Feb 25, 2008
FAQ: Complications of Seasonal Allergies With Other Respiratory Conditions With Henry Milgrom, MD & Lanny J. Rosenwasser, M.D
While most people gratefully welcome the longer days and warmer weather of spring, more than 35 million Americans dread the itchy eyes, runny nose, and sneezing that comes with the season’s pollens and mold spores.
Seasonal allergies can be especially difficult for those people who also suffer from asthma, COPD, or other respiratory diseases. Fortunately, there are more treatments than ever to help relieve allergy symptoms and make breathing as easy and comfortable as possible. New non-sedating antihistamines and nasal steroids can help relieve symptoms of hay fever and other allergic conditions so you can once again enjoy spring.
National Jewish the nation’s number one respiratory hospital and is also a world leader in allergy research and treatment. See how our doctors respond to frequently asked questions concerning hay fever (seasonal allergic rhinitis) and complications with other respiratory diseases.
Hay Fever, COPD, Emphysema, Chronic Bronchitis, and Asthma
Question: What can we expect during allergy season for our 8 year old daughter who has recently been diagnosed with emphysema? She is using albuterol and Flovent as well as bactrium, Prevacid and Reglan.
Dr. Rosenwasser's Answer: Emphysema is rare in an 8 year old, so other diagnoses may also be under consideration. Allergies are a common problem that can complicate other respiratory problems, like emphysema and cystic fibrosis. If allergy is a true problem, it should be diagnosed appropriately and treated independently of the other problems.
Question: I have COPD and problems with my sinuses. I currently use Claritin-D. Is there another medicine that will work better to clear up the drainage? I am also on Serevent, Atrovent, Proventil and Uniphyl. I rarely take Proventil.
Dr. Rosenwasser's Answer: Claritin-D can help sinus drainage for people with allergy and sinus drainage problems. Other antihistamines and decongestants can work including Allegra-D and Zyrtec. There are also over-the-counter antihistamine and decongestant combinations that help with sinus drainage. These medicines, however, would have no direct effect on COPD – the medicines you are already taking are treatment for COPD.
Question: I have emphysema and struggle with shortness of breath this time of the year due to allergies. What treatments and medications are recommended for those with COPD and heart problems (I had open-heart surgery nine years ago)?
Dr. Rosenwasser's Answer: Standard treatment for allergies should help when they complicate COPD. The standard treatment for nasal allergies includes nasal washes, antihistamines and steroid nasal sprays.
Question: I have a mother-in-law who lives in Napa, CA. She has bad asthma and wants to move out of California. Is there a list that shows the "best places to live for asthma suffers"? If so, can you direct me to it?
Dr. Rosenwasser's Answer: There are no lists of good or bad places to live with asthma. Since asthma can be triggered by things such as allergies, air pollution, and climate. There may be variations in these factors that can influence asthma control. For allergies caused by pollens there may be a short honeymoon from allergies when some one moves to a new place. However within a few years people get sensitized to new allergens.
Question: I recently moved to Denver from the West Coast and my asthma is much better here. I travel a lot for business, usually to the West Coast, and my asthma is worse again. What is the difference?
Dr. Milgrom's Answer: Because of its dry air and high altitude, Denver is free of the house dust mite. The house dust mite is a major allergen causing asthma flare-ups on the West Coast and in other humid areas of the country. This probably explains why you do well in Denver and suffer relapses of asthma when you travel.
Question: Why is it that some children only get sick with asthma in the wintertime? Should I always start my child on inhaled steroids in August? And leave him on them until March?
Dr. Milgrom's Answer: Good question. The most likely explanation is that your child's asthma flare-ups are caused by viral infections. These tend to be most common in the wintertime. A less likely explanation is that your child is allergic to indoor allergens such as molds, animal danders and house dust mites. The increased exposure in wintertime is caused by spending more time indoors and keeping windows closed. It is very reasonable to put your child on preventive therapy such as inhaled corticosteroids in the winter if you know from past experience that he is likely to have increased symptoms at that time.
Question: My respiratory allergies result in recurrent development of polyps in my nose and sinuses. I've recently had a fifth operation on my sinuses, just to remove the polyps this time. My ENT physician has suggested that I use Singulair to inhibit the growth of polyps. (I regularly take either Allegra or Claritin, and I also have asthma which is fully controlled by four inhalations of Vanceril and four inhalations of Intal each day.) Do you think that Singulair or other medications might reduce the recurrence of Polyps?
Dr. Rosenwasser's Answer: Yes, it is not published yet but Singulair and Accolate can help sinusitis and polyps.
Question: Can people with COPD take Allegra? I know Sudafed and others are not recommended for COPD patients.
Dr. Rosenwasser's Answer: People who have allergies as well as COPD can take antihistamines for their allergies. Sudafed is a decongestant and a different type of medicine.
This information has been approved by David Tinkelman, M.D. (January 2005).
Note: This information is provided to you as an educational service of National Jewish. It is not meant to be a substitute for consulting with your own physician.
© Copyright 2008 National Jewish Medical and Research Center