NATIONAL 2 (Spotlight Weekly)]

Remedial Risks

Doctors urge you to get help for seasonal allergies

BY AKSHAY SHARMA

Now that fall is in full swing with falling leaves and shorter daylight hours, people are stocking up on over-the-counter remedies for allergies. But non-prescription antihistamines and decongestants can have serious side effects, some of which you might not even notice while you are taking them. And many people don't respond to them at all. That's why doctors advise allergy sufferers to get tested, get treated, and get better.

"Allergies affect up to 30 percent of the population, and their toll is increasing world-wide. The disease often lasts year-round, but has spring, summer, and fall variations caused by different airborne pollens or fungal spores. From mid-August through the first frost, weeds are the major trigger for much of the country," says Dr Surendra Maharjan.

People in street : Vul nerable to allergies?

Unfortunately, it's a little more complicated than that. "Warm temperatures and a lot of rain can lengthen the pollen season, no matter where you live," says an allergy and immunology specialist, "And throughout the year, outdoor molds can increase suddenly without any set pattern."

That's why it can be so hard to tell the difference between a cold and seasonal allergy, Dr. Maharjan says, adding that the medical term allergic rhinitis is often the diagnosis when patients say they can't shake a cold. "But the symptoms are quite a bit different," he says.

"Here are some ways to tell the difference: Itching of the nose, ears, or mouth is a hallmark of allergies. Spasmodic or ëmachine guní sneezing is common with allergies. Nasal secretions are thin and colorless with allergies, thick and opaque with a cold. Colds are often accompanied by a fever, sore throat, or cough. Colds are usually gone within 14 days," he adds.

Some people just tough it out with their allergy symptoms, and others rely on over-the-counter medications for relief. "The problem is that non-prescription antihistamines have a sedating effect, and two-thirds of those who take them aren't even aware that they're sedated," says another allergy and immunology specialist.

Dr. William E. Berger, the author of "Allergies and Asthma for Dummies", says that over-the-counter decongestants also pose a risk. "Decongestants raise your blood pressure and heart rate, so they shouldn't be taken with other stimulants like diet pills," he says. He also warns that they should not be taken with the class of drugs called MAO inhibitors, like Nardil and Parnate, which are used to treat depression.

Dr. Berger advises allergy sufferers to talk with their doctors before taking non-prescription remedies, especially if they have high blood pressure, heart disease, asthma, or thyroid problems. He also offers some simple techniques for avoiding seasonal triggers: "Stay inside early in the morning and late in the afternoon. Keep windows closed while at home or in the car. Take a shower as soon as you get home."

If these measures fail, you may want to seek medical treatment for seasonal allergies. For mild symptoms, your doctor can prescribe a non-sedating antihistamine, says Dr. Prasanta Barakoti.

"If symptoms are more severe, they can be managed with a nasal steroid spray like Flonase or Nasonex, along with an antihistamine-decongestant combination like Allegra-D or Claritin-D," he says.

Dr. Barakoti, who helped write a set of national rhinitis guidelines, that most patients have a combination of seasonal and year-round allergies. "In some parts of the country, pollen and mold last so long that the seasons overlap," he says. "Many people also have indoor triggers, such as dust mites, pet dander, and cockroaches, making seasonal symptoms even worse."

That's why allergy testing is so important, says allergy and immunology specialist Dr. William Dolan, a professor of pediatrics and medicine at the Medical College of Georgia in Augusta who is currently in Kathmandu. "If we know what the triggers are, we can get a much better handle on symptoms," he says. "And contrary to popular belief, allergy testing isn't painful and doesn't require any injections. We just lift up a few cells, exposing the skin to a small amount of extract" of the substance suspected of triggering allergy symptoms.

For those who don't respond to drug therapy or can't tolerate it, doctors often recommend allergy shots. "Desensitization involves exposing a patient to increasing amounts of various triggers until they're symptom free," Dr Dolan says. "It's effective and covered by most health plans but should start right after the pollen season ends to help get ready for next year."

How To Avoid Low Back Pain

By Dr. ARVINDA K. SINGH

In today's fast-paced society, low back pain has become a common problem, especially in urban areas. However, it can be avoided by performing simple exercises each day. The following are common tips to avoid the occurrence of low back pain.

While Standing and Walking:

1. Stand with low back as flat as possible. By standing tall and sucking in and out of a tense abdomen, the lower back is straightened. Walk, stand and sit as tall as possible.

2. Bend knees when leaning and avoid leaning whenever possible. Instead, squat with a straight low back.

3. Avoid high-heeled shoes, they shorten the Achilles tendons and increase Lourdes's.

4. Avoid standing for long periods. If it is necessary, alternate leaning of left and right feet and, if possible, use the bent-knee position as this flattens the lower back.

5. When standing, do not lean back and support the body with the hands. Keep the hands in the fringe of body and lean forward slightly.

6. Open the door wide enough to walk through comfortably.

7. Carefully judge the height of curbs before stepping up or down.

While Sitting:

1. Sit in such a way that the lower back is flat or slightly rounded outward, but never with forward curve.

2. Sit so that your knees are higher then the hips. This may require a small footstool for a short person in a higher chair.

3. Begin contact with the back 4 to 6 inches above the seat and provide a flat support throughout entire lumber area.

4. Do not sit on a soft or overstuffed chair or sofa.

5. Do not sit with legs straight out on a footstool

6. Never sit in the same position for prolonged periods. Get up and move around for a while.

While Driving:

1. Push front seat forward so that your knees will be higher than the hips and the pedals are easily reached without stretching.

2. Sit with back flat. Do not lean forward. Sit tall.

3. Add a flat backrest if seat is soft while traveling long distances.

4. Be sure that your seat has a properly adjusted headset.

5. If on a long trip, stop every two hours to get out of car and walk about. Tense the abdomen and flatten the back for several minutes.

While In Bed:

1. Sleep or rest on a flat firm mattress. If not available, place a bedboard of three-quarters of an inch of plywood under the mattress. A board of less thickness will prevent proper spine alignment.

2. When sleeping, the preferred position is on the sides with both arms in front and the knees slightly drawn towards the chin.

3. Don't sleep on your stomach.

4. When lying on the back, place a pillow under your knees.

5. When lying in bed, don't extend your arms above the head. Relax at sides.

6. Sleep alone on an oversized bed.

7. While getting out of bed, turn over one side, draw up your knees, then swing your legs over the side of the bed.

When Lifting Weight:

1. When lifting weight, let the legwork, using the large muscle of the thigh instead of the small muscle of the back.

2. Don't twist the body, but face the object.

3. Never lift with your leg straight.

4. Don't lift from a bending forward position

5. Don't reach over furniture to open and close windows.

6. Tuck in the buttock and pull in the abdomen when lifting.

7. Lift a heavy load not higher than the waist and light load not higher than the shoulder.

8. Lift the object holding it close to the body.

(The writer is senior physiotherapist at Capital Hospital and Research Center)