April 7, 2025 • 32 mins
Send us a message with this link, we would love to hear from you. Standard message rates may apply.
Allergic rhinitis affects 20% of people with substantial impact on quality of life, causing symptoms like nasal inflammation, itchy eyes, and post-nasal drip.
• Allergic rhinitis is a nasal reaction to airborne particles causing a histamine response
• Symptoms include itchy nose, watery eyes, sneezing, nasal congestion, and sinus pressure
• Allergens fall into four categories: pollens, insects, animal dander, and molds
• Allergies can be seasonal (specific times of year) or perennial (year-round)
• Trigger avoidance is the first line of defense before medication
• For dust mites, use allergen-impermeable covers and wash bedding weekly in hot water
• Pet allergies are challenging—consider HEPA filters and increased cleaning if removal isn't possible
• Changing pillowcases daily during high symptom periods can significantly reduce exposure
• Controlling humidity below 50% helps with dust mites and mold allergens
• For outdoor allergens, stay inside during peak times and shower before bed
Join us next week for an in-depth conversation about medication options for managing allergic rhinitis.
Production and Content: Edward Delesky, MD & Nicole Aruffo, RN
Artwork: Olivia Pawlowski
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Ed Delesky, MD (00:00):
Welcome to your checkup.
We are the patient educationpodcast, where we bring
conversations from the doctor'soffice to your ears.
On this podcast, we try tobring medicine closer to its
patients.
I'm Ed Delesky, a familymedicine resident in the
Philadelphia area.
Nicole Aruffo, RN (00:14):
And I'm Nicola Aruffo.
I'm a nurse.
Ed Delesky, MD (00:16):
And we are so excited you were able to join us
here again today.
So you all right.
I've been waiting several daysnow because usually I'm the one
who has the list of things totalk about.
But I mean, you told me daysago you're like oh, I'm so
excited for this thing that Ihave to talk about in our little
pre-show run.
Nicole Aruffo, RN (00:36):
Yeah, so it's the I want to talk about.
I haven't talked about thiswith you because I want to know
if this one has happened to youyet.
And two, if you like, think thesame way that I do, okay, and
I'm a little nervous right now.
So we recently found ourselveswith a wedding date.
We're planning things, blah,blah, blah, blah, blah, whatever
(00:58):
.
So what I'm about to say, Inoticed it kind of, you know, in
the past just kind of generallysurrounding conversations of,
like other friends or familygetting married, planning a
wedding, and then during thosetimes I always kind of thought
it was a little bit of a weirdthing to say to someone, maybe
(01:22):
if someone put like annoyingwith a splash of like uncalled
for or rude like into one word,it might be that okay and then
it happened to me at work theother day oh
and I can confirm.
It is a strange thing to say tosomeone who just told you like
(01:43):
their wedding date or like thatthey're planning a wedding or
whatever.
And it's when you tell someone,especially when you tell
someone very vague details likethis is our date or this is the
venue, or anything that, likeyou know, leads someone to
believe that you're planning awedding, and it's when that
(02:04):
person just like immediatelygoes right into being like don't
, don't like care what anyonethinks about anything or what
anyone says, don't listen towhat anyone says, it's your day
and like, like, don't listen toanyone's opinions, it doesn't
matter what anyone says orthinks, and I'm like okay, I
like didn't tell you anything.
(02:24):
Crazy, this is a stranger thisis like a practical stranger
saying this um, I mean, it waslike someone I work with, oh
okay but yeah and like notsomeone who's like coming to the
wedding yeah but I just alwaysthink that it's so strange, like
right, it's not like.
I told a good friend, hey, we'rehaving fire breathing dragons
(02:47):
at cocktail hour yeah and thatfriend is like, it's okay, like
you do you girl, it doesn'tmatter, it's your day, like, do
whatever it was like so out ofcontext well, yeah, I feel like
that's always how it is whensomeone just kind of goes right
into like that, that whole likenarrative, and it's not even so
much a target on the person whois saying that, who I guess has
(03:10):
like nothing else better to sayto you, but it's more just like
as a society, like how did weget here and are we OK?
And I know, we know that theanswer is already no.
No, we are very much unwell asa society that the answer is
already no.
No, we are very much unwell asa society.
(03:30):
But like, why?
I mean, I've been to a lot ofweddings and we've talked about,
you know, things that we likeabout certain weddings or maybe
don't like, but any sort of likenegative thought.
I've never gone to the personto tell them that Do you know
what I mean?
Like I've never gone up tosomeone to be like, hey, your
cocktail hour sucked.
(03:51):
I'm going to have a better oneat my wedding.
You go to the wedding.
Ed Delesky, MD (03:55):
Yeah.
Nicole Aruffo, RN (03:56):
You bring a gift, you drink, you eat, you
dance, you shut up and you leave.
Ed Delesky, MD (04:01):
Sure.
Nicole Aruffo, RN (04:01):
You know like what?
Who is telling?
Ed Delesky, MD (04:08):
or like saying like negative, bad things with
were these people, so it'salmost sounds like I might be
understanding this in twodifferent ways.
This person was saying likedon't listen to the haters when
they talk about your wedding, orI guess, or in several layers
of decision making.
Make sure you're focusing onyour decisions and what's
important to you in the process.
Which is it closer to?
(04:29):
Which of the two?
Nicole Aruffo, RN (04:30):
I don't know.
It's like the same generalgeneral tune that I've heard
before, and then I'm like nowhearing about myself and my
wedding.
Ed Delesky, MD (04:39):
No, I've only heard it.
So you ask the question hasthis happened to me?
So you asked the question hasthis happened to me?
It's happened to me, but like,and someone like very close in
my life who's like suggested tolike reframe that message and
just make sure that, like beingsomeone who thinks a lot about
other people all the time, tolike really focus on centering
like what we want on that day.
(04:59):
There's like two differentthings here.
Like someone who, like comes atyou is like oh yeah, the whole
wedding planning thing is sonegative, also, not for nothing.
Like we're pretty efficient atit.
Nicole Aruffo, RN (05:09):
We are efficient and like there's.
Only there are two groups ofpeople who should have opinions
about it.
Ed Delesky, MD (05:17):
The one is the couple getting married and then,
if there's a second group, whoare paying for any part of the
wedding, sure then like yeah,fine, it's your money, you get
an opinion, oh yeah well, Ithink you know, in terms of
wedding planning and if we'relike that's something that's
going on in someone's life, itis the easiest low-hanging fruit
(05:39):
for small talk possible, butthey chose like a negative
connotation on it yeah, which,going back to my point, like why
are we, as a like, do you knowwhat I'm saying?
Nicole Aruffo, RN (05:52):
I guess like, why is it automatically like
someone who you have kind oflike a peripheral relationship
with someone tells you they'replanning a wedding and you're
immediately like don't listen towhat anyone says, like as if
everyone's already likegossiping or like talking badly
(06:12):
about it?
Ed Delesky, MD (06:12):
it's just so weird.
They're projecting, they'retalking about their own lived
experience and trying to conveythat why?
Nicole Aruffo, RN (06:18):
is it?
Does it seem like everyone'slived experience is so awful?
Well, honestly, it's been fineyeah, no, it's been.
Ed Delesky, MD (06:24):
It's.
It has been fine.
I think we've been workingreally well together on this
thing.
We work well under pressure.
Clearly also, the internet'smade it so much easier to
accomplish tasks than like everbefore, like meeting with people
.
Like you can meet, with plan tomeet four different people on
one day, but like no, when I goto work and I'm like in the back
(06:46):
and I'm like ask next timeyou're in clinic.
Nicole Aruffo, RN (06:51):
I guess that's when you're mostly with
everyone yeah because I, likeeveryone in your class, is like
engaged or like getting marriedrecently asked them if they
think it's weird but I feel likepeople always do that or even
if it's like someone close toyou who like whatever it's like
they're so excited for you, andthen it's like, oh, don't, don't
listen to what anyone says,like what?
Ed Delesky, MD (07:13):
well, I think it's a hard thing.
I wasn't just because likethat's.
No, I am, as a person, right.
You're much better at that than, like certainly me and probably
a lot of people.
Where it's tough, that's atough thing to do, and what is
to like take that advice andlike only listen to what you
(07:33):
want and what oh yeah, I thinkit's because I keep getting
served this content of like.
Nicole Aruffo, RN (07:41):
I keep getting served this content of
like what some might call anattitude problem of a girl who
is the firstborn child, onlydaughter and only granddaughter,
and that's me.
God, help my parents and you.
But like I don't know, maybe Ijust don't care about anyone's
(08:06):
opinion and that's just becausebirth order so it's first born,
only daughter, onlygranddaughter.
Ed Delesky, MD (08:14):
Yeah, okay, I'm even like looking through this
and I'm like I would say myexperience at work has been like
neutral, positive platitudes.
I mean I think a lot of peoplelike had been asking and were
celebrating that there was aplan, and I also like I don't
know, I keep to myself a decentamount.
So people were like I did askone question.
(08:34):
I was like how do you determinefrom one DJ to another?
And someone gave me some advice.
And then I came back the nextday and I was like, yeah, we
chose this DJ.
And they were like, what?
You picked a DJ already.
I'm like, yeah, we don't messaround around here.
Nicole Aruffo, RN (08:47):
Yeah, we got stuff done.
Ed Delesky, MD (08:48):
Work well under pressure.
That's usually why we recordthese episodes the day before
they go out.
What are we going to talk abouttoday, Nick?
Nicole Aruffo, RN (08:55):
Today we're having a seasonal episode and
we're talking about allergies.
Ed Delesky, MD (09:00):
And this is I mean near and dear to your heart
.
Nicole Aruffo, RN (09:04):
Yeah, I'm an allergic girly, very atopic
person.
Ed Delesky, MD (09:08):
Yeah, it really bothers you.
I think your primary was evenimpressed with how much it
bothers you, and I think we'rejust a hair before the season is
starting.
So perhaps with this episodeour very thoughtful, intelligent
audience will be a little moreprepared for what may come
(09:28):
coming in the rest of spring.
Nicole Aruffo, RN (09:29):
I mean, there's like really nothing you
can do, but that's not true.
Ed Delesky, MD (09:33):
We're going to arm you with several tools today
to be able to help navigateyour allergic rhinitis, and so
that's what exactly.
What we're talking about todayis allergic rhinitis, sometimes
otherwise called hay fever.
It affects literally so manypeople.
It is approximately 20% ofpeople of all ages.
Nicole Aruffo, RN (09:55):
Honestly, that feels low.
Ed Delesky, MD (09:56):
And it might feel low.
That is one in five people,people, and so, while it's
common, the quality on life Imean you as an example, and I'm
thinking of my friend Austin thequality of life impact is
substantial.
And so today we're going todiscuss what allergic rhinitis
(10:16):
is, its causes, symptoms,diagnosis, and then we are going
to dive in on the two arms oftreatment options, trigger,
avoidance and what medicationsyou can use.
So, Nikki, why don't you tellus a little bit, since this is
your coup d'etat what isallergic rhinitis?
Nicole Aruffo, RN (10:41):
So rhinitis means inflammation of the nasal
passages and there are.
You know you can have likerhinitis with a cold, um, but
allergic rhinitis, allergicrhinitis specifically, is a
nasal reaction to an allergen,which are small airborne
particles that you breathe in,and then you have a histamine
(11:06):
reaction and your face andrespiratory system kind of freak
out for a couple of weeks.
Yeah, that's for lack of abetter explanation, totally.
Ed Delesky, MD (11:17):
Sometimes those triggers can actually transmit
all the way down to the lungswhich can be a part of an asthma
exacerbation, if you will andsometimes they can also travel
to the eyes and give somethingcalled allergic conjunctivitis.
Nicole Aruffo, RN (11:33):
Oh my God, the itchy eyes are like the
worst thing ever.
Ed Delesky, MD (11:37):
Tell us more.
Nicole Aruffo, RN (11:39):
Tell you more .
Yeah, I mean.
It feels like you want toscratch your eyeballs out of
your head.
Ed Delesky, MD (11:44):
How do you, how do you even get by?
Nicole Aruffo, RN (11:47):
Well, you itch your eyes and then it makes
it worse and then you're likeall right, let's grow up, Stop
touching my eyes.
I mean, they're like eye dropsand stuff.
They don't work.
Ed Delesky, MD (11:58):
Great.
So there are triggers, like youwere mentioning.
There are allergens and they'rebroken up into four major
categories for allergic rhinitis.
There are pollens, insects,animal allergens and molds.
Pollens are really broken downinto different categories that
(12:19):
are more common in the springand summer and they're things
like from trees and grass fall,maybe ragweed, tumbleweed.
Insects.
There are house dust mites,which we're going to break down
what those are, how you can goahead and try to mitigate any
response that your body has tothem.
Cockroaches and ladybugs,specifically asian ladybugs also
(12:44):
.
There are animal allergensallergens a little proteins from
their skin, fur feathers can doit saliva of cats and dogs,
rodents, birds and ferrets, andthen topping it off, like we
mentioned earlier, with moldswhich can be really tricky to
actually treat.
I had someone ask me about thisin clinic, but oftentimes we
(13:06):
think about these as seasonal,which are most often pollen
related and perennial, or yearround, which most often caused
by dust mites, the animal dander, cockroaches and molds, and so
the timing can help identify thetriggers more specifically, and
I mean truthfully.
It's like so much easier to beable to say like yeah, it
(13:27):
happens in the spring every year, I have no problems in the
winter and boom, this isseasonal, this is probably from
pollen, but if it's someonewho's like, oh, I have this
runny nose, I have all thesesymptoms that we're going to
talk about next, but it'shappening all year round.
That makes the conversation alittle bit trickier, and so,
based on what we've had writtenhere in our research, but also
(13:49):
personal experience, what sortof symptoms are we talking about
?
Nicole Aruffo, RN (13:54):
okay, we have lots of symptoms.
We got the nose, the itchy nose, watery, runny nose, sneezing,
block nasal passages, a lot oflike like sinus pressure and
like your face, like your faceand like not your head so much,
(14:16):
yeah, like your face is likepounding yeah because they're
just like, feels like it'sthere's just junk in your face.
You know, you don't know Idon't um.
So you have your nose, youreyes itchy, red, gritty, feeling
eyes.
It's like your eyelids are likemade of sandpaper kind of oh my
god um throat and ears um.
(14:38):
Sore throat, hoarse voice,congestion, itchy throat, itchy
ears, ears popping um.
This can also all affect yoursleep, because your nose and
your like face are kind of justclogged up with mucus and then
that can like affect your sleepif you're like snoring or kind
of like can't get comfortable.
(14:58):
Oh my God.
Laying down to sleep.
Ed Delesky, MD (15:03):
And that post nasal drip.
Did you already describe that,did I?
Do you get that a lot?
You get this like goopysensation down the back of your
throat.
I feel like sometimes that canalso lead to some throat
irritation itself, do you?
Nicole Aruffo, RN (15:18):
get that a lot.
You get this like goopysensation down the back of your
throat.
I feel like sometimes that canalso lead to some throat
irritation itself.
Yeah.
And then I've noticed too, likewith kids, but like more
specifically, if like they haveit, or even if they just have
kind of like a dry, itchy throat, like they'll have a cough.
Mm, hmm of like a dry, itchythroat, like they'll have a
cough, and then, like I've heardparents say before and be like,
(15:38):
oh, like so and so has thiscough, and like they're not sick
.
And I've like taken them to thedoctor and like they're not
sick, I don't know what it is,and I'm like, okay, well, like
it's april right probablyallergies yeah, probably some
rhinitis in there yeah thatreally.
That's like one of the big rightand, like you know, like a four
year old can't describe whatpost nasal drip is.
They're just like have thiscough.
(15:59):
Oh my gosh.
Ed Delesky, MD (16:01):
Yeah, no, and I had this at one point in my life
.
I still, like, sometimes get it, so I can align with you in
this, but, very sincerely, donot get allergies nearly as
badly as you or ever.
And so this leaves us with,like you feel all of these
things.
How do you capture thisdiagnosis and when do you seek
help?
I mean, usually it's just aninterview.
(16:22):
It's an interview, it's aphysical exam, like a lot of
other things, but a part of thatconversation that you can come
armed with to your doctor isalready reflecting on the
allergens that you couldpossibly be experiencing.
So, keeping an eye out forthese things that are bothering
you might be able to help you,because I mean, truthfully, if
(16:44):
I'm talking to someone, lettingthem tell me what bothers them
is the answer, because now,after this, we're going to talk
about avoiding triggers some ofthe most common ones but if you
can't find what it is, you mightfind yourself getting skin
testing with a dermatologist oran allergist, or you might find
yourself getting blood tests,which will look at a whole bunch
(17:06):
of different things, butoftentimes those can be
cost-intensive, where maybeinsurance won't cover it as you
hoped, and so you might bepaying a lot of money for these
tests when, in truth, youmight've been able to just
reflect on what's in yourenvironment that's giving you
all these symptoms.
So once someone's triggers havebeen identified, the next step
(17:28):
for allergic rhinitis is I mean,truthfully, this is not rocket
science, but it is to reduceexposure.
But this is actually where itmight get a little bit more
complicated, like, how do youactually accomplish that?
So in the next portion of ourepisode we're going to talk
about that.
Triggers can be present at work.
They can be present at home,but most people spend most of
their time at home, and sorecognizing that we look at what
(17:53):
areas in the home can bebothersome.
So the bedroom is veryimportant because people spend a
significant amount of time inthere.
You think, like when you'resleeping, you're spending a ton
of time sleeping in your day Imean, some estimates would say a
third of your day sleeping andso it really is important to be
(18:14):
able to recognize what theseallergens are and how to change
your home to be able to do that.
Nicole Aruffo, RN (18:20):
All right, let's talk about dust mites
first.
How are we trying to avoid that?
Ed Delesky, MD (18:26):
Yeah, so dust mites are microscopic insects
you literally only see themunder a microscope and they live
in bedding, sofas, carpets,other woven materials, and they
eat organic matter like humanshed and animal skin, and they
absorb humidity, and that is howthey get along and live.
(18:48):
And so to protect yourself fromthese, we use a couple
different things.
One of them is barrierprotection, and this wouldn't be
like encased pillows,mattresses or encasing
mattresses or box springs,comforters, with mite
impermeable barriers.
(19:08):
So this is something you caneven look at if you're
purchasing something, is itimpermeable to mites?
For a children's bed, youreally should only be using a
tight-fitting commercial coverintended for this specific
purpose.
You should not be usinghomemade plastic sheeting,
because that might hurt yourchild and suffocate them, but
(19:30):
tightly woven fabrics with apore size of six microns or less
actually are effective.
And then anything two and abovestill lets air through.
Two microns and above stilllets air through, so it's still
breathable, in a way.
Another thing is washing yourbedding.
The suggestion here is to washyour sheets and blankets weekly
(19:55):
in warm water with detergent anddry them in an electric dryer
on the hot setting.
When you vacuum and you'redusting, it's important to think
about using a high-efficiencyparticulate air filter or a HEPA
filter.
Now, I don't think it's slamdunk in the literature that
these are like foolproof athelping, but it might help, and
(20:17):
so it's something to consider.
And make sure you're dustingregularly and really try to
minimize soft furnishings.
Reducing clutter and keepingother furniture where people
spend most of their time cleanwill be really helpful.
Honestly, sometimes you have tominimize even stuffed toys in
children's bedrooms and one ofthe most common things that
(20:40):
you'll see throughout all of ourthoughts here are that humidity
control is, and remains, veryimportant.
Thoughts here are that humiditycontrol is, and remains, very
important.
So dehumidifiers may be helpful, keeping the humidity in the
air less than 50%, buthumidifiers themselves may
worsen the problem, because dustmites don't like dry air.
And then, lastly, avoidsleeping on upholstered
(21:03):
furniture.
Don't sleep on the couch thebest you can.
So that was dust mites.
Nikki, can you take us througha little bit more about our
beloved pets, animal dander andanimal allergens?
Nicole Aruffo, RN (21:15):
I can Um.
So animal dander is the deadskin that is shed off of animals
.
Any breed of a dog or cat hasthis, and you can be allergic to
.
Cats are, or.
The primary allergen in cats isactually found in their saliva
(21:36):
skin glands, and in cats it'snot really like their fur.
A lot of it is their salivaskin glands, urinary tracts,
meaning that those creepy,skinless cats are not
necessarily like an anti-allergysituation.
Um, and then they're that weneither and then there are also
(22:01):
like rodents, birds, ferrets,but we're gonna talk about our
pets.
Yeah, um, this is probably oneof my top five fears in life
that we have a child that'sallergic to ollie oh my god
because we'll have to get rid ofthe kid.
Where's the closest orphanage?
Because that's where you'regoing, sorry.
Ed Delesky, MD (22:26):
That was funny.
I like that.
Nicole Aruffo, RN (22:30):
No, but really though.
Ed Delesky, MD (22:31):
Oh no, I hear you yeah.
Nicole Aruffo, RN (22:32):
And this happened to a girl I used to
work with Her daughter.
Her daughter has like severeallergies to like a lot of
things.
Ed Delesky, MD (22:38):
Yeah.
Nicole Aruffo, RN (22:39):
And when was their dog?
And they had to.
Well then, like another nurse Iused to work with who, like she
was close with, took the dogand he's like living his best
life.
So it was a good, like itturned out good, but like that's
still so sad that's so sad, youand your atopicness.
Ed Delesky, MD (22:55):
I really hope that this doesn't get passed on.
Nicole Aruffo, RN (23:00):
It is very does run in families, though, so
I know well, I got all mydermatological issues from our
one and only Mary, so thanks forthat.
Appreciate it.
Um, so unfortunately, the mosteffective option if the allergen
(23:20):
is your pet is removing the petfrom the home, and that really
sucks.
Removing the pet from the home,and that really sucks, and yeah
, that's all I have to say aboutthat.
Um, but maybe you'll have likea really nice friend or I feel
like, when I hear about thishappening, someone has like a
really close, like family member, like family friend that takes
(23:41):
the dog or the cat and all aswell yeah, maybe, like Karthik,
would take the kid.
Yeah, karthik, I think would bea great dad and I think Pri
would be a great mom.
Ed Delesky, MD (23:50):
So, like I feel fine about it.
Yeah, so what can happen ispost removal cleaning, Like once
you do suggest that the animalmight move to a different home.
This, like I don't, this justnow, like with I just couldn't
even imagine now we're sad yeah,now I'm sad, um, but just to
say it out loud, it can takemonths for the allergen levels
(24:11):
of the animal to drop from thehouse, and so, like it may take
that long for symptoms toimprove.
Nicole Aruffo, RN (24:17):
I mean it can take that long, for like I feel
like allergens are kind of justlike, whether it's like an
animal or pollen or whatever,like it's kind of like glitter
and it like gets everywhere andlike doesn't fully go away very
quickly.
Ed Delesky, MD (24:29):
That's an awesome analogy, and so if
removal isn't possible, which wewould recognize that it's like
probably not possible in a lotof situations.
Nicole Aruffo, RN (24:39):
It's okay, normalize getting rid of your
kid, yeah.
Ed Delesky, MD (24:42):
Maybe you could use a HEPA filter once again.
Increase the frequency ofcleaning, wash your pet
regularly this seems kind ofbogus, but it's a thought is to
confine the pet to rooms wherethe allergic individual spends
the least amount of time.
I don't know, I can't see thathappening with our buddy here,
(25:04):
but there's that, and thenthere's no like effectiveness to
this.
That is possible, but you mightthink about using air filters
as well.
Tough situation.
Really don't want to spend muchmore time talking about it
because I'm getting more sad aswe spend time on this segment
yeah, we have to go cuddle ollieshall we move on?
Nicole Aruffo, RN (25:21):
I know actually we shouldn't be sad
because we're not getting rid ofollie exactly.
Ed Delesky, MD (25:26):
So I'll take this next one, because I just
will.
The next section is aboutinsects, which is a recognizable
thing that unfortunately peoplehave to deal with in certain
environments.
We're talking about cockroaches, Asian ladybugs and other
rodents.
So, for cockroachesspecifically, their droppings
contain their allergens.
So for cockroaches,specifically, their droppings
(25:47):
contain their allergens, andcontrol involves multiple baited
traps or poisons.
Really getting rid of garbageand food waste as soon as
possible, washing dishes andutensils immediately, quickly
removing cockroach debris whenyou find it.
Eliminating standing water canbe helpful, keeping the humidity
(26:09):
low very common themethroughout this episode and you
really probably need to call aprofessional for infestations.
Nicole Aruffo, RN (26:14):
Yeah, I mean cockroaches are.
They're also big with theasthma girlies.
Ed Delesky, MD (26:20):
Absolutely, and we'll do one of those episodes.
Nicole Aruffo, RN (26:23):
And boys, you know.
Ed Delesky, MD (26:24):
Yeah, as my girlies and boys.
Asian ladybugs can be aseasonal allergen that can
affect people with like indoorrespiratory symptoms actually,
and so treating the exterior ofthe house with some chemicals
before the cold weather arrivescan prevent swarming inside.
And then there are rodents.
(26:44):
There are mice and rats it'sthe protein in their urine that
are actually allergenic, and socontrol here involves some sort
of combination of pest controlmethods and pesticides.
Keeping food and trash incovered containers and cleaning
food scraps and sealing cracksin walls, doors and floors can
(27:06):
be helpful.
So those are insects and othersort of vermin.
What about molds, nick?
So then there's mold.
Mold spores thrive in dampenvironments.
Reducing humidity can be, onceagain, very helpful here.
Truthfully, you need to removethe mold source, and so whatever
(27:29):
it is that's moldy, get rid ofit.
You have to clean moldysurfaces.
You have to regularly disinfectindoor garbage pails, clean
surfaces with a visible mold,like tiles and sinks, every four
weeks with dilute bleachsolution and what that basically
looks like is one ounce ofbleach in a quart of water and
(27:50):
then address any moisture issuesif you have a like leaky
plumbing, correct drainageissues and removing bathroom
carpeting exposed to steam allvery common things that you can
reflect on in your house, ifthis is something that's going
on I thought bleach didn't getrid of mold.
I thought it like actually madeit worse I feel like I remember
(28:14):
learning that in like chemistryor something really I mean yeah,
I mean, uh, you know, inaddition to our research here, a
little on the go, is that likeit might be helpful on hard,
non-porous surfaces, but itmight not be a routine solution
for things like drywall and wood.
So maybe we'll take some, takesome thoughts there.
(28:37):
Reach out to us in our fan mailif you know anything more about
getting rid of mold or maybethere's a mold company out there
listening and you want tosponsor us so we can stop
working, please?
Nicole Aruffo, RN (28:48):
Just kidding.
Ed Delesky, MD (28:50):
But what about your love, pollen and outdoor
allergens?
What?
Nicole Aruffo, RN (28:56):
can you do Stay inside and don't leave for
like two months.
Ed Delesky, MD (29:02):
Yeah, that's basically it.
Stay indoors when possible,especially during peak symptom
times.
Nicole Aruffo, RN (29:08):
Air conditioners can help yeah, much
to eddie's chagrin, we do notopen the windows in the spring
and we do turn on our airconditioning early, and that
sucks for you and you just haveto live with it.
Ed Delesky, MD (29:20):
He doesn't like when the pico bill's high, but
he doesn't like when I'mmiserable more so you gotta take
your, take your lumps herepicking shoes, um, you know, if
people are doing outdoormaintenance, you might consider
wearing a mask, um, doing likegrass cutting.
Nicole Aruffo, RN (29:37):
Or if you shower before going to bed to
remove allergens from your hairand skin you should showering
before bed and like washing yourhair more often helps which I
know sucks to wash your hairevery day.
Or at least like rinse it outif you can.
And your pillowcases honestly,everything always goes back to
(29:58):
your pillowcases, because Ithink I said this in the acne
episode.
Also buy a pack of pillowcaseson Amazon and honestly switch
them out every day.
Ed Delesky, MD (30:08):
Wow.
Nicole Aruffo, RN (30:09):
I feel like it's not realistic to like do a
load of laundry for like apillowcase but I switched them
out because whatever is like onyour skin or on your, in your
hair, if you like didn't washyour hair that night.
You're now laying on it andyour face is all in it all night
long, and now it's on yourpillowcase and it stays on your
pillowcase and then you go tobed the next day.
(30:31):
Maybe you did just take ashower and wash your hair, but
now there's all this pollenbecause, like, like I said, it's
like glitter, right, it'severywhere and it never all goes
away and it's just always there.
So now you're laying on thispillowcase that, like, has
pollen on it, and then you wakeup and feel like crap because
you've been sleeping in pollenfor eight hours.
(30:54):
Ollie agrees too.
Yeah, also, having a dogdoesn't help if you're allergic
to pollen, because, like they'reoutside and then they have
pollen and then they bring it inyour house and they get glitter
everywhere and that's how thatworks.
But yeah, pillowcases is a bigthing and I think you'll
actually see a difference.
Ed Delesky, MD (31:11):
That's awesome.
Thank you for that.
Oh, you're welcome, andsomething that we realized when
we were recording this episodeis that there is a lot of
content about allergic rhinitisand how to take care of it at
home, and so we're going to takea pause here, as we talked
about trigger avoidance, andthen invite you back next week
to continue the conversationabout a really in-depth
(31:33):
conversation about how we usemedications to help manage
allergic rhinitis.
So see you, then, and, moreover, we want to thank you for
coming back to another episodeof your Checkup.
Hopefully you were able tolearn something for yourself, a
loved one or an allergicneighbor.
Please check out our website,find us on Instagram, send us an
(31:54):
email yourcheckuppod atgmailcom and, most importantly,
stay healthy, my friends, untilnext time.
I'm Ed Dolesky.
I'm Nicole Ruffo.
Thank you and goodbye Bye.
This information may provide abrief overview of diagnosis,
treatment and medications.
It's not exhaustive and is atool to help you understand
potential options about yourhealth.
It doesn't cover all detailsabout conditions, treatments or
(32:15):
medications for a specificperson.
This is not medical advice oran attempt to substitute medical
advice.
You should contact a healthcareprovider for personalized
guidance based on your uniquecircumstances.
We explicitly disclaim anyliability relating to the
information given or its use.
This content doesn't endorseany treatments or medications
for a specific patient.
Always talk to your healthcareprovider for complete
(32:37):
information tailored to you.
In short, I'm not your doctor,I am not your nurse, and make
sure you go get your own checkupwith your own personal doctor.
Welcome to your checkup.
We are the patient educationpodcast, where we bring
conversations from the doctor'soffice to your ears.
On this podcast, we try tobring medicine closer to its
patients.
I'm Ed Delesky, a familymedicine resident in the
Philadelphia area.
Nicole Aruffo, RN (00:14):
And I'm Nicola Aruffo.
I'm a nurse.
Ed Delesky, MD (00:16):
And we are so excited you were able to join us
here again today.
So you all right.
I've been waiting several daysnow because usually I'm the one
who has the list of things totalk about.
But I mean, you told me daysago you're like oh, I'm so
excited for this thing that Ihave to talk about in our little
pre-show run.
Nicole Aruffo, RN (00:36):
Yeah, so it's the I want to talk about.
I haven't talked about thiswith you because I want to know
if this one has happened to youyet.
And two, if you like, think thesame way that I do, okay, and
I'm a little nervous right now.
So we recently found ourselveswith a wedding date.
We're planning things, blah,blah, blah, blah, blah, whatever
(00:58):
.
So what I'm about to say, Inoticed it kind of, you know, in
the past just kind of generallysurrounding conversations of,
like other friends or familygetting married, planning a
wedding, and then during thosetimes I always kind of thought
it was a little bit of a weirdthing to say to someone, maybe
(01:22):
if someone put like annoyingwith a splash of like uncalled
for or rude like into one word,it might be that okay and then
it happened to me at work theother day oh
and I can confirm.
It is a strange thing to say tosomeone who just told you like
(01:43):
their wedding date or like thatthey're planning a wedding or
whatever.
And it's when you tell someone,especially when you tell
someone very vague details likethis is our date or this is the
venue, or anything that, likeyou know, leads someone to
believe that you're planning awedding, and it's when that
(02:04):
person just like immediatelygoes right into being like don't
, don't like care what anyonethinks about anything or what
anyone says, don't listen towhat anyone says, it's your day
and like, like, don't listen toanyone's opinions, it doesn't
matter what anyone says orthinks, and I'm like okay, I
like didn't tell you anything.
(02:24):
Crazy, this is a stranger thisis like a practical stranger
saying this um, I mean, it waslike someone I work with, oh
okay but yeah and like notsomeone who's like coming to the
wedding yeah but I just alwaysthink that it's so strange, like
right, it's not like.
I told a good friend, hey, we'rehaving fire breathing dragons
(02:47):
at cocktail hour yeah and thatfriend is like, it's okay, like
you do you girl, it doesn'tmatter, it's your day, like, do
whatever it was like so out ofcontext well, yeah, I feel like
that's always how it is whensomeone just kind of goes right
into like that, that whole likenarrative, and it's not even so
much a target on the person whois saying that, who I guess has
(03:10):
like nothing else better to sayto you, but it's more just like
as a society, like how did weget here and are we OK?
And I know, we know that theanswer is already no.
No, we are very much unwell asa society that the answer is
already no.
No, we are very much unwell asa society.
(03:30):
But like, why?
I mean, I've been to a lot ofweddings and we've talked about,
you know, things that we likeabout certain weddings or maybe
don't like, but any sort of likenegative thought.
I've never gone to the personto tell them that Do you know
what I mean?
Like I've never gone up tosomeone to be like, hey, your
cocktail hour sucked.
(03:51):
I'm going to have a better oneat my wedding.
You go to the wedding.
Ed Delesky, MD (03:55):
Yeah.
Nicole Aruffo, RN (03:56):
You bring a gift, you drink, you eat, you
dance, you shut up and you leave.
Ed Delesky, MD (04:01):
Sure.
Nicole Aruffo, RN (04:01):
You know like what?
Who is telling?
Ed Delesky, MD (04:08):
or like saying like negative, bad things with
were these people, so it'salmost sounds like I might be
understanding this in twodifferent ways.
This person was saying likedon't listen to the haters when
they talk about your wedding, orI guess, or in several layers
of decision making.
Make sure you're focusing onyour decisions and what's
important to you in the process.
Which is it closer to?
(04:29):
Which of the two?
Nicole Aruffo, RN (04:30):
I don't know.
It's like the same generalgeneral tune that I've heard
before, and then I'm like nowhearing about myself and my
wedding.
Ed Delesky, MD (04:39):
No, I've only heard it.
So you ask the question hasthis happened to me?
So you asked the question hasthis happened to me?
It's happened to me, but like,and someone like very close in
my life who's like suggested tolike reframe that message and
just make sure that, like beingsomeone who thinks a lot about
other people all the time, tolike really focus on centering
like what we want on that day.
(04:59):
There's like two differentthings here.
Like someone who, like comes atyou is like oh yeah, the whole
wedding planning thing is sonegative, also, not for nothing.
Like we're pretty efficient atit.
Nicole Aruffo, RN (05:09):
We are efficient and like there's.
Only there are two groups ofpeople who should have opinions
about it.
Ed Delesky, MD (05:17):
The one is the couple getting married and then,
if there's a second group, whoare paying for any part of the
wedding, sure then like yeah,fine, it's your money, you get
an opinion, oh yeah well, Ithink you know, in terms of
wedding planning and if we'relike that's something that's
going on in someone's life, itis the easiest low-hanging fruit
(05:39):
for small talk possible, butthey chose like a negative
connotation on it yeah, which,going back to my point, like why
are we, as a like, do you knowwhat I'm saying?
Nicole Aruffo, RN (05:52):
I guess like, why is it automatically like
someone who you have kind oflike a peripheral relationship
with someone tells you they'replanning a wedding and you're
immediately like don't listen towhat anyone says, like as if
everyone's already likegossiping or like talking badly
(06:12):
about it?
Ed Delesky, MD (06:12):
it's just so weird.
They're projecting, they'retalking about their own lived
experience and trying to conveythat why?
Nicole Aruffo, RN (06:18):
is it?
Does it seem like everyone'slived experience is so awful?
Well, honestly, it's been fineyeah, no, it's been.
Ed Delesky, MD (06:24):
It's.
It has been fine.
I think we've been workingreally well together on this
thing.
We work well under pressure.
Clearly also, the internet'smade it so much easier to
accomplish tasks than like everbefore, like meeting with people
.
Like you can meet, with plan tomeet four different people on
one day, but like no, when I goto work and I'm like in the back
(06:46):
and I'm like ask next timeyou're in clinic.
Nicole Aruffo, RN (06:51):
I guess that's when you're mostly with
everyone yeah because I, likeeveryone in your class, is like
engaged or like getting marriedrecently asked them if they
think it's weird but I feel likepeople always do that or even
if it's like someone close toyou who like whatever it's like
they're so excited for you, andthen it's like, oh, don't, don't
listen to what anyone says,like what?
Ed Delesky, MD (07:13):
well, I think it's a hard thing.
I wasn't just because likethat's.
No, I am, as a person, right.
You're much better at that than, like certainly me and probably
a lot of people.
Where it's tough, that's atough thing to do, and what is
to like take that advice andlike only listen to what you
(07:33):
want and what oh yeah, I thinkit's because I keep getting
served this content of like.
Nicole Aruffo, RN (07:41):
I keep getting served this content of
like what some might call anattitude problem of a girl who
is the firstborn child, onlydaughter and only granddaughter,
and that's me.
God, help my parents and you.
But like I don't know, maybe Ijust don't care about anyone's
(08:06):
opinion and that's just becausebirth order so it's first born,
only daughter, onlygranddaughter.
Ed Delesky, MD (08:14):
Yeah, okay, I'm even like looking through this
and I'm like I would say myexperience at work has been like
neutral, positive platitudes.
I mean I think a lot of peoplelike had been asking and were
celebrating that there was aplan, and I also like I don't
know, I keep to myself a decentamount.
So people were like I did askone question.
(08:34):
I was like how do you determinefrom one DJ to another?
And someone gave me some advice.
And then I came back the nextday and I was like, yeah, we
chose this DJ.
And they were like, what?
You picked a DJ already.
I'm like, yeah, we don't messaround around here.
Nicole Aruffo, RN (08:47):
Yeah, we got stuff done.
Ed Delesky, MD (08:48):
Work well under pressure.
That's usually why we recordthese episodes the day before
they go out.
What are we going to talk abouttoday, Nick?
Nicole Aruffo, RN (08:55):
Today we're having a seasonal episode and
we're talking about allergies.
Ed Delesky, MD (09:00):
And this is I mean near and dear to your heart
.
Nicole Aruffo, RN (09:04):
Yeah, I'm an allergic girly, very atopic
person.
Ed Delesky, MD (09:08):
Yeah, it really bothers you.
I think your primary was evenimpressed with how much it
bothers you, and I think we'rejust a hair before the season is
starting.
So perhaps with this episodeour very thoughtful, intelligent
audience will be a little moreprepared for what may come
(09:28):
coming in the rest of spring.
Nicole Aruffo, RN (09:29):
I mean, there's like really nothing you
can do, but that's not true.
Ed Delesky, MD (09:33):
We're going to arm you with several tools today
to be able to help navigateyour allergic rhinitis, and so
that's what exactly.
What we're talking about todayis allergic rhinitis, sometimes
otherwise called hay fever.
It affects literally so manypeople.
It is approximately 20% ofpeople of all ages.
Nicole Aruffo, RN (09:55):
Honestly, that feels low.
Ed Delesky, MD (09:56):
And it might feel low.
That is one in five people,people, and so, while it's
common, the quality on life Imean you as an example, and I'm
thinking of my friend Austin thequality of life impact is
substantial.
And so today we're going todiscuss what allergic rhinitis
(10:16):
is, its causes, symptoms,diagnosis, and then we are going
to dive in on the two arms oftreatment options, trigger,
avoidance and what medicationsyou can use.
So, Nikki, why don't you tellus a little bit, since this is
your coup d'etat what isallergic rhinitis?
Nicole Aruffo, RN (10:41):
So rhinitis means inflammation of the nasal
passages and there are.
You know you can have likerhinitis with a cold, um, but
allergic rhinitis, allergicrhinitis specifically, is a
nasal reaction to an allergen,which are small airborne
particles that you breathe in,and then you have a histamine
(11:06):
reaction and your face andrespiratory system kind of freak
out for a couple of weeks.
Yeah, that's for lack of abetter explanation, totally.
Ed Delesky, MD (11:17):
Sometimes those triggers can actually transmit
all the way down to the lungswhich can be a part of an asthma
exacerbation, if you will andsometimes they can also travel
to the eyes and give somethingcalled allergic conjunctivitis.
Nicole Aruffo, RN (11:33):
Oh my God, the itchy eyes are like the
worst thing ever.
Ed Delesky, MD (11:37):
Tell us more.
Nicole Aruffo, RN (11:39):
Tell you more .
Yeah, I mean.
It feels like you want toscratch your eyeballs out of
your head.
Ed Delesky, MD (11:44):
How do you, how do you even get by?
Nicole Aruffo, RN (11:47):
Well, you itch your eyes and then it makes
it worse and then you're likeall right, let's grow up, Stop
touching my eyes.
I mean, they're like eye dropsand stuff.
They don't work.
Ed Delesky, MD (11:58):
Great.
So there are triggers, like youwere mentioning.
There are allergens and they'rebroken up into four major
categories for allergic rhinitis.
There are pollens, insects,animal allergens and molds.
Pollens are really broken downinto different categories that
(12:19):
are more common in the springand summer and they're things
like from trees and grass fall,maybe ragweed, tumbleweed.
Insects.
There are house dust mites,which we're going to break down
what those are, how you can goahead and try to mitigate any
response that your body has tothem.
Cockroaches and ladybugs,specifically asian ladybugs also
(12:44):
.
There are animal allergensallergens a little proteins from
their skin, fur feathers can doit saliva of cats and dogs,
rodents, birds and ferrets, andthen topping it off, like we
mentioned earlier, with moldswhich can be really tricky to
actually treat.
I had someone ask me about thisin clinic, but oftentimes we
(13:06):
think about these as seasonal,which are most often pollen
related and perennial, or yearround, which most often caused
by dust mites, the animal dander, cockroaches and molds, and so
the timing can help identify thetriggers more specifically, and
I mean truthfully.
It's like so much easier to beable to say like yeah, it
(13:27):
happens in the spring every year, I have no problems in the
winter and boom, this isseasonal, this is probably from
pollen, but if it's someonewho's like, oh, I have this
runny nose, I have all thesesymptoms that we're going to
talk about next, but it'shappening all year round.
That makes the conversation alittle bit trickier, and so,
based on what we've had writtenhere in our research, but also
(13:49):
personal experience, what sortof symptoms are we talking about
?
Nicole Aruffo, RN (13:54):
okay, we have lots of symptoms.
We got the nose, the itchy nose, watery, runny nose, sneezing,
block nasal passages, a lot oflike like sinus pressure and
like your face, like your faceand like not your head so much,
(14:16):
yeah, like your face is likepounding yeah because they're
just like, feels like it'sthere's just junk in your face.
You know, you don't know Idon't um.
So you have your nose, youreyes itchy, red, gritty, feeling
eyes.
It's like your eyelids are likemade of sandpaper kind of oh my
god um throat and ears um.
(14:38):
Sore throat, hoarse voice,congestion, itchy throat, itchy
ears, ears popping um.
This can also all affect yoursleep, because your nose and
your like face are kind of justclogged up with mucus and then
that can like affect your sleepif you're like snoring or kind
of like can't get comfortable.
(14:58):
Oh my God.
Laying down to sleep.
Ed Delesky, MD (15:03):
And that post nasal drip.
Did you already describe that,did I?
Do you get that a lot?
You get this like goopysensation down the back of your
throat.
I feel like sometimes that canalso lead to some throat
irritation itself, do you?
Nicole Aruffo, RN (15:18):
get that a lot.
You get this like goopysensation down the back of your
throat.
I feel like sometimes that canalso lead to some throat
irritation itself.
Yeah.
And then I've noticed too, likewith kids, but like more
specifically, if like they haveit, or even if they just have
kind of like a dry, itchy throat, like they'll have a cough.
Mm, hmm of like a dry, itchythroat, like they'll have a
cough, and then, like I've heardparents say before and be like,
(15:38):
oh, like so and so has thiscough, and like they're not sick
.
And I've like taken them to thedoctor and like they're not
sick, I don't know what it is,and I'm like, okay, well, like
it's april right probablyallergies yeah, probably some
rhinitis in there yeah thatreally.
That's like one of the big rightand, like you know, like a four
year old can't describe whatpost nasal drip is.
They're just like have thiscough.
(15:59):
Oh my gosh.
Ed Delesky, MD (16:01):
Yeah, no, and I had this at one point in my life
.
I still, like, sometimes get it, so I can align with you in
this, but, very sincerely, donot get allergies nearly as
badly as you or ever.
And so this leaves us with,like you feel all of these
things.
How do you capture thisdiagnosis and when do you seek
help?
I mean, usually it's just aninterview.
(16:22):
It's an interview, it's aphysical exam, like a lot of
other things, but a part of thatconversation that you can come
armed with to your doctor isalready reflecting on the
allergens that you couldpossibly be experiencing.
So, keeping an eye out forthese things that are bothering
you might be able to help you,because I mean, truthfully, if
(16:44):
I'm talking to someone, lettingthem tell me what bothers them
is the answer, because now,after this, we're going to talk
about avoiding triggers some ofthe most common ones but if you
can't find what it is, you mightfind yourself getting skin
testing with a dermatologist oran allergist, or you might find
yourself getting blood tests,which will look at a whole bunch
(17:06):
of different things, butoftentimes those can be
cost-intensive, where maybeinsurance won't cover it as you
hoped, and so you might bepaying a lot of money for these
tests when, in truth, youmight've been able to just
reflect on what's in yourenvironment that's giving you
all these symptoms.
So once someone's triggers havebeen identified, the next step
(17:28):
for allergic rhinitis is I mean,truthfully, this is not rocket
science, but it is to reduceexposure.
But this is actually where itmight get a little bit more
complicated, like, how do youactually accomplish that?
So in the next portion of ourepisode we're going to talk
about that.
Triggers can be present at work.
They can be present at home,but most people spend most of
their time at home, and sorecognizing that we look at what
(17:53):
areas in the home can bebothersome.
So the bedroom is veryimportant because people spend a
significant amount of time inthere.
You think, like when you'resleeping, you're spending a ton
of time sleeping in your day Imean, some estimates would say a
third of your day sleeping andso it really is important to be
(18:14):
able to recognize what theseallergens are and how to change
your home to be able to do that.
Nicole Aruffo, RN (18:20):
All right, let's talk about dust mites
first.
How are we trying to avoid that?
Ed Delesky, MD (18:26):
Yeah, so dust mites are microscopic insects
you literally only see themunder a microscope and they live
in bedding, sofas, carpets,other woven materials, and they
eat organic matter like humanshed and animal skin, and they
absorb humidity, and that is howthey get along and live.
(18:48):
And so to protect yourself fromthese, we use a couple
different things.
One of them is barrierprotection, and this wouldn't be
like encased pillows,mattresses or encasing
mattresses or box springs,comforters, with mite
impermeable barriers.
(19:08):
So this is something you caneven look at if you're
purchasing something, is itimpermeable to mites?
For a children's bed, youreally should only be using a
tight-fitting commercial coverintended for this specific
purpose.
You should not be usinghomemade plastic sheeting,
because that might hurt yourchild and suffocate them, but
(19:30):
tightly woven fabrics with apore size of six microns or less
actually are effective.
And then anything two and abovestill lets air through.
Two microns and above stilllets air through, so it's still
breathable, in a way.
Another thing is washing yourbedding.
The suggestion here is to washyour sheets and blankets weekly
(19:55):
in warm water with detergent anddry them in an electric dryer
on the hot setting.
When you vacuum and you'redusting, it's important to think
about using a high-efficiencyparticulate air filter or a HEPA
filter.
Now, I don't think it's slamdunk in the literature that
these are like foolproof athelping, but it might help, and
(20:17):
so it's something to consider.
And make sure you're dustingregularly and really try to
minimize soft furnishings.
Reducing clutter and keepingother furniture where people
spend most of their time cleanwill be really helpful.
Honestly, sometimes you have tominimize even stuffed toys in
children's bedrooms and one ofthe most common things that
(20:40):
you'll see throughout all of ourthoughts here are that humidity
control is, and remains, veryimportant.
Thoughts here are that humiditycontrol is, and remains, very
important.
So dehumidifiers may be helpful, keeping the humidity in the
air less than 50%, buthumidifiers themselves may
worsen the problem, because dustmites don't like dry air.
And then, lastly, avoidsleeping on upholstered
(21:03):
furniture.
Don't sleep on the couch thebest you can.
So that was dust mites.
Nikki, can you take us througha little bit more about our
beloved pets, animal dander andanimal allergens?
Nicole Aruffo, RN (21:15):
I can Um.
So animal dander is the deadskin that is shed off of animals
.
Any breed of a dog or cat hasthis, and you can be allergic to
.
Cats are, or.
The primary allergen in cats isactually found in their saliva
(21:36):
skin glands, and in cats it'snot really like their fur.
A lot of it is their salivaskin glands, urinary tracts,
meaning that those creepy,skinless cats are not
necessarily like an anti-allergysituation.
Um, and then they're that weneither and then there are also
(22:01):
like rodents, birds, ferrets,but we're gonna talk about our
pets.
Yeah, um, this is probably oneof my top five fears in life
that we have a child that'sallergic to ollie oh my god
because we'll have to get rid ofthe kid.
Where's the closest orphanage?
Because that's where you'regoing, sorry.
Ed Delesky, MD (22:26):
That was funny.
I like that.
Nicole Aruffo, RN (22:30):
No, but really though.
Ed Delesky, MD (22:31):
Oh no, I hear you yeah.
Nicole Aruffo, RN (22:32):
And this happened to a girl I used to
work with Her daughter.
Her daughter has like severeallergies to like a lot of
things.
Ed Delesky, MD (22:38):
Yeah.
Nicole Aruffo, RN (22:39):
And when was their dog?
And they had to.
Well then, like another nurse Iused to work with who, like she
was close with, took the dogand he's like living his best
life.
So it was a good, like itturned out good, but like that's
still so sad that's so sad, youand your atopicness.
Ed Delesky, MD (22:55):
I really hope that this doesn't get passed on.
Nicole Aruffo, RN (23:00):
It is very does run in families, though, so
I know well, I got all mydermatological issues from our
one and only Mary, so thanks forthat.
Appreciate it.
Um, so unfortunately, the mosteffective option if the allergen
(23:20):
is your pet is removing the petfrom the home, and that really
sucks.
Removing the pet from the home,and that really sucks, and yeah
, that's all I have to say aboutthat.
Um, but maybe you'll have likea really nice friend or I feel
like, when I hear about thishappening, someone has like a
really close, like family member, like family friend that takes
(23:41):
the dog or the cat and all aswell yeah, maybe, like Karthik,
would take the kid.
Yeah, karthik, I think would bea great dad and I think Pri
would be a great mom.
Ed Delesky, MD (23:50):
So, like I feel fine about it.
Yeah, so what can happen ispost removal cleaning, Like once
you do suggest that the animalmight move to a different home.
This, like I don't, this justnow, like with I just couldn't
even imagine now we're sad yeah,now I'm sad, um, but just to
say it out loud, it can takemonths for the allergen levels
(24:11):
of the animal to drop from thehouse, and so, like it may take
that long for symptoms toimprove.
Nicole Aruffo, RN (24:17):
I mean it can take that long, for like I feel
like allergens are kind of justlike, whether it's like an
animal or pollen or whatever,like it's kind of like glitter
and it like gets everywhere andlike doesn't fully go away very
quickly.
Ed Delesky, MD (24:29):
That's an awesome analogy, and so if
removal isn't possible, which wewould recognize that it's like
probably not possible in a lotof situations.
Nicole Aruffo, RN (24:39):
It's okay, normalize getting rid of your
kid, yeah.
Ed Delesky, MD (24:42):
Maybe you could use a HEPA filter once again.
Increase the frequency ofcleaning, wash your pet
regularly this seems kind ofbogus, but it's a thought is to
confine the pet to rooms wherethe allergic individual spends
the least amount of time.
I don't know, I can't see thathappening with our buddy here,
(25:04):
but there's that, and thenthere's no like effectiveness to
this.
That is possible, but you mightthink about using air filters
as well.
Tough situation.
Really don't want to spend muchmore time talking about it
because I'm getting more sad aswe spend time on this segment
yeah, we have to go cuddle ollieshall we move on?
Nicole Aruffo, RN (25:21):
I know actually we shouldn't be sad
because we're not getting rid ofollie exactly.
Ed Delesky, MD (25:26):
So I'll take this next one, because I just
will.
The next section is aboutinsects, which is a recognizable
thing that unfortunately peoplehave to deal with in certain
environments.
We're talking about cockroaches, Asian ladybugs and other
rodents.
So, for cockroachesspecifically, their droppings
contain their allergens.
So for cockroaches,specifically, their droppings
(25:47):
contain their allergens, andcontrol involves multiple baited
traps or poisons.
Really getting rid of garbageand food waste as soon as
possible, washing dishes andutensils immediately, quickly
removing cockroach debris whenyou find it.
Eliminating standing water canbe helpful, keeping the humidity
(26:09):
low very common themethroughout this episode and you
really probably need to call aprofessional for infestations.
Nicole Aruffo, RN (26:14):
Yeah, I mean cockroaches are.
They're also big with theasthma girlies.
Ed Delesky, MD (26:20):
Absolutely, and we'll do one of those episodes.
Nicole Aruffo, RN (26:23):
And boys, you know.
Ed Delesky, MD (26:24):
Yeah, as my girlies and boys.
Asian ladybugs can be aseasonal allergen that can
affect people with like indoorrespiratory symptoms actually,
and so treating the exterior ofthe house with some chemicals
before the cold weather arrivescan prevent swarming inside.
And then there are rodents.
(26:44):
There are mice and rats it'sthe protein in their urine that
are actually allergenic, and socontrol here involves some sort
of combination of pest controlmethods and pesticides.
Keeping food and trash incovered containers and cleaning
food scraps and sealing cracksin walls, doors and floors can
(27:06):
be helpful.
So those are insects and othersort of vermin.
What about molds, nick?
So then there's mold.
Mold spores thrive in dampenvironments.
Reducing humidity can be, onceagain, very helpful here.
Truthfully, you need to removethe mold source, and so whatever
(27:29):
it is that's moldy, get rid ofit.
You have to clean moldysurfaces.
You have to regularly disinfectindoor garbage pails, clean
surfaces with a visible mold,like tiles and sinks, every four
weeks with dilute bleachsolution and what that basically
looks like is one ounce ofbleach in a quart of water and
(27:50):
then address any moisture issuesif you have a like leaky
plumbing, correct drainageissues and removing bathroom
carpeting exposed to steam allvery common things that you can
reflect on in your house, ifthis is something that's going
on I thought bleach didn't getrid of mold.
I thought it like actually madeit worse I feel like I remember
(28:14):
learning that in like chemistryor something really I mean yeah,
I mean, uh, you know, inaddition to our research here, a
little on the go, is that likeit might be helpful on hard,
non-porous surfaces, but itmight not be a routine solution
for things like drywall and wood.
So maybe we'll take some, takesome thoughts there.
(28:37):
Reach out to us in our fan mailif you know anything more about
getting rid of mold or maybethere's a mold company out there
listening and you want tosponsor us so we can stop
working, please?
Nicole Aruffo, RN (28:48):
Just kidding.
Ed Delesky, MD (28:50):
But what about your love, pollen and outdoor
allergens?
What?
Nicole Aruffo, RN (28:56):
can you do Stay inside and don't leave for
like two months.
Ed Delesky, MD (29:02):
Yeah, that's basically it.
Stay indoors when possible,especially during peak symptom
times.
Nicole Aruffo, RN (29:08):
Air conditioners can help yeah, much
to eddie's chagrin, we do notopen the windows in the spring
and we do turn on our airconditioning early, and that
sucks for you and you just haveto live with it.
Ed Delesky, MD (29:20):
He doesn't like when the pico bill's high, but
he doesn't like when I'mmiserable more so you gotta take
your, take your lumps herepicking shoes, um, you know, if
people are doing outdoormaintenance, you might consider
wearing a mask, um, doing likegrass cutting.
Nicole Aruffo, RN (29:37):
Or if you shower before going to bed to
remove allergens from your hairand skin you should showering
before bed and like washing yourhair more often helps which I
know sucks to wash your hairevery day.
Or at least like rinse it outif you can.
And your pillowcases honestly,everything always goes back to
(29:58):
your pillowcases, because Ithink I said this in the acne
episode.
Also buy a pack of pillowcaseson Amazon and honestly switch
them out every day.
Ed Delesky, MD (30:08):
Wow.
Nicole Aruffo, RN (30:09):
I feel like it's not realistic to like do a
load of laundry for like apillowcase but I switched them
out because whatever is like onyour skin or on your, in your
hair, if you like didn't washyour hair that night.
You're now laying on it andyour face is all in it all night
long, and now it's on yourpillowcase and it stays on your
pillowcase and then you go tobed the next day.
(30:31):
Maybe you did just take ashower and wash your hair, but
now there's all this pollenbecause, like, like I said, it's
like glitter, right, it'severywhere and it never all goes
away and it's just always there.
So now you're laying on thispillowcase that, like, has
pollen on it, and then you wakeup and feel like crap because
you've been sleeping in pollenfor eight hours.
(30:54):
Ollie agrees too.
Yeah, also, having a dogdoesn't help if you're allergic
to pollen, because, like they'reoutside and then they have
pollen and then they bring it inyour house and they get glitter
everywhere and that's how thatworks.
But yeah, pillowcases is a bigthing and I think you'll
actually see a difference.
Ed Delesky, MD (31:11):
That's awesome.
Thank you for that.
Oh, you're welcome, andsomething that we realized when
we were recording this episodeis that there is a lot of
content about allergic rhinitisand how to take care of it at
home, and so we're going to takea pause here, as we talked
about trigger avoidance, andthen invite you back next week
to continue the conversationabout a really in-depth
(31:33):
conversation about how we usemedications to help manage
allergic rhinitis.
So see you, then, and, moreover, we want to thank you for
coming back to another episodeof your Checkup.
Hopefully you were able tolearn something for yourself, a
loved one or an allergicneighbor.
Please check out our website,find us on Instagram, send us an
(31:54):
email yourcheckuppod atgmailcom and, most importantly,
stay healthy, my friends, untilnext time.
I'm Ed Dolesky.
I'm Nicole Ruffo.
Thank you and goodbye Bye.
This information may provide abrief overview of diagnosis,
treatment and medications.
It's not exhaustive and is atool to help you understand
potential options about yourhealth.
It doesn't cover all detailsabout conditions, treatments or
(32:15):
medications for a specificperson.
This is not medical advice oran attempt to substitute medical
advice.
You should contact a healthcareprovider for personalized
guidance based on your uniquecircumstances.
We explicitly disclaim anyliability relating to the
information given or its use.
This content doesn't endorseany treatments or medications
for a specific patient.
Always talk to your healthcareprovider for complete
(32:37):
information tailored to you.
In short, I'm not your doctor,I am not your nurse, and make
sure you go get your own checkupwith your own personal doctor.
Popular Podcasts
Are You A Charlotte?
In 1997, actress Kristin Davis’ life was forever changed when she took on the role of Charlotte York in Sex and the City. As we watched Carrie, Samantha, Miranda and Charlotte navigate relationships in NYC, the show helped push once unacceptable conversation topics out of the shadows and altered the narrative around women and sex. We all saw ourselves in them as they searched for fulfillment in life, sex and friendships. Now, Kristin Davis wants to connect with you, the fans, and share untold stories and all the behind the scenes. Together, with Kristin and special guests, what will begin with Sex and the City will evolve into talks about themes that are still so relevant today. "Are you a Charlotte?" is much more than just rewatching this beloved show, it brings the past and the present together as we talk with heart, humor and of course some optimism.
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com