Opening up the window for a little springtime air is a simple pleasure Brenda Bell-Foster of St. Louis County does not take for granted. If oak allergen is topping the allergy charts for the day, the windows of her home stay closed and she tries to limit long-term outdoor activities. And when she is indoors, Bell-Foster avoids dust collectors – and dusting altogether. Her husband does the dusting.
It took several years of skin eruptions, stuffy sinuses and emergency room visits before Bell-Foster found out she has indoor and outdoor allergies. And it took a few more years to conquer her fear of what she heard about allergy needles to get tested to find out exactly what causes her allergic reactions.
She is allergic to oak, flowers and to ordinary dust, and even certain metals. She and her husband were forced to return a new mattress that made her break out from head-to-toe with hives. It turns out the mattress was made with lamb’s wool – something else she is allergic to.
Allergic reactions on Bell–Foster’s skin include atopic dermatitis- a type of eczema with severe itching and skin thickening, scaly rashes and bumps – all that can be scratched into sores.
Breaking out between her toes and where the sun doesn’t shine is not a matter to resign yourself to accept and live with. Bell-Foster said she had visited a number of doctors and a dermatologist for her skin condition.
“I had even been to a dermatologist about that and the dermatologist recommended Aveeno, which I use – which is fine, but it wasn’t the medicines I really needed to get my skin under control,” she said.
She does continue to use Aveeno products, but Bell-Foster’s husband suggested she try Dr. Michael Borts, of the Allergy, Asthma and Sinus Care Center in St. Louis.
“He took the allergy test a little differently than the previous doctor and it just really worked out really well for me.,” she said.
What Bell-Foster thought was two different issues turned out to have one culprit.
“I was having trouble with my skin too and I didn’t realize the problem with the skin was connected to the allergies.”
She said by listening to her specific symptoms, Dr. Borts made the difference in her allergy treatment and management.
“Dr. Borts basically just kind of stepped in and helped me with the right medications and the right doses … I was getting a shot three times a week at first, and then once a week and now I’m like once a month. I’m doing a whole lot better and I haven’t been to urgent care clinic in about four or five years – since I started seeing a doctor for the allergies,” Bell-Foster said.
“It’s a very serious condition –I just didn’t know how serious until I started to feel better.”
Allergist Dr. Michael Borts said persons who are not usually bothered by allergies have joined other allergy sufferers in seeking relief this year due to higher pollen counts.
“There are unpredictable environmental conditions…but we really have pleasant weather and we have not had as much rain as we often have other springs, and that results in a lot more pollen floating around,” Borts said.
When are allergy symptoms really not caused by allergies?
Borts said a clue is when over-the-counter allergy medicines provide no relief.
“Sometimes people have nasal congestion, runny nose or maybe a lot of sneezing. Sometimes people will jump to conclusions, saying, ‘Well, you’re allergic to the pollen,’ or ‘you’re allergic to the mold’ or ‘you need to get rid of your cat.’ Sometimes as many as half of the patients we see, we now identify something other than the allergy is responsible for their symptoms,” Borts said. “For example, sometimes people have an underlying sinus infection, then they may get that congestion or drainage. Some of our patients have what we call non-allergic rhinitis, which is more of an overly-sensitive nose, and exposure to temperature changes, weather changes, cigarette smoke, air pollution, things like that cause a lot of the same [symptoms], like congestion, drainage and runny nose. But things like the non-allergic rhinitis or a sinus infection won’t get better with allergy medicines.”
Borts said if OTC meds do a very good job of controlling symptoms, it probably is an allergy. If those medicines cause side effects, or if those medicines don’t control their symptoms, Borts said that is when it is appropriate to be evaluated and to be tested.
About that allergy skin test – consider it an unpleasantry that yields crucial information for getting allergies under control.
“Testing that we typically do in the office is what’s referred to as allergy skin testing. It does not involve needles or shots. It involves a little plastic template device whereby we apply drops of solution on the skin – each drop representing a different allergen,” Borts said. “And if someone has an allergy to that, they get essentially the equivalent to a mosquito bite reaction on that spot. So we are reproducing a localized allergy reaction on the skin to get insight as to what’s going on in their eyes, their nose and their lungs.”
And in Bell-Foster’s case, all over her body.
Borts tested her on one arm for indoor allergies and tested on the other arm for outdoor allergies. She said a tray with 15 to 30 tiny vials of substances was used to test her skin. She didn’t really want to call the skin test painful, but let’s just say it didn’t feel good.
“When they put the tray on your arm, it was about two inches wide and about an inch-and a half high, more or less…and it was really painful. It hurt only because I was allergic to it,” Bell-Foster explained. “It wasn’t the type of pain as if you stumped your toe or cut your finger. It was a different type of pain because it was an allergy reaction. When they stuck that thing on my arm, immediately, my arm started to swell and itch, just really, really bad. And he had told me not to scratch it, but I didn’t scratch it, but I did rub it. I couldn’t help it.”
Blood tests can also reveal allergies, there are occasions when blood tests are preferable to skin allergy testing.
“If the patient is very uncomfortable from their symptoms and cannot be without their antihistamine medicine – then we may do the blood test. Or if they have a severe allergy – something like allergy to peanuts, or fish or shellfish, where exposing them to the allergen can potentially be dangerous – then we would selectively do a blood test,” Borts explained.
“Most allergists you’ll find make use of both the allergy skin test and the blood test, and it’s really the circumstance that determines.”
Bell-Foster now uses a combination of prescribed skin ointments, creams and OTC products to keep her skin allergies under control in addition to avoiding her known allergens. And she says she follows all of her doctor’s instructions.
For persons who newly find themselves dealing with allergies this season, Dr. Borts said individual sensitivity will determine if it continues.
“What we often find is that patients do have symptoms every year, but some are a little bit more tolerant of their symptoms, particularly those patients who have Y chromosomes,” Borts said jokingly.
He said those are the ones who just sniffle all the time and put up with symptoms seem to not be aware of how miserable they really are.
“We often find that a lot of men, they tend to wipe their nose on their sleeve and put up with their symptoms, whereas children, their parents recognize their symptoms and they really recommend that they go ahead and get evaluated and get treated.”
