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Depending on the patient, some allergy treatments…
Date Recorded
May 09, 2014 Health Topics (The Scope Radio)
Family Health and Wellness Transcription
Announcer: It's time to get an update on the latest in allergy treatments. We're going to examine that next on The Scope. Medical news and research from the University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.
Interviewer: When I was young, it was the scratch test and shots. That's about the only options I had for my allergies, and they didn't work. But I guess things have changed for allergy sufferers since then, quite a bit. We're with Dr. Kevin Wilson, ear, nose, and throat specialist at the University of Utah Hospital. Tell me about some of the newer treatments for allergies. Maybe we should start with I come in with allergies. What are you going to do?
Dr. Wilson: The first thing I'll do is ask what your symptoms are because, really, the treatments are often directed at specific symptoms, and different treatments work those different symptoms. As I talk to a patient about their options, I divide treatments into three categories. The first is avoidance, or we also call it environmental control. So if you know what you're allergic to, then you can take steps to decrease exposure to those allergens and therefore reduce your symptoms. The second category is pharmacal therapy or medications. There's a wide variety of medications from nasal sprays to eye drops to pills, and they all work differently and target different symptoms. I really like to understand what the symptoms are so I can target that medication to those symptoms. The third option is something called immunotherapy, which is what you were mentioning before: allergy shots. We also offer allergy drops, which are drops under the tongue. The idea here is that we give the patient the things that they're allergic to, and over time, their body becomes desensitized to those allergens so that they stop making the allergic response or at least significantly reduce it.
Interviewer: Is there a logic to this hierarchy?
Dr. Wilson: There is. It depends on the severity of the symptoms and how much the patient is willing to invest in this treatment. Some things are relatively simple. Taking a pill can be a relatively simple thing. There are some side effects to different medications. Avoidance can sometimes be a simple thing such as by maybe taking the cat out of the bedroom and not letting it sleep next to you on the pillow or trying to keep dust down in the home. But sometimes it can be more difficult if you're allergic to grass pollen. Then, really, your option is don't go outside for two months of the year. Most patients aren't going to go for that.
Interviewer: Sure. Yeah. Understood. Have treatments gotten better over the years?
Dr. Wilson: Well, certainly, the medications have improved. In the old days, and people who are treated 20 years ago may remember how horribly tired they became with antihistamine pills. There's a new class of antihistamines that have come out since then that are not sedating or are very minimally sedating so that you can take a pill and still function throughout the day and not be sleepy and falling asleep at the computer at work.
Interviewer: Are they more effective at treating the symptoms? When I was a child, as I said, I got the shots, and I never really felt a lot of relief from those.
Dr. Wilson: Yeah. It really just depends on, again, what the symptoms are, what you're allergic to. Most people do respond to the shots or the drops. The studies show about 80 to 90 percent of people do respond to them.
Interviewer: Wow. That's pretty good.
Dr. Wilson: So you were unfortunately in that small minority, it sounds like, if you didn't respond.
Interviewer: Lucky me.
Dr. Wilson: Yeah. So most people do respond. The downside to the immunotherapy is that it is a long-term treatment. So it's typically a three to five year treatment. Obviously, that's going to require a significant commitment on that part of the patient. If their symptoms are on the mild side, they may not be willing to do that. But it's certainly a good option for those for whom the medications don't work or who continue to have a lot of symptoms with medications.
Interviewer: Tell me a story about somebody who came in suffering from allergies and how your treatment changed their life.
Dr. Wilson: Maybe I should give my own experience. I am currently on immunotherapy shots.
Interviewer: So you're on that third stage?
Dr. Wilson: Yeah. Yeah. I've been treating my own allergies my whole life with different pills and sprays, and they work OK. But they have their downsides.
Interviewer: What are some of those downsides for you?
Dr. Wilson: Well, the pills always made me sleepy. So I could function, but I was always falling asleep, even with the newer generation of antihistamines. I just wanted something more definitive. I wanted to be able to go outside and not have to worry about it. I like to ride my bike to work. I didn't want to get to work with itchy eyes every day. So I put myself on the shots basically, and life is a lot better.
Interviewer: Really?
Dr. Wilson: I'm a lot happier. Yeah. And I've got a whole group of patients that are doing very well and they're real happy with the treatment they're on.
Interviewer: Do you know if insurance covers these types of treatments?
Dr. Wilson: In general, it does.
Interviewer: In general it does. So what would you want an allergy sufferer to know at the end of the day?
Dr. Wilson: If your symptoms are bothersome, there is help. There's help out there.
Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, the University of Utah Health Sciences Radio.
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Kevin Wilson, M.D., video bio
Date Recorded
August 30, 2013
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Almost everyone is anticipating spring, except…
Date Recorded
March 05, 2014 Health Topics (The Scope Radio)
Family Health and Wellness Transcription
Interviewer: Can you prepare for spring allergy season in the winter? We'll examine that next, on The Scope.
Announcer: Medical news and research from University Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.
Interviewer: So, about this time in the winter everybody's dreaming about spring, except for maybe allergy sufferers and I think even they perhaps are dreaming about spring, maybe a spring without allergies. Is there actually something you can do in the winter to prepare for that? Dr. Kevin Wilson is an ear, nose, and throat specialist at the University of Utah hospital. What can I do now to prepare for allergies in the spring? Is there anything?
Dr. Wilson: Well, it depends on what you're allergic to.
Interviewer: Okay.
Dr. Wilson: So, if you're allergic to a year-round allergen like dust or your cat or dog or mold you've probably been suffering all winter long and it hasn't made a difference for you.
Interviewer: So mold's year-round, interesting. Okay.
Dr. Wilson: There are some seasonal parts of it because it tends to grow in moist, warm environments so it can grow in the thatch under your lawn.
Interviewer: Gotcha.
Dr. Wilson: So, when you first start mowing it's been that moist kind of melting snow and you'll get some mold in there and that'll start kicking up. You may notice some of that.
Interviewer: Alright.
Dr. Wilson: If you're, you know... spring's going to be bad for you if you're allergic to trees. That's the first thing that's going to be blossoming in kind of March-April time frame. Next will be the grasses in June-July area and then the weeds will be more in the fall so that can give you kind of an idea about when your symptoms are as to what you're allergic to. So, if your symptoms occur just as the snow is melting then you can assume it's a tree.
Interviewer: Darn trees!
Dr. Wilson: Yep and there's not really a lot you can do about it to prepare. Again, it's about avoidance, it's about treating the symptoms if you can, and then hoping that the time will come when those trees stop pollinating.
Interviewer: So, in the tree season if I'm on some sort of medication so I need to start ramping that up or can I start taking as soon as tree season hits? Do I need, like a two week period or whatever before?
Dr. Wilson: That's a great question. So, one of the main medications that we use is nasal steroid spray and that's a spray you get from your doctor. It's not available over the counter and it takes about a week or two for it to work so if you're going to be using a spray like that, then yeah you would want to use it a couple of weeks before you expect those symptoms to begin. The antihistamines like the pills and things, they work pretty rapidly so you can just start using those as needed when you start to get symptoms.
Interviewer: So really only if I'm using a spray is there anything I can really do to prepare other than just be aware it's coming?
Dr. Wilson: Just be aware.
Interviewer: Alright. Not a lot of preparation you take it as it comes. What about putting in... do filters in my house, heating and cooling systems make a difference?
Dr. Wilson: Yeah, you know, you can spend a lot of money on filters and purifiers and other things. The studies aren't that great, unfortunately.
Interviewer: Oh, okay.
Dr. Wilson: If you're going to invest in a filter, it's probably better to do an in-room filter rather than a whole house filter because they're more efficient and with a full house filter you'll really wear out your blower on your furnace.
Interviewer: Because you'd have to keep that on all the time...
Dr. Wilson: You've got to change that filter all the time because unfortunately pollens and allergens are very, very tine so you've got to get a very high efficiency filter for it to really be effective and of course that's going to plug up those holes pretty quick.
Interviewer: Sure.
Dr. Wilson: So I don't recommend in general the full house filter. I feel like treating the symptoms and focusing on the patient rather than on the environment, maybe getting the patient out of the environment rather than trying to change the environment is a lot more effective.
Interviewer: Final thoughts on preparing for allergies?
Dr. Wilson: Good luck with the season; everyone thinks that this year is the worst year. The reason is we have a very short memory.
Interviewer: Every year is bad!
Dr. Wilson: That's right! Every year is bad, there are worse seasons than others but you know your systems will likely roll around every year.
Announcer: We're your daily dose of science, conversation, medicine, this is The Scope, the University of Utah Health Sciences Radio.
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