1/

Seen a few tweets where people are reporting #hayfever It is likely this is due to the early tree pollens & suggests birch pollen; the cause of much misery in spring is not that far behind. This calendar from my book can help you work out which pollen is giving you problems
2/

One tip if antihistamines are not doing the trick is to start using a nasal steroid spray 2 weeks before your pollen season.

If buying over the counter, then I suggest to my patients fluticasone proprionate & if via the GP fluticasone furoate but other products work too.
3/

Often pats tell me nasal steroid sprays don't work. There are three common reason why:

1) Stopping them too soon
2) Closing one nostril when using them
3) Sniffing in as using the spray

And as I said above, starting them before you get symptoms can make a huge difference.
4/

Stopping them too soon.

These drugs take time to build up & you won't usually notice an immediate difference unlike antihistamines. Don't give up after 2 days.

Give them a fortnight.
5/

Closing one nostril.

This just pushes the bony septum across your nose & the spray hits it. That is not the part where the problem is. Direct the nozzle of the spray towards the outer wall of the nose, where the soft tissues can are inflamed by the pollen.
6/

Sniffing!

If you sniff you will eat your snot but also the spray. It works when in contact with your nasal lining, so if you eat it ... well ... it's like putting a moisturiser on & then wiping it off. Just breathe slowly after spraying.
Dab any that runs out with a tissue
7/

If you have found this useful can I recommend an excellent book 😉 called #understandingallergy
In it, I cover hay fever in detail, with practical tips. Which drugs to use when, what to do & when & how to stop it trashing your life.

amazon.co.uk/gp/product/024…

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More from @LondonAllergy

May 26, 2022
1/ Thread

Anaphylaxis is a spectrum.

Urticaria & a persistent cough can be anaphylaxis.

As can angioedema, wheeze & low blood pressure.

However urticaria & angioedema are not essential to make the diagnosis & in severe reactions may not be seen at all. Image
2/

The first-line treatment for anaphylaxis is Adrenaline.

Seems easy enough no?

But time & time again studies show a delay in administering it.

Pumphrey (2000). Lessons for management of anaphylaxis from a study of fatal reactions. Clin Exp Allergy 30(8), 1144–1150 ⬇️ Image
3/

Contrary to popular belief, facial angioedema does not equate to a patient being at increased risk of developing laryngeal oedema. Although people often worry about laryngeal oedema, wheeze with anaphylaxis seems to trigger less concern.

(Photo tweeted with written consent) Image
Read 9 tweets

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