Ep.9 - Allergens, Allergy Testing, and Red Wine Sniffles
In this ninth episode of the Swain Sinus Show, ENT Doctor and Sinus Surgeon Dr. Ron Swain, Jr, (Mobile, Alabama) talks about allergies and how allergens, that are all around us, effect sinusitis and our overall breathing and daily health. Host Stacy Wellborn shares her fear of needles and shots as we all learn about the benefits of immunotherapy. Lastly, Dr. Swain reveals the age old mystery of why some people get "the sniffles" when drinking red wine.
What you will hear:
> Allergies defined and specific examples of allergens. > How your sinuses and nose reacts to allergens. > When you should consider allergy testing. > When you and your doctor should consider immunotherapy. > Even ENT and Sinus Surgeons deal with allergy issues. > Short-term use of over the counter and prescription allergy medications. > Innovations in patient allergy treatment.
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Ep.9 Full Show Transcript
Stacy: Dr. Swain, we've talked a lot about sinus conditions and sinus surgery, but we haven't really talked about allergies, which is another big area that I know you must deal with, what is allergies?
Dr. Swain: Basically, an allergy is kind of an abnormal response to a foreign substance, like, pollen or cat dander. As an ENT doctor, we deal with a lot of people with nasal and sinus complaints, nasal congestion, and allergy plays a big part of that. The thing about sinusitis, is that it's an inflammation, and allergy can play a big role in your nose staying congested. That's in addition to, you know, getting sick all the time. The noses, it's got its own immunology, which is kind of fascinating really. So if you have an underlying condition that creates chronic inflammation there, your nose is kind of set up to have problems, especially when you do get a cold and get sick. So an allergy, in terms of your nose, is one of those things that can kind of set you up and predispose you to having long-term problems.
Stacy: And there are lots of allergens out there, right?
Dr. Swain: Hundreds. And there are inhalant allergies, there's, you know, and then there are food allergies. So with what we deal with, if you eat something, you can get a nose that's congested and stuffy, a lot of times, especially with red wine, the nose people will get stuffy if they drink red wine or, you know, if you're allergic to oak tree pollen, and you...it's oak trees, you know, oak trees are in bloom or pollinating, a lot of times, people will have a stuffy nose from that.
Stacy: So how do I identify what I'm allergic to?
Dr. Swain: We allergy test people. There are several ways to allergy test people. One way is to draw some blood, and we can test the blood to see if you have an allergy. The other way is to actually put a test on your skin, skin testing, and so we give you a little bit of what you might be allergic to and we watch and look at your skin and we see if you'll react or not, which is what people typically associate with being allergy tested. They'll talk about having stuff put on their arm or their back.
Stacy: Mm-hmm. And actually, I had that done probably 15 years ago, and at this point, I couldn't even tell you what I was allergic to because I guess there wasn't a lot, but my question would be, does it change? Like, if I were to get tested today, would it possibly be different than what it was 15 years ago?
Dr. Swain: As you get older, I think, there's less of a chance of things changing as opposed to when you're younger. I think everyone in Mobile has some allergy issue. I know I certainly do and I'm on allergy shots. One of the things that I'm highly allergic to is oak tree pollen, and so, you know, if you tested me five years ago, and tested me now, if you haven't done anything to try to change how your body responds, the response is still going to be the same, as long as your immune system is functioning as it has before. You know, we talk a lot about how you treat allergies and that can be complicated. There's some over-the-counter medicine that a lot of people use, and then they're talking about allergy shots, of course.
Stacy: So for someone suffering, what we might call, seasonal allergy, there's a plant here in Mobile, Alabama that affects me every spring, and I can see it start to bloom and so I tend to just take something over-the-counter for the two or three weeks that it blooms. But if there were something, like a grass, it's maybe year-round that's more gonna affect me, I may choose to do the allergy shots, would that be correct?
Dr. Swain: Yes, you can treat even the seasonal allergy with allergy shots depending on what your symptoms are. Certainly, an over-the-counter antihistamine, Claritin and Clarinex, Zyrtec, Benadryl are things that people commonly use. Nasal steroid sprays work really well, too. I know a lot of people who would use Flonase, or Nasonex, and Nasacort, just to name a few. There are other medicines, something called Singulair, which is a look or trying inhibitor, which is another oral medication that people can use. You know, nasal sailing spray, we've talked about that a whole lot, which can help as well. But that's just a band-aid. That's just treating the symptoms. You're having symptoms, you take something that makes the symptoms go away for a little bit. It's not trying to cure the underlying problem. The idea behind immunotherapy or allergy shots is to give you a little bit of what you're allergic to, over a long enough period of time, it kind of changes the way your body responds. And incidentally, one of the other things that is now being talked about, it's something called slit therapy or sublingual immunotherapy, and the idea behind that is we're not giving you a shot anymore, we're putting some things underneath your tongue. And it kind of accomplishes the same thing, it gives you a little bit of what you're allergic to, to try to desensitize you from reacting in the same way.
Stacy: I like the idea of that because I'm not a big fan of needles.
Dr. Swain: Right.
Stacy: I'm not gonna lie. But there's a point at which you have to make a decision that you don't wanna just band-aid it, you wanna have a solution and that's when we need to come be tested.
Dr. Swain: Correct. You know, it just depends on how long you've been having trouble and if you've not responding to the medication. And when you're not responding to oral medication, or you get tired of taking the oral medication, there's something else we can offer.
Stacy: So the process of testing and getting to the solution and to that immunotherapy, is that the right term?
Dr. Swain: Yeah, yes.
Stacy: What does that look like?
Dr. Swain: Well, it would first of all take a history and we've documented that you've tried, you know, oral medication or topical medications in your nose and then we would, you know, ask if you were interested in being allergy tested.
Stacy: So how long does the actual allergy test take?
Dr. Swain: It depends. Obviously, if you're having your blood drawn, that doesn't take very long at all.
Dr. Swain: The skin testing can take a little longer because it depends on how many things we put on your skin, you know, but most of that can be done within an hour.
Stacy: I mean, you're getting an immediate feedback from the skin test so you have a general idea pretty quickly.
Dr. Swain: Yeah, that's the amazing thing with people, especially when you do the skin testing, they can actually look down and go, "Wow," you know, "That really did react, I really am allergic to grasses or molds or [crosstalk 00:18:41].
Stacy: Which isn't as the patient is great to see yourself because then you can really...it's real.
Dr. Swain: It gives them some validation.
Dr. Swain: You know, they're not imagining this. They really do have something that they're reacting to and a lot of times they're even, you know, excited that, "Hey, look I think I found an answer to why I'm having all this trouble."
Stacy: I was just thinking that the exact thing is it's gosh when you've struggled for so long with these symptoms to get an answer is such a relief.
Dr. Swain: Right. And again, that's something that it's a non-surgical approach to having a nasal problem. There are things we do sometimes to help people breathe better through their nose, but an allergy test and treatment for people's allergies is certainly a way to help them breathe better, that is not going to require an invasive procedure.
Stacy: So when someone's ready to take that test and take that next step, what do they need to do to talk to you?
Dr. Swain: The big thing would be let's get you an appointment and take a look. It's really easy to get an appointment to see me. If you would call and speak to my nurses, the direct line 251-470-8823. Again, that number is 251-470-8823. And, of course, we're trying to make appointments online, there's drronswain.com for appointments as well. My nurses are Mandy Webster, and Chasity Wooten and Emily Demet. If you'd call that number directly, my nurses can help you get set up to have an appointment to see me.
Stacy: Great. Thanks, Dr. Swain.
Dr. Swain: Thank you.
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