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Lacamas Life Magazine
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Ask the Doctor
1. How can I cope with “hay fever” or nasal allergy season?
The moderate temperatures and wet winters in the Pacific Northwest mean we have allergy “season” nearly year round. In dryer climates, allergies may be limited to the spring and summer. But our damp winters here result in higher counts of mold spores, which trigger allergies in some people. The good news is the high humidity also helps moisturize our nasal passages, which also helps keep allergies at bay.
So what triggers “hay fever”, and how can you cope with the symptoms? Hay fever, or allergic rhinitis, occurs when substances that we are allergic too get into our nasal passages. With every breath you inhale pollen, dust, pollution, animal dander and mold spores. The nasal passages trap a lot of these particles and prevent them from going into your lungs. But if you are allergic to any of these triggers, it will cause the release of a chemical called histamine. It is histamine that is responsible for most of the unpleasant symptoms of allergies including sneezing, runny nose, itchy eyes, fatigue, and in some people asthma.
The most effective treatment for nasal allergies is also the least expensive. Nasal salt water or “saline” spray is actually a very effective way to wash all those allergy-causing particles out of your nose, before they can trigger the release of histamine. You can buy nasal saline over the counter for just a few dollars. It has no significant side effects. I recommend using this 4-5 times a day during your allergy season. Have you ever noticed that your nose feels the best right after you get out of the shower? All that warm, moist air dose your nasal passages good, and nasal saline spray does the same thing. If you have any leftover nasal sprayers, you can also buy safe, inexpensive contact-lens saline solution and use that.
The next most effective nasal allergy treatment are nasal steroid sprays like flonase, rhinocort, and others. These sprays decrease inflammation and block the release of histamine. In order for them to work, you need to use them daily during allergy symptom. They won’t give you immediate relief from allergy symptoms, but after using them for a week or two, your symptoms should be reduced. Unfortunately, these medications are expensive, and they do have some potential side effects. For people who have seasonal allergies, I generally recommend you use these for 6-8 weeks at a time during your peak allergy season.
If using saline spray or nasal steroids doesn’t work, the last resort is to take an anti-histamine. Anti-histamines are fast-acting medications that can give you rapid relief from the symptoms of allergies. I recommend them as “rescue” medicines, for when the other medicines don’t work or for particularly bad allergy days. The least expensive anti-histamines are over the counter medicines like benadryl, and chlor-trimeton. These medicines are mildly sedating, which can be a useful side effect if your allergy symptoms keep you up at night. Recently, Claritin (Loratadine) became available over the counter as well. This medication is more expensive, but less sedating than the other over the counter medications. Other non-sedating medications like Zyrtec and Allegra are available by prescription.
There are also a variety of eye drops and nasal sprays that can be used to help treat specific symptoms of allergies. If you are having problems, schedule an appointment to talk with your doctor about what would work best for you.
2. At what age should women start taking calcium supplements?
Calcium is one of the fundamental building blocks for our bones. Low calcium levels can result in weakening of the bones, or “osteoporosis”. Although women are more susceptible to osteoporosis than men, both men and women over 50 should have around 1200-1500 mg of calcium a day. The most important source of calcium is a well balanced diet. Most of our dietary calcium comes from dairy products. If you check the labels on the packages, it will give you an idea of how much calcium is in a typical serving. If you don’t have a lot of dairy in your diet, you may want to take some calcium supplements. Calcium supplements come in a wide variety of pills, but one of the cheapest is calcium carbonate or Tums. Tums contain 500 mg of calcium, so 2-3 should be sufficient. One important thing to know is that calcium is best absorbed if taken on an empty stomach, and with some vitamin D. Some over the counter calcium supplements include vitamin D as well.
Too much calcium can be a problem, particularly for some people with kidney stones or kidney problems. So check with your doctor to make sure you don’t get too much of a good thing!
3. What can be done about "liver spots"?
“Liver spots” are actually poorly named… they have nothing to do with your liver! The medical term for these is “solar lentigo”. They are the result of damage to the skin over time, and generally occur on sun exposed portions of the body. They are flat, irregular, tan or brown colored spots on the skin. The good news is solar lentigo are not a precursor to cancer, but they can be a cosmetic problem. Since they are caused by sun damage, other more serious conditions like skin cancer may occur in the same areas. The most important thing to do is to have an examination from a knowledgeable physician, who can differentiate between the two. In many cases, a small skin biopsy may need to be done to distinguish them.
The most important thing is to prevent them, but wearing good sun screen, hats with wide brims, and clothing to protect your skin from sun exposure. But if they have already formed, these spots can be lightened through a variety of techniques. In some cases, we can use liquid nitrogen to treat these in the office. Other alternative include Hydroquinone cream which is available by prescription and can lighten the lesions over time. Finally, laser treatments can be used to lighten these lesions.
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