Tip for Triathletes With Allergies
Its been a late bloom out here in Montana, and I am currently living in the 7th level of allergy hell. At this very moment, I have a cough, runny nose, and a red eye that gives Ben Stein nightmares. As a doc, I get a lot of questions about allergies and I know there must be a lot of fellow triathletes struggling with the sniffles. SoI thought I would again share with you guys some tips I give my patients on how to deal with the semi-annual pollen attack.
1. Prevention of exposure is the first line defense against allergies. Before venturing out, take a look at wunderground.com or weather.com for your local pollen levels. If the level is high, and the farmer next door just finished cutting his hay in preparation for today’s Miss Furry Cat of Montana Pageant, it may not be the best time to get that 17 mile run in. Keeping your house and car windows closed, wearing sunglasses, and taking a shower after being outside for awhile are a few easy ways to keep your allergy exposure down.
2. Be realistic. If I knew of a magic pill that would eliminate all allergy symptoms for everyone, I would be writing this from my private Gulfstream Jet on my way to France for Le Tour. Even with the best treatments, most people will experience some minor discomfort during allergy season. Due to this fact, I have seen many patient’s shun medications and suffer needlessly because they failed to get 100% better with treatment. Proper treatment can alleviate the majority of allergy symptoms, and in my world, 80% better is a lot better than 0%.
3. Be careful with which over the counter medications you use. There are many medications available over the counter that can have some serious side effects, especially in the allergy section. Take Benadryl for example. A powerful antihistamine and anticholinergic, Benadryl works great for allergies. Unfortunately, it can also cause more drowsiness than Prince’s Purple Rain movie. It’s sedative properties are so strong that it is sometimes prescribed just for sleep. Unless you know that your not really affected by Benadryl, I would avoid this medication during the day. The last thing you need while blasting a downhill on your bike is a sudden urge to nap. Like Benadryl, Sudafed is another common OTC medication used for congestion. Sudafed works as a decongestant by constricting blood vessels in the nasal passages. Unfortunately, this blood vessel constriction can also cause marked increases in blood pressure. Beware if your BP is giving your powermeter readings a run its money.
3. The meds I recommend first are the second generation antihistamines. These are medications such as Claritin, Allegra, Clarinex, and Zyrtec. These medications are preferred as they cause significantly less sedation. Of the second generation antihistamines, Zyrtec and its mimics are the most likely to cause drowsiness. These medications work well for stopping sneezing, runny nose, and itchy throat/nose/eyes. They dont do so well for nasal congestion. Everyone reacts to these medications differently and I recommend trying one at a time for 2 weeks each to gauge effectiveness. If one medication doesn’t work for you, it doesn’t mean the other meds in this class wont be helpful. Keep going down the line and hopefully you can find your miracle drug.
5. Another option that can be tried after oral antihistamines is nasal antihistamines. This includes medications such as Astelin and Patanase. The drawback is that it can take three hours for these medications to take effect and there can be some drowsiness.
6. Be careful with intranasal decongestant sprays. This includes medications such as Afrin, Neo-Synephrine, and Nasin. This class of medications is different from intranasal antihistamines and corticosteroids. As mentioned prior, the decongestants work by constricting blood vessels in the nose. This also means they may affect blood pressure. As for symptoms, they do well to tackle congestion, but will not be effective for things like runny nose and itchy eyes. In addition, if used more than 3-5 days, a condition called rhinitis medicamentosa can develop and lead to rebound nasal congestion after cessation of use.
7. If your face feels likes its going to explode, then you may have significant nasal congestion. One easy way to help relieve this is by using humidfied air intermittently. Another option is a nasal saline spray over the counter. If you need more than that, talk to your doctor about intranasal steroids. This class of medications is the single most effective group of drugs for allergies and include medications such as Flonase and Nasonex. The sprays work well for nasal congestion, rhinorrhea, itching, and they may also reduce eye symptoms. Moreover, research studies so far have not shown any long term systemic steroid side effects from their use. Sure, learning to tolerate huffing a spray is tough, but so was peeing on the bike.
Hope this helps you folks some. If you really get into a sneezing marathon at the sheer mention of ragweed, there are even stronger medications available to help. My best overall advice is that you speak with your doctor if your having symptoms and before following any of the advice above. Many of my patient’s feel silly asking about help with allergies because they figure everyone has them. Yes, allergies are common, but that doesn’t mean it isn’t a serious and debilitating condition. Get out and put that doc to good use and you wont think twice about that Spring ride through a valley full of blooming wild flowers!