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Hayfever

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  • 1. Allergic Rhinitis (“Hayfever”) Richard Saint Cyr MD DABFP [email_address] www.myhealthbeijing.com August 2, 2009
  • 2. Case: Spring In The Garden
  • 3.
    • When: late April
    • You spend the afternoon at the Beijing Botanical Garden
    • That night: slight headache and runny nose. Itchy eyes and sneezing at night; “fuzzy head” in daytime
    • You take OTC Rx for a “cold”; doesn’t help
    Case: Spring In The Garden
  • 4. Q: What Next?
    • Get antibiotics at pharmacy
    • Get anti-allergy pill from pharmacy
    • Go to clinic doctor
  • 5. Dx: Allergic Rhinitis
    • “ Hay fever” 花粉病 huāfěnbing
    • Allergic reaction to pollen in flowers
    • Seasonal patterns
      • Spring - Trees
        • Beijing poplar 杨树 yángshù & willow 柳树 liǔshù
      • Summer – Grasses
      • Fall – dry grasses & weeds
    • Indoor allergens (all year)
      • Mold 霉病 méibìng , dust mites 尘螨 chénmǎn
    • Dog & cat hair
  • 6. Beijing Tree “Sex Change”
    • Female poplar & willows
    • April-May: huge pollen release
    • 2007 campaign to:
      • inject females to neuter them
      • replace with males
      • replace all with gingko trees
  • 7. Symptoms
    • Common:
      • Sneezing; watery, itchy eyes; clear runny nose; sore throat; itchy skin rash
    • Serious:
      • Bacterial infection (sinus, ears)
      • Children: asthma 哮喘 xiàochuǎn , eczema 湿疹 shīzhěn
      • Anaphylaxis 过敏性 guòmǐnxìng
    • Usual Course:
      • Flower season, every year
  • 8. Racoon Eyes
    • “Allergic Shiners”
  • 9. Prevention
    • Avoid the pollen
    • Take antihistamine daily
    • Nasal rinse daily
    • Severe cases only:
      • Allergy injections to build immunity
  • 10. Prevention: Indoor Allergens
    • Air purifiers
    • Open windows every day ~1/2 hour
      • Not overnight! Diesel fumes too strong
    • Pets – wash
      • Only helps ~24 hours
    • Beds, pillows (dust mites)
      • Special covers
      • Throw out old pillows
  • 11. Air Purifiers
    • Work well – but $$$
    • Look for HEPA rating
      • IQAir – best rated; 10,000RMB+
      • BlueAir – very good; 6,000RMB+
      • Chinese products?
  • 12. Self Treatment
    • Avoid the pollen
    • OTC Rx
      • Antihistamine 全身抗组胺药 pills
        • Clarityn 开瑞坦 once a day; non-sedating
        • Benadryl 苯海拉明 every 6 hours; sedating
      • Steroid nasal spray
        • Flixonase 辅舒良
      • Eye drops
        • Naphcon-A 那素达
    • Nasal saline rinse
    • Epi-pen: epinephrine injection 肾上腺素
      • Carry always, if severe risk
  • 13. Rinse Out Your Nose
    • Cleans out toxins & mucus
    • Helps allergies & colds
    • Twice a day
    • 8 oz (250cc) warm water (filtered/boiled) + ½ teaspoon salt + pinch of baking soda
    不好玩儿!
  • 14. What Clinics Can Do
    • Physical exam: allergy vs. infection
    • Lab test:
      • Allergy panel; CBC
    • Rx:
      • Severe reactions: injections
      • OTC and prescription Rx
    • Hospital/ER:
      • Severe reaction; shock
  • 15. In Your Travel Kit…
    • Antihistamine pills, sprays, eye drops
    • Epi-pen: history of severe reaction
  • 16.
    • Get antibiotics at pharmacy
    • Take anti-allergy pill
    • Go to clinic doctor
    A: What Next?