Healthy Living for Life – Seasonal and Indoor Allergies (Full Version)
21
August

By Adem Lewis / in , , /


– [Narrator] Living longer, living healthier,
living better than ever before. Welcome to Mountain-Pacific’s Healthy Living
for Life, – Welcome back, today I’m talking to Dr. David
Kluge about air and seasonal allergies. Dr. Kluge is a specialist in ear, nose, and
throat with an allergy practice as well. Thanks so much for being here today. – Thank you. – So let’s start out talking about seasonal
allergies. Is there a peak time when these allergies
flare up? – Seasonal allergies will start usually in
the spring time which can be as early as March. And that’s usually with trees in March, and
the trees will peak for a few months and then beginning around June or even late May you
can have some grasses which will start to come out and you’ll have grass pollen which
causes a lot of problems for people and then towards late June and early July then a lot
of the weeds pollen will come out as well and that’ll persist until we have a couple
hard freezes so even almost as long as Thanksgiving people can still suffer from seasonal allergies. – [Beth] Wow, okay, and so what are some of
the common symptoms that people experience when it comes to seasonal allergies? – So sneezing, itchy eyes, itchy nose, nasal
congestion, nasal drainage, eye watering, all of those things happen when people are
outside, about, and working outside or just even walking to and from their cars sometimes. – So what exactly is in the air that causes
these seasonal allergies and for people to experience those kinds of symptoms? – So outside seasonal allergies are gonna
be pollens for the most part, and that’s gonna be tree, grass, or weed pollens which are
floating around and you can kinda determine based on what time of the year it is what
kind of pollen you might have around. – [Beth] So why do people react to pollen? What’s the science there, I guess, that causes
people to react to those things in the air? – So the pollen is floating around in the
air all the time, you can’t usually see it, some pollen you can actually see like on your
car you’ll see a coating of pollen sometimes in the morning, that’s usually a bad sign. But in general you don’t really see it, but
you do breathe it in all the time and you get it on your skin and your clothes so you
can get it in your eyes if you itch your eyes and you’re breathing it in all the time so
it causes a lot of nasal symptoms with swelling, congestion, runny nose. It can cause eye swelling, people’s eye can
actually swell shut sometimes almost. But a lot of eye drainage or itchiness because
they’re itching their eyes or they’re just getting the wind blowing in their eyes and
also getting the pollen that way. – Okay sure, and so how many people would
you say in the U.S. are affected by seasonal allergies? – Probably almost half the United States is
affected at some time or the other with some kind of allergies, either indoor or outdoor
allergies. Half the U.S. will have some sort of allergy
reaction at some time in their life. – [Beth] Are there more common allergies or
common symptoms that people in our area, Montana and Wyoming would experience compared to other
parts of the United States? – I think that allergies are pretty universal
as far as symptoms go, it’s gonna be just the allergic rhinitis symptoms with the sneezing,
itchy eyes, itchy nose, or the allergic conjuctivitis symptoms with the itchy eyes, runny eyes,
swollen eyes. Those are pretty universal throughout no matter
where you live with pollens or even indoor allergens as well cause similar symptoms. – Okay, and what about hay fever, what exactly
is that? – Hay fever is just a slang term that people
use for allergic rhinitis. Usually seasonal allergies because they experience
it when they’re around hay, traditionally, and that was back maybe in the 1800s, 1700s,
where people were out in the fields cutting hay, out in the grass and so they experienced
very intense symptoms in that time because they had very intense exposure. They’re out working in the grass, working
in the hay, around those kinds of things that might be exposing them to allergens to make
them have symptoms. – Okay, so I would imagine that would still
affect farmers in agricultural areas today. – Yes, absolutely, I have a lot of farmers
and ranchers at my practice, and they say that when they cut hay, or they’re in hay
barns or grain bins, they’ll have significant allergy symptoms. – Sure, okay, so can hay fever impact people
more than just sneezing and coughing, or is that generally what they experience? – So yeah, that’s how it starts usually, and
then it can develop into ocular symptoms where they have issues with their eyes. It can develop into swelling where they can
get swelling in their nose, causing congestion, or swelling in their eyes, and it can even
go into an asthma type reaction where they can have some shortness of breath. – [Beth] Okay and so you just mentioned asthma. Do allergies cause asthma? – Allergies can trigger asthma for sure, yes. Adult onset allergies and asthma is a major
issue with exposures. You could not even know you really have any
reactive airway problems and get exposed to something that you’re allergic to and then
develop asthma type symptoms. – Okay, so can you talk a little bit more
about what exactly happens there, what happens in your lungs or in your body where allergies
become asthma? – So, similar to breathing in the pollens
or breathing in things that we’re allergic to into your nose, they cause nasal symptoms,
but also, they’re going into your throat, and down in your throat, into your windpipe,
and into your lungs where they can cause similar inflammation and so cause the muscles in the
lungs to constrict which is what an asthma attack really is, can cause you to make more
mucous in your lungs, and have you cough and have more stuff that you’re coughing out of
your lungs. – Okay, and so just how dangerous is asthma? Can asthma lead to death, especially if it’s
not treated? – Absolutely, yes, asthma is, for sure definitely
can be life threatening. It’s fairly easy to treat and so it’s a silly
way to be sick, but yes if you ignore it or if you don’t know if you have a certain allergy
that might set you off and you get exposed to that in a sever magnitude, you can have
a severe life-threatening reaction. – Okay, can you talk a little bit about when
someone should definitely consider seeing a doctor if they’re experiencing those kind
of breathing issues. – For anytime, any kind of shortness of breath
which can’t be explained due to working out in a gym that you’re short of breath or going
up a flight of stairs and you’re just out of shape and short of breath, if you really
are feeling you can’t catch you air and you can actually hear yourself or somebody else
can hear you wheezing then you should be seen in the E.R. right away. – Okay, great, and you said that it was easy
to treat. Can you talk a little bit about some of the
treatments people can do for asthma? – Sure, so you can do treatments as easy as
avoidance, avoiding what might set off your asthma if you have allergy-induced asthma
then you can just try to avoid those triggers. You can take traditional allergy medications
which would treat your allergies and in so would also treat you asthma as well in that
case. And then you can go into inhalers which would
be either emergency inhalers that you would take several times a week at the most if you
had to. Or you could take a daily inhaler which is
a different kind of inhaler which you would take everyday to avoid the symptoms altogether. – Gotcha, okay great, thank you so much Dr.
Kluge. We’re gonna pause here for just a quick break,
But coming up after these messages we’re going to continue our discussion on allergies. Don’t go away, we’ll be right back in just
a couple of minutes, stay tuned. – Welcome back, we’re talking about seasonal
allergies with Dr. David Kluge, thanks for staying with us, doctor. So can you talk about, some people develop
seasonal allergies later in life, why does that happen? – That can happen for several different reasons,
and it’s actually kind of controversial and not really well understood at all. But it can go both ways, people can develop
allergies as they get older and they could have had severe allergies when they were younger
and then kind of grow out of them as they get older as well. And that can happen with asthma as well. You could have severe asthma as a child and
then grow out of it as a teenager or never have asthma at all in your life and then have
it when you turn 30 or 40 years old. Some of the mechanisms are understood a little
bit and one of the mechanisms that I’ve noticed a lot is hormonal changes and that affects
men only once in their life when they go through puberty and their allergies and asthma can
change significantly at that time in their life. And then over the course of their life over
usually years or decades can also change but usually much more slower. But the hormonal changes can happen rapidly
in the period of months or even a year. And then for women, they have the same thing,
you know with puberty, but then every time a woman gets pregnant of course her hormones
are gonna be in a state of flux, and so that can change her immune system, and she can
go from having no allergies to having severe allergies or again the other way around. She can develop food allergies. Sometimes the food allergies will be permanent,
sometimes the food allergies will go away after she gives birth, it’s very interesting
because then the child could go on to develop allergies that were similar to the mother’s
when she was pregnant, so it’s very interesting. And then finally with woman with menopause,
their allergies can also change one more time, again in a rapid, fairly rapid, menopause
is a fairly lengthy period, but still it can over a period of a short couple years it can
change pretty remarkably that way. And again asthma can do the same thing. So that’s one main mechanism that we do understand,
but lots of other mechanisms do exist for adult-onset allergies, some of those can also
have to do with exposures, moving to a different area of the country, having a new house, having
had an incident in your house with water or flooding or mold in your house, new animals
in the house, all of those things can trigger allergies as the adult-onset. A lot of them can be figured out, but a lot
of them cannot. – Okay, are there times that someone might
have an allergic reaction, especially to seasonal allergies for example, that is so bad, they
would need to seek out emergency help? – Typically with traditional allergic rhinitis
and allergic conjuctivitis which is the nasal and eye symptoms, those are just very inconvenient
but not necessarily life-threatening. As we’ve spoke about before though, when the
allergies can trigger an asthma reaction or a lung issue then that can become life-threatening
and have to be seen in an emergency setting, yes. – Okay, are there some things that folks can
do to sort of keep control of those symptoms related to seasonal allergies? – So avoidance is the key, you know, if you
know what triggers you, if you know what you’re allergic to, then trying to avoid those particular
things is the number one thing to do. If you do have exposure, then trying to basically
decontaminate yourself as fast as possible after the exposure. So let’s say that you know that when you mow
the lawn that you’re eyes are gonna swell up and you’re gonna have trouble breathing
so then, you can mow the lawn, you might wanna wear a mask if you’re very severely affected
as soon as you get done mowing the lawn though, you’d wanna come inside, take your clothes
off, put them in the wash, get in the shower, and then something that people don’t usually
think about is your nose filters all that air that you’re breathing and so getting your
nose washed out just like your body washed off is important, so using nasal saline spray,
Ocean spray or Simply Saline, some form of a generic of that is also great to wash out
your nose and get it cleaned out. – Okay, those are great tips, can someone
get tested to find out what allergies they have? – Yes, that’s the purpose of the first step
of allergy treatment is if you have symptoms that are not controlled with traditional medications
then going and getting seen by an allergist and getting tested, so we can find out almost
exclusively what you’re allergic to, yes. – Okay, are there potentially any side effects
to those test? – The test can cause typical allergic reactions
so if you’re very uncontrolled, the test can put you into an asthma reaction which would
be very rare, but can occur. Testing is occurred in two different ways. We do skin testing which we actually put a
little piece of what we think you might be allergic to under your skin as a scratch test
or as an intradermal test, those tests are anywhere from not uncomfortable at all to
being moderately uncomfortable, not really painful, but they can be a slightly uncomfortable
test. Most of the testing does not even involve
needles, though, but some testing sometimes does involve needles, and that testing can
be very minimally dangerous, but again we’re trained to, we’re allergists, so we’re trained
in allergy reactions and we’re set up for those kinds of reactions in the office if
anything happens. The other part of testing that can be done
is blood testing which is where your blood is drawn and they test your blood for different
antibodies for things that you might be allergic to as well. Of course that test is just as dangerous as
getting your blood drawn which isn’t really dangerous at all. But those are the two different ways. Skin testing is considered much more accurate
in general, so we try to do skin testing if we can. – Okay, does insurance typically cover those
types of tests? – Insurance usually, almost universally, insurance
covers those tests, either the skin testing or the blood testing and it just depends on
what your insurance co-pays might be or deductibles to be met but otherwise it’s very well covered. – Okay great, are there prescription medications
that people might get prescribed if they find out they’re allergic to something? – So there are, at this time most of the medications
that we had in our tool bank of medications, tool box of medications are over the counter,
which is very convenient for patients. But there still are some prescription medications
and those include medications that we’d use for asthma as we talked about before with
either a rescue inhaler or daily inhalers or medication such as Singulair or montelukast
that’s one of the only prescription medications left that we can prescribe patients and that
works for allergies and asthma and when it does work it works very well, but sometimes
it doesn’t work at all for some patients. – [Beth] Okay so you mentioned prescription,
over the counter meds, any side effects that people should be aware of when taking those
kind of medications? – So the over the counter medications which
used to be prescription which are now over the counter would include Flonase or Nasonex
or Rhinocort, nasal sprays, and those are steroid based nasal sprays, they work very
well for nasal congestion and nasal drainage and sneezing, but mainly congestion and drainage. The number one side effect for any of those
nose sprays is gonna be nose bleed, second most common side effect is gonna be headache,
they’re not addictive nose sprays, there are some nose sprays over the counter which I
do not recommend which are addictive, and basically your nose gets addicted to those
nose sprays, and those are awful and those are the afrin or the nasal 4 Way nose sprays
which should be avoided unless you’re sick and only should be used for a couple days
in a row. But the Nasonex, the Flonase, the Rhinocort,
and those ones are great to use long term and not addictive. Other class of medications over the counter
would be the antihistamines and that includes the old-fashioned Benadryl which works great,
everybody’s taken Benadryl, it makes most people very sleepy only lasts for four hours,
but it works very well. It’s the most potent antihistamine that really
we have. If you go to the E.R. with an asthma attack
they’re gonna give you Benadryl. So it works great and I recommend if you’re
having a severe attack to use a liquid Benadryl like a children’s Benadryl or a liquid gel
Benadryl because it’s absorbed faster in your body. But other antihistamines which are newer than
Benadryl which don’t cause as much sedation would be Claritin, Zyrtek, Allegra, or Xyzal
which is one of the newer ones as well. Zyrtek and Xyzal can cause some sedation but
typically Allegra and Claritin do not cause much sedation. Unfortunately though, Claritin and Allegra
don’t seem to work as well as Zyrtek and Xyzal. Xyzal and Zyrtek seem to be stronger but they
can cause about 10% of people to be sleepy. – Okay perfect, alright doctor thank you so
much. We’re gonna take another break, but we’ll
be back right after this, stay tuned. – Welcome back to Healthy Living for Life. We’re continuing our discussion with Dr. David
Kluge on allergies, so I understand as we age our body changes, obviously, and that
we may produce, or that may cause more air borne allergy problems. So can you talk a little bit about the changes
in our body, I know you mentioned hormones earlier, but what happens that can make allergies
worse? – Well for some reason as we get older everything
gets worse it seems like. But, one thing that we do see is that the
nose continues to get more plugged and congested and our throat also tends to get more constricted
and just the way of aging and so one thing that we do see is more sleep apnea as we get
older because our muscles tend to be more relaxed and our nerves don’t seem to work
as well, and so our whole upper airway system kind of just gets worse as we get older and
so the allergies that may have caused nasal obstuction and some drainage when we were
younger may now cause sleep apnea and collapse of the upper airway completely as we get older
which would have to be treated in a whole different way than just with allergy medication. – [Beth] Okay, let’s talk a little bit about
indoor allergies, what are some of the more common indoor allergies? – So indoor allergies are gonna be limited
just to what’s inside the house or what can be inside the house and that’s gonna be dust
mites, cats, dogs, or other animals if you have other animals in there such as birds
or other rodent type animals and also molds and molds are really underappreciated as far
as how bad they cause severe allergy symptoms. – Okay, can a doctor like you, an allergist,
help identify what is causing people to have symptoms that’s inside their house? – We can help, we can give them ideas to look
for, and we can also tell by when the patients have symptoms. As we talked about earlier, some people have
symptoms that peek in the summertime, such as hay fever, where they get outside and they
work around and they get worse, some people will have symptoms that get worse in the wintertime. They do fine all summer long and then as soon
as they button up their house for the winter, then they get worse. And those are gonna be people that have indoor
allergies. Another thing about indoor allergies is that
they can affect you all year around. So you can have symptoms all year around,
spring, summer, fall, winter, all the time, maybe worse in the winter, but they can also
still affect you the summertime as well. And they can still be indoor allergies that
are getting you. – Okay, if somebody brings something new into
their house, a new piece of furniture or carpet, can that cause allergies? – It can cause allergy-type symptoms. The chemical released from new furniture or
new carpets or chemicals released in smoke or in perfume or in household cleaners can
cause allergy-type symptoms. It’s hard to say that they’re really allergic
to it, but as far as the patient perceives, what they notice, what they feel, they feel
that they get congested, they feel that they can’t breath, they feel their nose runs, that
their eyes might get swollen or their eyes might run, but inside their body, it’s a different
reaction that’s happening, but what the patient perceives is still the same. – Okay and you just mentioned cleaners, what
about those and air fresheners? – So anything with a strong odor, cigarette
smoke, car exhaust, forest fire smoke, you know volcano smoke for folks in Hawaii right
now, all those can basically irritate an already irritated system so if the system is revved
up due to an allergy-type system reaction already then those other irritants can make
that reaction worse. – [Beth] So if someone is buttoned up, as
you said, for the winter, what can they do to lessen those symptoms? – Keep the house as clean as possible. Of course, they probably know, whether or
not they want to know or want to think about it, they might be allergic to their animals
or not, so minimizing exposure to the animals that they may have in their house also is
useful, keeping the house as clean as possible, keeping the animals out of your bedroom, you
spend eight hours a day or more in your bedroom and so that’s eight hours you could have as
a clean space for you if you can keep the animals out of there if you’re allergic to
the animals. Also changing your sheets often, vacuuming
frequently, using a hepa filter, using an air freshener in your house. It helps if you know what you’re allergic
to as well, so if you’ve seen an allergist and you’ve been tested and you know that you’re
allergic to dust mites but not your dog then that’s useful because you know how to treat
that in your house differently than somebody that doesn’t know what they’re allergic to. – Sure, okay and what if you clean all the
time and you’re still experiencing symptoms, what do you do then? – So then you would take medications over
the counter which we talked about before which would be antihistamine and maybe a nasal steroid
spray and if those are not affective enough then you probably need to see an allergist
to find out what is setting you off to see if you can avoid it or if you need to take
the next step in treatment. – [Beth] Okay would you recommend an air purifier? – Absolutely, yes, and I would keep that in
places where you sit more often, so in your bedroom having it on your night stand would
be nice or in your bedroom as well, just close to where you breath and if you have a place
where you sit and read or watch tv in the living room all the time having one out there,
again to keep the air clean by where you’re sitting. Something that I wanna mention really quickly
though, is that house plants can be a big source of indoor mold. Keeping house plants away from your bedroom
completely and away from your sitting areas can be a good way to avoid that source of
mold in your house. – [Beth] Okay so we’re almost out of time
doctor, but really quickly, smoking, does that make allergies worse? – Smoking, again is like an irritant, so of
course, and it always surprises me people that have asthma and they smoke. But yes, it basically takes a system that’s
already irritated and then you’re just adding another layer of irritation on top of it. – [Beth] Okay and then again just really quickly,
medications for indoor allergies. – They would be exactly the same as the outdoor
allergy medications. I know the drug companies want you to think
that some medications are approved for indoor or outdoor allergies, really all the medications
are almost all the same. The antihistamines are almost the same. The nasal sprays are almost all the same. Just use them as you think you should use
them. – Okay perfect, thank you so much great information
and expertise, so thanks for being on the show today and thank you for joining us, we
hope you’ll come back again next week, until then, stay fit, stay well, and stay healthy
for life with Healthy Living for Life. – We’d love to hear from you. If you have suggestions for future programs,
visit our website at MPQHF.org or call us at 406-443-4020. You can also catch us on youtube by visiting
our website and clicking the youtube icon. Special thanks to Fire Tower Coffee House
and Roasters. Production facilities provided by Video Express
Productions.


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