The Questions within this Forum are replied to by Board-Certified Physicians.

Topic 1. What are Seasonal Allergies associated with Traveling to Alaska ?

From: Elaine H.

Sent: March 15, 2006 4:46 PM

Question:

Hello,

I am planning to come to Alaska in July and I am seasonal allergy sufferer with asthma triggered by the allergens...currently experiencing upper Respiratory problems which is normal for me in the spring and fall, but not usually the summer. I live in hot Texas summer months and experience no problems, but what about Alaska in July.....This year in Texas we have had no winter in our area, so many people are suffering more than usual with all the triggers....so don't know how to compare Alaska with my situation. I certainly don't want to get sick there because of a high risk of asthma triggers there.

I start Vancouver , cruise to Skagway , and take a train and motor coach to Fairbanks ....on train to McKinley and back down to Anchorage ending up at the Aleskia resort for two days before returning to Texas . I will be exposed to many different climates, outdoors and water does not bother me, except for mold. I do take allergy shots weekly.

What are my chances that would occur there due to your wondrous beautiful state....I am female, 67 and in good physical shape otherwise. I am only allergic to cats and I don't do the outdoor stuff like hiking, fishing. I am just a looker at scenery person with a camera.

I already bought the package so I sure hope you have good news.

Elaine Herring

Response:

First, congratulations on your trip to Alaska . Summer is an amazing time to visit. Our most important allergens in the summer are the grasses. It sounds like spring (trees) and fall (weeds) are your worst times, so from an allergen trigger standpoint you should do fine. Indoor molds can be a problem anytime of year; outdoor molds tend to be at their worst in the fall (rainy season). Respiratory tract infections tend to be an important trigger for many asthmatics. With travel in a large group in enclosed settings with people from “all over” there is increased risk for infection- so, take the usual precautions, stay well hydrated, well rested and most importantly wash your hands. Unfortunately, like everything else in life, there are no guarantees of health, so, prepare, make sure you have your medications and enjoy your time in Alaska ! There are plenty of wonderful sites and animals to see.

-- Teresa Neeno, MD

From: jdeidooley

Sent: Sunday, April 30, 2006 2:55 PM
Question: allergies in Alaska - better?

I had read that Alaska was better for allergies than any other state - shorter seasons and fewer types of trees.  Is this true?  My son has severe environmental allergies (as well as food allergies and asthma) and we would even consider a move like this if it would help.  He is very miserable in the spring here (trees), does fairly well in summer (grasses), and then is miserable in the fall again (ragweed).  He continues to have symptoms all winter, but we are in Arkansas and there are tons of kinds of trees and grasses here, as well as a moderate winter.He takes weekly allergy shots and is on many medications.    Any information you could give me would be helpful.  Thank-you, D Dooley

Ms Dooley: Even though you have trees in “bloom” year round that does not mean they are pollinating all year. Every where in the world trees pollinate in the spring, grasses in the summer, and weeds in the fall. Every location may have different plants and different pollens, and shorter or longer dates of pollination. In Anchorage our pollen season is from about May 1 to October 1 with our primary pollen being birch from May 15 – July 1. It is likely your son will do better since he will be away from the pollens he is allergic to in Arkansas but he may over time develop allergies to pollens here. As for year round allergens, which may also be an explanation for your son's winter symptoms, we have less dust mite and mold allergy as we are drier, but animal dander problems may be slightly worse as cats and dogs may be indoors more of the year. Food allergy would not likely be any different.

Thad L Woodard, MD

Topic 2. Feeling Sick, Frustrated & Hard to Breath: Is this Asthma?

From: MMFett

Sent: April 14th, 2005 2:13PM

Question:

Hi I have a question.

Last Winter I got pneumonia and was sick for almost 2 months, the thing is I never felt better and about 3 and a half weeks ago I started feeling worse again and I checked on my Peak Flow Meter (my doctor gave me one when I had pneumonia) and noticed that the numbers went down.

I went to the doctor and was told that I might have Asthma and might have had it for years and didn't realize it.

She told me that since I was coughing we would try the tests the next time I came in, two weeks later and put me on Advair twice a day and Albuterol every 4 hours.

I went back two weeks later (a week and a half ago) and she didn't do the tests but told me that I was looking better and to only use the Albuterol as needed and to keep using the Advair twice a day but she didn't do the tests.

I stopped using the Albuterol because frankly I was sick of it and within days started feeling worse. I used the Albuterol as little as possible and yesterday started using it again when my Peak Expiratory Flow fell to 280 (my max is 460)

Today it's up to 430 but frankly I'm getting frustrated, I quite smoking 4 weeks ago because I was feeling horrible. Now I feel worse after I've been taking the medicine and my doctor's out of town for a week.

I'm figuring if I feel worse now then when I did when I was smoking I might as well be smoking!!!!!

I just need advice, should I go to another doctor? Does what I have even sound like Asthma, I thought Asthma was just not being able to breathe and wheezing alot, and well the not being able to breathe I have. I've been really congested, I feel like there is something squeezing my chest, I had a headache from Sunday until Tuesday night, I've been really tired but yet I've had trouble sleeping and I've started coughing again, but generally only at night. It's really the fact that I feel so tired and I'm sick of being sick. It's not like I can't breathe at all, but it's hard to breathe.

Does this sound like Asthma or something else? I'm sorry for the long post but I am getting really frustrated!!!

Response:

When we make the diagnosis of asthma, the story is very important- symptoms you have, what triggers you to have problems and what happens when we treat with asthma specific medications. Following lung function by peak flow and by spirometry is also important. These tests are helpful in that they can be supportive of the diagnosis of asthma. If your peak flows are decreasing, you may need more aggressive therapy- especially if you are having frequent use of albuterol. The goal for albuterol use is less than 2 times per week.

I cannot diagnose via this forum. It is reasonable for you to return to your doctor and further address the posibility of asthma.

--Teresa Neeno, MD

Topic 3. The use of HEPA or Air Filters/Purifiers in reducing Asthma Symptoms.

From: mandy0elle
Sent: February 1st, 2005 7:51 AM

Question:

Has anyone heard of using air purifiters or shower filters to help with asthma symptoms. I heard chlorine can combine with organic particles to form chloroform, which irritates the lungs.

-Mandy

Response:

Air cleaners can help some symptoms due to triggers of asthma due to particulate matter in the air. Danders, smoke, dust are examples than can be removed to some degree by HEPA filters in particular. How much benefit from this is hard to gauge however and some studies find little benefit and others moderate benefit. This is due to other triggers not cleared by air cleaners, for example the major trigger, respiratory viruses and dust mites which are not in the air to a significant degree.

Chlorine gas alone as well as chloroform is a respiratory irritant and can increase symptoms.

Overall, best to have good underlying control of asthma inflammation, use air cleaners if you can, avoid irritants as possible.

T Woodard, MD

Topic 4. Asthma in Infants.

From: sam

Sent: July 15th, 2004 9:36 AM

Question:

I recently had a son, and he appears to have some difficulty breathing -- things like grunting, wheezing, mouth breathing (which they tell me he's not supposed to be doing much). How early can I get him tested for asthma? Is there a way to treat him if he does have asthma?

Response:

There are no reliable tests for asthma in infancy. The diagnosis is suspect in any infant with recurrent episodes of cough or wheeze, especially if the infant has allergic eczema, documented food allergy, or a parent with asthma or allergies. Grunting and mouth breathing are not the most common symptoms of asthma in infancy and wheeze may or may not be suggestive of asthma as other problems can cause wheeze. Wheeze without cough, and persistent wheeze is not characteristic of infant asthma.

There is very safe and effective treatment for asthma.

T Woodard, MD