7 December 2016 – By Dr John Mackellar
Hay fever is little more than a nuisance to many people and, perhaps also to doctors, who have never had the problem.
But to sufferers it can be quite serious. The runny nose may be accompanied by watery eyes, sinusitis, irritable airways and even asthma. Most have trouble breathing, can’t sleep or often wake with a dry, sore throat from mouth breathing. It is not a fever; there is no elevated temperature present.
There is usually a family history and sometimes there is an obvious cause, such as a grass, pollen of flowering bushes or a tree. Quite often, very young children or adolescents have hay fever, especially in the Spring and it is then referred to as seasonal and is often a problem for those studying or sitting exams.
Management will always depend on a correct diagnosis and the identification of the offending allergen. Sometimes, this will require blood testing (RAST tests) or skin testing by an allergy specialist. Treatment is then offered according to the patient’s need:
- Short term (1 – 7 days): – avoidance of the allergen (closed windows at night), oral antihistamines (not in small children) and decongestants – both of which could have side effects. Over the counter medications are readily available, but may not be appropriate.
- Medium term (2-30 days): – injectable steroids (only from an experienced GP) – very effective and safe, with almost no side effects. Ideal for students studying.
- Long term (1-10 years): – a desensitising course of fortnightly injections of an appropriate serum prescribed by the allergy specialist. In children, these should commence no later than year 9 or 10 and may need to be given for two-monthly periods over 1 or 2 years. This prepares students for years 11 and 12 and avoids the need for sedating and brain-slowing antihistamines. Parents hoping to get the best out of their kids in Years 11 and 12, should consider long term protection from about Year 7 or 8.
Quite often hay fever symptoms are caused by problems within the bedroom, most commonly house dust mite or moulds. Nearly every house has house dust mite in doonas or blankets, which reproduce and cause symptoms, especially in May and November. Washing of bed linen and vacuuming is insufficient. House dust mite, and when mould is present in wardrobes or under beds, should be totally eradicated every year or so.
Shepparton, being part of an irrigated area producing a range of exotic grass and tree crops, not to mention the flowering of native grasses and trees, will always have many patients with hay fever when compared with (say) Melbourne. Visitors to the Goulburn Valley will often say they have never had hay fever until coming here.
Unfortunately, in Shepparton many patients are given antibiotics – often requested by parents, when they believe an infection to be present. Your GP should make the correct diagnosis and offer some suggestions for treatment.
Much has been written and said about hay fever, and 2016 has been an unusually bad year. But now – as the weather warms up and the year ends – hay fever will also decline.
As an afterthought, hay fever should not be confused with other forms of blocked nose and sneezing caused by temperature changes, irritants (eg cigarette smoke), the rebound from over-the-counter nasal drops, unknown irritants or spicy or pungent food. This group is sometimes referred to as nonallergic rhinitis and is managed by avoidance.
Kialla Medical Clinic
21D/8025 Goulburn Valley Highway
Kialla, Vic 3631
Mooroopna Medical Centre
87 McLennan St