Ladies and Gentlemen, Start Your Sneezing!

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I know spring is finally sprung when I walk outside, anxious to soak up some warmth and sunshine, then sneeze and rub my itchy eyes.  Behold the heavenly aroma of the hyacinth… and the cough and wheeze which follow.  I gravitate, lighter than air (if you knew me, that’s saying something) towards the crab apple tree in full bloom… and quickly thereafter start the steroids and applying cold compresses to my hives.   Allergy season is here, my friends.   Let the sneezing begin!

Environmental allergies can manifest themselves in a variety of ways and if you’re unlucky enough to have them, you may experience any and all of the following: itchy, watery eyes; serial sneezing; runny nose; popping ears; itchy skin; wheezing and sputtering.

Avoidance of the pollens and other allergens is a very effective way of dealing with allergies – possibly as effective as medication – so you can:

  • Stay inside when pollen counts are highest, generally in the early- and mid-morning.
  • Stay inside when the air quality is especially bad.
  • Keep your windows closed and the air conditioning on.
  • Stay inside when you hear the sound of lawnmowers.
  • Take a shower, change and wash your pollen-covered clothes as soon as possible after playing in the great outdoors.

But can your allergies be controlled without forcing you to live in a bubble?  Fortunately, yes.  There are a variety of over-the-counter (OTC) medications called “antihistamines” that are pretty effective at controlling allergy symptoms.  They’re all fine to use now and then if you can tolerate a little (or possibly a lot) of drowsiness and fatigue.  The older antihistamines like diphenhydramine (Benadryl) are more sedating while newer ones like cetirizine (Zyrtec) and loratadine (Claritin, Alavert) are less sedating.  

For the floodgate that noses can sometimes be, occasional use of a decongestant like pseudoephedrine (Sudafed) can be helpful.  Pseudoephedrine usually has the opposite effect of antihistamines and acts a stimulant so it can keep you awake at night, and raise your blood pressure.  Try to avoid OTC nasal sprays and definitely avoid the OTC asthma medications.

When OTC medications just aren’t enough, ask your health care provider for some help. We have a variety of very useful drugs in our tool belts, and when necessary can refer you to an allergy specialist for testing and possibly desensitization therapy.

So by all means, get out there for a hike, a run, a picnic, to study, or whatever is your pleasure.  But if the great outdoors leave you gasping for breath or struggling for a Kleenex, give us a call.

Victoria Rentel, MD

Medical Mythbusters – Green Snot!

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sheknows.com

True or False: My snot is green so I need an antibiotic, right?

AFalse!!

This is one of the most tenacious, and frustrating, medical myths out there: that clear snot indicates a viral infection that will clear on its own while green snot automatically means a bacterial infection that requires an antibiotic for treatment. 

This is simply not true! Coming down with a sinus infection is very common this time of year. You may know the symptoms: headache, stuffy nose, nasal discharge, facial pain and pressure, fever, cough and ear pressure. The vast majority of cases are caused by viruses and resolve on their own within 10 days.  The only time antibiotics are recommended is when the infection lasts for more than 10 days, or worsens over 5-7 days.

Many people come to the doctor expecting antibiotics for minor viral infections but keep in mind that not only do antibiotics do nothing against viruses, they are not always benign either. They can have side effects such as upset stomach and diarrhea. More importantly, overuse can lead to resistance, so that if heaven forbid you come down with a serious infection that does require antibiotics in the future, they may not work as well and the infection will be more difficult to treat.

As for the myth of the green snot, microbiologists believe the color comes from enzymes released by your white blood cells (myelo-peroxidases and other oxidases) to break down bacteria and other organisms. These enzymes contain iron, which gives off a greenish color. Also, the longer the mucus stagnates in your sinuses, the more likely it is to look green when it comes out. So when your sinuses are clogged up during a sinus infection, it is more likely to stagnate and appear green, just as your early morning snot will be more green just from sitting in your nose all night. The only kind of snot that deserves antibiotics is purulent (think pus) mucus coming from your nose or throat.

Remember, most of these infections clear on their own with a little TLC. Over the counter products such as pseudoephedrine (“Sudafed”) or my personal favorite, the neti pot are usually effective at alleviating the symptoms while the infection runs its course.   

If your sinus infection has been going on for more than 10 days, or it’s been getting worse over the past week, be sure to contact Student Health Services to be evaluated.

Angela Walker, Med IV (OSU COM)

John A. Vaughn, MD (OSU SHS)

photo: sinusinfocenter.com