Could you have asthma?

The ongoing cough you can’t get rid of could be a signal that you have asthma, according to the American Academy of Allergy, Asthma & Immunology (AAAAI). Asthma is a chronic lung disease that affects 20.3 million people in the United States. It accounts for approximately 14.5 million missed work days for adults and 14 million missed school days for children annually.

For people who have asthma, the air flowing in and out of their lungs may be blocked by muscle swelling and squeezing. Symptoms of asthma include cough, chest tightness, shortness of breath and wheezing.

Ask yourself these questions:
For you:

• Is there a family history of asthma or allergies?
• Are you constantly short of breath and wheezing?
• When do you notice your symptoms – when you have a cold, when you are exercising or around allergens, such as pollen, mold and animal dander?
• Are you missing work because of symptoms?
• Is coughing and wheezing keeping you up at night?

For your child:

• Does your child cough, wheeze (a rattling sound when they breathe), have chest tightness or shortness of breath?
• Does your child cough or wheeze with play, exercise, laughter or during temper tantrums?
• Is your child missing school because of symptoms?
• Is coughing and wheezing keeping your child up at night?
• Is there a family history of asthma or allergies?

If you are experiencing symptoms and they are keeping you from work, school or normal activities, you should consider talking to a doctor to see if you have asthma.

Every person has their own triggers. If you have asthma, you can minimize your symptoms by avoiding the factors that trigger your symptoms and by working with your allergist/immunologist.

Uncontrolled EIA limits physical activity

People with exercise-induced asthma (EIA) may not be able to participate in physical activities if it is not properly controlled, according to the American Academy of Allergy, Asthma & Immunology (AAAAI).

About 20 million Americans suffer from asthma. In addition, many non-asthmatic patients, up to 13% of the population, experience asthma symptoms with exercise.

If someone is experiencing symptoms of EIA, it is important for them to be properly diagnosed by an allergist/immunologist to make sure it is not something more serious. The physician will be able to treat the patient’s EIA with proper medications and will also address other issues to ensure the person can participate in sports and exercise to their fullest capacity.

EIA is caused by airways that are overly sensitive to sudden changes in temperature and humidity, especially when breathing colder, drier air. During physical activity, people tend to breathe through their mouths, allowing the cold, dry air to reach the lower airways without passing through the warming, humidifying effect of the nose.

Symptoms of EIA include wheezing, chest tightness, coughing, chest pain, shortness of breath and fatigue. These symptoms can be controlled with proper medication and guidance from an allergist/immunologist. Schedule your appointment with Allergy Clinical today.

Inhaled medications taken prior to exercise are helpful in controlling and preventing exercise-induced bronchospasm. The medication of choice in preventing EIA symptoms is a short-acting beta 2 agonist bronchodilator spray used 15 minutes before exercise. These medications are effective in 80 to 90 percent of patients, have a rapid onset of action, and last for up to four to six hours. These drugs can also be used to relieve symptoms associated with EIA after they occur.

In addition to medications, a warm-up period of activity before exercise may lessen the chest tightness that occurs after exertion. A warm-down period, including stretching and jogging after strenuous activity, may prevent air in the lungs from changing rapidly from cold to warm, and may prevent EIA symptoms that occur after exercise.

When to see an allergy/asthma specialist.

Patients should see an allergist/immunologist if they:

• Have exercise-induced symptoms that are unusual or do not respond well to pre-treatment with albuterol, nedocromil, or cromolyn.
• Have had exercise-induced anaphylaxis or food-dependent exercise-induced anaphylaxis.
• Want to SCUBA dive and have a history of asthma.

If you believe you may have EIA or have been diagnosed with EIA, talk to your allergist Pittsburgh/immunologist about a personalized management plan for your EIA and begin exercising again. Many asthmatics have found that with proper medical treatment, they are able to reduce the symptoms of EIA.

Frequent infections may be a sign of immunodeficiency

People who get frequent infections, such as ear infections, sinusitis or pneumonia, may have a more severe condition called immunodeficiency, according to the American Academy of Allergy, Asthma & Immunology (AAAAI).

Patients who have immunodeficiency have infections that usually do not go away without using antibiotics and often recur within one or two weeks after antibiotic treatment is completed. These patients frequently need many courses of antibiotics each year to stay healthy. There are several forms of immunodeficiency and while some are very severe and life-threatening, many are milder but still important enough to cause recurrent or severe infections.

People with immunodeficiency get the same kinds of infections that other people get—ear infections, sinusitis and pneumonia. The difference is that their infections occur more frequently, and are often more severe, and have a greater risk of complications.

Allergist/immunologists often use the frequency of the use of antibiotics to mark the frequency of significant infections. General guidelines for determining if a patient may be experiencing too many infections are:

• The need for more than four courses of antibiotic treatment per year in children or more that two times per year in adults.
• The occurrence of more than four new ear infections in one year after four years of age.
• The development of pneumonia twice over any time.
• The occurrence of more than three episodes of bacterial sinusitis in one year or the occurrence of chronic sinusitis.
• The need for preventive antibiotics to decrease the number of infections.
• Any unusually severe infection or infections caused by bacteria that do not usually cause problems in most people at the patient’s age.

When to see an allergy/asthma specialist
If your child has any of these conditions, consult with an allergist/immunologist for more information on recurrent infections, immunodeficiency, proper diagnosis and treatments.

Patients should see an allergist/immunologist if they:

• Have chronic or recurrent infectious rhinosinusitis.
• Have any of the following warning signs:
  • Eight or more new infections within one year.
  • Two or more serious sinus infections within one year.
  • Two or more months on antibiotic with little or no effect.
  • Two or more pneumonias within 1 year.
  • Failure of an infant to gain weight or grow normally.
  • Recurrent deep skin or organ abscesses.
  • Persistent thrush in mouth or elsewhere on skin after age 1 year.
  • Need for intravenous antibiotics to clear infections.
  • Two or more deep seated infections.
  • A family history of immune deficiency.

10 tips to ease your allergy symptoms

Millions of Americans are keeping their tissue boxes close by in preparation for the peak of the spring allergy season. The budding trees and blooming flowers associated with the return of spring mark an increase in itchy, watery eyes, sneezing and other allergy symptoms.

Seasonal allergic rhinitis, or “hay fever,” affects more than 20% of the people living in the United States, according to the American Academy of Allergy, Asthma & Immunology (AAAAI). Allergies are triggered by substances called allergens, such as pollen or mold spores. Many trees, grasses and weeds contain small and light pollens that are easily carried by the wind, causing allergy symptoms to flare up in the spring.

One of the best ways to help prevent allergy attacks is to start taking medication prescribed by your allergist about a week before peak allergy season in your area begins. With continued use of medication and avoidance of potential triggers, allergic symptoms can be minimized.”

In addition to timing medication, the AAAAI offers the following tips to help allergy sufferers find some relief this spring:

• Do a thorough spring cleaning – windows, book shelves and air conditioning vents collect dust and mold throughout the winter that can provoke allergy symptoms.
• Minimize outdoor activity when pollen counts are high. Peak pollen times are usually between 10 am and 4 pm.
• Take medications at least 30 minutes prior to outdoor activity. Consult with an allergist/immunologist to ensure medications are helping you and notify an allergist/immunologist when reactions to medications occur.
• Shut windows in your house on days pollen counts are high. Avoid using windows or fans that may draw pollen inside.
• Wash bedding weekly in hot water.
• Dry laundry indoors. Sheets hanging on an outside line are an easy target for blowing pollen.
• Shower and wash your hair before bed – pollen can collect on your hair and skin.
• Keep pets off of furniture and out of the bedroom. Pollen can cling to the dog or cat after being outside.
• Keep car windows closed during peak season. Use air conditioning and point vents away from face.
• When mowing lawn or doing gardening, wear a filter mask.

Seek proper treatment prior to and during your peak allergy season:
If you are an allergy sufferer, consult with an allergist/immunologist to discuss treatment and environmental control options. An allergist/immunologist is the best-qualified medical professional trained to manage the prevention, diagnosis and treatment of allergies and asthma.

ACHOO! Aches and pain. Sniffle, sniffle. Wheeeeeeze. Are these the terms that describe an allergy or a cold? To knock out either a cold or an allergy, knowing the difference between the two is important when planning your attack.

The similarities between them can lead to confusion about which you are suffering from. One can easily mistake an allergy for a cold, or vice versa. Yet left untreated, allergies can cause more serious conditions such as sinusitis or ear infections.

The main difference between a cold and an allergy is the length of time the symptoms last. While a cold will last a week, allergies can last longer than that. Get a proper diagnosis on your condition before you begin treatment.

Look at the chart below to determine if you have an allergy or a cold:

COLDS
A cold is commonly caused by a virus. You can get a cold from another person that has that virus, even though you may be in good health. This happens when you breathe in germs or come in direct contact with the infected person.

To prevent yourself from getting a cold, frequently wash your hands, use a disinfectant on any contaminated surfaces and be careful when sneezing and coughing around others.

The best course of action for curing a cold is to let it run its course. Get adequate rest, drink lots of fluids and eat nutritiously. Over-the-counter medications, like an oral decongestant or a nasal saline, will help to alleviate the symptoms, but they will not cure your cold – only time can do that.

ALLERGIES
Allergies occur during an exposure to an allergen. During this exposure, the nasal cavity becomes irritated and inflamed.

Although the symptoms are close to that of the common cold, allergies are not contagious. If you have a high temperature or an achy body, it is most likely that you have a cold, as this is not caused by allergies.

Common allergens include pollen, dust mites, animal dander, molds, fungi and cockroaches. If you are unsure of what you may be allergic to, talk to your allergist/immunologist about getting a test done that can identify them for you.

There are no cures for allergies, but there are other options. Prescription or over-the-counter medications can treat allergies, as well as allergy shots, a treatment your allergist Pittsburgh/immunologist can give you to reduce your sensitivity to the allergens.

What is immunotherapy?
Do you sometimes feel like there will never be any relief from your allergy symptoms? The runny nose, itchy, watery eyes and wheezing will just never go away. But alas, there is relief in sight! A technique called “immunotherapy” or “allergy shots” can help you alleviate symptoms caused by allergies.

Although immunotherapy is not a cure, it is the next best thing. You can dramatically reduce your allergy symptoms by completing immunotherapy treatment.

How does it work?
Immunotherapy is an effective vaccination program that can increase your immunity to substances called allergens that trigger your symptoms. It works by gradually increasing the amounts of an allergen given to patient over the course of several months. The injections of the allergens will first be given on a weekly or bi-weekly basis and eventually on a monthly basis.

Through your body’s exposure to small, injected amounts of a particular allergen, in gradually increasing doses, your body builds up immunity to the allergens to which you are allergic. This results in reduced allergic symptoms when the patient comes into contact with the allergen. The concentration of this dosage will vary depending on the patient’s sensitivity. It is also important to see your immunotherapy treatment all the way through, as stopping will cause a loss of efficacy of the program.

Benefits of immunotherapy
For those people who have allergy symptoms that are moderate to severe, occur throughout most of the year, who do not respond adequately to the medications and cannot easily avoid their triggers, immunotherapy will cause significant relief. Before immunotherapy, a patient could have extreme allergic reactions when exposed to a known trigger, such as ragweed, pollen or animal dander. But immunotherapy can minimize the symptoms during exposure, and lead to a more care-free life.

However, there are some down-sides to immunotherapy. First of all, the initial treatment is very frequent, resulting in many trips to the allergist’s office. In addition to this, you will be required to stay in the office for 20 minutes after your injections. This is purely for your safety, as the physician would want you there in case of an adverse reaction to the shot. Some patients also develop swelling at the site of the injection. These “local reactions” can be resolved with oral antihistamines, ice packs or an adjustment of the dose given.

The positive side of immunotherapy outweighs the negative side in most cases. For some individuals, allergy shots can provide relief and a way of life that would never have been possible previously.

If you believe immunotherapy could help you, you should be examined by an allergist/immunologist. After taking a detailed history and examining you, your doctor will assess your allergy triggers

Avoiding the ouch:
Advice on stinging insect allergies

As summer approaches, you may notice an increase in the number of insects buzzing around outside. People with an allergy to stinging insects will want to take extra precautions this time of year. According to the American Academy of Allergy, Asthma & Immunology (AAAAI), up to 5% of Americans are at risk for a severe, potentially life-threatening allergic reaction from insect stings.

For most people, getting stung results in temporary pain, redness and swelling at the site of the sting. However, for those with allergies to insect stings, it can result in a sudden, severe reaction called anaphylaxis. This may be fatal if not treated immediately. Symptoms of anaphylaxis to watch for include: itching and hives over large areas of the body, separate or away from the site of the sting; swelling in the throat or tongue; difficulty breathing; dizziness; stomach cramps; nausea and diarrhea. If you suffer from a stinging insect allergy, you should take extra precautions to avoid being stung.

Unfortunately, most people are not aware they are allergic to insect stings until after experiencing a reaction. An allergic reaction occurs when the immune system overreacts to the insect venom. When this happens, an allergic person’s body produces an allergic substance called Immunoglobulin E (IgE) antibody, which reacts with the venom. This triggers the release of histamine and other chemicals that cause allergic symptoms and, in the most severe of cases, a rapid fall in blood pressure, loss of consciousness and sometimes even death.

Because a severe and sometimes fatal reaction can occur, it is important to know what common stinging insects look like. The most common stinging insects in the United States include:

• Yellow jackets – black with yellow markings, found in various climates
• Honeybees – a round, fuzzy body covered with dark brown and yellow markings
• Paper wasps – slender, elongated bodies that are black, brown or red and have yellow markings
• Hornets – black or brown with white, orange or yellow markings and are larger than yellow jackets
• Fire ants – reddish-brown ants living in large mounds, mostly in warmer climates

It is also critical for anyone with allergies to insect stings to take precautions to avoid a potentially dangerous reaction. The AAAAI recommends the following tips to avoid being stung:

• Avoid the “territory” of the stinging insect’s nest. These insects are most likely to sting if their homes are disturbed.
• Remain calm, quiet and slowly move away from stinging insects. Do not swat them.
• Avoid brightly colored clothing and perfume outdoors that may attract stinging insects.
• Be careful when cooking, eating or drinking sweet beverages outdoors. Keep all food and beverages covered until consuming them.
• Avoid loose-fitting garments that can trap insects between material and the skin.

When to see an allergy/asthma specialist
If you have experienced a reaction to insect stings or you think you may be allergic, consult with an allergist/immunologist to accurately diagnose your condition. An allergist/immunologist is the best qualified medical professional trained to manage the prevention, diagnosis and treatment of allergies and asthma.

An allergist/immunologist might also suggest allergy shots, also known as immunotherapy treatment. Venom immunotherapy shots take effect within just a few months. Venom immunotherapy is the closest thing to a “cure” for allergic reactions. It is shown to be 97% effective in preventing future allergic reactions.

Patients should see an allergist/immunologist if they:

• Have reactions possibly due to insect stings for accurate identification of specific allergen and consideration for immunotherapy (allergy shots).
• Have systemic reactions possibly due to biting insects, for accurate identification of specific allergen.
• Have an allergic reaction (anaphylaxis) without an obvious or previously defined trigger.
• Have had anaphylaxis attributed to food, drugs, or insect stings.

AAAAI: Look out for latex in unexpected places

Allergic reactions to latex happen commonly in medical settings, where rubber gloves are in abundant supply. But less-visible elements in other environments can also pose danger, according to the American Academy of Allergy, Asthma & Immunology (AAAAI).

Consider that restaurant meals are frequently prepared by cooks wearing latex gloves. In schools, the cafeteria may be a threat, but there is also potential exposure to latex in school supplies. This type of inadvertent exposure poses a serious health risk to millions of Americans.

Estimates of latex allergy prevalence vary, but the condition disproportionately affects healthcare workers and others with frequent exposure to latex – including those who have had multiple surgeries. At least 10 percent of healthcare workers and more than half of individuals with spina bifida are believed to have the allergy, versus 1 percent to 6 percent of the general population.

Reactions to latex can result in skin irritation or anaphylaxis – which can be life-threatening.

Avoidance is key to preventing an allergic reaction and the responsibility of education often falls to the patient. The AAAAI recommends these tips for latex-allergic patients:

• Avoid contact with latex products, including gloves, balloons and condoms.
• Inform your doctors, dentist, family, employer and school personnel of the allergy and request accommodations as needed.
• Remember that the federal Americans with Disabilities Act provides workplace protections for individuals with latex allergy. If protective gloves are required for your job, your employer should consider an alternative synthetic material, which is equally effective in most situations.
• Ask your physician if you should wear a medical bracelet identifying your allergy.

An allergist/immunologist is the best-qualified medical professional to diagnose and treat latex allergy and other allergic diseases.

A sign of a serious condition?

Do you or your child wake up coughing, or have a prolonged cough lasting for weeks? Parents should recognize that this is something potentially serious requiring medical attention, according to the American Academy of Allergy, Asthma & Immunology (AAAAI).

Cough is the most common respiratory symptom for which patients seek medical attention. Cough protects the body by removing mucus and irritating particles from the respiratory tract. Coughing is a useful function and does not always mean there is a problem with your child. However, coughing at night, after going to sleep indicates the need for medical attention.

Cough is a symptom with a variety of causes including:

• Viral upper respiratory tract infections
• Asthma
• Nasal and sinus disease
• Stomach and esophageal problems such as GERD
• An inhaled foreign body
• Habit
• Environmental irritants

The good news is that relief is possible for almost all patients with the help of a knowledgeable expert, such as an allergist/immunologist. This requires a thorough patient history, physical examination and in some cases selected testing.

When to see an allergy/asthma specialist
The AAAAI’s Referral Guidelines provide information to assist patients and health care professionals in determining when a patient may need consultation or ongoing specialty care by the allergist/immunologist. Patients should see an allergist/immunologist if they:

• Have a cough that lasts 3-8 weeks or more
• Have a cough that coexists with asthma
• Have coexisting chronic cough and nasal symptoms
• Have a chronic cough and tobacco use or exposure

Asthma is still in session even during summer break

With school out for the summer, children across the country will be taking to the community pools, baseball fields and other outdoor venues for some fun in the sun. But for the 9 million children in the United States suffering from asthma, it’s important that parents not let their child’s asthma management take a vacation as well.

Parents need to be observant of their child’s asthma management especially during the summer months when children tend to be more active and outdoors. But if parents work with their child to take the proper precautions there is no reason why their child can’t enjoy everything the summer months have to offer.”

Whether it’s swimming at the local pool, heading off to summer camp or playing in the backyard, the American Academy of Allergy, Asthma and Immunology (AAAAI) offers the following asthma tips to help parents manage their child’s asthma:

• Try not to exercise outside when pollen counts are high, as this could aggravate your child’s asthma.
• Consult with an allergist/immunologist to ensure your child is taking the proper medication and notify them if reactions to medications occur.
• Make sure your child properly stretches and warms up before exercising, take breaks during, and cool down afterward. Instruct them to drink plenty of fluids as well.
• Make sure your child always carries an asthma inhaler, so they are prepared for any trigger that may cross their path.
• If your child is going to summer camp, meet with camp counselors to ensure proper asthma management.
• When building a fire, make sure your asthmatic child sits farther away and out of the wind so the smoke does not irritate their lungs.
• Check your area for ragweed, mold and any other triggers that can affect your child’s asthma.
• Pay attention to Ozone Alerts in your area. High temperatures combined with pollution can pose a health problem for children with asthma.

See your allergist/immunologist
The AAAAI urges parents to work with an allergist/immunologist to develop an effective management plan for their child’s asthma. An allergist/immunologist is the best-qualified medical professional trained to manage the prevention, diagnosis and treatment of allergies and asthma.

By Michael Palumbo M.D., Allergy and Clinical Immunology

Q. My 3-year-old child is sick with respiratory infections all of the time. What should I do?

A. In addressing this issue it is important to discuss the particular types of infections that children are having. Viral respiratory infections, or colds, are common and typically last five to 10 days. Children can get up to 12 colds a year and still not be a concern as long as these infections improve without needing treatment. Young children have immature immune systems and close contact through daycare and schools leads to a rapid spread of infections.

Evaluation by a doctor should be sought for infections that routinely linger for longer than 10 days without improvement. Viral respiratory infections should clear on their own with only palliative measures to control fever, cough and nasal drainage. Patients who always require antibiotic courses to clear infections should be considered for further evaluation, as this is a sign of a bacterial infection.

Underlying factors contributing to frequent infections need to be considered. They include an anatomical obstruction in the sinuses, immune deficiency, allergic disease or certain other upper respiratory conditions (such as ciliary dyskinesia or cystic fibrosis) that can impair the body’s ability to fight or clear these infections. Of course, if we are talking about other types of infections — such as pneumonia or more severe infections — the indications for further testing vary.

Immune deficiency may also explain recurring infections. According to the Jeffrey Modell Foundation, warning signs of a deficiency include: two or more pneumonias a year, two or more months on antibiotics with little effect, two or more serious sinus infections within one year, the need for intravenous antibiotics to clear infections, or recurrent deep skin or organ abscess. If any of these are present, further testing for underlying immune problems should be discussed. As always, it is a good idea to keep documented history of these infections including any laboratory testing or radiologic imaging and discuss these concerns with your pediatrician before considering further

While many people rejoice when the weather gets warmer, it’s not always a pleasant time for everyone. Those who suffer from seasonal allergies know to expect difficulties around this time of year, but the severity of allergy season can vary.

The presence of the common causes of spring allergies pollen and mold – can fluctuate depending on a number of weather-related factors. Here are some of the conditions that can affect pollen counts.

• Length of the growing season. Longer growing seasons might be a good thing for famers and gardeners, but it can mean increased misery for allergy sufferers, as it increases the time pollen and mold are present as well.
• Erratic weather.  A warmer than usual winter season, as experienced this year, makes trees pollinate earlier. If spring weather fluctuates greatly between warm and cold spells, it can result in more intense periods of pollen release during the warm spells, when plants take the cue to grow and release pollen.
• Rainfall.  Rain can be either a good thing or a bad thing for allergy sufferers, depending on when it happens. The worst allergy seasons are often preceded by a wet spring, which promotes rapid plant growth later on. But rain can also provide a much-needed respite for those with allergies, as a heavy rainfall can help clear the air of pollen.
• Wind.  Dry and windy weather is not kind to people with allergies, as the wind spreads pollen and mold.

Since so many factors contribute to high pollen counts, it’s all but impossible to predict how intense an allergy season will be. However, in addition to taking steps to limit your exposure to allergens that affect you, seeing an allergist before the season starts can also help ensure you find relief.

Why see an allergist?  Allergists are not only trained to treat your systems, but can identify the source of your allergies and develop a treatment plan to address your symptoms. A doctor who is also a certified allergist can teach you how to avoid potential triggers for your allergies, and recommend treatment options that may go beyond over-the-counter medications.

An allergist may also recommend allergy shots, also known as immunotherapy, which can alter the progression of allergies, providing more than just symptom relief. Even if an allergy shot might not be for you, an allergist can recommend both prescription and over-the-counter medications that can best treat your symptoms.

In fact, studies suggest immunotherapy when used on the appropriate patients can result in health care cost savings of up to 41 percent.

Five Things that Can Aggravate Your Suffering.

1. Noshing on fruits and veggies – Many people with seasonal allergies also suffer from pollen food allergy syndrome (also called oral allergy syndrome), a cross-reaction between the similar proteins in certain types of fruits, vegetables (and some nuts) and the allergy-causing pollen. One in five people with grass allergies and as many as 70 percent of people with birch tree allergies suffer from the condition, which can make your lips tingle and swell and your mouth itch. The trick is to determine which problematic produce is causing your symptoms and then avoid eating it, (although you might be able to eat it if it’s peeled, cooked or canned). If you’re allergic to birch or alder trees, you might have a reaction to celery, cherries or apples. If you have grass allergies, tomatoes, potatoes or peaches may bother you. Usually the reaction is simply annoying and doesn’t last long. But up to 9 percent of people have reactions that affect a part of their body beyond their mouth and 1.7 percent can suffer a life-threatening allergic reaction called anaphylactic shock. If you’ve had a systemic reaction, you should see an allergist and ask whether you should carry injectable epinephine.

1. Using the wrong air filter – Using an air filter to keep your home pollen-free is a good idea, but be sure it’s the right kind. Studies show inexpensive central furnace/air conditioning filters and ionic electrostatic room cleaners aren’t helpful – and in fact the latter releases ions, which can be an irritant. Whole-house filtration systems do work, but change the filters regularly or you could be doing more harm than good.

1. Opening your windows – When your windows are open, the pollen can drift inside, settle into your carpet, furniture and car upholstery and continue to torture you. So keep your house and car windows shut during allergy season.

1. Procrastinating – You may think you can put off or even do without medication this spring, but the next thing you know you’re stuffed up, sneezing and downright miserable. Instead, get the jump on allergies by taking your medication before the season gets under way.

1. Self medicating – Perhaps you’re not sure exactly what’s making you feel awful so you switch from one medication to the next hoping for relief.  Your best bet is to see an allergist, who can determine just what’s triggering your symptoms and suggest treatment. You might even benefit from allergy shots (immunotherapy), which can stop the suffering altogether.