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oral allergy syndrome

About Oral Allergy Syndrome: Symptoms & Treatments

Do you experience allergic symptoms in the mouth when eating certain raw foods? If you do, you could be suffering from oral allergy syndrome.

Oral allergy syndrome is actually fairly common for seasonal allergy sufferers. As people with seasonal allergies eat uncooked or raw fruits, vegetables, and some nuts, the immune system in their mouth can mistake certain proteins in the raw food as pollens and a local allergic reaction follows.

Learn more about oral allergy syndrome including the causes and how you can treat the symptoms.

What Is Oral Allergy Syndrome?

Oral allergy syndrome (OAS) is also known as pollen-food allergy syndrome. This is caused by cross-reacting allergenic proteins found in airborne pollens and raw vegetables, fruits, and tree nuts.

The immune system of individuals with seasonal allergies recognizes similar appearing proteins in raw foods as allergens, which causes a local allergic reaction inside the mouth.

Raw foods tend to cause the most allergic reactions. Often times, the allergy sufferers won’t experience an allergic reaction when the food is heated and cooked. This is because heating changes the molecular structure of the protein and renders it non-allergenic.

What Causes Oral Allergy Syndrome?

Not everyone with a pollen allergy will experience oral allergy syndrome. Common triggers for oral allergy syndrome include:

  • Grass Pollen – cross reacts with foods including peaches, oranges, melons, tomato, and celery
  • Birch Pollen – cross reacts to foods including peaches, pear, plum, kiwi, cherry, apple, hazelnut, almond, carrot, and celery
  • Ragweed Pollen – cross reacts with foods including melons, banana, cucumber, zucchini, and sunflower seeds

What Are Oral Allergy Syndrome Symptoms?

Oral allergy syndrome symptoms are typically experienced immediately after coming in contact with food. These uncomfortable allergic reactions can include:

  • Itchy mouth
  • Scratchy throat
  • Mild swelling of lips, mouth, tongue, and throat
  • Itchy ears (in some cases)

Most of these symptoms are concentrated in the mouth area and do not spread; however, there have been rare reports of more severe and systemic symptoms. Symptoms typically occur quickly as the fresh fruit or raw vegetable reaches the mouth. After swallowed or removed, the allergic symptoms may subside within minutes to one hour.

Most Common Oral Allergy Syndrome Culprits

How Do You Avoid It?

The best way to avoid oral allergy syndrome symptoms is by avoiding raw foods known to be problematic. Be aware of your pollen allergies and which foods are associated with certain pollen proteins.

An allergist can help diagnose which pollens and foods cause allergic reactions by reviewing your clinical history, conducting skin pricks, and performing oral food tests with raw fruit and vegetables.

By educating yourself about the foods causing the problem, you can avoid the reaction from taking place.

What are Your Options for Oral Allergy Syndrome Treatment?

Though symptoms may subside in a few minutes or within the hour, don’t ignore allergic symptoms when they occur. Stop eating foods which cause an allergic reaction and take an antihistamine to relieve itchiness.

Consult with your allergist when you or your child experience oral allergy syndrome symptoms. Symptoms may occur in children as young as 3 or 4 or begin later in life for adults. An allergist can conduct tests to pinpoint which foods are causing allergic reactions and whether it’s oral allergy syndrome or another kind of food intolerance.

Interested in discovering if you suffer from oral allergy syndrome and seasonal allergies? Contact the Allergy & Asthma Specialists of North Florida for more information.

17 Back-to-School Tips for Parents of Allergy Sensitive Kids

back to school food allergy tips

It’s back-to-school time again, and if you’re the parent of a child who suffers with allergies or asthma, it can also be a stressful time.

Food allergies affect approximately one in 13 kids. That means that in the average classroom, there are about two students who are coping with some form of food allergy. Of these students, nearly 40 percent have a history of severe allergic reactions or anaphylaxis. Parents, teachers, and school officials need to be aware of the potentially life-threatening situations that can arise and be ready to handle them should they strike.

Here, our board-certified allergists offer advice and resources for allergy- and asthma-sensitive kids and back-to-school preparedness.

Request a meeting with the school nurse.

Often, the nurse is the most experienced and best-trained staff member when it comes to medical emergencies. Your school’s nurse is the food allergy “champion” in your school, and the nurse should be your connection for developing a coordinated effort to ensure an all-inclusive approach to managing your child’s food allergy and asthma management in the school setting. This is why one of the first things we recommend parents to do is meet with the nurse and explain all of your child’s allergy or asthma symptoms.

Speak to the school counselor to discuss whether a 504 Plan is appropriate. 

Under federal law, a food allergy may be considered a disability. In those instances your child may qualify for educational services under Section 504 of the Rehabilitation Act of 1973. 504 plans outline appropriate accommodations, aids or services that a student with a disability needs to be able to fully participate in a free and appropriate public education environment. A 504 plan allows you to create, in collaboration with your child and the school, a written management plan outlining how the school will your child’s food allergies. It will also allow your child to participate safely and equally alongside their peers in all normal facets of the school day.

Disclaimer: We are not experts on 504 Plans—if you believe your child would qualify for a Section 504 Plan, please discuss this with your child’s counselor or the Special Education/504 Plan liaison at your student’s school.

Share your emergency care plan.

In conjunction with the nurse and teachers, share the emergency care plan you use for your family. Make sure all staff who works with your child is aware of this plan. This emergency care plan outlines the treatments recommended in case your child experiences an allergic reaction, the form is great for including emergency contact numbers and can be signed by your physician, pediatrician, and allergist.

Download Food Allergy & Anaphylaxis Emergency Care Plan

Share pictures of typical reactions your child has.

If your child’s teacher has not cared for kids with severe allergies, it could be helpful to share pictures of what typical allergic reactions look like. If you have pictures of your student’s reactions that would probably be the best option, but even just directing staff to websites with allergic reaction pictures.

Ask your child to describe to his/her teacher what they’re symptoms feel like. 

Children explain things in their own special way. They have a way of describing their experiences that are vastly different than the way adults describe things—and their way of describing allergic reactions are no exception. Knowing how a student experiences their reactions will help the adults around them save precious time when needing to recognize a reaction that is happening. Some kids, especially little kids, will place their hands to their mouth or pull and scratch their tongues in response to an allergic reaction. Additionally a children’s voice may change in response to a reaction (they may become hoarse or squeaky), and they could begin slurring their words.

Here are some examples of what a child may say to describe their allergic reaction:

  • “My tongue is hot/on fire/burning…”
  • “It feels like something’s poking my tongue.”
  • “My tongue/mouth/lips is tingling…”
  • “My throat itches…”
  • “My mouth/tongue feels funny…”
  • “It feels like there is something stuck in my throat…”
  • “My tongue feels fat/heavy…”
  • “My lips hurt…”
  • “It feels like something/bugs are in my ears…” (to describe itchy ears)
  • “It feels like my skin is burning…”
  • “I feel bumps on the back of my tongue/throat…”

Speak with school lunch staff.

Most schools have electronic systems for tracking lunch purchases. Ask that a notification or alert be included on your child’s profile. This notifies lunch personnel of your child’s allergy status and helps ensure he or she isn’t accidentally served foods he or she reacts to. In some instances, if your child has a very severe reaction to certain foods—especially if just being in close proximity to the food can cause a reaction—staff should be able to ensure a safe area in the lunch room or a safe eating area for your child.

Keep an epinephrine injector at school.

For parents in Florida, schools can keep non-student specific epinephrine pens stocked for children who suffer from anaphylactic reactions at school. However, every child with a severe food or insect venom allergy (i.e. to bees, wasps, fire ant, etc…) should have their own prescription for an auto injector that can be kept on hand at school. We recommend EpiPen, Auvi-Q or Adrenaclick (generic). You can also check out our patient education page for info on proper use of EpiPens.

Use safety tattoos for notifying staff.

You probably don’t need these for long-term use, but for the beginning of the school year (or other times when your child will be with new care providers), these safety tattoos can be extremely helpful in making sure people are aware of your child’s allergies.

Have your child wear a medical alert bracelet.

Especially for children at risk for severe allergic reactions, this is a better option than the safety tattoos. They are also helpful for EMTs who might respond in case of a medical emergency. Also, for your fashion-conscious kids, medical bracelets can be made like stylish jewelry.

Create a “safe food box.”

It’s common for classrooms to have snacks that may cause issues for your child. Create a safe food box that can be kept with the teacher to substitute for your child with severe allergic reactions. If safe food boxes are not encouraged, you can also offer up a safe food list for your child’s teacher to ensure that reactionary foods are not in the classroom.

Ask for a list of birthday party dates.

If your child’s classroom celebrates birthdays, it is possible to ask for celebration dates in advance and whether there will be dangerous treats available. Nowadays most treats have allergen-free alternatives that can be substituted for your child to ensure they don’t feel left out.

If you have the flexibility, consider being a “classroom parent.”

This would give you a little more advance notice on events going on in the school and classroom. Also, volunteering in the PTA and on field trips can help you monitor your child (and other children that might have allergies). Additionally, many schools are in dire need of volunteers and assistance—so you’ll be helping your child and your community school.

Ask school administrators to limit or not use your child’s classroom for after school activities.

Sometimes schools have to use rooms for after-school activities or to support outside groups. Ask that your child’s room not be used for these activities. While there is no guarantee the administration can honor your request, it could help to limit allergens brought into your child’s classroom.

Find out your school’s procedures for limiting allergens on buses and transportation vehicles.

Determine if the policies and procedures are appropriate for your child. In some instances, you might be best served by transporting your child to and from school yourself. Most districts have a “no food” policy on their buses unless medically necessary (i.e., a diabetic child with low blood sugar). Some policies might include having an adult on the bus who is trained in administering epinephrine or ensuring special seating arrangements.

Request advance notice of all field trips.

This should be standard procedure for your school and student’s teacher, but don’t just assume they will give you a lot of notice for the field trips. Your child’s allergies needn’t prevent him or her from attending educational and fun field trips. But asking staff to provide you with as much advance notice as possible gives you a chance to prepare and address any allergy concerns.

Ask to speak with the kids in your child’s class.

Unfortunately, bullying occurs for all sorts of things, and kids with allergies aren’t immune to bullies. Ask your child’s teacher and principal if you can address your child’s class to help them understand what allergies are and what happens to your child if he or she has a reaction. This won’t prevent all bullying, but it’s a good way to address issues ahead of time. If speaking to the class isn’t possible, allow the teacher to address the class about your child’s allergies (without giving too much personal information). For younger classes, a great little book to share is Binky Goes Nuts — check with your child’s school or local public library to see if it’s available.

Work with your child on how to self manage his or her allergies.

Older kids need to learn how to manage their allergies and advocate for themselves. When you feel it’s age appropriate, make sure your child knows to carry their medicine at all times and how to self-administer epinephrine if appropriate.

The good news for parents is that schools are becoming more aware of kids with severe food allergies and the actions to take to keep them safe. But it’s still important for you to be your child’s number-one advocate. Follow these tips to make sure you, your child and his or her school are ready for the coming school year!

If you suspect your child has allergies or asthma and would like to have him or her tested for food allergies, contact us to schedule an appointment with one of our board-certified allergy and asthma specialists. We have four convenient allergy clinics in Jacksonville.

Each school district may have different policies regarding school nurse staffing and student health policies. For our patients in Northeast Florida, please visit your school district’s website for more information:

What You Should Know About Stinging Insect Allergy This Summer

While stinging insects may be a minor annoyance to some, for others they can lead to serious, life-threatening allergic reactions. Thousands enter emergency rooms each year and potentially life-threatening allergic reactions occur in 0.4%-0.8% of children and 3% of adults. Anaphylaxis resulting from insect stings claims at least 90-100 lives each year.

Learn more about insect sting allergy, including symptoms, treatment, and how to prevent getting stung.

What Are Common Symptoms of Insect Sting Allergy?

Insect stings can cause one or more of the following symptoms:

  • Redness
  • Swelling (near the sting and beyond)
  • Pain
  • Itching
  • Hives

Serious allergic reactions require immediate medical attention. Symptoms of a potentially severe allergic reaction to an insect sting may include:

  • Hives, itching, and swelling beyond the site of the sting
  • Intense nausea or diarrhea, vomiting, and abdominal cramping
  • Swelling of the tongue or throat and difficulty swallowing
  • Anaphylaxis, a potentially life-threatening reaction that impairs breathing and causes the body to go into shock

Severe reactions can occur within minutes after a sting. Those who experience an allergic reaction to an insect sting have a 60% chance of a similar or worse reaction if they are stung again.

How Is Insect Allergy Diagnosed?

If you’re concerned about having an insect sting allergy, your allergist can diagnose the allergy and offer a treatment plan.

An allergist can test for the following five insects:

  • Fire ant
  • Honey bee
  • White-faced hornet and yellow-faced hornet
  • Yellow jacket
  • Paper wasp

After reviewing your medical history, an allergist will ask questions about previous insect stings, any reactions to stings, and what additional symptoms you experienced. A skin-prick test or a blood test can help diagnosis an allergy.

How Do You Manage & Treat Insect Allergy?

There is a two-step approach for managing and treating insect allergy:

  1. As soon as a reaction occurs, seek medical attention immediately.
  2. Preventive treatments can help prevent future allergic reactions.

Medical Attention

Don’t delay when a reaction occurs. Medical attention may include epinephrine, antihistamines, and in some cases, oxygen, intravenous fluids, and corticosteroids. If you have a known history of insect allergy, injectable epinephrine should be carried with you and call 911 if epinephrine is used.

Preventive Treatments

Venom immunotherapy is a highly effective therapy administered by an allergist that helps to retrain your immune system to become tolerant to insect venoms and thereby prevent future life-threatening reactions to insect stings. This is accomplished by gradually administering very small doses of the culprit insect venom to decrease sensitivity to the venom. While there is no cure for allergies to insect venoms, immunotherapy is the closest thing to it because it substantially decreases the likelihood that a life-threatening allergic reaction will occur to future insect stings.

How Can I Prevent Insect Stings?

The best way to prevent stings is to avoid bees, fire ants, wasps, hornets, and yellow jackets during the summer. Try not to look or smell like a flower when spending time outdoors. Some experts think khaki and gray colored fabrics and abstaining from perfumes or other scented personal use items will help you avoid getting stung.  Always use caution around areas where yellow jacket nests are in the ground or hornet and wasp nest found in trees, bushes, or on buildings.

In addition, use the following precautions:

  • Avoid being barefoot in the grass
  • Do not leave open beverage cans unattended
  • Keep food covered outdoors
  • Seal garbage cans
  • Repair door and window screens
  • Keep epinephrine on you at all times if you are allergic to stinging insects

Are you ready for summer? Stop by one of our Four Allergy & Asthma Specialists of North Florida Clinics if you’re concerned about insect allergies and discuss those concerns with a board-certified allergist today. A proper diagnosis and treatment plan can help ensure a fun and safe summer.

 

How to Guard Yourself Against Forest Fire Smoke and Other Respiratory Irritants

forest fire smoke allergies treatment jacksonville

When forest fire smoke levels or other outdoor respiratory irritants are high, even healthy people can experience symptoms or health problems. It’s important to understand how forest fire smoke and outdoor irritants can affect your health, including who is most susceptible to reactions.

The Negative Effects of Forest Fire Smoke on Your Health

Forest fire smoke is a mixture of fine particles and gasses from trees and plant material. The gasses and particles can be dangerous if inhaled. Carbon monoxide is a risk to people who work near smoldering areas.

Smoke can irritate your eyes and respiratory system. This can worsen symptoms for chronic heart and lung diseases. If exposure to smoke causes you to experience serious health issues, seek medical attention immediately.

People Most Susceptible to Health Issues from Outdoor Irritants

Those with pre-existing health conditions and those who are sensitive to air pollution may experience worse symptoms. Other groups susceptible to health issues include:

  • Individuals with asthma or other chronic respiratory disease
  • Individuals with cardiovascular disease
  • Individuals age 65 or older
  • Infants and children
  • Pregnant women
  • Smokers (especially those who have smoked for several years)

5 Tips to Reduce Exposure to Respiratory Irritants

While the best thing you can do is limit your exposure to smoke, a combination of strategies may work best to protect you. The more you can do to limit your exposure to forest fire smoke, the more you’ll reduce adverse health effects.

Keep Indoor Air as Clean as Possible

Keep windows and doors closed at home or at work. Use a high-efficiency particulate air (HEPA) filter to reduce indoor air pollutions. In addition, remember to change your air filter on your furnace and air conditioner every few months. Avoid smoking tobacco, burning candles, using wood burning stoves or fireplaces, and vacuuming (which can stir up dust and particles).

Use the AC in Your Car

Avoid leaving your windows down and use your air conditioning on the recirculate setting for fresh, cool air.

Drink Plenty of Water

Flushing your system by drinking plenty of water helps remove irritants from your body. Drink up to reduce a scratchy throat and coughing to stay healthy during fire and pollen seasons.

Reduce Time Spent in Smoky Areas

Whether it’s a forest fire, campfire, or tobacco smoke, avoid being where smoke is present. While sometimes it may be unavoidable, less exposure to smoke is better for your health.

Avoid Outdoor Activities

Vigorous outdoor activities such as running, biking, soccer, or other sports should be avoided during times of high smoke levels or outdoor irritants. Limit your workouts to indoor gyms and sports centers.

Wear Proper Protection

In areas with high levels of forest fire smoke, a simple dust mask isn’t enough. An N95 respirator mask fits over your nose and mouth and can filter 95% of smoke particles. N95 respirators do not filter toxic gasses and vapors.

Be aware that these masks can make breathing seem difficult and may lead to increased breathing or heart rates. If you have a heart or respiratory disease, only use the mask under the supervision of your allergist or other health care clinician.

Are you concerned about exposure to forest fire smoke or outdoor allergies? Talk to an allergist at the Allergy & Asthma Specialist of North Florida about testing and a treatment plan to stay healthy this summer.

 

Vitamin D Deficiency and Food Allergies: Does One Relate to the Other?

Food allergies are becoming an epidemic in today’s societies with a noticeable increase in cases in just the last decade. In the U.S. and Australia alone, 10% of infants 12 months old have been clinically diagnosed with a food allergy.

Just as food allergies increased, levels of vitamin D decreased. It’s estimated that 50% of the population in Western countries lack sufficient levels of vitamin D with 10% of the population are deficient in vitamin D.

This makes researchers wonder, could there be a correlation between food allergies and vitamin D?

Benefits of Vitamin D[1]

Vitamin D is often known as the “sunshine vitamin” because it is absorbed by the skin. It is also absorbed by eating certain foods or taking supplements.

Oily fish including salmon, sardines, and tuna have the richest sources of vitamin D. Other good sources include egg yolks, liver, and foods specially fortified with vitamin D.

Vitamin D is an essential nutrient to support healthy body functions. Sufficient levels of vitamin D helps:

  • Regulate calcium and phosphorus absorption to support healthy bones and teeth
  • Protect against diseases such as type 1 diabetes, hypertension, cancer, and multiple sclerosis
  • Support brain health, the nervous system, and the immune system
  • Aid in cardiovascular health and lung function

Symptoms of Vitamin D Deficiency[2]

How do you know if you are vitamin D deficient? Many people don’t develop symptoms until their levels are low for a while. This can make vitamin D deficiencies hard to diagnose.

Common symptoms include:

  • Bone pain
  • Frequent bone fractures
  • Muscle weakness
  • Difficulty forming clear thoughts
  • Depression

Low levels of vitamin D can lead to more severe health issues such as:

  • Cardiovascular disease
  • Cancer
  • Cognitive impairment in older adults
  • Asthma in children

Can Vitamin D Affect Food Allergies?  What the Research Says

Studies show locations further away from the equator (areas lacking ultraviolet radiation (UVA)) have higher rates of child food allergy-related hospital visits, peanut allergies, and epinephrine prescriptions. In addition, being born in the fall or winter with less UVA exposure relates to higher risks of food allergies and anaphylaxis in children.

Diet can also be a contributing factor. An Australian study found that children who were introduced to eggs after six months of age had a higher risk for food allergy than infants who were introduced to eggs when they were 4-6 months.

What This Means for You

The research comparing vitamin D deficiencies to food allergies is not conclusive and more research is needed to know if vitamin D can reverse food allergies. What we do know is vitamin D can protect against food allergies and is critical for your overall health and well-being.

If you think you may be vitamin D deficient, your doctor can assess your levels by a simple blood test and recommend supplements. Only take supplements under the care of health care professionals such as your primary care physician or allergist.

If your child is experiencing food allergy symptoms, schedule an appointment with the Jacksonville Allergy & Asthma Specialists for allergy testing. Call us at 904-730-4870 if you have questions about food allergies.

References:
[1] http://www.webmd.com/food-recipes/features/vitamin-d-vital-role-in-your-health#1
[2] https://medlineplus.gov/vitaminddeficiency.html

jacksonville allergy specialists tips to handle pollen allergy

7 Things You Can Do to Feel Better During Spring Allergy Season

Sneezing, runny nose, and itchy, watery eyes. The true signs that spring allergy season is here.

According to the American Academy of Allergy, Asthma and Immunology (AAAI), pollen season can begin as early as February and lasts through October–depending on weather patterns and your location. In Jacksonville however, we can count on a very long pollen season that begins in early January and ends in November!

If pollen allergies get you down, use these tips to feel better this spring allergy season.

1.    Drink Lots of Water

Water is central to a healthy life. Proper hydration helps fight off excess congestion from spring allergies by thinning out mucus in your nasal passages. Drinking plenty of water also prevents allergy-related sinus headaches.

2.    Avoid Being Outside During Peak Allergy Hours

Each spring, trees release millions of tiny pollen particles into the air. Simply breathing the air can cause allergic reactions. When pollen counts are high, avoid being outside as much as possible. Especially in the morning between 5 a.m. and 10 a.m., on windy days, and dry, hot days.

Protect your eyes with sunglasses and wear a mouth mask when doing yard work. Avoid bringing pollen inside your home by showering, washing your hair, and changing your clothes.

3.    Track Allergy Levels on Your Phone

Use your favorite weather or allergy apps during allergy season to view daily pollen and mold count reports. Check before you head out for the day so you know what to expect.

4.    Take Allergy Medications

Avoiding the outdoors in the spring isn’t always realistic. Your allergist may recommend antihistamines and decongestants which can help relieve symptoms in adults and children.

Nasal sprays can help severe allergies but don’t take effect right away. Relief could take up to a few days. If other medications don’t offer relief, your allergist may suggest allergen immunotherapy, also known as “allergy shots.” These shots contain traces of pollen and help your body build up a defense over time.

5.    Prevent Symptoms Before They Start

Prevention is key. Don’t wait for your allergies to spiral out of control. See your allergist for a treatment plan before spring allergy season begins and take allergy medications at the first sign of symptoms. Start your allergy medication routine one week before allergy season to get the medicine working in your system.

6.    Go All-Natural

Natural remedies may help offer relief. Of course, the best way to manage allergies without medications is being vigilant about avoiding known triggers.  If you’re feeling stuffed up, nasal saline irrigation with a neti pot may help by washing away the pollens, dusts and animal dander from the lining of your nose. Saline irrigation also helps to thin nasal drainage so it can be blown out and it also gently moisturizes the lining of the nose.  Products labeled “natural” or “alternative” may not be safe for all users. Some remedies can cause further allergic reactions. Consult with your allergist on which natural remedies may be right for you.

7.    Allergy Prevention Starts at Home

Keep allergens out of your home by prepping your home for spring allergy season.

  • Enforce a “shoes off” rule when entering your home.
  • Keep windows shut and cool your home with filtered air from your air conditioner. Avoid using ceiling fans which can spread pollen around a room.
  • Vacuum with a HEPA filter vacuum to suck up particles on your furniture, floors, rugs, and in the air.
  • Avoid hanging your clothes outside to dry as pollen can get stuck to sheets, towels, and clothing.

Don’t let allergies get the best of you this spring. Visit us at the Allergy & Asthma Specialists of North Florida for allergy testing and a personalized treatment plan. Start your spring allergy medications now for long-term relief.

Medication and Allergies: Things Every Adult Patient Need to Be Concerned About

It’s common for adults to take several prescriptions to support their health and well-being as they age. But sometimes an individual drug or a combination of them can cause harmful side effects, particularly in adults with allergies and asthma.

It’s important to inform your doctors, including your dentist and ophthalmologist, if you have asthma and allergies. In addition, the side effects of allergy medications may be tolerable for some people while causing greater reactions in other patients. Work with your doctor or your allergist to avoid taking medications which may trigger severe and even fatal reactions.

Learn More About Our Drug & Medication Allergy Treatments

Allergy Medications Adults Should Be Cautious Of

Allergy medications are known for their excellent safety profile. However, high doses of allergy relief medications can cause harmful side effects for those you are sensitive to them or when they are combined with certain medications. Be aware of the side effects of the following two types of allergy medications.

Antihistamines

An allergist may prescribe antihistamines for allergies including allergic conjunctivitis (eye allergy), allergic rhinitis (hay fever), or urticaria (hives).

Antihistamines can cause drowsiness, confusion, blurred vision, and reduced alertness in older adults which can lead to falls and injuries. Other side effects include constipation and urinary retention.

When feasible, the newer second and third generation antihistamines should be used. Unlike first generation antihistamines, these newer antihistamines do not typically cause drowsiness and have fewer overall side effects. Discuss your options with your primary physician or allergy specialist to make sure you’re getting the safest antihistamine.

Decongestants

Pseudoephedrine is a common over-the-counter decongestant sold individually or in combination with an antihistamine. Pseudoephedrine is typically the “-D” or decongestant component in many over the counter allergy medications. Pseudoephedrine is a stimulant and is notorious for causing increased blood pressure, rapid heartbeat, and irregular heartbeat. Those with heart disease or hypertension should be very careful when taking over the counter nasal decongestants.

Medications Capable of Inducing Asthma-like Symptoms

Patients with asthma should be aware of the reactions of these types of drugs, which can trigger symptoms that mimic asthma. 

ACE Inhibitors

Ace inhibitors treat hypertension, heart disease and kidney disease. These are usually well tolerated but can trigger a dry, repetitive cough in some people that is often confused for asthma. Interestingly, having a repetitive cough can worsen acid reflux which in turn can increase coughing and worsen asthma symptoms.

Aspirin and Other Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)

Over-the-counter pain relievers such as naproxen, aspirin and ibuprofen can also trigger serious asthma symptoms in some asthmatic patients. This condition is known as ‘NSAID or aspirin associated respiratory disease.’ Those with known sensitivities to NSAIDs and aspirin should avoid these drugs as resulting asthma attacks can be severe and fatal. Aspirin-sensitive patients often tolerate acetaminophen and other prescribed pain relievers.

Beta-Blockers

Beta-blockers are often used for the treatment of migraines, high blood pressure, heart disease and glaucoma. This class of medications can be classified as cardio-selective and non-selective. Non-selective beta-blockers (propranolol) are often avoided in asthmatics due to the potential to provoke bronchoconstriction and jeopardize asthma control. Cardio-selective beta-blockers are thought to be a safer choice for asthmatics given their limited action in the lungs. Be sure to tell all your doctors that you have asthma, including your ophthalmologist, because beta-blockers can be in many types of medications, including eye drops.

At Allergy & Asthma Specialists of North Florida, our board-certified allergists specialize in complete allergy and asthma care for adults and children. Contact us today and schedule an appointment to learn if you’re taking the right allergy medications for your age and health needs.

 

Everything You Need to Know About Tree and Spring Pollen Allergies

tree pollen spring allergies

Compared to the rest of the U.S., midwinter and early spring in Jacksonville is a really beautiful time of year.

Although, our mild temperatures tend to attract folks from more frigid regions, that doesn’t mean our “cool” seasons are completely free of any downsides. In fact, if you’re allergic to tree pollen — one of the most common allergens we have here on the First Coast — you know this all too well.

Another downside? Jacksonville was in the Top 50 Worst Cities for Spring Allergies in 2016 (although, on the bright side — that is an improvement from the previous listing where we were in the top 30).

Across most of the country, trees don’t release their pollen until early spring. But, thanks to our temperate climate here in North Florida, local trees produce an abundance of pollen starting in late December!

If you suffer from tree pollen sensitivity, here’s a helpful guide for tree pollen allergies and our best advice for controlling a reaction this spring season.

First: What is Tree Pollen?

That super-fine yellow dust you find on your car in the morning or the layer of yellow  dust on outdoor surfaces is tree pollen—pine pollen to be exact.

tree pollen

Pollen carries a plant’s DNA from the stamen to the pistil (generally considered the “female” part of a plant). This process is called pollination and it’s what allows plants to reproduce.

What Trees Cause the Most Allergy Issues in Florida?

Tree pollen is a well-known, highly allergenic substance. Allergic trees native to Northeast Florida include:

Birch

river-birch-betula-nigra

River Birch are common in Northeast Florida. People with birch pollen allergies will be at their worst when the trees bloom, typically in late winter and early spring. However, birch pollen allergies are a bit different for sufferers — researchers have found that some produce can trigger allergic reactions in people susceptible to birch tree pollen allergies — this is oral allergy syndrome.

Bayberry

bayberry pollen allergies

Bayberry pollen can be easily spread when wind picks up in the spring. It’s a common Florida allergen, and many people are sensitive to the pollen as well as the scent. Bayberry is

Elms

elm tree pollen allergies jacksonville

Large, towering elms can be a beautiful sight, but for allergy sufferers elms can create a significant problem starting in late January though the spring months. Elms are wind pollinated trees and the pollen is easily carried by springtime winds.

Oak

oak tree pollen allergies jacksonville

Oak trees, especially Bluejack Oaks are a severe allergen for Floridians. These trees are common throughout residential areas and parks — so the pollen potential is very high. Oaks cause real seasonal suffering for people with oak pollen allergies because the trees have a long period of pollen production.

Maple

maple tree pollen allergies jacksonville

Red maples are one of the most abundant and widespread trees in North America. Maples are a moderate allergen and they are also one of the first trees to begin pollinating in the Winter and Spring seasons.

Pine

pine tree pollen allergies jacksonville

Although pine tree allergies are fairly uncommon, they do present issues for sufferers. Pines can be produce large amounts of pollen, often leaving layers of pollen on surfaces and spreading easily through the air. Pollen is usually worse in the early mornings, and can sometimes be mitigated by our moist, humid air.

Misconceptions About Tree Pollen Allergies

Most people assume that trees with large or fragrant flowers must be the cause most allergy problems, but actually the opposite is true. Trees with showy flowers have larger, “stickier” pollen that quickly falls to the ground. As a result,  flowering trees depend on insects (not the wind) to carry their pollen. Since these pollen aren’t blowing in the wind, you’re less likely to inhale them and develop allergies to them.

Another common misconception (which can be applied to all types of allergies) is that you cannot develop seasonal allergies as an adult if you didn’t have them as a child. Allergic reactions can come on rapidly and appear even in adulthood. It is also common when people move to new regions and are exposed to allergens they may not have been exposed to where they previously lived.

Also, people believe that there is little to no pollen near the beach — but pollen can be airborne and carried for hundreds of miles well into our beach areas. While our beaches do have lower pollen counts, they also have wild grasses and plants that can increase allergic reactions.

What Triggers Make Tree Allergy Reactions Worse?

Sometimes a perfect storm of factors can trigger allergic reactions.

Here are some common triggers that can make already bad tree pollen allergies even worse:

  • Mild, breezy days with cool evenings. When the wind picks up pollen and disperses it through the air, you don’t need to have trees in your vicinity to suffer. With occasional exceptions, this pretty much sums up the weather in Jacksonville during the second half of December through March.
  • Thunderstorms. While rainy days bring relief for allergy sufferers, thunderstorms can actually make matters worse for you. Pollen grains can be carried by the winds produced in thunderstorms and easily rupture—leading to increased allergic reaction during storms and a phenomenon called “thunderstorm asthma.” If the forecast calls for thunderstorms, stay indoors as much as possible since the rapidly changing weather preceding storms seems to increase pollen load in the air.
  • Some types of fruits or vegetables. You read that correctly! People who suffer nasal allergies from specific tree pollens also have a higher risk of reaction to certain raw fruits and vegetables. If, for example, you have a birch pollen allergy and eat raw apple or pear, you may experience a localized allergic reaction with mild swelling and itchiness inside your mouth. This is called the pollen-food allergy syndrome (formerly known as the oral allergy syndrome) and occurs when the immune system in your mouth mistakes certain raw fruit and vegetable proteins for pollens that you are allergic to. One way to fight this is to simply peel your raw fruits or vegetables and cook them (at least the ones that can be cooked) which will lessen or help you completely avoid a reaction.
  • Proximity to the trigger trees. If you have one of the culprit trees in your yard, you are, of course, more susceptible to allergy symptoms and reactions. But you may be surprised at just how much more susceptible you are: Trigger trees in your yard could expose you to more than 10 times the amount of pollen as a tree down the block.

Tree Pollen Allergy Symptoms

A sensitivity to pollen causes your body to produce an abundance of allergic antibodies called IgE. IgE allows your immune system to launch a full scale allergic response when it sees a culprit tree pollen. These reactions result in a  flood of histamines in your eyes and respiratory tract and can lead to following allergy symptoms:

  • Itchy and tearing/watery red eyes. Your eyes may be inflamed, itchy and red. There might also be “crust” (dried eye mucus) along your eyelids, most commonly experienced upon waking in the morning.
  • Bags under the eyes. You might  also notice dark circles and bags under your eyes. These are sometimes called allergic shiners and are due to congested blood vessels associated with nasal inflammation.
  • Runny nose. People with tree pollen allergies experience nasal congestion and a runny nose at the same time. A runny nose might also result in post-nasal drip. Children can develop a semi-permanent crease along their noses from constantly rubbing the tips of their runny noses upward—a maneuver affectionately termed the allergic salute!
  • Sneezing and congestion. You may sneeze frequently, have an itchy nose, and feel pressure in your nose and sinuses.
  • Coughing fits or sore throats. Allergies to tree pollen may also cause you to experience a scratchy, sore throat. The discomfort can be due to inflammation, post-nasal drip or both. Depending on how much you’re coughing, you could also develop laryngitis and hoarseness.

Airborne pollen can also trigger asthma, making breathing difficult and leading to coughing, wheezing, and shortness of breath.

While these symptoms may seem mild at first, over time they can cause progressive impairment of quality of life, work  and sleep. More severe reactions may occur in people with asthma and other respiratory problems.

In addition to the above symptoms, some of our patients report feeling as if they have the flu for months and just feel physically drained. Pollen allergies are also described like a bad cold that just won’t go away.

Tips for Avoiding or Limiting Tree Allergies

Since we have a good idea of when the tree pollen allergy season will begin each year, it’s easy to start taking precautions early. Some of the precautions are common-sense and, depending on your situation, some may be more realistic than others.

  • Avoid contact with tree pollen as much as possible. It’s best to avoid coming into physical contact with pollen as much as you can. Limit your time outdoors on high pollen days; keep windows in cars closed at all times during tree pollen season; and consider wearing gloves or a mask if pollen counts are very high and you must be outside.
  • Remove trigger trees. If possible, remove any trigger trees that are in your yard. If removing the tree is not an option, get it trimmed back as much as allowable to reduce the amount of pollen it produces.
  • Keep windows and doors shut. On these beautiful days it’s tempting to open up the windows and doors for some fresh air—but high pollen counts and windy days will bring pollen inside to get trapped in carpets and furniture.
  • Do not dry clothes outdoors. Although it can be a money saver, do not hang laundry outside to dry—they will certainly collect pollen.
  • Avoid early morning outdoor exercise. Trees tend to pollinate in the early AM. If you must exercise early, try to do so in a gym or some other indoor setting. Outdoor exercise should be left to later in the day when pollen has had a chance to settle.
  • Always check the pollen forecasts. Be aware of what the coming days will bring. Like our Facebook page for allergy forecasts or visit www.pollen.com or weather.com for other allergy reports around Florida.
  • Shower in the evening. Showering before bed will remove pollen from your hair and will help avoid spreading it all over your pillow and bedspreads.
  • Vacuum often. Vacuum your house at least twice per week to remove pollen and dust that have become trapped in your carpets. Consider wearing a mask when vacuuming, as your machine can kick up dust and pollen articles into the air when vacuuming and emptying it’s contents.
  • Clean out and replace filters as recommended. Many air conditioning units are equipped with whole house filters to trap dust and air particles. Clean and replace filters as recommended by your air conditioning unit and manufacturer’s recommendations.

Allergy Testing and Treatment

The good news is that you don’t have to suffer through tree pollen season. Be sure to contact an allergy and asthma specialist for a formal allergy evaluation, preferably before the season begins or very early in the season. You may already know that you have a seasonal allergy, but do not know just which pollen(s) you are allergic to. Allergists can determine the specific pollens that are causing your problems and can tell you when that pollen is expected to be in the air.

Your allergist will take a detailed history of any reactions you’ve had, then if indicated, he or she can test for allergies to identify the culprit allergen and determine the best course of treatment.

The most common method of testing for pollen allergies is a simple skin prick test. At our office, we use a very fine stylet that is lightly pressed against the skin. The stylet introduces individual pollens and other allergens to the immune system in your skin. If you’re allergic or sensitive to a particular allergen, a small pink raised bump will appear within minutes where the skin prick test was placed.

For some people, a blood test may be the best option to determine your allergic sensitivity. A small amount of your blood is taken and tested to check for antibodies that respond to specific allergens. Depending on your allergy test results, we can offer guidance about the best and most direct course of action for your symptoms.

Treatment options for tree pollen allergies can range from avoidance, to physician-recommended over-the-counter or prescription medicines to allergy shots (also known as allergen immunotherapy) for more severe reactions. Your allergist will work with you to determine what is best for your needs and your lifestyle.

What do you do if you’re caught off guard without allergy medicine?

Here’s a great, quick remedy treatment you can use in case you find yourself in a situation where you can’t take medication or avoid your triggers.

First, check the pollen forecast. Then use nasal saline rinse or irrigation several times throughout the day during the worst of the tree pollen season. The saline irrigation removes pollen particles from the surface of your nasal passages, clears thick or crusted nasal drainage and soothes irritated nasal membranes.

There are a number of studies that found that patients with allergic rhinitis or chronic sinusitis who use regular saline rinses have less bacterial load and require fewer antibiotics. Using a rinse may also reduce your need for medication to control allergies.

You can buy saline rinse or irrigation kits at any drugstore and many grocery stores. These kits usually use a squeeze bottle or gravity to direct saline through the nasal passages. A common squeeze bottle technique is to position your head downward and rotated slightly to the left (do this over a sink). Gently squeeze some of the solution into your right nostril; the solution  will come out through your left nostril. Now repeat on the other side.

Ready or not, tree pollen season is here! If you haven’t already prepared and expect you’ll need help this season, be sure to contact us today to schedule an appointment. This is a gorgeous time of year that should not be missed by staying indoors. Don’t suffer, we’re here to help.

 

asthma prevention jacksonville kids

Tips for Preventing Asthma in Children

Watching any child suffer from asthma can leave a parent feeling helpless. Thankfully, there are a few things a parent can do to prevent asthma in the first place.

By becoming familiar with the most common asthma triggers, a parent can learn to identify and prevent asthma in their child.

Allergies

Does your child sneeze when he pets a cat? Does she come home with puffy eyes and a slight wheeze every time she returns from her friend’s house? Your child might suffer from allergy induced asthma.

Allergies are a very common trigger for asthma, causing a child to progress from allergy symptoms such as a runny nose, puffy eyes and sneezing, to restricted breathing or even an asthma attack.

Familiarizing yourself with the most common allergies – such as dust, mold, pets, and pollen – and keeping a journal or mental note of when and where your child’s asthma flares up, can help you determine which allergies your child might have. Keep in mind, sometimes a child’s allergic reaction will be strongest immediately upon leaving the environment to which he or she is allergic.

Finding it difficult to figure out what things your child might be allergic to? Allergy testing by a board-certified allergist can immediately identify pertinent allergic triggers.

Once you’ve figured out which allergies your child has, discuss how you can work together to avoid environments that cause allergic reactions.

  • If she’s allergic to dogs but loves playing at a friend’s house who has a dog, suggest they play outdoors instead of indoors.
  • If you find he has a mold allergy, teach him to identify mold and avoid the places that have it.
  • If dust is a problem, buy hypo-allergenic products to make her bedroom(where she spends at least one-third of the day) a healthier place for her.

Avoiding exposure to allergens not only prevents an immediate reaction, it can make a significant difference in your child’s health over the long term as well.

Cigarette Smoke

Even a few seconds of second-hand smoke can be enough to irritate the airways of a child with asthma. Exposure to second-hand smoke during pregnancy has been linked to the development of allergies in children.

If you or your child are exposed to cigarette smoke on a regular basis, consider making changes.

Exercise

Does a short game of tag leave your child coughing or wheezing? They might be suffering from exercise-induced asthma. The majority of those with asthma experience symptoms during exercise.

If you notice your child suffering from asthma after running around the yard or during gym class, discuss with your doctor what you can do to lessen the symptoms when your child is active.

Poor Air Quality

For those who do not suffer from asthma, perhaps the least obvious trigger is the air we breathe: in our homes, at our parks, and in our schools.

According to the American Lung Association, over half of Americans live in areas with unhealthy levels of air pollution. Over time, polluted air irritates the lungs and reduces lung function, making a child with asthma even more prone to attacks.

Though it’s often not possible to move to an area with better air quality, there are things you can do to significantly improve air quality for your child. Install a HEPA air purifier in the bedroom and have an indoor air quality check in your home, also check the local air quality index (AQI) before deciding which days are better suited for outdoor activities and which days might be better spent at home.

If you’re concerned about your child’s asthma, contact us to get started on a prevention plan.

Our Top Tips for Allergy Safety this Halloween

halloween allergy safety tips

With pumpkins everywhere and stores filled with Spiderman costumes, it’s almost time for what may be kids’ favorite holiday — Halloween.

Their excitement, however, is tempered by parents’ caution about their children’s safety. For parents of a child with allergies, the concerns are even greater.

The good news is that there is a lot you can to do ensure your kids have a safe, fun Halloween. Here are four tips that can help:

Help Make Your Child’s School Party Safe

Many schools and daycare facilities host Halloween parties, which can be especially stressful for parents since you’re not there to protect your children. In addition, younger children don’t have the awareness to say no to certain types of candy or give in to the temptation to have the same foods their friends are enjoying.

The keys to a stress- and allergy-free class party includes partnering with the teacher, class parent or other school staff member. If you’re unable to volunteer to help or be present on party day, find out who the party host will be and coordinate with him or her in advance about your child’s allergy and any action plan that may be needed to respond to an allergy emergency.

If you can be involved in the party planning, you can encourage a focus on non-food related activities, such as crafts, little toy bags, a scavenger hunt, or Halloween games.

Food will likely be part of the festivities however, so discuss options that would be safe for your child and that can still be enjoyed by everyone. A great way to ensure your child isn’t being left out is to offer to provide his or her treats or find out if there is an allergy-free version of the treat your child will be able to have.

If you are sending your child with their own safe food, ensure the teacher or monitor knows this is the only food that you child can eat at the party.

 Download Our Free Halloween Safety Checklist

Know Ahead of Time What Candies are Safe for Your Child

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Deciding to allow your child to trick-or-treat should depend on how severe his or her allergies are. If you decide it’s safe enough to go door to door, always have a safety plan in place and have precautions ready.

Let your child know before you even leave the house that he or she is not to eat any food until you’ve gotten home and had the chance to check all their candy. Setting the expectation before you head out is crucial for kids of all ages. Older children probably already have a good understanding of why this is necessary, but with a simple and appropriate explanation of the dangers, younger kids can be made to understand why they’ll need to contain their excitement about sampling treats while they’re out.

Before Halloween arrives, consider alerting your neighbors to your child’s allergy. Ask them to not offer any foods to which your child is allergic and suggest they offer a toy, a little money or other non-food item. (You could even provide your neighbors with such items yourself.) Asking in advance allows your neighbors to be prepared.

Once trick or treating is done, sort through the treats and find the safe ones and put them back into your child’s bag – then create a pile of definite no’s. You may have a third pile of “unsure” treats. You may need to do some research to determine if they are safe for your child, or if you feel it’s not worth the risk, simply remove them. Often, mini-bagged treats will have warnings on whether they were produced in facility that processes nuts or other allergens.

Do not leave your child alone with his or her candy. Temptations can be too strong, and you may find your child digging in at the first opportunity.

We’ve found that certain normally safe candies may be produced in different plants for the holiday version of the candy, and this may make them unsafe. This is why it’s so important to read labels on all potentially dangerous candies.

If throwing out a lot of candy seems wasteful to you, one fun tradition we’ve heard of is to place all the unsafe candy in your young child’s trick-or-treat bag and place it on the porch overnight. They will get a visit from the “Great Pumpkin” who will exchange their unsafe candy for something they can enjoy.

If your child suffers from severe allergies and trick-or-treating is just too dangerous, planning a fun party with some of their friends and having Halloween shows and crafts is a great option. Although candy is most associated with the holiday, it doesn’t have to be the most important thing. Kids will have just as much fun dressed up and playing as they do knocking on doors.

Always Have Your Safety Supplies on Hand

You already know this, but we’ll say it again: You must always have your safety supplies ready whether your child is walking your neighborhood, at a school party, or at a friend’s house. If your child is prone to an anaphylactic shock always have an epinephrine autoinjector and other medications that your allergist has provided. If your child’s allergies are less severe, have sanitizing wipes available for contact allergies and any medications you give for minor allergic reactions.

You should also discuss with your child what to do if he or she starts feeling itchy, having trouble breathing or showing any signs of a reaction. Talk with your child in advance about what happens when an allergic reaction occurs and what treatment measures you may have to take. The more they are involved in their treatment, the more in control they will feel.

Candy Is Not the Only Issue – Don’t Forget Costumes

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If your child has contact allergies or suffers from hives or other skin issues, be aware of costumes and face and skin paint accessories that could lead to reactions. Most kids costumes are safe and hypo-allergenic, but some of the accessories may set off a reaction. Look out for nickel in some costume accessories such as cowboy belts, swords, tiaras and magic wands. Nickel is one of the most common causes of allergic contact dermatitis, which can make skin itch and ruin an otherwise fun night of trick-or-treating.

Be on the lookout for ingredients in cheap Halloween makeup, which may cause allergic reactions.  If your child must use makeup, opt for the higher-quality products. Don’t assume, however, that because it’s more expensive it’s safe – always test makeup ahead of time by applying a little bit to a small area of skin a few days in advance to check for a reaction.

Look for the Teal Pumpkins

The Teal Pumpkin Project is a FARE campaign to help make Halloween safer for kids with allergies.

Launched in 2014 the Teal Pumpkin Project aims to increase awareness of food allergies as well as promote inclusion for all of our trick-or-treaters. There are some great resources to show your support and even to add your house to a crowd sourced map of a list of homes that are participating—most Teal Pumpkin participants are offering treats other than candies.

Do some pre-Halloween planning and keep a few tricks handy, and you and your goblins can be sure to have a safe and awesome Halloween!

If you are worried that you or your child might have allergies or asthma – contact Allergy and Asthma Specialists of North Florida to schedule an appointment or to talk with one of our Board Certified Allergists.

For more great allergy safety information visit our friends at FoodAllergy.org

 Get Your Free Halloween Safety Checklist