Many Spink County residents have been extra stuffy, sniffly, and itchy lately. This may soon get worse. Dr. Thomas Luzier predicted a spectacular ragweed season. Luzier, an allergist based in Aberdeen, used to take his own pollen counts each year. August 1st, you can almost set your watch by it. Ragweed would start, and it would continue until hard frost.
Local Bob Brugger said that he hasnt noticed a worsening of his allergies. When they do act up, he cant breathe so good, and he gets stuffy and itchy. His allergies are significant enough that he takes over-the-counter medication, as well as prescription medication. On top of that, he gets a shot from his primary care doctor every 3 months. This is so I dont suffer.
If ragweed pollen hasnt exploded yet, whats been going on? Luzier said Theres a lot going on. Just before the Fourth of July, grass pollen is kind of as high as it gets, then it kind of fritters off. Theres more to worry about, however. He continued But all the other things that people are allergic to, like tree pollen and molds, kind of gin up your immune system. And then if you throw in a little Canadian smoke and that kind of thing, it makes it even more intense. Right now we really are at a little dip in whats happening with pollen, but we are not with mold because we had all that rain. Theyre trying to get the hay down and cant get it down. So thats primarily whats in the air when the winds blowing.
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Luzier said that soon pollen from kochia, Russian thistle, tumbleweed, ragweed, and sagebrush will be in the air. This followed the data from his years of pollen counts. He said It was always tree pollen early in the spring, and then grass pollen would occur from about May 15th to July 4th. Then there was a little dip, but it was primarily molds and that sort of thing. At about the first of August, ragweed would take over.
Ragweed pollen tended to peak around the time of the county fair, when people were out and about. Youth participating in FFA events could be especially prone. The kids are out and theyre grooming their animals, which is of course picking the pollen up. If theyre not allergic to the animal itself, theyre allergic to the pollen in thats in the air. He used to have a busy booth at the Brown County Fair.
Allergy woes extended past the animal barns. And then were haying right now. For those people that are in haying, its like giant lawn mowing that gets a lot of mold up into the air. Luzier said.
Mold is everywhere, all the time, and gets highest at harvest. he said. The mold lives with the grass, so when grass gets mowed, mold gets into the air. Mold, dust, and pollen bring about hay fever. Symptoms of hay fever affect the upper respiratory system. They include nasal congestion or a runny nose; post-nasal drip; and sinus pressure. Other symptoms can include itchy, watery, red eyes; headaches; and discoloration and puffiness around the eyes. Hay fever is a type of allergic reaction. Other general allergy symptoms include itchiness, as in skin, throat, or ears; shortness of breath; as well as rash or hives.
Luzier gave an overview on the allergic response in the body. What happens is, that pollen or mold or cat or dog or dust mite comes into your nose. You have cells in your nose that are called antigen-presenting cells. They take anything thats foreign, and they go Oh, thats foreign. Thats not you. We need to dispose of that.
He explained that either a white blood cell will dissolve the antigen, or an antigen-presenting cell will send a message to the B-cells to make antibodies. The next time that antigen is encountered, the antibodies react. Luzier said that one must be sensitized. Thats why you dont ever get a bad reaction on the first bee sting. The body has to encounter it more than once. An antibody that is involved in allergic reactions is called IgG. The allergic reaction is the bodys mechanism to get rid of the invaders.
According to Luzier, about 20% of people suffer from allergies. Also, it affects grown-ups more than kids. He said Its more of an adult process, because the number of exposures you get gives you a bigger opportunity to be sensitized. Pregnancy can change a persons allergies. When women have babies, the placenta tells the system to downregulate. When the baby is born, the womans immune system boots back up again. Sometimes it boots up allergic when it wasnt before, and sometimes theyre allergic and when it boots back up again, theyre not allergic. he said.
Theres also a strong familial link for having allergies. If your mom is allergic, you have about a 70% chance of being allergic also. If your dads allergic, you have about a 30% chance. Luzier said. And if your mom and dad are allergic, you should have chosen your parents more carefully. he added with a laugh.
Allergy severity can run the gamut from barely noticeable to miserable. Its possible to have mild allergy and feel no symptoms. Luzier cited a study done at the University of Kansas. Students were skin-tested for allergies. Many had no symptoms, but tested positive on the skin tests. When the students were re-tested a couple of years later, they had symptoms of those allergies. The skin test kind of anticipated the allergy. You have people out there who dont have any symptoms this year, but might have symptoms next year. he said.
Eczema, a common skin condition, isnt quite an allergic reaction. Atopic dermatitis is a different kind of inflammatory response. Luzier said. He explained that people with eczema/atopic dermatitis may still show high levels of the IgG antibody. But this is because With eczema, your skins just open to the environment. A person can sensitize and develop an allergy via skin contact. We call it an itch that rashes. Eczema is generally treated topically, with prednisone, triamcinolone, or hydrocortisone.
How are seasonal allergies treated? The most common way to do it is to treat with antihistamines. Luzier said. Brand names include Allegra, Claritin, and Zyrtec. Zyrtec is the strongest one. It makes people sleepy or crabby. Claritin is the weaker one. Thats why it doesnt make em quite as sleepy. And Allegra doesnt go in your brain, so it does a nice job of not making you sleepy. he said. Other medications are more localized. If nasal congestion is the major thing, then you use Nasacort or Flonase because thats like using prednisone, only just in your nose. It doesnt have the side effects, because the dose is so much lower when you spray it directly in your nose. he said. If your eyes are still itchy, then you use an antihistamine for your eyes called Pataday. Then if all that doesnt work, the you have one thats called Singulair. Singulair works by a different mechanism.
That may still not offer relief. If all of that doesnt work, then you do allergy shots. You are given a little bit of what youre allergic to in increasing doses. It takes about 3 years of weekly shots to reverse your allergy, typically. Luzier said. After that, shots are done twice a month, then monthly. If you still do well, youre finished. Usually, 80% of the time, your allergy does not come back. he added.
Luzier mentioned one more medication. Then we have a weird one. We have a monoclonal antibody called Xolair, which will completely shut down your allergy. Its so effective that if you have like a food allergy and you cant eat peanuts because youll blow up like a pufferfish, this Xolair, when you take it weekly, will keep you from doing that. This medication isnt known to have a lot of side effects. Luzier said When people ask me Whats the side effect of the Xolair? I say poverty. For the most part, allergy medications are affordable. Luzier said that allergy shots are often covered by insurance. Its just the hassle of having to get into a clinic to get a shot every week.
Another condition Luzier treats is asthma. About 70% of people with asthma, especially young people, have an allergic component that makes their airway reactive. he said. But other things, such as cold air, viral infections and running could also do this. Theres a whole lot of triggers for asthma. Asthma is reversible inflammation in your airway. he said. This can be temporary. Thats why we see people sucking on their albuterol inhalers, because its reversible, but the albuterol wears off in 4 hours. So youre back to where you were. Luzier had a two-pronged approach for treatment. You use an inhaled steroid, just like we do in the nose, and that gives you a more permanent and better treatment for whats in your airway. Its just hard to get the steroid all the way down into your small airways. So we usually use both a long-acting albuterol, plus a steroid. That does a very good job of controlling peoples asthma.
Luzier stated that any respiratory illness, including covid infections, could make an airway reactive. You could get RSV (respiratory syncytial virus) and then have airway reactivity for a very long time, for years after youve had that infection. Symptoms of airway reactivity could include wheezing during a cold, when exposed to cold air, or during exercise. It happens a lot in children. Luzier said. Asthma overall is more common in boys than girls at a ratio of 3:1. he said. The boys tend to out-grow it. Until the boys go through puberty. Testosterone is excellent for asthma. Estrogen isnt so good.
The only way to avoid allergens would be a bubble. Luzier said You could keep your windows closed, unless you want to just stay inside. But summer in South Dakota, who wants to stay inside? Wearing separate clothes outside and inside would have limited use. Youd have to cover your airway. Luzier said. I tell people who are mowing lawns to mask, but if you ever put a mask on when its 90 degrees out, thats not fun. he added.
With the summer warmth comes the pollen in the air. Luzier stated that each type of pollen looks a little different. Ragweed pollen looks like a mace, a medieval weapon.
Luzier had unpleasant predictions. Ragweed this year is going to be spectacular. Because the crops got flooded out, the farmers arent going to be able to keep up with the weeds.
He opted to specialize in Allergy/Immunology because I could see that immunology was going to be a frontier, and I had allergies. He had a ragweed allergy. It was cured by doing allergy shots.
For those who have not been cured, it will be an itchy, sneezy season. Luziers clinic has been ridiculously busy. Speaking of ragweed season, he said Its gonna be bad bad for you, and good for me.
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