Woman blowing her nose

Did you know that Florida has specific allergy triggers? In this episode of the audio blog, we talked with Licensed Practical Nurse Raquel Sabina, and she tells us that unlike other parts of the country, Florida does not experience traditional spring allergies. And while allergies are annoying, it is essential to treat them, even if symptoms seem minor. The reason? Like many things in life, if ignored, it can get worse.

Shelby Stockton (00:00):
Welcome to the South Florida ENT Audio blog. I'm Shelby Stockton. Today, I spoke with licensed practical nurse Raquel Sabina. She's had 32 years of experience with allergies. We discussed allergy triggers specific to Florida, and their symptoms. She explains how allergies are diagnosed and different methods of treatment. We also talk about why it's important to treat your allergies. Sure, allergies are a nuisance, but if ignored for too long, they can actually get worse.

Shelby Stockton (00:28):
Raquel, thanks so much for taking time out of your day to talk to me today.

Raquel Sabina (00:32):
Oh, thank you, Shelby. Thank you for having me.

Shelby Stockton (00:35):
I want to talk about allergies, and I want to be super specific about allergies in Florida. What are the allergy triggers in Florida?

Raquel Sabina (00:44):
Well, I think, as in any other place, probably pollens play one of the biggest parts in our allergy season, per se. We also have mold and we also have perennial allergens, such as dust and of course, animal dander and whatnot. But definitely, the specific triggers that are worse in this part would be definitely pollen, followed by mold.

Shelby Stockton (01:10):
Can I ask you a question? Since Florida has a pretty consistent climate, do these allergies last all year round or do they spike during sometimes?

Raquel Sabina (01:21):
Actually, they fluctuate, and they fluctuate almost in the opposite way as the rest of the country. We really don't have seasons, per se, here. So right now, actually, we have a lot of pollen allergy. It's really, for this year, at an all-time high. So pollen right now is our spring, in any other place where they have flowers and they have a lot of stuff that's blooming.

Shelby Stockton (01:57):
Okay. So what are the symptoms of pollen allergy, specifically? 

Raquel Sabina (02:02):
Pollen allergy follows pretty much the same others, as sneezing, a runny nose, congestion. And specifically, pollen causes a lot of allergic conjunctivitis, which is a very uncomfortable situation in the eyes. And it can go both ways. It could be watery eyes and it could be a dry eye, and they're both equally uncomfortable. And people usually run to the ophthalmologist thinking they have another situation. And really, what it is, is an allergic conjunctivitis, which often turns into a bacterial conjunctivitis. And that's of concern, of course.

Shelby Stockton (02:42):
So I didn't have allergies when I was younger, and as I got older, I started to develop them. And I thought I was just catching a weird cold. How would you know the difference between if it's an allergy or a cold?

Raquel Sabina (02:54):
Well, one of the things that we do is, a history of when these symptoms come up is paramount. When you have someone telling you consistently, or you can see their chart and they've been coming in every year, January or February, and they show the same symptoms, you can tell by history, a lot of what's going on before you even test the patient, which of course is a very important part of really determining which type of triggers the patient has. But an allergy history is paramount, knowing when these triggers come in, how they come in. And if you know the way allergy works, you pretty much know what the patient has before you get to test them. It's pretty much, it's going to be consistent. Flare ups, maybe sinus, maybe some people get hoarse because of the inflammation in the vocal cords. There's all kind of symptoms that allergy does not just catch us in the sneezing, runny nose, congestion type of reactions.

Raquel Sabina (04:07):
There's also skin manifestations. There's polyps. Nasal polyps is what I'm referring to, which a lot of people that are allergic have. It's very important to have an ENT exam, because when you have an ENT exam, the doctor can tell exactly what's going on, sometimes before the patient tells us, because nothing looks like allergy except allergy in the nasal area.

Shelby Stockton (04:38):
Okay. So let's say I come into the doctor's office, I think I might have allergies. What is the testing process like?

Raquel Sabina (04:46):
Well, the doctor will take a medical history. When that medical history is taken by the medical assistant and given to the doctor, there's usually some indication of whether it might be an allergy or not. And then he or she will proceed to do an ENT exam, which will feature a visualization of the nasopharynx, usually with a little camera or a endoscope. And you can see swelling, you can see presence of mucus buildup. We have structures in the nose called turbinates, which actually become inflamed. And when that happens, people cannot breathe and they're obstructed. So they can identify a series of conditions just by doing that, that would alert them to, well, this may be an allergy happening here.

Shelby Stockton (05:44):
Are any of those procedures painful?

Raquel Sabina (05:49):
No, they're not. We usually numb the patient in the nasal cavity. And it's not a pleasant situation, but it's a little uncomfortable. That's how I would categorize it.

Shelby Stockton (06:02):
Okay. So what are some of the treatments, once diagnosis has been established?

Raquel Sabina (06:09):
Once the patient's been tested and we know exactly what the triggers are, then for example, we would go into, what are you going to do in your household for environment control? That may be using an air purifier, dehumidifier. There is several things that we can use to diminish different allergens in the home or in the office. Sometimes it is a problem in the office as well. So we try to do that. We try to medicate the patient accordingly to give them some relief. And of course, identifying which allergens they have a problem with, then we can desensitize them to environmental factors. That's what generally is called allergy shots. And it's desensitization with a particular allergen to make your body act differently when it's exposed to that allergen. So it would be sort of training your body to produce antibodies to fight these and to not react in an inflammatory way.

Shelby Stockton (07:27):
So you know how some people are just like, "Ah, I'll just live with it, I'll fight through it. It's temporary." What would you say to those patients who are suffering and they're just like, "I just don't want to take another medication," or something, or afraid to go to the doctor?

Raquel Sabina (07:41):
Right. And sometimes that is a situation that you can take medication for it. Medication, specific antihistamines do not work the same after you've been using them for a while. So allergies, if you don't change any of the conditions that you're exposed to, will become worse. So the problems may become, from a mild cold, it might become a sinus condition. After a sinus condition, acute sinus conditions turn into chronic sinus conditions. And of course, that's the concern. We don't want to have this patient in the future have to go through polyp surgery or sinus surgery because we didn't address the allergy problem, so that would be one thing that I would explain to the patient.

Shelby Stockton (08:37):
Okay, which is a great transition to my next question. Do you have any advice for patients who are reluctant to come in, just maybe their fear of the doctor or anything like that?

Raquel Sabina (08:51):
Sure. It happens all the time. It's my day-to-day speaking to people, saying exactly what you had said before. This will go away in a couple of months and I'll be fine. And it's not such a serious condition, because when someone has chest pains, they call in sick and they go to the emergency room. And that's not a condition you want to put on the back burner. But with allergies, it's completely different. Because sometimes we do take an antihistamine, it helps, and we can continue being productive the whole day. But with time that changes, and it becomes harder and harder to treat these allergies. And the allergies increase, so that's the concern there.

Shelby Stockton (09:36):
All right. That is awesome advice. Raquel, thank you so much for spending time talking about this. This is very important and educational.

Raquel Sabina (09:45):
Absolutely. It's my pleasure.


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