AHH-Choo! Cedar fever is here; How to fight the area’s peskiest allergen

This story is slated to appear in the December 2010 issue of the Leon Springs Community News.

Story and photograph by Pamela Price

Dr. Dalys Gomez demonstrates an allergy exam with Laura Thompson. (Image copyright Pamela Price, 2010)

Runny nose. Coughing. Fatigue. This time of year in Central Texas, those symptoms may mark not the onset of a cold but the arrival of what locals call “cedar fever.”

“There’s not usually a fever present, unless of course the patient has developed an infection,” said Dr. Dalys Gomez of Leon Springs Allergy & Asthma in Leon Springs. “Cedar fever symptoms present initially almost the same as a cold-except with the allergy the symptoms persist.”

Gomez said that the worst cedar allergy sufferers experience “red, itchy eyes with tearing and eye rubbing. And then there’s the itchy ears and throat, which are not common to the cold. There may even be a loss of taste.” In addition to fatigue, there may be a general feeling of being unwell.

“I’ve had patients come here after going to a psychologist first, because they felt depressed,” said Gomez. “Often, it was an allergy that was really causing their problems.”

The culprit is the ordinary Ashe juniper, aka Juniperus ashei, but commonly referred to locally as a cedar. Found in Texas and surrounding states, the scrappy, drought-tolerant Ashe juniper’s heaviest concentration is in the Austin-San Antonio area, making Leon Springs part of the “cedar fever capital.” The annual release of juniper pollen is responsible not only for the itching and sneezing but also for that blue-tinged haze on hillsides on cold winter mornings.

“I tell patients that they can expect symptoms from Thanksgiving through to Valentine’s Day,” said Gomez. Depending upon weather conditions and rainfall, the season can run from early November up through March or April. “It usually peaks around New Year’s. That’s when I see the most patients, around a freeze. The cold air makes the plant release the pollen inside those blue berries in a puff.”

An Ashe juniper in rural Bexar County (Image copyright Pamela Price, 2010)

When it comes to treating allergies, much like the approach taken by New Year’s Day bowl game coaches, the best defense is a good offense. The local pharmacy is a good place to start.

“I love, love, love [saline] nasal washes. They decrease the amount of time that the pollen is in contact with the mucus membranes. I personally use a wash twice a day. Probably allergists would have fewer patients overall if everyone used a wash.”

Gomez also recommended simple, over-the-counter saline sprays. “You can carry them with you when you leave the house. Just a quick spray before you leave and when you return can really help.”

Many patients underestimate the amount of pollen that adheres to clothing, hair and even beards. A shower before bed can be useful, as can a regular face wash with gentle baby shampoo.  “The shampoo can help a lot with the itchy eyes,” said Gomez.

For individuals with mild symptoms, over-the-counter antihistamines may help. However, Gomez warned that allergies tend to get worse over time, making a visit to the allergist early in the season-or even before it starts-important for repeat sufferers.

“We want to stop the problem before it becomes an infection. Too often I see patients after the cascade of symptoms has begun and an infection has set in. When that happens, I have to treat it, the inflammation, usually with steroids that are relatively safe because very little of the medicine is absorbed by the body. After the inflammation is down, then we turn to nasal washes.”

Gomez said that while many new patients ask for allergy shots, that treatment approach takes time. In other words, beware the promise of the quick fix. “Non-allergists often use sub-lingual immunotherapy, but that’s not FDA-approved. It’s important for patients to know that.” Allergy shots, she added, are “really for the heavy-weights, the patients who’ve tried everything else. It’s effective, but it’s a time commitment.”

Cedar fever can affect people of all ages, including children. “A saline spray can be fun for kids to try. Also, with pets, it’s important to remember that they bring the pollen into the home and into family beds.”

Washing pets and bedding frequently can help remove pollen in the home, as can limiting Fido’s access to furniture and bedrooms, at least during the winter months.

Gomez emphasized that “avoidance is best and early treatment can make a real difference. The hardest part of an allergist’s job is to persuade people that prevention is the best approach.”

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