Finding a Way to Breathe, Sleep and Live Comfortably
Almost from birth, Summer was a child who sneezed and wheezed. “She had been suffering from a runny nose, ear infection or asthma – one illness right after another – since she was an infant,” said her mother. “We were in and out of doctors’ offices and hospitals. Finally, we were referred to Dr. Sandberg at Kelsey-Seybold Clinic.”
Allergy testing in December 2000 indicated that strong environmental triggers were causing Summer’s symptoms after treatment with prescription medications failed to offer sufficient relief. Summer started allergy shots in January 2001 when she was 4 years old. Within a few months, she experienced relief, and “she has not been sick a day since,” her mother noted.
Eric T. Sandberg, M.D., is an allergy and immunology specialist with Kelsey-Seybold Clinic. While Summer is one of his younger patients, he notes that allergies and asthma are quite common in children. Genetics and the environment both play a role in the development of these afflictions.
All in the Family
When it comes to allergies, the track record of other family members helps predict the risk. Allergies develop in about 15% of the general population. However, if one parent has allergies, a child’s estimated risk of developing allergies increases to about 30%. If both parents have allergies, the child’s risk nearly doubles again to 50-60%.
Hay Fever, Asthma Linked?
Typical symptoms of hay fever or allergic rhinitis include sneezing, runny nose and itchy eyes. Patients with asthma suffer from episodes of wheezing, shortness of breath and tightness in the chest due to the narrowing of the small airways of the lungs. For many years, medical experts have known that children with hay fever have an increased risk of developing asthma. Recent medical evidence suggests that for many children these are not separate conditions, but rather, “one-airway, one-disease.”
Hay fever predominates in the upper airway, especially the nose. In the lower airways, the lungs are affected. The same allergic agents or allergens -- pollens, etc. Risk factors for both diseases include a family history of hay fever or asthma, as well as exposure to indoor and outdoor allergens, especially at an early age.
Proper attention to problems of the nose, especially in children, can help reduce or help avoid problems in the lungs. “It is important to treat nasal symptoms promptly and aggressively to prevent worsening of lung problems,” says Dr. Sandberg. “We treat hay fever and allergies aggressively when identified in a young person, in an attempt to reduce asthma in teen years,” the doctor explained.
Altered Immune Response
An allergy is an altered immune response, or sensitivity, to a usually harmless substance. The immune system usually ignores common allergens, such as dust mites and grass pollens. However, in some children, the exposure to allergens allows the immune system to manufacture various proteins called “antibodies.” These antibodies may trigger an allergic reaction on the surface of the airway. The resulting swelling of the airway lining and the secretion of mucous may lead to congestion, runny nose and watery eyes.
Allergic reactions that occur in the nose, eyes and bronchial tubes are usually caused by airborne allergens, such as pollens, dust mites, mold spores and animal dander. In some instances, rashes and sudden episodes of wheezing can be caused by food allergens.
Common Allergies in Houston
“Different allergies predominate in different geographic areas,” the doctor notes. The major outdoor causes of allergic diseases in Houston are pollens from grass, oak and ragweed. The high humidity in Houston also increases the risk of mold allergy. In Austin, the culprit is often cedar pollen. In Italy, olive tree pollen is a common source of allergy. Indoors, the causes include dust mites and pet dander.
“Other U.S. cities, such as Charleston, South Carolina, may have higher allergy burdens, but Houston consistently rates near the top of lists of locations with high risk of allergy,” Dr. Sandberg noted. “High humidity contributes to high dust mite concentrations, while warm weather produces long growing seasons for grass.”
The Allergic “Shiner”
Hay fever symptoms are not limited to a runny and stuffy nose, itchy eyes and sneezing. “Commonly, you’ll also see dark circles under the eye, or what is known as an allergic shiner,” says Dr. Sandberg. These dark circles result from nasal congestion that slows the blood flow in the skin of the lower eyelid.”
So, what can you do about allergies? “The first line of defense is allergen avoidance,” says Dr. Sandberg. “Whenever possible and practical, simply avoid the allergen. For allergy to animal dander, avoid making contact with cats and dogs. When that’s not possible, our second line of defense is allergy medication. We concentrate on providing symptomatic relief by helping to reduce the stuffy, runny nose and helping patients to sleep more comfortably. Our third line of defense is allergy shots or immunotherapy for specific allergens. It’s a process of desensitization.”
Immunotherapy consists of administering increasing concentrations of allergy extract over a 3-5 year period. But first, the allergy must be confirmed. “Many children with allergies that fail to improve with medications will require some type of testing to precisely determine specific allergens,” says Dr. Sandberg. “After a thorough family history and physical exam, we use skin testing, which is rapid and accurate, to identify the allergens. In some situations, blood testing is preferable to skin tests.”
When to See a Specialist
If you think your child suffers from allergies, talk to your pediatrician. He or she may refer you to an allergy and immunology specialist if:
Your child is missing school because of repeated bouts of runny nose, congestion and/or wheezing.
Your child is having difficulty sleeping comfortably through the night.
Your child has been prescribed medications, but the symptoms persist.
There is a family history of allergies or asthma.
You want to identify the allergic factors that are causing a problem.
You want a second opinion or recommendations on how to control the symptoms.