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News Camping with Allergies

By Dr David Kluge

accommodation-camping-langdaleSummertime in Montana means a bustle of activity.  For many, that activity includes heading to the mountains or lake to take in the beautiful scenery of Montana.  That also means getting back to nature.   For some, getting back to nature means getting close to things that we are not often around.  Whether that means heading to the forests and mountain creeks or to the open water of Montana’s lakes, it also means leaving the protection of our houses and cars with their filtered and conditioned air.

While that open air might be paradise for most, for some people it can be torture.  To the unfortunate folks that suffer from allergies, the open air can mean misery.  It can even be life threatening.  From a simple runny nose to a fatal asthma attack, allergies can cause a multitude of symptoms.  That threat can come from the trees, weeds or grasses that surround us.  The molds that live in the ground and decaying plant matter can affect us as well.

If you have ever slept on the ground, whether in a protected house or an open tent, and woke up with a stuffy nose or puffy eyes, you likely have some sort of allergy.  If your nose plugs up after camping for a couple days, I bet you don’t have a cold.  It is probably allergies too.  If you have tightness in your chest or you cough more when out in nature, you may have asthma that is made worse by nature’s rawness.

Being out in nature increases our exposure to allergens.  Allergens are things that cause us to have an allergic pollen-allergy-proof-400x400reaction (sneezing, itchy eyes, nasal blockage, facial puffiness, etc).  Allergens can be pollens from grasses, trees and weeds.  They can also be mold spores mostly from the ground.  Other allergens that can affect us anywhere are dust mites and animal dander.  But in nature, pollens and mold spores are what cause problems.  These pollens and spores are very light and are easily carried by the wind, so windy days can be bad.  Being close to the source (in the forest or prairie or on the ground) doesn’t help either.  Camping and boating puts us right in the middle of these allergens.

Allergic reactions are triggered in our bodies through the chemical histamine.  This chemical is actually made by us!  It is supposed to cause a reaction in our bodies to help us heal faster when injured and, strangely enough, protect us from parasites.  Histamine causes an inflammatory response cascade.  In people with allergies some of their own white blood cells mistake normal things in the environment (pollens and molds) as parasites and attack them.  This causes these usually normal things to become allergens for that person.   Reactions can vary but usually include swelling, itchiness and more drainage from the eyes and nose.  Allergens can make asthma worse in some people too.

So, now that we know that histamine is involved, how do we treat it?  What if we could block histamine’s effects?  Well, we can.  We have two primary ways of doing this.  The first is to block histamine directly and the next is to block the inflammatory cascade.

Antihistamines block histamine.  Now nothing can block all the histamine but these medications do a good job.  Folks with mild to moderate allergies can sometimes get complete relief from these drugs.  One of the earliest and still the most effective is Benedryl (diphenhydramine).  It works great!  It’s cheap!  However, it makes most people too sleepy to actually enjoy camping or boating.  It just knocks them out.  That being said, for severe allergic reactions, it is the absolute best drug to have available.  It is important to know that it only lasts 4 hours.  Other antihistamines that don’t usually cause drowsiness are Claritin (loratadine), Allegra (fexofenadine) and Zyrtec (cetirizine).  Zyrtec is considered the strongest.  They all last for 24 hours.  All antihistamines come in liquid and fast dissolving forms for children or more rapid effectiveness for adults.  These last three are not as strong as Benedryl, but they are better for daily use or mild symptoms.

The other class of allergy medications is new to the over-the-counter market in the last couple of years.  These are the nasal steroids.  Steroids block inflammation.  They are made in the human body to protect us from stress and are part of our fight-or-flight system.  We use them in medicine for their very potent anti-inflammatory effects.  In allergy, they block the histamine cascade as well.  Because they are so strong, steroid pills are prescription only.  However, now available over-the-counter are three steroid nose sprays.  These sprays use microgram dosages of different man-made steroids.  They are very effective but take 4-7 days for full effect.  They are dosed once a day.  Although they are nose sprays, they probably all also help eye symptoms too.  They are Flonase (fluticasone), Nasacort (triamcinolone) and Rhinocort (budesonide).  They are all considered equally effective, so buy the least expensive you can find.

If these medications are not effective enough, it is possible to actually modify the immune system to have it not react to allergens at all.  This retraining of the immune system can occur with allergy shots given by a doctor trained in allergy.  The shots can take a year to work.   They must be given, usually monthly, for up to five years or more in some people.  If effective, the shots can make the above medications work better or even eliminate the need for them altogether.

So, even with allergies, it is possible to enjoy the beauty of Montana first hand.  It might take a pill or a nose spray or a shot or even all three, but even the most severely allergic person should be able to ‘Get Lost’ in Montana.

david klugeDr. David Kluge is a board certified Otolaryngologist.  Dr. Kluge provides comprehensive care for all types of ear, nose, and throat problems, and has a special interest in diagnosis and treatment of allergies.  Dr. Kluge practices full time at the Great Falls Clinic Specialty Center at 3000 15th Avenue South, Great Falls. For more information or to schedule an appointment, please call 406-454-2171 or visit www.gfclinic.com.

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