Frequently Asked Questions

---

Hay fever, can also known as allergic rhinitis. Hayfever is nothing to do with having a fever! It’s actually an allergic reaction to airborne pollen. It can also be an allergy to dust or pet dander (fur etc) too. It causes inflammation of the nasal passages and sinus areas.

Hayfever symptoms vary from person to person and can be mild in some people, right through to very severe in other people. Typically symptoms include:

• Nasal symptoms: Sneezing, runny or stuffy nose, and itching.
• Ocular (eye) symptoms: Itchy, red, or watery eyes. or all 3!
• Throat symptoms: Itchiness or soreness of the throat.
• Others symptoms include: Coughing, headache, fatigue, and difficulty sleeping. Some people can also get skin reactions such as hives.

1. Avoidance: Limit you’re exposure hat ever it is you’re allergic. If it’s pollen, try avoiding cutting the grass, try to stay in doors if possible when the pollen count is high. Avoid gardening and flowers And places like garden centres which are inevitably full of pollen.
2. Home remedies: It’s ALWAYS a good idea to rinse out your nasal passages and sinuses. Not only will this help prevent pollen build up, but it will also reduce you’re chances of getting infections such as common colds. Saline nasal rinses such as Sterimar can be bought over the counter. Use these twice per day in each nostril, tilt your head down, and point the tip into your nose at a 45 degree angle, facing the septum (middle part of the nose). 
3. You can also use air purifiers to remove the pollen from the air in the home. keeping windows closed during high pollen peaks is also a good idea.
4. Place vasalene at the base of the nose. This catches the pollen and traps it there so it doesn’t actually enter your nose and cause symptoms! 
5. If you have been outdoors, when you’re back home remove you’re clothes and pop them in the washer, then have a shower, making sure you also wash you’re hair. This removes all the excess pollen which is on your skin.  A shower before bed can also help you sleep much better and prevents any pollen from your skin attaching to the pillow case and causing you symptoms during the night which disturbs you’re sleep. 
6. DONT DRY YOURE WASHING OUTSIDE! Pollen attaches to the clothes and then you and you’re loved ones wear them! This is just a recipe for a Hayfever disaster! 

1. Medications:
   • Antihistamines: these are best started 2-3 weeks BEFORE you’re hayfever normally starts, that way you’re already reducing your histamine levels in you’re body which will then prevent you’re symptoms coming so severely when youre hayfever actually starts. They help Reduce itching, sneezing, and runny nose. Tablet and liquid forms are available over the counter and includes medications such as Loratadine, Cetirizine, Chlorphenamine, Fexafenadine.
   • Nasal corticosteroids: these target the nose specifically and they work by reducing  the inflammation in the nose. This includes fluticasone & Beconase (mometasone).
   • Leukotriene receptor antagonists: These are prescription drugs int he UK and they work by blocking certain chemicals in the immune system which can make allergies worse. In the UK we tend to use a medication called  montelukast.
   • Mast cell stabilizers: Prevent the release of histamine and other chemicals which can contribute to symptoms getting much worse. This tends to be in the form of eye drops in the UK. Typically Sodium Cromoglicate (Opticrom eye drops).

• Immunotherapy: in the UK its ann option where your GP can refer you to the hospital to see a specialist who specialises in the immune system (an Immunologist). They can start a course of allergy injections to gradually desensitize the immune system to allergens. This is usually done for people whom have severe hayfever which affects their activities of daily living and are trying everything else above but its not effective at controlling their symptoms.  This does come with risks of having a severe allergic reaction Such as anaphylaxis. However these risks are reduced by the injections being done in the hospital settings and all the necessary reversal drugs such as adrenaline to hand. All the risks and potential side effects are discussed with you before hand. 

• Kenalog Injection: This is where we can help. Nurse Clare does andminister these injections in clinic. Each Kenalog injection contains Triamcinolone acetonide 40mg/1ml. Triamcinolone acetonide belongs to a group of medicines called corticosteroids (steroids). The main effect of corticosteroids is to reduce the body’s inflammatory & allergic response and they are used very commonly for many serious medical conditions in the NHS and elsewhere. Their use has saved countless lives since they were discovered in the 1940’s but they do have significant risks.  Kenalog injections were given routinely to severe hay fever sufferers via the NHS until about 5/10 years ago but have now fallen out of favour. The NHS no longer prescribes or administers Kenalog for hay fever as their guidelines have determined that the potential risks do not justify the benefits that people may gain from the treatment.  Kenalog continues to be routinely administered to patients in other countries around the world.  A Kenalog injection does not cure hay fever. It just temporarily suppresses the immune system enough to take away the symptoms in most people who need it.  The potential problems from Kenalog last for about 3 weeks after the injection but can be long term. Many people find the relief from symptoms commonly lasts the entire season. Some people need just 1 injection per season, the odd person may need 2 injections per season.
  
  

Everything comes with risks. We believe that the decision to proceed with the Kenalog injection is not our decision, but it’s yours. An informed decision making process giving the client all the information to make their own decision as to wheather  or not they are willing to accept the risks. If Hayfever is significantly impacting on a clients quality of life with severe symptoms after trying the above treatments, sometimes quality of life is what’s more important to the individual client, which is where this injection can help.