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www.FredParent.NET • 19 Sponsored Material Join us March 9 for the live conversation on Do you have questions for Mark Wenger, MD.,M.Sc.? He'll be chatting live with us on our Facebook page on March 9, 2017 at 8:00 pm. Come join the conversation! facebook.com/FredericksburgParent a sk t h e e x p e rt Q: Why does pollen make us react in the fi rst place? For many patients, the body produces an antibody to external things called Immunoglobulin E (IgE). Pollen can attach to the IgE and will then cause cells in the body to release infl ammatory compounds, such as histamine, that lead to symptoms such as sneezing, itch, congestion and asthma. Q: My kids are dying to get a pet, but a member of the family is allergic to pet dander. Is there anything we can do? Yes, there is! Many allergic patients who have problems with pets will respond to immunotherapy/ allergy shots. As with the prior question, the shots have to be done at a high dose to be effective. One thing that does not work is the adoption of a "hypoallergenic" pet. While they may shed less, the amount of dander they produce is just as much as other dogs. Interestingly, it turns out that there is signifi cant dander variation between dogs of the same breed, that one golden retriever may have far more or less dander than another golden. Q: Do seasonal allergies typically get better or worse with time? They can go either way. However, only about one-fi fth of patients will have near-resolution of symptoms in time without intervention. Q: At what point, should we nix the over- the-counter medications and make an appointment with an allergist? My greatest concern is if allergies are impacting activities of daily living. Do your allergies keep you from work or school? Do they keep you from enjoying the outdoors? Are you unable to visit friends and family with pets? If the answer is yes, despite the use of over-the-counter medications, we may be able to help you. Other reasons to see an allergist would be if you have side effects to medications or if you have a desire not to be on medications long-term. Q: What is a typical appointment like? The visit starts with detective work. With allergy, the history is very important, so initially we will discuss different exposures to allergens you may have and symptoms that may be associated with them. If there is a question of asthma, we will likely do a simple breathing test that will help us quantify the problem. We may do allergy testing, and the most accurate way to do this is with a scratch test during which a plastic "scratcher" disrupts the surface of the skin after being dipped in an allergen. You will get a temporary hive where the scratch was performed if you are allergic to the substance. Q: Should I see an allergist multiple times throughout the year? Patients with asthma should see their allergist or other provider every six months. As long as an allergic rhinitis patient is doing well, we will follow them on an annual basis. Typically, there is no reason to repeat allergy testing to environmental allergies in patients on allergy shots who are doing well unless there is a change in symptoms and there is concern about new sensitivities. We will see patients about every six months who are allergic to foods that are typically outgrown in time. Q: If my allergies become worse during pregnancy, will they typically stay that way once the baby is born? Not necessarily. There is something called rhinitis of pregnancy where 30 percent of pregnant women suffer from signifi cant nasal congestion. This will resolve after delivery. In patients who are allergic already, about one-third will get worse, stay the same or get better after the pregnancy from where they were initially. Do your allergies keep you from work or school? Do they keep you from enjoying the outdoors? Are you unable to visit friends and family with pets? If the answer is yes, despite the use of over-the-counter medications, we may be able to help you. At what point should I see an allergist?