[00:00:01] Hello and welcome to a Wonder Care podcast. My name is Sheena Mitchell and I am a pharmacist mum of three and here to guide you through all of your family healthcare needs. [00:00:15] To start off season eight, I thought it was a really good idea to just dive into some information about hay fever. Hay fever is something that is really bothering an awful lot of people right now. So I want to take this chance before I go into my whole gut health series to try and give you lots of tips and information on how you can help to reduce symptoms, why it's so bad this year, and how to treat symptoms if you need to for you and your entire family. So why does hay fever seem to be getting worse and worse every year? Well, although it doesn't feel like we've had the warmest to spring times ever, the fact is that climate change has resulted in a year on year rise in global temperatures. And Ireland is no different. Last year, 2023, was the hottest year ever in Ireland for 124 years. That was followed closely by the previous year, 2022, which was the second warmest year for our country since meteorological monitoring began. Why does this impact hay fever, you might ask? Well, unfortunately, climate change contributes to an earlier, longer and more intense allergy season, and there are over a million people living in Ireland with hay fever, and that includes 20% of children. So this is affecting an awful lot of people. As the planet heats up. A longer growing season for plant life, combined with the increased carbon dioxide input from fossil fuels, has resulted in a huge increase in seasonal allergy complaints. In essence, plants are growing and releasing pollen for longer, and the excess carbon dioxide that we're producing through fossil fuels is acting as a fertilizer for those plants. So there is a thought that the pollen that's being released is actually a lot more allergenic than it used to be. Now, I know it could be easy to say, okay, that's all a bit wishy washy, you're just making that up. But actually, the prevalence. So the frequency it occurs of allergic rhinitis, which is irritated nasal passageways and allergies amongst children, is rising. Things were looking so concerning that the international study of asthma and allergies in children has been established. It has recorded evidence of a significant rise in the prevalence of allergic rhinitis across all age group in kids, including an increase from 13% to 19% during an eight year period in 13 year olds here in Ireland. A smaller study in Cork showed a 3% increase in the prevalence of allergic rhinitis to almost 11% during a five year period in six to nine year olds, that's quite startling. Five years is not a huge amount of time for a disease burden to be affecting 3% more of a childhood population. If things continue to go this way, allergies are going to become more and more difficult to deal with. Children are especially sensitive to climate change, impacts of increased pollen and airborne allergens because they're still growing and developing. They spend so much more time outside, they have less control over their surrounding environments and less understanding of health risks. Really, they are relying on us adults, whether we're at home, in school, or engaging in sport or recreation outdoors. They're relying on us to protect them and to respond to high pollen alerts. I myself have three children and one of them suffers particularly bad with hay fever. If I hadn't identified that and treated it with antihistamines, Esalen plus and a few other products that I'll tell you about later on, then her life would genuinely be miserable. Of course she wouldn't know to stop going outdoors. Of course she would know not to roll in the grass because children do not understand the risks from pollen and the allergic reaction that it can cause. Complicating all of that a bit further is, is that asthma is the most common chronic disease in both kids and adults. In Ireland, asthma is a chronic respiratory condition and it actually affects 10% of irish children. Allergies and asthma often go hand in hand. Unfortunately, about 80% of people with asthma will also suffer from hay fever, and any rise in airborne pollen can cause a sudden reduction in their lung function and an increase in bronchial hyper responsiveness. In essence, hay fever season can trigger asthma flare ups. So for all of you people with asthmatics in the household, make sure that everyone is using their brown inhalers really regularly. The brown inhaler works to prevent asthma flare ups. It's no good using it when you already have one. That's what your blue reliever inhaler is for. The more regularly you use your brown inhaler as prescribed, the less you should need your blue reliever inhaler. If you find that your child is constantly looking for their blue reliever inhaler, then it might be time to go back to the GP to discuss the dosage. And asthma is no joke. Obviously it's extremely distressing for both parent and child, but it also costs the state already €472 million a year. And considering that allergic asthma is the most common form of asthma and hay fever is the most common allergen, you can see that this just is not going to end well if we're not all careful. So what are the symptoms of hayfever? [00:05:49] Well, with hay fever, you can get itchy eyes, and usually you'll get tear like, watery discharge from them. So it's not like conjunctivitis, where it's all horrible and crusty and thick. The runny, itchy eyes from hay fever looks just like regular tears. Your eyes can also get a little bit swollen around the whole eye socket area. Often people will suffer from a stuffy or congested nose as well. They'll often get sneezing. Sometimes they'll end up having a sore throat and potentially a cough. But one thing to note is that while, yes, it can cause a bit of fatigue and you just feel like rubbish, it's no wonder, really, you won't get weakness from hayfever. The other thing that you won't get from hay fever is an actual fever. So if you or your family member is having a lot of aches and pains, or they're feeling weak or they have a high temperature, then it's likely not down to hay fever. The annoying thing about hayfever is that it's different for everyone. There are more than 30 types of pollen and 20 types of spores, all of which can trigger hay fever and allergy symptoms. In general, from January to April, it's mostly tree pollen that's circulating in the air and causing symptoms. The kinds of trees that release pollen at this time of year are birch, ash, oak, willow, hazel, alder, and elm. In late April, you'll also start to get some flowers blooming, which can lead to additional pollen release. But for most people, the grass is the main culprit. And really, that kicks off in May and June. Grass is definitely the biggest trigger of hay fever symptoms for people. And if you escaped hay fever in March and April because you don't react to trees, just don't get too comfortable, because it is May, June, July, and August where all of that grass pollen is being released. It's not just grass, of course. You also get rapeseed, tree dock and nettle leaves. Usually. Then after the grass becomes the prime allergen, which, as I said, affects 90% of people who suffer from hay fever, things start to die down in about September to October. But unfortunately, that's when you get a lot of mold spores, fungal spores, and dust mites, so allergies can persist all year round. I know, delightful news. It can be really hard to have hay fever yourself or have a child with hay fever because it can really cause disturbed sleep at night because be a lot of tossing and turning and the interrupted sleep can cause problems concentrating in school. And obviously this is a time of year where many students will be taking on junior and Leaving Cert exams. So I suppose what I'm saying is you really do have to be proactive because we can't stop pollen being released and we don't want to, and we also don't want our children to have to live in a bubble. However, there's lots of ways that you can reduce their exposure to pollen and I'm going to run through some of them with you. Now met Aaron do a fantastic pollen count tracker. Now it's not on the app where the weather is, so you have to go on your phone into Metairen and just Google Metairn pollen tracker and it comes up and it'll tell you if it's low, moderate or high levels of pollen. That can be really helpful because it gives you the next couple of days of predicted pollen levels and say, for example, you have the kids off during the summer and you're trying to decide what to do. Well, if you know the pollen's going to be really high, you might choose to avoid forest walks or visiting farms, that kind of thing. And instead you might choose to go to the seaside. The sea is a fantastic place to be as a hay fever sufferer. Not only does the wind coming from the sea not generally contain any pollen, salt in the sea air also reduces inflammation and helps to clear your airways. This brings me on to how to try and create that beach like environment at home where the air is pure and clean. Really. First of all, I would say keep all windows and doors closed. This stops aeroallergens from coming inside. I definitely recommend using a salon plus salt therapy device. Now, straight up, they are the sponsors of this podcast season, but that is only because I have been harping on about this product for years. Anyone who has followed my instagram or Facebook pages in the last twelve years knows that I have been recommending salon plus for a long, long time before I started working with them. The salon plus is a device which basically filters all of the pollen particles that are floating in the air out and they then it pushes the clean air through a salt filter. So this is basically a filter that is embedded with micro crystalline salt particles. These are teeny, teeny tiny little salt particles that are then pushed by the fan so that they circulate all around the bedroom. They're so, so small that while you sleep during the night, you breathe in the particles and they are actually so tiny that they can reach the mucous membranes within your airways and your entire respiratory tract. A lot of people use this all year round. I'm one of them because my allergies, unfortunately, aren't just grass. I'm one of those people who suffers with tree grass and dust mite allergies. So not ideal. To use the salon plus effectively, you need to have it on for a minimum of 8 hours overnight. I usually turn mine on really full blast for 2 hours before I go to bed, and then I might turn it down a little bit when I get in there. There is a little dial on the back to control the power of the fan. And I really haven't heard many people complaining about the noise of it when you sleep because it's not an irritating noise, it's a constant low hum. One of my children is a particularly bad sleeper, so I always have it on really low when they're going to sleep. So you can basically not hear it. It's inaudible. And then when I'm going up to bed, I sneak in and I turn it up and it doesn't wake them. It's a fantastic product and I like it so much because it's natural and it's preventative. So by using the salon plus, you can help to prevent issues with your sinus asthma, allergies, COPD, and so much more. In fact, I'd say a good portion of customers who've bought the salon plus off me have bought it for their snoring husbands. Yep. It helps to reduce inflammation in all the airways and it can help to reduce snoring. Another thing you can do in terms of keeping your indoor space pollen free, mop regularly and use damp cloths to wipe down the surfaces when pollen gets into the house and you just go to use your dusting cloth like normal, all you're doing is moving the pollen around from one place to the other. You're circulating it in the air, so you do need to use a damp cloth to capture it. I have dogs in my house and they love playing in the grass outside during the summer. So when they come in, I have a damp towel sitting in a basin at the back door and I just use. I just basically rub that over them. I use it as, I suppose, a way to try and rub some of the pollen off them so they're not coming in and putting pollen all over the couch because, yes, do sit on the couch. And it also helps because the kids love to pet them and then if the children are petting the dogs and they're covered in pollen, and then the kids will rub their eyes, and then all of a sudden, you've got full blown, swollen eyes and hay fever symptoms. Try and encourage your children to take off their shoes when they come into the house and before bed. If you can get them to have a shower and change, it'll wash all the pollen off them if they've been playing outdoors. If it's a particularly high pollen day, I would go as far as washing their hair. If you can't convince them, or you're like me sometimes not really enthusiastic about the energy that it takes to get a child's hair washed and dried at bedtime, you can bring them outside and use a good paddle brush and just try and brush any pollen out of their hair. Just make sure you do do it outside, because otherwise you're spreading pollen around the house. So then you've done everything you can to prevent pollen being in your home. So at that stage, you can start thinking about how, how you protect your body or your child's body from making contact with pollen and producing a histamine reaction. So it's a good idea, especially for young children, to wear wrap around sunglasses. So this stops any pollen getting in contact with their eyes. For both adults and children, you can use haymax balm. This is a little balm that contains aloe vera, and you can just apply it around the entrance to your or your child's nostrils before they go outside. Basically, this means that the bam will catch any pollen that's floating around in the air and it won't be able to get up into their nasal passageways. It's a similar concept when you use a barrier moisturizer on your child's skin. My personal favorite is the lipocar balm because it's a really nice texture and it provides a really good barrier. This can help prevent pollen from being absorbed in the skin. You can also use wet wipes. I know we have hay fever wipes in the pharmacy, which can be really handy to have in your handbag, especially if you're going to a park or forest, etcetera. You can just hand them out and get everyone to wash their hands frequently while they're out playing. This will stop them rubbing their eyes and getting pollen in their eyes. Make sure and look for a brand that are biodegradable. Now, I haven't tried this myself, but while I'm talking about natural products or alternative treatments, I just want to recommend off the back of a lot of positive feedback I've gotten from customers, the hay bands, acupressure, armbands. So, as I said, I haven't used them myself, but they are completely drug free and they're based on chinese medicine. So as a community pharmacist, I can't stand here and tell you that I have evidence to support that. But I can tell you that, anecdotally, some of my customers have found it great. They're not suitable for use in pregnancy because the Kai chi pressure point that they stimulate may bring on labor. Definitely avoid. Okay, so now we're moving on to medical treatments of hay fever. So while we're still talking about prevention, I think it's really important to mention a range that has come out recently that I really like, again, because it's 100% natural. So fusion allergy is the name of the range. I will pop links up to these on my instagram. Actually, I might already have one up for this in my hayfever highlight. So they do a few different products. The first one is fusion allergy eye drops. All of the fusion allergy range contain a natural amino acid derivative, and it's called ectoin. Ectoin has protective and hydrating effects on the skin. This helps to maintain the integrity of your membrane barriers. So when you're thinking about your ocular, so your eye surfaces or any of your mucous membranes, so that's inside your nose, etcetera, it helps to protect them, to keep them in good condition so that they're not dry and they can actually form a proper barrier. One of the biggest problems we get in hay fever season is when people are rubbing their nose so much that their inside of their nasal membranes get damaged. Unfortunately, that damage then allows pollen particles to make quicker contact with the inner membranes, which can trigger a histamine reaction. So the best way to protect, and this is, again, a daily preventative treatment, is to use something like the fusion allergy eye drops and the fusion allergy nasal spray. So both of these products are suitable from birth, which is amazing. The eye drops come in little single unit doses, so they're really handy to fling into the bag, and you can have them then whenever you need them. The nasal spray is really nice. There's no major smell off it. It's not really foamy like some of the other products that I was recommending last year. Beko defense is one of those. And while it is really effective, and I have used it myself as an adult, my children just did not love the foam up their nose. Where this nasal spray is just gentle mist, and it contains the ectoes, so it will help to prevent pollen from contacting the mucous membranes. Helpfully, they also do a fusion allergy cooling mask. This is basically a mask that you can pop into the fridge or freezer for ten minutes and then use it over your eyes. If your eyes are really swollen or inflamed or irritated, can just be really nice and cooling and help to take down some of that reaction. For young kids under two who aren't able to take an antihistamine, all of these products are a really good idea, because the ectone, while obviously it is protective, it can also help to reduce symptoms by hydrating and protecting the ice from further damage. So even if you haven't caught it early enough and the damage has happened, it's still definitely worthwhile using those eye drops and the nasal spray if your child is suffering from symptoms. Speaking of which, I get a lot of questions about, you know, can really young children get hay fever? And while the answer is that most commonly it occurs in those over two years, it can absolutely happen to a younger child. So definitely respond to symptoms as you see them. But if there's any sign of an actual high temperature, do remember to make contact with your gp if it's lasting for longer than 24 hours, or if you have any worries over your child's general well being. Right. So for the overtooth, in terms of treatment, really, it has to be cetirizine, oral solution. So there's two brands of this, Zyrtec, which was the original brand, and then antihist, which is the generic, and it's sometimes a little bit cheaper. It really tastes quite nice, and you can give it twice daily for the whole of the hay fever season if you need. Taking an oral antihistamine is a good idea because it kind of deals with all of the symptoms, so it'll help with the congestion, the runny eyes, the itchy throat, everything. And then if at that stage that your symptoms still aren't under control, you can kind of try and figure out what's bothering you the most. So if it's your eyes, you can use something like a cooling mask, like I mentioned there, from fusion allergy, or their eye drops, and actually, which I found out recently myself, because I started wearing contact lenses. Sometimes they are suitable for use in contact lens wearers as well as suitable from birth. So that's handy if you need to step it up a bit. There is optichrome, and optichrome contains a drug called sodium chromoglycate. This basically relieves the symptoms as they arise by preventing the release of histamine. You do have to be six years of age to use it and it's not suitable for contact lens wears, so just bear that in mind. And then finally you've got atravine antistine. So this contains two active ingredients, xylometazoline, which is a decongestant, and antazoline sulfate, which is an anti allergy agent. And these work really quickly together to relieve irritation. One problem being they're only suitable from twelve years for short term use only, but they're really, really good for adults. I would definitely recommend not using them for longer than two days at a time if your symptoms are really severe. Beyond that, I think you should go and see a doctor. And again, unfortunately not suitable for contact lens wearers in terms of nasal symptoms. So congestion or sneezing, definitely for babies you've got a whole range of things you can use. So saline nasal sprays, any brand really, whichever you find easiest to use. The sterimire one is quite good because you can spray it from any angle. If your baby hates the canister mist, you know, it can be a little bit stronger than the likes of say maybe the cal poly nasal spray. So you just need to make sure and get the baby one and not the three year plus one if your child is under three. For adults as well, Sterimar, they do a congestion one and they do a hay fever and allergies one. So if you're particularly blocked up, go with the congestion relief because it has a stronger concentration of salt in it and it will actually draw out even more mucus. And it also has copper to help calm things down. A nice natural one, which is actually really, really good, is avogal sineuforce nasal spray. So this is really good if you're actually quite blocked up. It contains menthol, peppermint oil, eucalyptus oil, so it really does help relieve your breathing fairly instantly. I mentioned the beko defense earlier and the kids one. The kids one is suitable from six years of age, but as I said, they'd want to be quite happy because it is a little bit foamy. After that, if those nasal sprays aren't working for you, you can get steroid nasal sprays, but you do have to be careful with these. So with a steroid nasal spray, the risk is that sometimes if you don't use it correctly, it can cause thinning of the skin. So when you're using a steroid nasal spray and you have to be over 18, to use one, you need to make sure that when you put the nozzle at the entrance of your nose, you're spraying it right up toward the pupil of your eye. Whereas if you, if you just put it in your nose, it'll kind of tilt so that the spray is going to hit the middle wall of your nose, your septum, and that's what causes the damage. And it can even go on to cause things like nosebleeds. So when you're using a steroid nasal spray, just make sure that when you pop it into the entrance of your nostril and it's just the entrance, you just make sure that it's pointing right up at the roof and not in across your nose. For adults, in terms of antihistamines, there was traditionally two antihistamines available over the counter. One is called cetirizine. Brand names for cetirizine include zyrtec, antihist, cetrine, and the other drug is loratadine. So Loratadine is what is in claritin, Lorat. And I think that's it, actually, brand wise for loratadine. So these two antihistamines are one a day, non drowsy. You can take them all through pollen season. It's absolutely no harm to do that if you suffer from hay fever. Recently, a medication called fexofenadine came off prescription. So the brand name of this is Telfast, and it comes in a 120 milligram tablet over the counter. Some people do find this more effective, so it's definitely worth trying if you've had no joy with either dice, cetirizine, or Loratadine based antihistamines. So, in essence, I suppose what I'm saying is I always recommend a step up approach with hay fever. So my first protocol is always going to be measures to keep the pollen out of the house. And actually, another little tip on that is make sure you do not hang your laundry or sheets outside on high pollen days, because you're literally just bringing the allergen back inside into your home. But, yeah. So try and keep the pollen out of your house by keeping the windows and doors closed and wiping the surfaces with damp towels and cloths and changing and all of that rigmarole that I set at the start. Then I would start using something like a regular once a day antihistamine. Obviously, for children from two, they'll be using the solution. So depending on their age, it will, it could be twice daily or once daily dosing. Just do have a read of the patient information leaflet. I also recommend using the salon plus all night every night. It really is a fantastic machine. You just plug it in, I leave it near to my bed, make sure the windows are closed. I have it pointing at my head and it will remove the pollen and any other allergens that are flying floating around your bedroom. I actually also really like it at the moment because we live in a dormer house and the heat rises into the bedrooms upstairs and it is stifling and I think without the gentle fan of the salon plus circulating the air, I'm not sure how much sleep I would have gotten in the last week. So yeah, handy one, you do have to replace the salt filter every four months and we do email reminders for that once you get a device from us. And yes, I'm just going to say it, I think we are the cheapest on the market consistently. [00:26:34] I'm proud of that. We don't do any kind of marketing cons. Our price is just consistently low for salon plus. So that is because I recommend them so much that we buy them in bulk and we pass that great offer on to you, the customer, as a thank you for supporting me and my community pharmacy. I always just set a little reminder on my phone every four months so I know to change the filter. So after you've done that, you're taking your daily antihistamine, you're potentially using the salon plus. The next thing I would do is if your nasal symptoms are still bothering you and you're an adult, try first of all a natural nasal spray. So something like asteromar or the fusion allergy nasal spray. If they aren't working for you, you can absolutely try something like the sinu force which has all of the essential oils in it, which can help to relieve congestion. But if your hay fever symptoms are still really persistent and you're over 18, it's absolutely okay to use a steroid nasal spray for the duration of the pollen season. Just do be cautious on how you're using it. Make sure and have a look at the leaflet because as I said, it can cause a little bit of nasal irritation if you're not using it properly and if your eyes are irritating you and you've tried using the fusion allergy eyedrops to protect from symptoms, then you can absolutely step up to the opticrome for kids over six, or to the antistine, the atravine antisten eye drops from over twelve. With all of that, I hope you survived the hay fever season, but actually on a serious note, asthmatics out there. Please, please, please take your preventer inhalers regularly as prescribed. I cannot emphasize that enough that will make sure that your lung surfaces are not going to overreact to the allergen that's circulating in the air. So if you find you're using your blue inhaler more than a couple of times a week, like if you're using your brown inhaler, then you really shouldn't need to use your blue inhaler much. And if you find that you do need it, then it's definitely time to go back to the doctor to get the dose of your steroid reviewed. If you are pregnant and you need an antihistamine, then I would choose loratadine. That is the one that is most recommended to take during pregnancy. So I just wanted to highlight that because there is nothing worse than suffering from hay fever when you're pregnant. When you're pregnant, you already have a lot of congestion issues because you've got a higher blood volume load and it can cause your nasal passageways to be swollen. So, you know, again, you can use the fusion allergy nasal spray. If you're in your second trimester, you can use the sinu for so just be avoided towards the end of your pregnancy. But you can take loratadine, which is claritin or Lorat, as an antihistamine during pregnancy. The Beko defense nasal spray might also be your best friend. I know that I had to use it a lot during my three pregnancies and using it before you go out can really help to prevent any symptoms from occurring. Okay, so I hope you found that really helpful. If you did, it would be great. Great if you could please, please give me a review on whatever platform you are using to listen to this podcast. Follow me over undercare iRL on Instagram where I spend way too much time chatting and sharing healthcare advice and I'll talk to you next week.