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HOUSE CALL WITH DR. SANJAY GUPTA
Spring Allergies; Overhauling Kids' Perceptions Of Food In Berkeley
Aired April 15, 2006 - 08:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
SANJAY GUPTA, CNN SENIOR MEDICAL CORRESPONDENT: Good morning and welcome to HOUSE CALL. I'm Dr. Sanjay Gupta. Well, spring has arrived and in most areas of the country, the longer, sunnier days have people rushing outside to enjoy the weather. However, for others being outside this time of year can bring misery, headaches, tiredness and cold-like symptoms.
KRISTEN STONE, ALLERGY SUFFERER: It's a haze, like a fog, like you're just walking through life in a fog. That's when it's mild. When it's severe, it's almost -- I would say like getting a migraine. You know, your head just -- the pressure is very painful.
GUPTA: For years, Kristen Stone woke up groggy and unfocused, enduring frequent headaches, living with a burning itch in her eyes, nose, and throat, working hard to breathe through her congestion.
STONE: I don't think people know how debilitating allergies really are. I think they're just like, oh, you have an allergy, big deal, just deal with it.
GUPTA: But they are a big deal to at least 30 million Americans. Kristen and many others suffer from hay fever or outdoor allergies made worse in the spring and the fall. And many allergists like Dr. Clifford Bassett say seasonal allergies have been on the rise. The main trigger? Pollen.
CLIFFORD BASSETT, ALLERGIST: In many urban areas, we've seen an over planting of male plants, trees and shrubs. And male plants typically are involved with pollen that produces a lot of allergy symptoms.
GUPTA: And the prettier and more fragrant the plant is, it's less likely that it will trigger allergies. Beautiful plants tend to be insect-pollinated plants, not wind pollinated plants like trees or grass. The best way to prevent debilitating allergies, reduce your exposure to pollen by spending less time outside in the morning when levels are at their highest, and reduce your exposure at night by washing your hair at the end of day, changing your clothing, and removing your shoes before getting into the bedroom.
BASSETT: That will help to reduce pollen exposure by over 50 percent, which will translate into feeling better when you wake up in the morning. GUPTA: Also, use a HEPA filter and air conditioning at home and in your car to filter out the allergens. Avoidance is one thing, treatment another. It's become a billion dollar industry from over- the-counter medications like Claritin and Benadryl, to a whole host of prescription antihistamines, decongestants, and asthma medications like Zyrtec and Allegra, to immunotherapy in the form of shots.
The good news? There are a lot of options. The bad news -- the best treatment is different for everyone.
BASSETT: Get tested and get the right treatment. And early treatment and continuous treatment works better than just taking as needed treatment.
GUPTA: For Kristen Stone, she's finally found something that works for her, a daily, over the counter antihistamine.
STONE: It helps keep me focused and alert. I'm able to go to events. I'm able to go to my kids' soccer games and softball games and be able to do those things that I couldn't do before.
GUPTA: You like the sounds of those bugs at the end there? Kristen found the help she needed to live a normal life. And that's what we're trying to do to help you this morning.
Studies show that more than 50 percent of the U.S. population is sensitive to one or more allergens. Now this is a substantial increase over a similar study done in the '70s. And experts aren't sure why that is.
What we do know, though, is that if you have seasonal allergies, there are more and more ways to try and get relief. And helping us find that relief is Dr. Kathleen Sheerin. Now she's an allergist right here in Atlanta, where pollen counts are through the roof. You see it in the air. You see it everywhere. Are you pretty busy this time of year? How's it going?
DR. KATHLEEN SHEERIN, ATLANTA ALLERGY & ASTHMA CLINIC: Oh, very busy. It's been a busy two weeks. And this is the time of year we're always busy in Atlanta and throughout the country.
GUPTA: Yes, I bet. And is this year any worse than in years past?
SHEERIN: We actually did a poll across the country before I came down. And it really is a typical year. We see spring pollen in late March, early April in the south, April to the beginning of May in the north.
GUPTA: You know, it's funny. We just put the topic up on our Web site and we got so many questions actually coming in. Let's see if we can try and get to some.
This comes from Jana in South Dakota, who writes this, "When I lived in North Carolina, I was diagnosed with an allergy to pollen. Why did I develop an allergy when I never had an allergic reaction before?" And I think she's probably talking about as an adult, adult onset allergies.
SHEERIN: Right. You can develop allergies at any age, but it's more common to develop them in childhood, teenager, early 20s. Now she -- the e-mail address said South Dakota. And then she mentioned North Carolina. We see that a lot in the mobile society that we have. People move from the north, where it's cold and it snows, and then they move to the South, where it's very green.
SHEERIN: And people sometimes develop allergies when they're exposed to new things.
GUPTA: I mean, has it been ever been so bad for one of your patients you've said OK, you've just got to move from the south, move somewhere else?
SHEERIN: I joke with them all the time when they're allergic to everything. I said so the prescription is move to the North Pole. And that's where really they would do well, but there's not very much opportunity for employment and schools and things like that.
GUPTA: Yes, not the North Pole, but you can get your allergy medicine still.
SHEERIN: Correct. But there are allergists in every state in this country. So there are allergies everywhere. So I would go with good job opportunity rather than trying to escape pollen.
GUPTA: All right, let's keep on topic here. Another e-mail. This coming from Kathy in Illinois who asked this. "Do allergies cause shortness of breath? I notice when normal allergy symptoms like itchy eyes appear, I have trouble breathing and experience tightness in my chest." How bad can it get?
SHEERIN: Well, this person is probably describing some asthma. And there are about 20 million Americans with asthma. Half of them have allergic asthma. So it can be triggered by the pollen or the dogs and the cats.
So I think she points out a very real problem. And that it's not just in her nose, but it may be in her chest.
GUPTA: Anything special she has to do?
SHEERIN: I'd talked with her doctor because the medicines that you use to treat your nose aren't the same medicines that you use to treat your chest.
GUPTA: Allergies, asthma induced allergies.
SHEERIN: Allergy induced -- allergy...
SHEERIN: Allergy induced asthma.
GUPTA: Right. That happens to people.
SHEERIN: Right, correct.
GUPTA: Something to be aware of.
Another e-mail now from a frustrated parent, this one in Maryland. Nancy writes this. "My daughter has bad, stuffy sinuses in the morning and is constantly clearing her throat in the evening. Antihistamines help, but she still wakes up stuffy. Her father and I both have allergies. She has psoriasis." What more can she do, they're asking?
SHEERIN: OK, I think there are a couple points you can make here. Number is one about antihistamines. Antihistamines don't help congestion. They help the runny, itchy, sneezy, but don't do a whole lot for congestion. So I think she could talk to her doctor about some medicines, either a nasal steroid spray.
I don't like decongestants in kids, because they tend to rev kids up.
SHEERIN: And then they have trouble sleeping at night.
The other thing is seeing an allergist and finding out what she's allergic to, because it could be something in her bedroom that's making her worse, be it the dust mite, or the gerbil that's next to the bed, or the three dogs that are sleeping in bed with her. So knowing what your triggers are can help.
GUPTA: It's not always seasonal necessarily.
SHEERIN: Correct. And then the final thing in that question was psoriasis not related to allergies. Actually eczema or atopic dermatitis is the allergic disease, not psoriasis.
GUPTA: I wonder if she meant that. That's a good point, though.
GUPTA: All right, good stuff. We're talking with Dr. Kathleen Sheerin. We'll be talking more about which treatment is best for you when HOUSE CALL continues.
UNIDENTIFIED FEMALE: Shots and pills, our expert tells us when it's time to stop medicating yourself and see a specialist.
And later, colds versus allergies, we'll give you easy tips to figure out which you should be fighting.
First answer this. What foods may aggravate seasonal allergies? That answer after the break.
UNIDENTIFIED FEMALE: Before the break we asked, what foods may aggravate seasonal allergies? The answer, fruits and vegetables like apples, pears, celery, and some melons may irritate symptoms, depending on your allergies.
GUPTA: More than 35 million Americans suffer from seasonal allergies. They are left sneezing, sniffling, tired, coughing during allergy season. And the choices for treatment can be dizzying in and of themselves.
From prescription anti inflammatories, steroids, nasal sprays, allergy shots, you name it, to over-the-counter medicines like antihistamines and decongestants.
And recently, a small study found Sudafed was just as effective as the prescription drug Singulair in relieving allergy symptoms.
Now all of this can leave you with more questions than answers when it comes to what you should do for your own relief. So to help clear things up, again, Dr. Katherine Sheerin.
It is a little bit confusing. There's lots of medicines out there. Let me start off by asking, is there anything new out there that we can tell our viewers?
SHEERIN: Well, unfortunately, there isn't any great new breakthrough. I think one thing that people would like to know is there are a couple of old standard antihistamine and nasal sprays that are now generic. So it will help with the co-pays significantly.
Allegra is now available in a generic form. Fexofenadine may be the name of your new prescription. And then Flonase as well, which is fluticasone.
And so you may notice something coming home with a different color cap, or the medicine looks a little different, but it's working the same for the patients and costing less.
GUPTA: OK. And you were just talking about Flonase. So we have an e-mail coming up actually about that, our inbox.
And Neil from Pennsylvania asking this, "I have been taking Flonase and Patanol for severe springtime allergies. Can I build up a resistance and are there long-term side effects?" What do you tell him?
SHEERIN: Well, I think two parts to that question. Usually you do not build up resistance to the nasal sprays or to the eye drops. People get the over-the-counter drops and nose spray confused with the prescription. I'd like to tell him don't confuse it with Afrin or Dristan, because if you use those long term, you can actually get hooked on them. You have a physical dependence on it. And the more you use, the more you need. With the Flonase, you don't get dependent on it. And you don't develop a resistance to it. Eye drops, same thing. Over-the-counter versus the Patanol or prescription eye drops. It's the decongestant components in the over-the-counter drops that can make you become dependent on them.
GUPTA: You know, it seems like I see people using the Flonase a lot, though. I mean, is -- can you overdo it?
SHEERIN: If you use the enhanced steroids, the nasal steroids too much, you may end up with a nose bleed. And the rare patient, and it's a rare exception, can get a perforation in their septum.
Most of those people that it happens to, have had previous nose jobs. They've had their nose fixed.
SHEERIN: But they've really been around for a long time and are very safe drugs. People want to make sure they aim them laterally, though. Don't shove it in your nose and bounce it off the septum. Aim it laterally. And they're safe, but it's a one time a day drug.
GUPTA: That's how often you should be using.
SHEERIN: Correct. So nobody should be carrying Flonase around in their purse.
GUPTA: All right, hopefully Neil's hearing that.
Another e-mail now. Cindy in Florida writes this. "I have suffered with seasonal, pet, and dust allergies all my life. My primary physician prescribes medication when they act up. What are the benefits of an allergy shot versus continuing pill popping? Is it possible I'm missing something by not having seen a specialist?"
A couple of questions in there.
GUPTA: First of all, you know, does someone know when it's time to actually switch over to shots?
SHEERIN: Well, I think it's an option. There are patients out there who hate taking medicine. They just -- they say they're not going take medicine. And they want an option.
The pill popping, I like to make the analogy to it's treating the symptoms. It's putting a Band-Aid on it.
Allergy shots actually can change the immune system and make you less allergic. Therefore, more like a cure, although I don't like to promise a cure.
Pills treat symptoms, stop the pills, symptom comes back. Allergy shots make it such that you don't have to take the pills all of the time.
GUPTA: And if you get the shots, for example, in your 30s, you get your course of allergy shots, is it good for the rest of your life? Should it be?
SHEERIN: Most people take shots for three to five years. That's the usual course. And when they stop, the vast majority of them never go back on.
That -- it doesn't mean they're not going have any symptoms, but they're usually controlled by medicine. About 20 to 30 percent of people who go off of shots end up going back on.
GUPTA: So my dad got the shots when he was in his 30s. And he's now starting to develop some symptoms again in his 50s. So he should take some medicine probably.
SHEERIN: Of course, yes, definitely. But we are smarter now than we used to. So 25, 30 years ago, our shots weren't as effective as they are today. So if it worked before, it should definitely work again.
GUPTA: OK, because he asked me about that all the time.
And we are talking about allergies with Dr. Kathleen Sheerin. More HOUSE CALL coming up after the break.
UNIDENTIFIED FEMALE: Finding alternatives to shots and medicine. Could vitamins provide the answer?
Plus, steamed veggies, brown rice, and organic muffins, a new wave in feeding kids in school.
But first, this week's medical headlines in "The Pulse."
JUDY FORTIN, CNN CORRESPONDENT (voice-over): Estrogen therapy alone does not increase the risk of breast cancer in post-menopausal women. This, according to new findings of the massive Women's Health Initiative Study. This contrasts with results from the same study, which found an increase in breast cancer in women who combined Estrogen with progestin therapy.
Americans may not be seeing their own weight problems in the mirror. According to a recent phone survey by Pew Research, nine out of ten people agree that their fellow Americans are overweight, but just four in ten Americans admit that they personally are packing on the extra pounds.
Judy Fortin, CNN.
(COMMERCIAL BREAK) GUPTA: We're back with HOUSE CALL. A new survey out this week finds Hartford, Connecticut and Greenville, South Carolina are the most challenging places to live if you suffer from spring allergies. Rounding out the top five, Boston, Detroit, and Orlando.
To see how your city ranks, go to allergycapitals.com. Allergist Dr. Kathleen Sheerin is back with us answering your questions. That surprised me. Detroit, Boston, Orlando.
SHEERIN: Well, it -- you have to look at how they do that survey and how they come up with the list. It has to do with how many prescriptions are written for antihistamines, how many doctors there are. It's not a true measure.
GUPTA: Got you.
SHEERIN: So I wouldn't use it to go change your location.
GUPTA: OK, so don't move based on this survey necessarily.
GUPTA: OK. Lots of e-mail questions coming in. Tons of -- Joni from New York writes this question. "I'm plagued with allergies during the spring and fall. Should I take medication just during those times or all year long?" That's a good point, actually.
SHEERIN: If she's bothered just in the spring and in the fall, then you can take medicine seasonally. The key is knowing when to start. So I tell my patients with a spring allergy in Atlanta, you better start at the end of February. If you wait until April, you're too late.
GUPTA: OK, so you know, there's a conception that you have to take medicines year round. Don't go on and off of them. That's not a problem here.
SHEERIN: Not if, but what's triggering your symptoms is the spring pollen. The spring pollen goes away. It's different if you're allergic to dust mites or cats and dogs. They don't go away. And many may need a medicine year round.
GUPTA: OK. You know, you probably get this question a lot in your office about alternatives as well. We got questions about that. Many people are looking for alternatives to medication, like Carolyn in New York who asked this. "Can taking vitamins regularly ward off allergies? Is there any one vitamin that you can take in place of the usual over the counter allergy medications during allergy season?" Any rule for vitamins?
SHEERIN: First off, there's been no studies that have proven that vitamin therapy helps. And I always tell my patients I'm not an expert in alternative and complementary medicine.
But the NIH has a great Web site. NIH.gov, they have a whole site on alternative and complimentary medicine. First off, you don't want to do any harm. So double-check before you do anything.
GUPTA: That's the best advise of all, I think.
GUPTA: We're taking lots of questions about seasonal allergies. More coming up after the break.
(BEGIN VIDEO CLIP)
UNIDENTIFIED FEMALE: This is what we're feeding children.
(END VIDEO CLIP)
UNIDENTIFIED FEMALE: How a renegade chef is getting rid of the old and getting kids to like vegetables.
GUPTA: Welcome back to HOUSE CALL. We're in the midst of our Fit Nation tour to fight obesity. We're visiting universities across the country and getting ideas about how to stop this epidemic.
(BEGIN VIDEO CLIP)
UNIDENTIFIED FEMALE: We propose that in addition to the new curriculum, there actually be a class that's mandatory for new students where it would be more like a peer mentoring class. You would be paired with someone who is actually a fit college student.
(END VIDEO CLIP)
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: Let's get college students involved by going down to the elementary schools, to the middle schools, and working out with these kids, actually going out there and being excited about getting fit.
(END VIDEO CLIP)
GUPTA: They were getting excited. Lots of great ideas. Those are just a few of the ideas we got from some of the student leaders at UNC. This week, we're headed out West, stopping at Berkeley, California, where we found a grassroots effort to overhaul kids' perceptions of food.
GUPTA (voice-over): Nestled behind what looks like a typical urban middle school playground, lies an unexpected paradise. A not so secret garden grown completely by young teens.
UNIDENTIFIED MALE: Tina, we're twins.
GUPTA: Berkeley's Martin Luther King Middle School made national headlines when it embraced the edible school yard, a program integrating lessons about gardening, cooking, and a passion for healthy food into just about every class.
UNIDENTIFIED FEMALE: Anybody knows what this one is?
UNIDENTIFIED MALE: Parsley.
UNIDENTIFIED MALE: This is parsley, exactly. Flat leaf parsley.
GUPTA: It's the brain child of a world famous Berkeley restaurant owner, Alice Waters. Waters started edible school yard, worrying about this generation's unhealthy relationship with food.
ALICE WATERS, FOUNDER, EDIBLE SCHOOLYARD: Children are learning sort of out there and fast food nation. We need to reconnect food with agriculture and culture in a pleasurable way.
GUPTA: But the Edible Schoolyard is only in one school. The district actually seemed to be teaching children at the other schools the opposite lesson about food.
ANN COOPER: This is all we're feeding children. I came in and grilled cheese sandwiches came this way. I -- you know, chef for 33 years. I didn't know grilled cheese sandwiches came in plastic bags.
GUPTA: So last fall, Waters Foundation brought in an executive chef who calls herself the renegade lunch lady.
From her cramped, cooking command center, Ann Cooper spreads the good food gospel to the entire district. In mere months, Cooper radically reshaped the menu. Fried and processed foods, gone. Transfats out.
What's in? Steamed veggies, a kid sized salad bar, organic muffins, fresh fruit, even brown rice. The USDA, which regulates school food programs and has closely watched this one, says nationwide school food is improving. That's a slow process, but change is essential.
ROBERTO SALAZAR, USDA: We recognize that this growing epidemic of obesity, if you will, has been occurring over the past 30 years. And so it's reasonable to expect that it's going to take time to turn that around.
GUPTA: Cooper hopes her program can speed up the process. And maybe one day, other districts will use hers as a model.
COOPER: And I think if we can do it, everybody can do it.
GUPTA: All right, Ann Cooper. I wish you were around when I was going school. Good stuff. Keep up the good work.
And make sure to tune in next week. We're going to meet up with cycling champion Lance Armstrong at the University of Texas. Stay where you are. We're taking your questions about allergies after the break.
GUPTA: To find out if pollen is ramping up in your area, go to CNN.com/allergy. Put in your zip code and find out the pollen count near you.
We're talking about spring allergies with Dr. Kathleen Sheerin, an allergist here in Atlanta. Busy one this time of year.
We got time for just one more question I think. Carol in Florida wants to know this, "How can I tell if I'm suffering with a bad head cold or if I just have allergies?" I have the same types of symptoms.
SHEERIN: Very common question this time of year especially. When a cold starts, it's very similar to allergies, sneezy, runny nose, then congestion. Cold often has fever or muscle aches with it. Allergies don't.
And allergies, if it's seasonal, are going to persist for months. A cold will go away in 10 days.
GUPTA: You know, a lot of people watching today, a lot of people have allergies as you know. And some of them are probably on your waiting list at your office.
GUPTA: Is there a final thought that you'd like to leave our viewers with?
SHEERIN: I would tell people there really isn't a need to suffer. So if you've tried the over the counter medicines, talk to your doctor. There are lots of treatment options.
GUPTA: Don't suffer.
SHEERIN: Don't suffer.
GUPTA: Good final message, I think, for sure.
GUPTA: Unfortunately, we're out of time for today. Dr. Kathleen Sheerin, I want to thank you very much for being the guest.
SHEERIN: Thank you.
GUPTA: Lots of good information there. Thank you as well, everyone at home for all the great e-mails. Keep them coming. E-mail us at housecall@CNN.com. Remember, this is the place for the answers to all of your medical questions.
Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.
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