February 24, 2020
Allergists across the Mid-Atlantic and Northeast regions of the U.S. typically recommend patients start getting ready for pollen season in mid-March. Most pollen prediction sites rely on historical pollen averages, average monthly temperatures, and frequency of days above 60 degrees as predictors for pollen forecasts. This same data is used by the National Park Service to determine when the cherry blossoms will bloom this year (it is between April 3-5). As an allergist in Maryland, I often see patients when it is too late. Trying to treat allergies in the middle of allergy season can be extremely challenging. In reality, your Spring health care should begin with preparing today.
Here is a list of the most common tips I give out before allergy season.
1. See your allergist, and stay on any Immunotherapy regimen
Make sure that if you have been exhibiting any excessive allergy symptoms that you consult your allergist BEFORE your next injection. Some patients find it helpful to return for injections every 2 weeks instead of every 4 weeks during the Spring season. In addition, very sensitive patients may need to decrease their injection concentration during the Spring.
If you have never seen an allergist before, and consistently have known issues in the Spring, now (before the pollen rush) is a great time to book an appointment. As opposed to medications that only suppress allergy symptoms, allergen immunotherapy helps you become less allergic over time.
2. Start treatment with over the counter anti-histamines/nasal steroid sprays/sinus rinses now on a daily basis until the end of April.
Daily antihistamines: Zyrtec (cetirizine), Claritin (loratadine), Allegra (fexofenadine), or Xyzal (levocetirizine).
Nasal steroid sprays: Flonase (fluticasone), Nasacort (triamcinolone), Rhinocort (budesonide), Nasonex (mometasone). Maximum effectiveness takes 3-5 days of consecutive use.
Sinus Rinse (Neti-pot, Neil-med squeeze bottles) nightly over the sink or in the shower. Only fill your sinus rinse with the recommended solutions of the manufacturer which is typically a mixed in saline solution and distilled water. Do not use tap or bottle water. Tap water is okay only if boiled and cooled before use.
3. Spring cleaning!
Spring cleaning should begin now when there is very little pollen in the air. It’s a good time to open your windows and let your house air out. Take note of any mold, or dust collecting in corners of your house. Make sure once you clean it, it doesn’t come back. Also, make sure you clean everything. There are many areas in your house that could collect dirt and dust that you wouldn’t ordinarily clean. I found several websites such as quickanddirtytips.com and lifehacker.com that can help you make sure you hit these oft-missed, dirt-catching areas. Window shades and blinds, ceiling fans, thresholds, bedding, blankets, and afghans seem to be on everyone’s “miss” list. Area rugs and carpets should be steam cleaned to help release dirt, dust, or dander that may be caught in the fibers. While it isn’t necessarily something you can do yourself, getting your HVAC ducts cleaned can also help eliminate the spread of allergens as well as improving your system’s efficiency and lowering your electric bill. You want to make sure your house is a safe zone when it is time to shut your windows again.
4. Track pollen levels
There are several great resources, including pollen.com, which can give you an extended forecast for many different types of pollens. It is important to note that especially in the MD, DC, and VA areas, forecasts can change daily. Tree pollination can go dormant in rain, and ramp up on a clear, warm day. It is also important to do the bulk of your outside activity in the evening. While most trees start releasing pollen in the morning, pollen levels start accumulating to their highest points between the hours of noon and 6 p.m. (acaai.org)
5. Shut your windows
It may sound like common sense, but often times we get a little too eager to finally shut the heat off and enjoy the night air. Unfortunately, that gentle breeze will be carrying pollen spores right back into your home, causing you to wake up miserable.
6. Change and clean your air filter
There are several different types of air filters you can buy for your home. Make sure you check with your manufacturer before buying any air filter to make sure it is recommended for your HVAC system. When you are comparing air filters make sure you look at MERV ratings (minimum efficiency reporting value). The higher the MERV value, the smaller the pores are in your filter, which means it can trap more particles. The big caveat in MERV ratings is that the higher the MERV the more difficult it is for your HVAC system to push out air and your system becomes ineffective and inefficient. A better recommendation would be to get an air purifier. Air purifiers can handle HEPA (high efficiency particulate air) filters, which can trap the smallest level of particulate. Most experts agree that if there is one area to put an air purifier, it would be the bedroom where people spend the most time. Nothing is worse than waking up stuffy!
7. Change your clothes/bathe yourself and pets!
If you have been outdoors for a prolonged period of time or involved in activities that exposed you to pollen, make sure to change your clothes and shower/wash your hair when returning indoors. Pollen can track through the house on your clothing fibers, body, and hair. Wearing hats, avoiding gels/leave-in products, and wearing your hair up can help to avoid pollen in lieu of a shower. Pets can be the worst culprits of pollen tracking. Wipe your pet’s fur and paws when they come inside and make sure to bathe them regularly.
8. Protective gear for high exposure
If you have no choice but to expose yourself to tree pollen in higher levels, there are certain precautions you may take to limit exposure. People who have a lot of grass to cut, or outdoor jobs may simply have too much exposure to pollen for any of the previous steps to help. The CDC recommends an N95 NIOSH respirator as the minimum rating to filter out pollen allergens. N99 and N100 masks are rated even higher in particulate capture but they are also prohibitively more expensive. Most N95 respirators are disposable while N99 and N100 are washable. To use your respirator most effectively, make sure it is sized and fitted properly to your face. Also, ensure that the mask is replaced when it gets dirty or more difficult to breathe through.
Make an appointment today with your allergy provider to get a jump start on the spring season.