Month: March 2016

7 Things You Can Do To Get Ready for the Tree Pollen in the Spring

Well it is the middle of March in Arlington, VACentreville, VA, and Vienna, VA as well as the rest of the Washington, DC, northern Virginia, and Maryland metropolitan area, and Spring is around the corner.  Pretty soon the cars will be covered in yellow pollen, the cherry trees will be in full blossom, and many allergy sufferers will be complaining of hay fever (i.e., allergic rhinitis) symptoms.  As the temperature climbs, the buds will appear on various trees in the Washington, DC area.  This coincides with the release of tree pollen from numerous trees in the area.  Some of the more prevalent trees to cause allergy symptoms in the Arlington, Centreville, and Vienna areas of northern Virginia include, but are not limited to, the following trees:  alder, ash, beech birch, box elder, cedar, cottonwood, elm, hazelnut, hickory, maple, mulberry, oak, pecan, pine, poplar, sycamore, walnut, and willow.  Currently, the tree pollen counts are elevated after a relatively recent mild winter this year.  The pollen counts tend to increase as the Spring progresses, usually peaking in late April – early May.  The tree pollen counts tend to peak at about 1,200 grains of tree pollen per cubic meter of air.  For reference, in the Washington, DC area, a tree pollen count of 80 or more is considered “high.”

As Vienna allergists, we see that the manifestations that allergy sufferers experience vary in both the type and severity of the symptoms.  Some of the classic symptoms of Spring hay fever may include sneezing, runny nose, itchy nose, nasal congestion, post-nasal drip, itchy roof of the mouth, itchy ears, itchy eyes, watery eyes, redness of the eyes, puffy eyes, dark circles under the eyes, sinus congestion, sinus headaches, sinus pain, fatigue, and, snoring.  If the allergies effect the lungs, they can cause or exacerbate asthma symptoms such as wheezing, shortness of breath, chest tightness, and/or coughing.

Given the above, there are 7 simple ways to get ready for the tree pollen in the Spring which are as follows:

1.)  Check the pollen count, so you know when the counts are high, so you can avoid being outdoors, if possible.  (You can check the pollen count by clicking Today’s Pollen Count or clicking it at the top right of our website daily.)

2.)  Try to minimize your exposure to the tree pollen by closing the windows in your home and car and turning on the air conditioner and setting it to “re-circulate” so it will not bring in outside air that is high in tree pollen.

3.)  Be proactive and begin using prescribed or over the counter nasal sprays a few days prior to when you normally begin to feel the symptoms of tree pollen allergies.

4.)  If you go outdoors or enjoy exercising outside, try to avoid exercise early in the morning as the pollen count tends to be highest at these times.

5.)  If outdoors for a prolonged period of time during the tree pollen season, shower and change your clothes as soon as you re-enter your home.

6.)  Minimize your contact with pets and individuals who have spent a lot of time outdoors as they will bring the pollen to you.

7.)  Wear sunglasses to prevent the tree pollen from directly entering your eyes.

In addition to the above 7 ways to help prevent the tree pollen from aggravating your allergies, there a multitude of medications that can be taken in order to help reduce allergy symptoms you can get from your Vienna allergist.  The medications come in the forms of tablets, capsules, powders, syrups, nasal sprays, and inhalers.  Allergy shots (i.e., allergy injections, allergy immunotherapy, allergy desensitization) are an extremely effective treatment for hay fever and asthma.  They are effective in 80-85% of patients that take allergy shots.  They take about 4-6 months to become effective and the average person is on allergy shots for 3-5 years.

The board certified allergists of Black & Kletz Allergy have been diagnosing and treating both adults and children in the Washington, DC, northern VA, and Maryland metropolitan area for over 50 years.  We have offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA.  There is on-site parking at all of the offices.  The Washington, DC and McLean, VA office locations are Metro accessible and there is a free shuttle that runs between our McLean office and the Spring Hill metro station on the silver line.  The Vienna allergy doctors of Black & Kletz Allergy specialize in all types of allergic conditions including hay fever, asthma, sinus disease, hives, eczema, swelling problems, food and medication allergies, and immunological disorders.  If you would like to schedule an appointment, please call us or alternatively you can click Request an Appointment and we will respond back to you within 24 hours on the next business day.

New Tests for Food Allergies

It is estimated that about 3 million children and adolescents in the U.S. have food allergies. As an allergy doctor serving Mclean VA, I see many food allergy cases. For reasons that are not entirely clear, the incidence (newly reported and diagnosed cases) has been increasing steadily over the past several years.

Milk, wheat, egg, peanuts, tree nuts, and shellfish account for a vast majority of food allergies. Among these, peanuts and tree nuts (e.g., almonds, Brazil nuts, cashews, hazelnuts, pecans, walnuts) are more likely to cause serious life threatening allergic reactions.  They are also less likely to be “outgrown” than other food allergies.

The diagnosis of peanut and tree nut allergies from an allergy doctor in Mclean VA is based on a detailed history of the nature of reaction and the specific food trigger along with the results of prick skin tests and/or blood tests to estimate the level of an antibody called a specific IgE.  An elevated specific IgE level indicates a higher likelihood of a reaction upon exposure to the specific food.  Elimination of any exposure to the involved food and carrying a self-injectable epinephrine device (e.g., EpiPen, Auvi-Q) are the only treatment options at this time.

Many children diagnosed with peanut and tree nut allergies and their parents experience considerable anxiety about accidental ingestion and the potential for a serious reaction.  A few newly available tests may ease their fears to some extent.

Both prick skin tests and blood tests, while extremely useful in detecting sensitivity, can also be falsely positive in a significant percentage of patients (especially in children with eczema) and can overestimate the risk of a reaction upon exposure.  Peanuts and tree nuts contain more than 10 types of proteins which trigger an allergic reaction, and some of them are more dangerous than others.

Until recently, the available tests for peanut allergy only measure the total quantities of all peanut specific antibodies.  A new “component” blood test can measure the levels of individual peanut protein antibodies, helping us better delineate the actual risk of a reaction.  The five major peanut proteins are as follows:  Ara h 1, Ara h 2, Ara h 3, Ara h 8, and Ara h 9.  An elevated Ara h 1, Ara h 2, or Ara h 3 level predicts a higher likelihood of a reaction than an elevated Ara h 8 or Ara h 9 protein level.

Children with elevated Ara h 2 levels should strictly avoid all exposure to all peanut products at all times.  Ara h 8 resembles the protein found in birch pollen, which is one of the tree pollens that is responsible for hay fever (i.e., allergic rhinitis) in the Spring in the Washington, DC metropolitan area.  Higher levels of Ara h 8 in the absence of Ara h 1, Ara h 2, and/or Ara h 3 can predict less severe reactions with symptoms limited to an itchy mouth, throat, and/or lips [i.e., Pollen-food syndrome (formally known as oral allergy syndrome)].  These children can undergo oral food challenges to peanuts under controlled conditions in the presence of a board certified allergist.

Oral food challenges to peanuts involve consumption of tiny quantities of peanut-containing foods while closely monitoring for adverse reactions.  Small incremental doses are given at regular intervals.  If the usual daily dose is tolerated, peanut can then be integrated in the regular diet of the patient.  It goes a long way in reassuring the family and alleviating the anxiety.  Similar tests are also available for certain tree nut specific component proteins.

The board certified allergists at Black & Kletz Allergy treats both adults and children and will gladly answer any questions you have concerning food component testing and related food allergy issues.  Black & Kletz Allergy has 3 offices in the Washington, DC, northern Virginia, and Maryland metropolitan area with locations in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA.  We offer on-site parking at each location and the Washington, DC and McLean offices are also Metro accessible.  There is a free shuttle that runs between our McLean office and the Spring Hill metro station on the silver line.  If you would like to make an appointment with an allergy doctor Mclean VA, please call us or alternatively, you can click Request an Appointment and we will respond within 24 hours by the next business day.  Black & Kletz Allergy has been providing quality allergy, asthma, sinus, and immunological services to the DC metro area for more than 50 years.