Health Education, Healthcare Information, Patient Education The Wandering Nurse Health Education, Healthcare Information, Patient Education The Wandering Nurse

Finally it is Spring 💃🏾! It is also HAYFEVER season 🤧 😫 😭!

I for one, am looking forward to Spring, sunshine and not having to turn on the heating while constantly staring at the gas meter wondering how i am going to afford to pay for it all! The only problem i have is that i suffer from bad hayfever and spring really is not my friend. The crusty eyes, constant sneezing are a pain and having to use my nasal spray, eye drops and antihistamine tablets are just some of the ways to survive pollen season, which seems to start earlier and earlier every year!

A sunny spring day.

Seasonal allergic rhinitis commonly known as hay-fever, can be disruptive to ones quality of life and if you are one who finds this time of the year miserable with a huge negative effect on you life, limiting what you are able to do, then you can be reassured that help is at hand.

Your GP/Doctor can refer you to an allergy specialist who will take a thorough history from you about(not an exhaustive list):

  • Your symptoms and when to they start/get worse/better?

  • How long you have had the symptoms for?

  • any medication you take/use to relieve the symptoms?

  • any other illnesses you may have?

  • any other relevant history?

A comprehensive history helps to narrow down what are the likely causes of your allergies and is used alongside Skin Prick Testing to the specific allergens to confirm or rule out the Doctors suspicions.

Aeroallergens are commonly tested for and these could include and are not limited to:

  • Timothy Grass

  • Silver Birch

  • House dust mite

  • Aspergillus

  • 6 Grasses

  • 3 Trees

Skin Prick Testing Allergen Solutions.

Once your clinician has decided what tests need to be done, an appointment is then made to come to clinic. You would normally be advised to stop taking any antihistamines at least 5 days before you Skin Prick Test appointment. This is because, antihistamines can mask your reactions to the allergens being tested and hence the results would be skewed. It is also important to note that allergy testing is NEVER 100% conclusive. You may also have a blood test to look for sensitization to the suspected allergens.

A sample of a skin prick test request form.

The testing procedure involves using a drop of allergen solutions applied to your skin in a grid like fashion and then using a lancet to prick your skin lightly do introduce the solution into your skin and illicit a reaction which is then observed and interpreted after 15 minutes. A negative solution( saline) and positive solution(histamine) are used a controls.

Skin prick test allergen solutions laid out with lancets ready for testing.

Below is a sample test i conducted on myself and you can see from the wheals and redness which allergens are responsible for my hayfever! It also shows how the test and subsequent reactions show on dark skin as most images around are of white skin.

Your clinician would then collate and review all your results and advise as to which i the best course of action treatment wise for you. Available treatments depending on the severity of your symptoms and recommendation from your clinician could be:

  • Higher dose of antihistamines or changing the antihistamines you currently use.

  • Steroid Nasal sprays.

  • Immunotherapy.

So, you don’t have to suffer, help is out there. If you are currently using a nasal spray, please see below on how to use one correctly to help gain maximum benefits.

Correct Nasal Spray Technique.


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Healthcare Information S.D. Onyango Healthcare Information S.D. Onyango

Lets talk about Allergy!

Lets talk about Allergy!

Looking at allergy and some of the most common allergens.

If like me you are constantly sneezing, almost gorging your eyes out and constantly apologising ( especially in this Covid-19 era!), or have to mind where you get your take out, or are constantly reading ingredients at the supermarket or shops when buying packaged food or skincare products, then you understand the frustrations having an allergy can bring.

Allergies are caused by allergens - which is defined as “a substance that causes an allergic reaction” ¹, and can be roughly broken down into 5 categories: Eczema, Rhinitis, Asthma, Food and Anaphylaxis. We will look at briefly, a list of the most common allergens for each category, and what services and help are available ( some will be UK specific) to help identify what is causing your allergy and how to manage it.

Gathering at a Barbecue

Gathering at a Barbecue

So what are the most common allergens?

  1. ALLERGIC RHINITIS ²

    Furry animals like cats and dogs, Mould, Pollen and House dust mite.

  2. ASTHMA ³

    Furry animals like cats and dogs, Mould, Pollen and House dust mite.

  3. ECZEMA ⁴

    Milk, Wheat, Soya, Peanut, Eggs, Mould, Pollen, Furry animals like cats and dogs and House dust mite.

  4. FOOD ⁵

    Children: Tree nuts and peanut, Wheat, Soya, Milk, Eggs.

    Adults: Tree nuts and peanut, Shellfish and Fish.

  5. ANAPHYLAXIS ⁶

    Latex, Drugs, Fruits, Milk, Fish, Shellfish, Eggs, Tree nuts and peanut and Insect stings.

IS IT ALLERGY? What happens next!

Most mild allergic reactions can be treated with a dose of antihistamine, bought over the counter like Cetirizine, loratadine or if the allergen is know, for example if its a food stuff then avoidance measures can be used, life threatening allergies with likely hood of causing anaphylaxis may require one to carry a precribed adrenaline auto-injector( Epi-pen, Jext pen, Emmerade). Best practice is always a referral to an allergy clinic, where detailed clinical history is taken, and a range of tests can be carried out like Skin prick tests(amongst others) of suspected allergens, specific IgE blood tests for suspected allergens combined with exposure reduction advice to all sensitised allergens, like removing carpets and replacing them with wooden floors to reduce prevalence of house dust mite for house dust mite allergy or avoiding all shellfish for shellfish allergy. The severity of the allergy and potential risk is also accessed and advice and treatment is prescribed accordingly. It is especially important to attended an allergy clinic if there is increased risk of ANAPHYLAXIS or a suspected case of ANAPHYLAXIS has occured. This is because anaphylaxis is a medical emergency that can end in death and the sooner the causative allergen is found or not and preventative measures are put into place, the chances of not dying from anaphylaxis are improved.

REMEMBER: Use your adrenaline auto-injector as instructed ( if you have one) and call an ambulance or rush to the hospital if you experience any of the following symptoms immediately or within an hour of coming into contact with a suspected allergen.

  • feeling lightheaded/dizzy/ collapse

  • throat closing up

  • shortness of breath

  • facial swelling( eyes, tongue, lips etc)

  • All over body itch with hives

REFERENCES:

  1. Lexico online dictionary: https://www.lexico.com/en/definition/allergen [Accessed June 2020]

  2. NHS Rhinitis: www.nhs.uk/conditions/allergic-rhinitis/causes [Accessed June 2020]

  3. NHS Asthma: https://www.nhs.uk/conditions/asthma/causes/ [Accessed June 2020]

  4. NHS Eczema: https://www.nhs.uk/conditions/atopic-eczema/ [Accessed June 2020]

  5. NHS Food: https://www.nhs.uk/conditions/food-allergy/causes/ [Accessed June 2020]

  6. NHS Anaphylaxis: https://www.nhs.uk/conditions/anaphylaxis/ [Accessed June 2020]

USEFUL LINKS:

  1. Anaphylaxis Campaign: https://www.anaphylaxis.org.uk/

  2. Resuscitation UK: https://www.resus.org.uk/anaphylaxis/

  3. EAACI: https://www.eaaci.org/

  4. The British Society for Allergy and Clinical Immunology: https://www.bsaci.org/index.htm

  5. Allergy and Immunology West Midlands: https://allergyandimmunology.heartofengland.nhs.uk/

  6. Thermo Fisher Scientific: https://www.thermofisher.com/diagnostic-education/hcp/wo/en/allergy-autoimmune-diseases.html

  7. Allergy Society of Kenya: https://www.allergysociety.or.ke/

  8. Allergy tests- Kenya Paediatric Assosiation: http://www.kenyapaediatric.org/wp-content/uploads/2017/05/Allergy-test-their-Application-in-Clinical-management-Dr.-Priya-Bowry.pdf

DISCLAIMER: This article is not a substitute to seeking professional medical advice nor should it be used in place of medical advice.

WORLD ALLERGY WEEK 13th - 19th JUNE 2021.

This year’s focus is on Anaphylaxis: how to Spot. Treat. Prevent. A handy info graphic has been produced by World Allergy Week Organisation and you can learn more at:

https://www.worldallergy.org/

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