A hay fever victim may find relief by moving to an area where the offending allergen, pollen, or mold is not present. Some asthmatics, especially those whose asthma is caused by infection or complicated by it, may benefit from ‘a warm, dry climate. Before a change of cli­mate is recommended, however, the climate sought should be studied thoroughly and comprehensively. The change itself is not as impor­tant as proper treatment and, where possible, removal of the allergen. In most cases, moving to another area does not cause the allergy prob­lem to improve. When a move is not practical —for economic, pro­fessional, or other reasons—air-conditioning and such other home-filtration devices as electronic air cleaners may be helpful. Working against air pollution through citizen clean air groups is another, al- beit more long-range, way to reduce airborne allergens in one’s own community.

Whenever allergens in a patient’s environment can be isolated, they should. This is fairly easy when a feather pillow or dust-catching furniture is the problem. When a person is sensitive to a cat, dog, or bird, however, removing the allergen source may not be easy because of an emotional attachment. It can be done, though, by using patience and compassion and by explaining the risk of keeping the pet. If foods are the cause of the difficulty, they must be eliminated from the diet. The timing and proper use of medications are important in treating allergic disease. A medical doctor must prescribe the medications and their dosages. Numerous medications are now available that are helpful both in preventing symptoms and in providing relief from them. They may be all that is needed in cases of mild allergy. If symp­toms persist despite the proper use of medications and the removal of allergens from the environment, immunizing injections may be neces­sary to control the disease.

Generally, people who are aware of their problems can avoid offending allergens by not walking or driving in the country during the pollen season; by avoiding drafts and exposure to cold, damp air - by keeping away from house dust; by trying not to breathe the fumes of paint, insecticides, or products containing irritants; by not using or coming in contact with aerosols, cosmetics, dyes, or strong cleansers. Allergic people should strive to keep in good physical con­dition and to avoid emotional tension and fatigue. When they occur, respiratory infections should be taken seriously and treated early. It is especially important that parents watch children for allergic tendencies. Foods are a common cause of allergy in infancy. Breast milk is preferable to cow’s milk in potentially allergic children. Eggs, raw vegetables, and fruits should be added to the diet one at a time, and the child’s reaction should be monitored. Bedrooms and play areas should be as dust-free as possible, and dogs and cats should be avoided.

Intal is the trade name for sodium cromolyn, a powder that is in­haled into the lungs. It can be useful both in preventing asthma and as a medication. Intal, however, contains a small amount (20 milli­grams per capsule) of lactose sugar, something your physician, if aware of your condition, will take into consideration. Other than this, there should be no problem in using this medication.

In many patients, the tendency to allergy is inherited. Because this predisposition to allergy may remain for life, it is not possible to speak of a "cure." This does not mean, though, that allergic condi­tions cannot be controlled to the point where the patient is symptom-free and can lead a virtually normal life. Early investigation of aller­gies, removal of offending allergens, timely and correct use of new drugs for symptomatic relief of allergic diseases, and improvements in immunization have led to a high success rate in the treatment of allergic diseases. Many more allergy sufferers can benefit from the dissemination of information about allergies and their treatment and by providing better medical facilities. / am twenty-three and would like to have a child. I hesitate to do so, however, because of my long history of allergies and asthma. I take cromolyn sodium capsules. My doctor advises me to discontinue the drug while I am pregnant, but my allergist said I could continue the drug. What should I do? According to the instructions accompanying cromolyn sodium, its dosage and frequency of use during pregnancy have not been estab­lished, because no controlled, clinical trials have been performed among pregnant users. The drug has few known side effects, however, in general use, and has been found useful in some cases of asthma. Although most allergists continue to prescribe cromolyn sodium for pregnant women, the decision ultimately is the patient’s. At any rate, use of the drug —or of any medication—during the first trimester should be kept to the smallest dosage compatible with the control of symptoms. The pregnant woman should rely on the advice of her allergist, who is likely to be more knowledgeable about asthma medi­cation than the obstetrician. / am pregnant and am currently taking weekly allergy shots for grass and dust. My child is allergic to milk and soybean formulas. Is it possible to prevent allergies in my unborn child? There is no certain way to prevent the development of allergies in the children of allergic parents, but here are some suggestions: 1. Breastfeed the baby. When the child is weaned, use evapo­rated milk rather than whole cow’s milk. If soybean milk formula does not cause diarrhea, that may be used. 2. When cereals are added to the diet, use single ones rather than mixtures. That way, causative agents can be identified more readily if trouble develops. 3. Feed the baby no eggs, chocolate, or orange juice during the first year. Vitamin drops may be substituted for orange juice. 4. Do not let wool come in contact with the baby’s skin. 5. Do not allow pets in the house. 6 Use water- and dust-proof covers on the child’s mattress, as well as acrylon pillows, instead of those made with feathers. This rule also applies to stuffed animals; choose toys of acrylon or foam rubber.

Your doctor, in addition to taking a thorough history of your ill­ness, may make a study of your home and work environment, your diet, and your living habits. The doctor will also give you a physical examination and run some laboratory tests. Using extracts of common allergens, the doctor may perform various skin tests to ascertain aller­gies to specific allergens. After reviewing the family history, giving an examination, and running skin tests, the physician will be able to determine whether you have an allergy or allergies and, if so, what allergens are involved. This requires planning, skill, and patience. An accurate diagnosis cannot be obtained simply by performing allergy tests alone, as is done in some testing laboratories.

Allergic disorders are seldom fatal, though it is estimated that about five thousand people in the United States die each year from asthma. There are approximately forty deaths each year from allergic reactions to insect stings. Reactions from some drugs, and from cer­tain foods such as nuts and seafoods, have occasionally proved fatal. Asthmatic patients are at additional risk when undergoing surgery that involves anesthesia.

It is true that such emotions as anxiety, fear, anger, and strong excitement can precipitate allergic attacks or make an existing con­dition suddenly worse. This is not to say, however, that these emotions are the physical basis of the allergy —which is real and of primary importance to people with allergies. Few patients need psychological help, but a child with severe asthma may cause serious disturbance in family life. In such cases, counselling for other members of the pa­tient’s family is of great benefit as an auxiliary to medical treatment. In general, the allergic patient is better off in an atmosphere of calm and confidence. Parents of asthmatic children should, as much as possible, maintain an attitude of calm and reassurance. The allergic child should be encouraged to be self-reliant and to take part in all activities to the extent possible.

In some cases, yes. Severe hay fever, if left untreated, can lead to nasal polyps and sinusitis. Patients with allergic rhinitis who also have nasal polyps should undergo allergic evaluation and therapy to help prevent further growth of the polyps. Allergic dermatitis, or eczema, that is not treated early can spread and occasionally be complicated by secondary infection. The patient who originally has only occasional periods of asthma may develop a chronic condition. If the allergies are detected early, however, and appropriate treatment is begun, the condition may improve or at least be controlled.

Yes. The best way to achieve and maintain good health is with a balanced diet and a well-rounded program of exercise, recreation, and rest. Smoking is extremely harmful and, in the case of the allergy suf­ferer, must be avoided. Although these measures will not cure an al­lergy, they do contribute to better resistance.