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DEL.ICIO.USClearing up some allergy confusion
The Atlanta Journal-Constitution
I’m sitting in the drop-off line at my kids’ preschool hoping like crazy that no one notices the snot dripping from my son’s nose. I dosed him with Benadryl this morning to halt the tell-tale line of clear liquid inching down his upper lip. It’s not green and he doesn’t have a fever so, according to my rudimentary understanding of medicine, he’s not sick. I think — I hope — it’s just allergies.
Up to 20 percent of children are affected by allergies of some type, says Dr. Keith Phillips, an associate professor of Pediatrics at Emory University School of Medicine and a specialist in allergy and immunology.
He took some time to answer some of our allergy questions. Here’s what we learned:
Q. What are the best ways to tell the difference between a seasonal allergy and a cold?
A. One of the best discriminating symptoms is allergy itches. You have nasal itching, and frequently itching of the eyes. The child may rub the nose and eyes vigorously and often have not just sneezing, but short bursts of sneezing. Allergy has no associated fever. Drainage from the nose should be clear. All of the other symptoms — congestion, sniffling, nose blowing, red eyes, even sore throat, can be seen with either allergy or infection.
Q. Will the lymph nodes swell if it is just an allergy?
A. Lymph nodes, particularly in the front of the neck, are often fairly prominent in allergic children. These lymph nodes, however, should not be tender or cause discomfort. [However, the] sudden appearance of tender nodes in the neck or any other body area is usually due to a regional infection.
Q. Do allergy seasons affect asthma?
A. Yes, but only if allergy is a triggering factor for a child’s asthma. Allergy plays a role in up to 80 percent of children over age 3 who have asthma.
Q. Does having pets, such as a cat or dog, during a child’s infancy affect his chances of developing an allergy to that animal?
A. A theory states that low allergen exposure in the first year of life actually promotes development of the allergic state.
Q. So, should we let them be exposed to the dog and cat?
A. Despite these general observations, many children become intensely sensitive to animals despite considerable exposure to pets in the first year of life. My feeling at present is it’s probably best to avoid indoor pets if there is a family history of allergy.
Q. What is the best way to treat allergies?
A. If possible, the best way to treat allergy is to avoid your child’s triggering factors. If they’re sensitive to food, these are recognizable and avoidable. With house dust mites and animal allergens, avoidance also can be very helpful. What you can do about reducing pollen or mold exposure, on the other hand, is relatively limited. The second step, if the first is not successful or practical, is a well-designed, safe, well-tolerated medication program.
Q. If a child is constantly on Claritin or Zyrtec, can that hurt his liver?
A. Overall, the safety of the medicines we employ in treating childhood allergy are excellent.
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By Theresa
March 27, 2006 08:31 AM | Link to this
Here is some extra info on the allergies that we didn’t have room to print in the newspaper, but we can offer online.
Q. Are there hard and fast rules to help a mother decide on the fly whether to send her child to school? There is no 100 percent way to separate the two, particularly in first to second day of a viral infection. Even a viral infection has some nasal itching and clear drainage. Only after 48 to 72 hours does the drainage in a viral infection become discolored. Allergy symptoms are not sudden in onset unless you have some unusual offending exposure, such as a grandmother who has an indoor cat. Viral infections are relatively explosive and without any forewarning.
Q. Can they get a sore throat from allergies – from the snot draining down their throats? A. Sore throat in allergy is common. Most frequently it comes from the fact that children are breathing through the mouth drying out the tissues in the throat.That usually disappears after they have eaten and drank with breakfast. Any throat discomfort will be relatively mild, scratchy, and itchy. If you have much pain, you have to be suspicious that there is an infection.
Q. Can a child grow out of it? A. There is a tendency for children often to have spontaneous resolution to cow milk, to egg, wheat and soy allergies. Those sensitivities may disappear by 5 years of age. Many children who have mild or moderate asthma will experience improvement or resolution as they hit adolescence. Moderate to severe asthma tends to persist. Allergic nasal symptoms usually continue into adulthood. Asthma may reappear in middle life (later 30, 40s).
By Theresa
March 27, 2006 08:36 AM | Link to this
Two other thoughts: I asked Dr. Phillips a bunch of asthma questions as well. We’re going to run those at a later date so keep an eye out for that information.
Also, Dr. Phillips had a lot more info on the allergies to animals and here is the gist of what else he said: There is a theory that the reason farm kids don’t have many allergies is that they are exposed to so many animals. And it’s actually the endotoxins in the animals’ poop that allergists believe help prevent the allergies. So one dog or one cat in your home does not produce enough endotoxins to help stop the allergies but they do produce enough allergens to cause the allergies.
In my little nerdy mind this was fascinating!
By Todd
March 27, 2006 09:16 AM | Link to this
Good information during the beginning of intense allergy season… I consider myself an expert in allergies and asthma since I have lived with both for 33 years and I have a degree in Biology. Theories about how allergies develop are always interesting to me. I grew up on a farm and we had all sorts of animals yet my allergies actually got worse (or perhaps I noticed them more) as I got older. The OTC medications were OK for mild treatment of symptoms but I really noticed a difference when I started taking prescription meds such as Rhinocort Aqua, Clarinex, and Advair. My advice is also to avoid contact with allergans as much as possible (i.e. animals in the house) but also to start on a daily medication to alleviate the symptoms of other allergans that you cannot avoid such as mold, pollen, and dust. In my case, these unavoidable allergans caused me much more grief than the dogs or other instigators!
By fk
March 27, 2006 09:38 AM | Link to this
My son has pollen allergies and had suffered with sinus infections in the spring along with ear infections when he was younger. He does have some autumn allergies, but nothing like the springtime stuff.
Benadryl made him drowsy, which in turn, made a noticeable difference on the baseball field. Geez, you would think he would be safe out in right field for one inning, but I worried he was going to get hit by the ball as he did not seem to be in tune with his surroundings. He simply was not paying attention and unfocused.
He started on Rx allergy meds on a routine basis to prevent allergy symptoms in elementary school. He did okay, but still suffered a bit. However, no more sinus infections.
About five years ago, the pediatrician prescribed a nasal spray in addition to an Rx allergy med. What a difference!!! It was as if he no longer had allergies…he was able to play spring sports without sneezing or rubbing his eyes. He takes the combination of meds for just about three months in the spring and then for about six weeks in the fall. He is able to mow the lawn (something that makes Dad very happy) and participate in football symptom-free. Believe me, he spends a lot of time in the grass, and everything that lands in it, playing football. The nasal spray made a big difference.
By Theresa
March 27, 2006 11:55 AM | Link to this
Todd — I think allergies can get worse as you get older — I never had them as a kid and now mine are terrible. My allergist told me having babies (which obviously you hadn’t done) can also increase (in some patients decrease) your allergies.
fk - Has your son’s smelling ability been hurt by the nasal spray? I was on one and I swear I couldn’t smell dirty diapers any more — which you think would be a good thing except then my kid’s walking around with poop in his pants and everyone else could smell it but me. I stopped taking it during the off allergy season and am taking a different one now — We’ll see if I can still smell on it.
My kid’s both have some allergies and my pediatrican gave me Brovex — It last 12 hours and does not make them sleepy, and really seems to work. It wasn’t one that I heard of before. Plus it tastes like bananas — which they love.
By fk
March 27, 2006 04:43 PM | Link to this
Theresa,
I don’t think so. We were in church a couple of years ago and a little one got sick. He turned to me in a panic because the smell was making him sick, so we had to leave! Manhood is on the horizon.
I’ll ask him this evening. If I don’t write back, the answer is no. I’ve never heard of the nasal spray affecting one’s sense of smell. That concerns me.