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Sneezin’ Season

May 31, 2013

Sneezing used to be fun when I was a young boy. My great grandmother used to say:

One for a wish

Two for a kiss

Three for a letter

Four for something better

Five for silver

Six for gold

Seven for a secret,

Never to be told.

If this rhyme is anything to go by, I’ve accumulated a lot of secrets over the years. This sneezin’ season,  I’d like to share one particular secret with you: How to take control of your hay fever (seasonal allergic rhinitis).

Allergic rhinitis is common, occurring in up to 40% of the population. It results from genetic predisposition (a family history is often present) and exposure to environmental allergens such as dust, molds, animal dander and pollen. Although it is not a life-threatening condition, it should be regarded as a quality-of-life threatening condition. It is associated with asthma, breathing problems, sinusitis, sleep disturbance and other problems.

Here are some of the symptoms you may recognize in yourself:

Symptoms of Allergic Rhinitis






Runny nose


Itchy nose

Stuffy nose

Post-nasal drip



Watery discharge

Red eyes

Facial pain


Nasal discharge

Fluid in the middle ear

Eustachian tube dysfunction



Shortness of breath

Children with allergic rhinitis may have a crease on the bridge of the nose from constant rubbing (“allergic crease”) or dark circles under the eyes (“allergic shiners”). A tell-tale sign of allergy involves your child rubbing his or her nose upward with the palm of the hand (the so-called “allergic salute”).

When it comes to successful treatment, there are many medications to ACHOOse from.

Salt-water rinses and sprays can be useful but doctors usually start off by prescribing an oral antihistamine such as Reactine®, Claritin®, Aerius®, or Allegra®.

The next step is to add an intranasal corticosteroid. Steroids will give you the most bang for your buck and have been shown to be the most effective in reducing symptoms of allergic rhinitis. There are various different kinds on the market, e.g.,  Avamys® , Omnaris® , Nasonex® , and Flonase®. The combination of intranasal corticosteroid and azelastine (Dymista®) may be more effective than the individual components alone.

Steps for Intranasal Administration:

  1. Blow nose slightly and shake product

  2. Insert nozzle in nose and breath in lightly

  3. Remove nozzle and breath out through mouth

A third step to treatment is the addition of a drug called Singulair® .

If all of the above fail to achieve the desired control, a referral for immunotherapy may be appropriate. Immunotherapy involves the administration of allergen by injection. This type of therapy can benefit nasal symptoms in patients with allergic rhinitis, especially for pollens and house dust mites. A sublingual tablet for grass pollen allergy will soon hit the market.

For ocular symptoms, several eye drops are available. You could try Patanol® , Pataday®  or Opticrom® , just to name a few.

If you are allergic to your pet, the sad reality is that the best possible treatment is to remove your pet from your home.

If this is not an option for you then you may get some benefit from using a “HEPA” air filter. Unfortunately, allergens are not like Pennywise’s balloons, they do not all float. So you may have to replace your carpets with bare floors, drapes with blinds, and use a vacuum cleaner with a “HEPA” filter.

Bathing your dog twice a week may be helpful but bathing your cat will only increase your chances of having to visit the emergency room.

Have a happy summer and …

Bless you!

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  2. very nice article.

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