The blooming flowers and trees mean Spring in Iowa is here, but it also signals the beginning of hay fever season. Many of us know it all too well – runny nose, watery eyes, sneezing. Dr. Javen Wunschel, board-certified in Allergy/Immunology at MercyOne North-Iowa Allergy/Immunology Specialty at Mason City Clinic helps us understand allergic rhinitis, better known as hay fever, in this podcasts, and how best to prevent and treat it.
Carol Gifford: So welcome to Mason City Clinic Docs on Call series. We are with Dr. Javen Wunschel who is board certified in allergy and immunology. And she practices at MercyOne North Iowa Allergy Specialty Clinic at the Mason City Clinic. She is here with us today to talk to us about hay fever. Many of us are experiencing that right now because it is spring time in Iowa.
The official name for hay fever is allergic rhinitis. And she’s going to help us understand how we get it, how we might be able to prevent it and certainly, if we have it, how we can treat it.
So welcome to the program, Dr. Wunschel.
Dr. Wunschel: Thank you. Thanks for having me.
Carol Gifford: Tell us a little bit about what allergic rhinitis is.
Dr. Wunschel: So allergic rhinitis is essentially when the immune system makes a mistake and thinks that something in your environment is harmful. This triggers a specific response of certain cells and proteins down the allergy pathway that then lead us to have the classic symptoms that we think of when people say they have hay fever.
Carol Gifford: think that we all sneeze and we cough and all of that. How do you distinguish the symptoms of hay fever from just having the common cold or maybe the flu or something?
Dr. Wunschel: So the symptoms of environmental allergies or hay fever mostly include sneezing, itchy, watery red eyes, runny nose, or stuffy nose, drainage down the back of the throat, some people can have sinus pain or pressure, headaches or fatigue. And the biggest thing that differentiates this from just the common cold is it tends to last longer and people notice a pattern to it.
Carol Gifford: And so what do you recommend for patients if they’re experiencing these symptoms?
Dr. Wunschel: Well, the first thing is to identify exactly what you’re allergic to. The same symptoms can be from allergies or from something else, like irritants. So figuring out if and what you’re allergic to is the first step. The most common and the best validated ways to look at environmental allergies is with skin testing or blood testing. So often I can do the skin test at the very first visit. It’s very easy. It’s very well tolerated and it will take 15 to 20 minutes and we’ll know exactly what you’re allergic to and what we can do about it.
Carol Gifford: And so then once you figure out what the allergy is, what are some of the different treatment options that patients are available for?
Dr. Wunschel: So every treatment should be tailored specifically to each individual patient, but in general, there are certainly some things we think about. The first step is avoidance measures. Of course, if you can avoid what you’re allergic to, then that will help to decrease your exposure. And at that first visit, we usually talk about some tips and tricks of what you can do to decrease that exposure. Second is medications. So there’s a lot of over-the-counter medications, such as steroid nasal sprays, something like Flonase or Nasacort, but these have to be used on a regular basis in order to get benefit from them.
There’s also over the counter anti-histamines or anti-allergy pills and I always recommend the non-sedating version, like Zyrtec or Allegra, so that you’re not drowsy throughout the day. There’s also additional prescription medications that can be given, which might be nose sprays or other pills on top of this that help to target the allergy pathway. And then finally, the best treatment for environmental allergies is allergy immunotherapy or allergy shots. All the medications in the world will only treat your symptoms. If we want to get at the root of the problem and cure your allergies, then what you need is allergy shots.
What this entails is basically giving the patients with a small amount of protein, the things that they’re allergic to, and increasing it over time. And this trains the immune system to become tolerant to those things. So instead of going down the allergy pathway, it now has a much more appropriate response to the thing you’re allergic to. And allergy shots are a commitment, but the effects are lifelong. Patients are very happy after they complete the course and then their bad season rolls around and they don’t have any symptoms, they don’t need a ton of medications, and so it really can be life changing for people.
Carol Gifford: So the shots really help them build up an immunity to their allergen. And then are you saying then when the next allergy season or hay fever season rolls around, they might get like a reaction, but it’s not as severe or they might not get a reaction at all?
Dr. Wunschel: Exactly. So most people don’t get any reaction at all. They’re able to completely come off their medications. Some people might need a medication here or there just an as needed over the counter pill, or they might need to pull out their nose spray, but they’ve gone from five meds down to one. So either way, it’s a win.
Carol Gifford: That sounds terrific. And we are in the middle of hay fever season now, but it comes around again in Iowa when?
Dr. Wunschel: So there’s multiple things that can trigger environmental allergies in people, and absolutely you’re right. So people who are suffering from issues now is likely because of tree pollen or grass pollen. Trees pollinate in the spring. Grasses pollinate in the summer. Both of those counts are really high right now here at the end of May. But another very common allergen here in Iowa is ragweed and other weeds. Weeds pollinate in the fall time, so we tend to see a big increase in allergies then as well. It’s also important to note that molds, indoor and outdoor molds, can be an issue for patients as well as things inside like their pets, cats and dogs, dust mites, or like I mentioned, indoor molds as well.
Carol Gifford: Wow. So this is very interesting and very educational. Thank you for taking the time. How can patients come and see you if they want to talk to you about their allergies or anything to do with their immune system? How do they get in touch with you, Dr. Wunschel?
Dr. Wunschel: Yes, absolutely. Just give me a call at my office. I’m located at the MercyOne Allergy Specialty Clinic at the Mason City Clinic and the number there is 641-494-5380. I’m currently taking new patients and I’m happy to get people in as soon as possible.
Carol Gifford: Okay. Well thank you for your time this morning and happy allergy season.
Dr. Wunschel: Thank you. Thanks for having me.
Carol Gifford: Okay. Thank you so much. Bye. Bye.