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Wednesday, April 1, 2020  Spokane, Washington  Est. May 19, 1883
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Seeking solutions to allergy symptoms

Dr. Zorba Paster

Stuffy nose? Itchy eyes? Mucus going down the back of the throat? If you’re prone to wheezing, perhaps you’re experiencing a wheeze or two? Or three? Or four? Or maybe you’re just tired and miserable all the time at this time of year?

Of course, you know what I’m talking about: allergies. They come with the season, just like mosquitoes and those pesky flies.

Where to start in treatment of allergies and what’s new? It’s a question I get all the time — on my radio show, in my office, from friends, relatives and everybody else. So let’s review the basics of allergy treatment.

First, let’s go back to the good old days of Benadryl and Coricidin. These two name-brand antihistamines were the mainstays, making up the backbone of allergy treatment.

Well, let me tell you, when I was in high school or college and the allergy season struck, I was so miserable I would pop one of these. Ever take one in the middle of the day? I dare you to try; it will put you right to sleep.

I was done in, tired beyond tired. So I would prop myself up with my pep-up pill, Sudafed. The problem with that is it would rev me up without waking up my sleepy brain. I was a jittery zombie.

I couldn’t do that and make the grade to get into medical school. So I suffered, suffered, suffered without medication.

In 1985, the breakthrough drug Seldane came to the market as the first-in-class antihistamine not to cause sleepiness. It was removed a few years later because of side effects, but we now have over-the-counter Claritin, Allegra and Zyrtec. You can finally get all of these great drugs without a trip to see your doctor.

Is there a difference in these three medications? Yes. From what I’ve gathered, Zyrtec is a bit stronger but more likely to make you sleepy. Claritin is the least powerful, with some allergists recommending two tablets to do the trick. And Allegra is somewhere in the middle.

In any case, if one doesn’t work then try the other.

Now, on to nasal sprays. Flonase, the most commonly used steroid nasal spray, is finally available over the counter. Other brands are just as good; pick the one on sale and try that first.

I recommend a full dose for a couple of days — two sprays in each nostril, morning and night. And if that works, taper down over a few days to see what is the minimum number of sprays given the minimum number of times that is still effective.

These sprays work differently than Afrin, which works instantly to clear the nose. But if you use that one too much, you’ll become dependent on it. The other types work more slowly, often taking a day or two to kick in, but they can be used for months at a time.

I recommend these nasal sprays as the first line treatment, better than the pills. And, by the way, you can mix them together, pills and spray.

Let’s talk eye drops next. Start with the over-the-counter kind; there are several types on the market. Talk to your pharmacist to learn the differences.

Some have antihistamines, some have decongestants, some have both. Some burn a bit, which relieves the itch, while others do not. And if they fail, try one or two generic brands before you call your doctor for one of the prescription eye drops. Those are stronger and they work when the others bite the dust, but they’re expensive.

Now, how can you tell the difference between an allergy and a cold? Allergies occur at roughly the same time year after year. The nasal discharge is clear, not yucky green or yellow. And rarely, if ever, are they associated with a fever. If there is one, it’s just a pinch high. And, of course, allergies come with those itchy eyes, which clinches the diagnosis.

One final thought: For some reason people think they won’t get colds in the summer or that the “summer cold” is a rare event. It’s true that winter is cold season, but there is no assurance you won’t get a virus next week — in the height of summertime.

So, folks, keep up the same precautions: Sneeze into your arm, not your hands; use hand sanitizer if you think you’re getting sick; and don’t cough on your neighbors, it’s bad form. Stay well.

Dr. Zorba Paster is a family physician, professor at University of Wisconsin School of Medicine and Public Health, and host of the public radio program “Zorba Paster on Your Health,” which airs at noon Wednesdays on 91.1 FM, and noon Sundays on 91.9 FM. His column will appear twice a month in The Spokesman-Review.

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