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Spring-time SurvivalSpring-time Survival

Spring, it’s the season of promise. With winter behind us we can start to look forward to longer days and better weather. But for the 20% of New Zealanders who suffer from hay fever, spring can signal the start of months of sneezing, itchy eyes and a streaming nose. So what’s the best way to cope?

Hay fever is a term used for allergic rhinoconjunctivitis occurring in spring and summer. As the name suggests, it is principally caused by grasses, although tree pollen can contribute a little, for a few weeks in late August. Unfortunately you don’t need to be around grass to get hay fever. Grass pollen can be blown on the wind for hundreds of kilometres, which means that even if you live in an apartment in the centre of Auckland, and suffer from hayfever, grass will still be the culprit!

Some of the symptoms of hay fever include sneezing; a runny or stuffy nose; itchy ears, nose and throat; red, itchy or watery eyes; and headaches. For some people, the symptoms of hay fever can be so severe they can’t sleep or concentrate, and they may feel tired and unwell.

So what to do? Many people go to a pharmacy when they have symptoms and take whatever is recommended on an as required basis, which is fine, if you only have occasional or mild symptoms, says Immunologist and Allergy Specialist Dr Andrew Baker.

If you suffer from moderate or quite frequent symptoms, though, Dr Baker recommends the following strategies:

1 Consider an ongoing treatment plan. In other words, use some treatment at the start of every day from September to February, in a proactive preventative approach. “This is much more effective than trying to rescue the situation once you’re plagued by symptoms."

2 Use a steroid nasal spray regularly. Brands such as Flixonase are used as a local treatment, to help both the nose and the eyes, with minimal absorption (1%) into the rest of the body. Quality of life can be transformed if a steroid nasal spray is used daily during spring and summer. Steroid sprays are slow to start working so don’t expect to feel better straight away. Dr Baker advises using it daily from September to February, and then deciding at the end of the season whether it helped or not.

3 Seek evidence-based advice. Make an appointment to see a specialist health professional, such as an Immunologist. “The number of people who are given substandard advice is unfortunately very high,” says Dr Baker. “Frequently, the details of how treatment is administered makes all the difference to getting your quality of life back.”

4 Consider desensitisation (see magazine p6). Also known as immunotherapy, or allergen immunotherapy, desensitisation is the best treatment for hay fever (and for all forms of rhinitis, such as dustmite or pet allergies). The only treatment that can decrease the underlying allergic tendency, the effects of desensitisation can be life-changing in terms of quality of life. There are different forms of desensitisation, including daily tablets or liquid taken under the tongue, and monthly injections. All treatments run for 3-5 years, and the benefits continue for a number of years after the treatment finishes.

5 Plan ahead. Take antihistamines before big exposures to grass pollen, for example if you’re planning a walk in the country on a windy day in November. Cetirizine tends to be more effective than loratadine, but cetirizine can make around 10% of people drowsy. Also, keep the car air intake vents on recycle on peak hay fever days, such as windy days in October, November and December.

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Issue: Spring 2017