32
ALLERGIC LIVING |
SPRING 2012
CANADIAN NETWORK FOR RESPIRATORY CARE SPECIAL SUPPLEMENT • SPRING 2012
Spring is literally in the air
. Tree andgrass pollen and even mould are causingsneezing, runny noses, congestion, watery eyes and worse. Many Canadians enjoyeda pleasantly mild winter, but this meansthe symptoms of seasonal allergic rhinitis– better known as hay fever – have beenplaguing them for months. In the prairies,where snow doesn’t usually melt untilApril, those with allergies have been suf-fering since January.But whether your allergies are justramping up or you didn’t catch a reprievethis winter, it’s important to appreciate:spring allergies are much more than a caseof the sniffles. Allergic rhinitis can have amajor impact since symptoms disruptsleep, leading to daytime fatigue, poor
BY JACLYN LAW
FEND OFF SPRING’SHIDDEN TOLL
Pollen allergiescan lead to sleep loss, inability toconcentrate and mood swings.
concentration at work or school and moodswings, says Bev Kulbaba, a CertifiedAsthma Educator (CAE) at the Children’sAsthma Education Centre in Winnipeg.There’s a loss of productivity and feeling of dragging through the day.Rhinitis allergens can also be big asth-ma triggers, so those with asthma need tobe prepared to avoid asthma flare-ups.“The vast majority of people with asthmahave an allergy of some sort,” Kulbabanotes. “Allergies that cause symptoms inthe upper airway can worsen asthma.”The key to staying well is to have yourasthma under control, to follow an asthmaaction plan and to tackle seasonal allergicrhinitis symptoms
before
they exacerbate your airways.
6 SPRING TIPS
These useful strategies can reduceyour reaction to springtime allergens.
1.
If you were able to reduce asthmamedication in the winter, make sureyou’re back to taking enough in thespring if you have allergic rhinitis, saysKulbaba’s colleague, Lesley Stewart, aCAE. “It’s important for people witha pollen allergy to start inhaled cortico-steroids, nasal sprays or antihistaminesaround the spring melt to establishgood asthma control.”
2
. Avoid early-morning activities, whenpollen counts are higher.
3.
Close windows at home and whenyou’re in the car.
4.
Stay inside on dry, windy days; themorning hours tend to be the worst.
5.
If you air-dry your laundry, do it indoorsso clothes don’t become full of pollen.
6.
Do regular follow-ups with your allergistor family doctor, recommends Kulbaba.“Have an asthma action plan that givesguidance on how to treat asthma andmake changes to your medication.”
Quiz answers, page 35
True or False:Asthma has noeffect on life expectancy.True or False:The first symptomof asthma seen in infants isusually cough.True or False:Patients allergicto ragweed are more prone toreacting to melons and bananas.
QUIZ
123
with Jolanta Piszczek
P t : M i c h a e l K e l l e r / c b
ALLERGIC LIVING |
SPRING 201233
Certified Educators take yourasthma and allergy questions.
Send questions to: ask@allergicliving.com
Q. Recently our 5-year-old was diagnosed with asthmaand we are working to understand the disease and gaincontrol. He’ll be playing soccer outdoors this spring; thefirst time he’s taken part in an organized sport. How canwe make sure his asthma doesn’t flare up on the field?
Shona Elder:
Spring allergies, such as tree pollen and grass, canbe a trigger for some asthmatics. Combine this with exercise andsome people can run into trouble. The key is to achieve asthmacontrol before he begins to play soccer, which means using hisprescribed medications appropriately. Asthmatics should notfeel limited by exercise or activity if their asthma is controlled.Having his rescue inhaler available at the field is a requirement.He could also take a non-sedating antihistamine before playing,if he is bothered by allergic symptoms.
Q. I’m in my fifties, and have struggled with severe asthmaall my life. I’ve been hearing about the drug Xolair lately.What’s your opinion of it for someone like me?
Olsen Jarvis:
Xolair is a drug for asthma that requires an injec-tion once or twice a month. Asthma experts are seeing encour-aging results with it, and you could ask your specialist about thedrug. However, it is not covered by many insurance companiesand is very expensive. To qualify for coverage in most provinces you will also need a specialist to support that your asthma issevere.Before pursuing Xolair as a treatment option, make sure theasthma basics have been covered. Have you had allergy testingand done your best to avoid or eliminate allergens that trigger your asthma? Have you addressed all causes of rhinitis and postnasal drip? Do you have gastric esophageal reflux disease, char-acterized by regular heartburn and nighttime awakenings withcoughing, wheezing, sore throat and shortness of breath? If these issues have been addressed and you have allergic asthmathat is resistant to treatment, ask your doctor for a referral to arespirologist or allergist and speak to that specialist about Xolair.
Q. I consider my asthma under control but when I visit myin-laws’ farm, I get symptoms and need my reliever. Whatcould be triggering my asthma, and how can I deal with this?
Lindsay Douglas:
Many things can trigger your asthma whenvisiting a farm. Some barns have high temperatures, humidity and poor ventilation, which can promote mould growth and isan ideal setting for dust mites. Other triggers include grain, graindust and mould found in fields.Many farm animals are also triggers, including horses, cattle,sheep, pigs, goats, chickens, geese and ducks. You may need toadjust your controller medication when visiting the farm toreduce the need of your reliever. Trigger avoidance is also impor-tant; make sure to keep windows closed when indoors andshower after spending time outdoors to rinse away allergens.
Q. How can I prepare my 7-year-old for spirometry testing?
Shona Elder:
Kids are often concerned when you tell them they are having testing done at their doctor’s appointment. I wouldexplain to him that this is a very simple test that does not hurt atall. He will have to blow into a machine that measures how muchair he can blow out of his lungs, and how fast. Be sure to find outahead of time which inhalers he needs to stop before the test andfor how long. It’s also a good idea not to have a large meal or doany vigorous activity prior to spirometry testing.
Q. I’m allergic to birch and maple tree pollen. Would gettingallergy shots for those help my asthma control – or am Ilikely to still need to increase my controller meds in spring?
Lindsay Douglas:
Things you are allergic to can cause inflam-mation in your lungs. Allergy shots can be an effective way todecrease allergy symptoms, thereby helping control your asthma.They begin to take effect over a period of six to 12 months. You willthen continue to get shots for three to five years. If effective, aller-gy shots can be a good way to help control your asthma and canlead to a decrease in the amount of controller medication needed.
Q. I’m a graduate of hairdressing school and got a great job four months ago. But sometimes in the salon, I havebreathing difficulty. Could this be a form of asthma? Icertainly don’t want to give up on my career!
Olsen Jarvis:
Shortness of breath does not necessarily mean you have asthma. If you are only experiencing your symptoms atwork this could indicate a reaction to one of many chemicals inthe salon. My suggestion is to note the time and the tasks beingperformed when the symptoms occur. Make an appointmentwith your doctor who can determine if you need allergy tests ora breathing test or both. As well, if you figure out that a particu-lar chemical or work procedure sets off your breathing, try toarranging with your workplace to avoid that task or chemical.
Shona Elder is a pharmacist and CRE in Regina; Olsen Jarvis is a respiratory therapist and CRE in Winnipeg; Lindsay Douglas is a registered nurse and CAE in Windsor, Ont.
Q& A
Lindsay DouglasShona ElderOlsen Jarvis
34
ALLERGIC LIVING |
SPRING 2012
suPPleMent
The Canadian Network for Respiratory Care
is a non-profit organizationandregistered charity that works to improve the lives of Canadians living withrespiratory disease.We certify health-care professionals as Certified Asthma and Respiratory Educators (CAEs and CREs). Our CAEs and CREs work to help patients withtheir asthma, COPD, allergies and smoking cessation efforts. For more infor-mation or to find a CAE or CRE near you, please see
www.cnrchome.net
orphone:
905-880-1092
.
ABOUT US
T
here has been a clearincrease in the numberof people with allergiesin the developed world. What’sbaffling is why this is so. Oneof the widely believed theoriesis the “hygiene hypothesis”. Itsuggests that more of us havebecome allergic because we aretoo clean, have fewer infectionsand therefore do not have theproper immune responses todifferent proteins that becomeallergens.A major social trend in thedeveloped countries has beena push from rural, farminglives to urban lives. The moveaway from farming has result-ed in less time outdoors, lessexposure to “good” bacterialparticles, having smaller familiesand altered diets.Several scientific studies haveshown that farming families are sim-ply less prone to allergies. There isgood Canadian data that farmers areabout 60 percent less likely to devel-op asthma than urban dwellers.When one considers the numbersinvolved, living on farms couldpotentially prevent asthma in mil-lions of Canadians.Getting back to the land may notsound like a potential treatment, but
P t : r i c K c h a r d
THEASTHMAEXPERT
With Dr. Harold Kim, Allergist
there are studies looking at whetherit’s conceivable to treat the allergicresponse that occurs in patients withasthma or other allergies with non-disease-causing microbes (or partsof the microbes). If successful, thiscouldlead to more definitive treat-ment for all of the allergic conditions.It is certainly very early to suggestthat returning to a more agrarianlifestyle or exposing ourselves to dif-ferent aspects of rural life wouldreverse the “epidemic” of allergy. Butit is nice to dream .…
Asthma andYour Weight
Besides the damage
that high-fat,sugary foods do to your waistline,research is revealing that those whoare overweight are more likely to suf-fer from asthma.“There’s an increased prevalenceof asthma in obese subjects, we don’tknow exactly why,” says Dr. Louis-Philippe Boulet, a respirologist at theQuebec Heart and Lung Institute atLaval University in Quebec City. “Itseems that very often, asthma devel-ops after people become obese, whichsuggests a causal relationship.”Almost half of people with a BMIof 40 or higher have asthma, saysBoulet. (BMI, or body mass index, isbased on height and weight; 30 orhigher is considered obese.) It’s alsoharder to control asthma in peoplewho are severely overweight.“Sometimes the obese person doesnot respond as well to asthma medica-tion. That might be due to resistanceto the drugs or to the fact that obesity per se is causing symptoms in addi-tion to asthma,” says Dr. Boulet.Even a modest amount of weightloss (10 to 15 percent of body weight)can significantly improve asthma. Dr.Boulet recommends consulting a die-titian about eating habits, as well asincreasing physical activity.He cautions that asthma andweight may not be the only culprits.People who are obese tend to haveother health conditions, such as heartdisease. These should be treated,“because they can either generatesymptoms by themselves or worsenasthma.” –
Jaclyn Law
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