allergic to, she formulates those allergens into a serum that you're injected with every week. Your dosage is consistently increased until you get on a monthly maintenance that you'll continue for three to five years. The effects should last at least a few years, if not forever. Plus, you save money: five years of shots won't come close to equaling a lifetime supply of other meds.
Tip: Needle-phobic? Some doctors use allergy drops (under the tongue) instead of shots. When researchers at the Imperial College of Medicine in London recently reviewed 22 study trials, they determined that treatment with allergy drops results in a 34 percent reduction in symptoms on average. Some U.S. doctors may be reluctant to prescribe allergy drops, so shop around until you find one willing to consider this option.
Your Allergy Situation: You prefer nature's way.
While traditional medicine treats specific symptoms, acupuncture treats the whole body -- the source of your allergies, says Dr. Joel Lewis, an acupuncturist and allergist in California.
Depending on the severity of your symptoms, expect to be stuck with a dozen or so tiny needles anywhere from once a week to once a month to once, period. Needles typically are placed around your sinuses and in such places as your leg or hand.
While traditional medicine isn't sold on acupuncture's effectiveness against allergies, its practitioners believe acupuncture stimulates your body's infection-fighting and pain-killing chemicals. Those, in turn, help to restore the body's broken energy flow caused by allergies. Sessions range from $50 to $100 and might even be covered by your insurance.
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The Secret Life of GermsTip: If you decide to try acupuncture, see someone who is accredited and licensed. You can check with the American Academy of Medical Acupuncture at medicalacupuncture.org for a list of the accredited therapists in your area.
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