After a fitful spring, summer is finally here. With the warm weather, plants bloom—and so do allergies.
Seasonal allergies can range from a brief two weeks of springtime sneezing to a three-season ordeal stretching from early spring until the arrival of the frost. And with global warming in the mix, it seems that allergies are growing worse almost every year.
Seasonal allergens are mostly inhaled, so they usually affect the respiratory tract, which is where singers live. In addition to the usual symptoms that affect everyone—itchy eyes, sneezing and coughing—singers are plagued by vocal difficulties, which come from upper airway congestion and a tight chest.
How do allergies develop? With every breath, we inhale hundreds of particles that float in the air. Some of these particles, such as pollen, are so tiny that they have almost no weight, and normal respiration easily sweeps them into the nose, the throat, and even the trachea. Pollen particles typically land on the mucous membranes of the nose. A normal person develops no symptoms—but once the pollen is docked in an allergic individual, these particles may evoke an inappropriate inflammatory reaction.
Inflammatory cells (mast cells), which contain tiny granules of histamine, rupture and liberate histamine into the tissues. This potent inflammatory chemical causes swelling, itching and all the other pleasures of an allergic reaction. The lower airway may also suffer constriction of the air passages, causing wheezing and asthma. For the professional singer, sounding nasal while working hard to support the breath is no way to audition or perform.
The typical seasonal allergy sufferer reaches for an OTC compound for “cold, sinus, allergy and headache,” which leaves her dry, drowsy, and unable to focus. For singers, this “cure” is almost as bad as the disease.
Unlike perennial allergies, seasonal allergies may not require allergy shots. You just have to get through those few lousy weeks every year! So what can you do, other than roll up the windows of your SUV and turn on the air conditioner (and further contribute to global warming)?
First, minimize your time outdoors during high allergy times. Nature is very profligate when it comes to reproduction, and generates way more pollen than we really need for the next generation of saplings. Check the pollen count for your particular allergens, such as tree pollen. If you jog, either do it indoors, or chose the time of day when going outdoors is least harmful to your airway.
Next, keep your mucous membranes wet, inside and out. These membranes clear pollutants using an escalator mechanism, which pushes mucus along the cell surface. Drink lots of water so the mucus remains thin. Equally important, wash your nose several times a day, using either a neti pot or a saline spray. The more you flush those pollen granules off the membrane surface, the less time they have to cause inflammation.
If you need medication, try to take something with minimal side effects. If you are inclined toward alternative treatments, consider stinging nettle capsules. Stinging nettle has good anti-allergic effects without causing dryness or drowsiness. Acupuncture also can be helpful, particularly to treat nasal and sinus congestion, as well as tracheitis, cough and bronchial symptoms.
I often prescribe Singulair, a well-known asthma medication that now is also recommended for allergies. It is not an antihistamine, so it often lives up to its motto: “minimal side effects.” If you want to avoid cortisone nasal sprays, Astelin spray may be a good alternative.
Obviously, these remedies are good only if they work for you. If you need something stronger, you may need to resort to antihistamines (such as Claritin, Allegra or Zyrtec), or steroid nasal sprays (such as Flonase, Rhinocort or Nasalide). If congestion is a large part of your symptoms (vs. just itching or irritation), consider using an antihistamine-decongestant combination (such as Allegra-D or ZYRTEC-D). Remember, there is only one commercially available decongestant out there: pseudoephedrine (Sudafed). So, whenever you see the word “decongestant” or the initial “D,” it stands for pseudoephedrine. This is similar to adrenaline in that it can cause high blood pressure, palpitations, and to a lesser degree, dryness.
Most importantly, analyze your own specific allergy symptoms, and customize your treatment. You can minimize seasonal allergies by avoiding exposure, removing the allergens from your mucous membranes, and taking the appropriate medication. Avoid “shotgun” treatment with “cold/sinus/headache/backache” compounds. And remember, when your allergy season is over, stop treatment!
Disclaimer: The suggestions given by Dr. Jahn in the columns are for general information only, and are not to be construed as specific medical advice or advocating specific treatment which should be obtained only following a visit and consultation with your own physician.
