The Asthma and Allergy Foundation of America ranks Dallas 13th among the top 100 most challenging places to live with seasonal allergies.
That can be challenging for children with asthma.
KERA’s Sam Baker talks about this in today’s Vital Signs with Dr. Cesar Termulo, Associate Medical Director for Parkland Health’s network of Community-Oriented Primary Care health centers.
Baker: What's so bad about this city or region?
Dr. Termulo: One thing, especially in the spring, is this huge abundance of oak, elm, and pecan trees. Because of that, there are a lot of pollens in the air that cause the overreaction of patients with asthma to those particular pollens.
So, for children with asthma, how bad is this?
Depends on the kind of asthma that one has.
Asthma can be triggered by such things as smoke, cats, or dogs. But there are also kinds of asthma that are sensitive to things such as allergies.
So, if a child with a seasonal allergy goes outside and starts to develop allergic symptoms from tree pollens, it can cause a mild attack or even a severe asthma attack.
How do you determine what triggers that in one person versus another?
Sometimes it's very difficult to distinguish the difference.
Oftentimes, with a child I know who has asthma and is very sensitive to seasonal allergies, it's going to be hard to know whether their mild, runny nose and cough is actually asthma or if it's just allergies.
So, symptomatically, they might start with just a runny nose, some sneezing and a little bit of a cough. But then I will start to think that they're about to have asthma, especially if they have a cough that’s more severe, a cough that wakes them up at night, or a cough that's more persistent. And of course, when I start to examine them, I can hear wheezing in their lungs or less air movement, indicating chest tightness.
So, it's kind of subtle in terms of when a seasonal allergy is developing into an asthma attack.
What are some preventive measures parents can take to minimize their child's exposure to seasonal allergens?
A lot of people take their medications when symptoms start, and then when their symptoms begin to decrease, they'll stop the medications.
But for a patient with asthma, if you know you're going to have allergies more in the springtime or the fall, you will have to take the medicines every day during that season.
What are the treatments?
There are antihistamines, oral antihistamines, and then there are nasal sprays that one can use. There are also medications that you can use for the eyes that are over the counter. Those are for the majority of patients who have seasonal allergies.
But some can have more difficult-to-control allergies. And sometimes we even use allergy shots. But those are situations where one was seeing an allergy specialist.
Can you cure allergies?
Children can have much less severe allergies as they grow older. However, some children can have severe allergies even through adulthood, and they get allergy shots to help them become less sensitized to a particular allergen.
Is the same the case for having asthma?
We used to tell patients you can outgrow your asthma or you can cure your asthma, but we try to avoid that lingo right now because I've had many patients who have had no asthma for ten years, and then all of a sudden they can have an asthma attack.
So, in practicality, as one grows older, most of one's symptoms can very much disappear. However, there's always a chance that a child or even an adult with asthma can have a sudden attack.
Dallas was ranked 13th among the top 100 most challenging places to live with seasonal allergies. If you're really trying to deal with that, is it best to consider moving elsewhere? Or would you face the same problems wherever you went?
My feeling is that if one gets regular medical care, and gets evaluated frequently, we can treat these things with a combination of your pediatrician, your family care physician, or a pulmonologist. We can take care of these things so that they can have a normal quality of life, and they can live where they want to live.
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