Posts by Nurse Practitioner Jean Nelson, FNP-C:

Do I have a Cold or might it be Allergies?

Comments Off on Do I have a Cold or might it be Allergies? Written on September 27th, 2014 by
Categories: Allergies, Allergist, Allergy Advice, Allergy Articles, Allergy Shots
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The fall season is here and along with that comes a common comment heard in our office….. “I don’t know if I have a cold or allergies but I feel miserable.” The symptoms of colds and allergies often overlap and have a similar presentation. This article is going to look at some of the differences between these two very common conditions.

TIME OF YEAR: A cold is a viral infection, which is caused by one of many rhinoviruses that affect the nose. Although it is possible to “catch” a cold at any time, cold viruses are more common during the winter months. By contrast, an allergic reaction is an immune response to a harmless substance and is most prominent during the spring and fall months when pollen counts from trees, grasses, and weeds are at their highest.

SYMPTOM ONSET: One of the early differences between colds and allergies is how rapidly symptoms occur. Cold symptoms generally have a gradual onset over a period of several days. A cold may begin with a general sense of fatigue, sore throat, or runny nose and over time progresses to severe nasal congestion, headache, and perhaps even fever and body aches.  The symptoms of allergies have an abrupt onset (when exposure to the allergen occurs) with one of the first and most common symptoms being sneezing…..often multiple times in a row.

DURATION OF SYMPTOMS: Cold symptoms persist for anywhere from 5-10 days and then gradually improve.  Allergy symptoms may last for months or as long as you are exposed to the allergy trigger.  If you are symptomatic greater than 10 days, you will want to consider the possibility of your symptoms being of an allergic nature.  Remember, a person can develop allergies at ANY time in their life, so just because you don’t have a history of allergies in the past, doesn’t mean you don’t have them now!

SYMPTOMS: How many times have you been asked in a health care setting, “what color are your nasal secretions” (Interesting question huh?!) This is an important clue to determine the cause of your symptoms. Both conditions may cause a runny nose or nasal congestion but nasal secretions will be consistently clear and watery when you are experiencing allergies. A cold virus may begin with clear nasal secretions but over 3-4 days the mucous becomes yellow/green and opaque as the illness develops. Another important difference is that itching of the eyes, nose, throat, or ears are uncommon with a cold but are very common allergy symptoms. If you have a fever or feel achy, chances are you have a cold and not allergies. It is important to remember that with either allergies or a cold, continued nasal discharge that becomes thick, brown, dark yellow, or green might indicate a sinus infection and may require the use of an antibiotic.

While a cold is a condition that just requires a bit of time to clear up, allergies do necessitate treatment.  If you are experiencing allergic symptoms which are persistent in nature, seek the advise of an allergist so that appropriate testing and treatment can be initiated. At Allergy, Asthma, & Immunology, our clinicians and staff are committed to improving your health and your quality of life. We look forward to hearing from you!


Have you heard about the New Test for Asthma?

Comments Off on Have you heard about the New Test for Asthma? Written on June 27th, 2011 by
Categories: Allergy Advice, Asthma, Asthma Articles
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Exhaled nitric oxide (eNO) is a new test you may he asked to complete in your clinician’s office if you have symptoms of asthma. This test is receiving wide spread attention from pulmonary and allergy specialists because it offers an easy and noninvasive means to directly monitor airway inflammation. Why is it important to be aware of the level of inflammation in your airways? It is well known that asthma is a disease of chronic inflammation, which causes airway constriction, excessive mucous production, and bronchospasm. Generally speaking, the higher the level of inflammation, the greater are one’s asthma symptoms. One of the causes of this inflammation is the presence of white blood cells called eosinophils in the lungs. The eosinophils are believed to release inflammatory mediators that contribute to inflammation and the resultant symptoms of asthma.

exhaled nitric oxide asthma testNitric oxide is a gas that is produced naturally in the airways and is detectable in the exhaled breath. Research has discovered that eNO levels significantly increase when airway inflammation is present. It is now possible to measure this gas in order to aid in the diagnosis and management of asthma as well as other lung diseases. Levels will be high in untreated or poorly managed asthma and will lower when asthma therapy is initiated and asthma is controlled. Therefore, the results of the test can help to determine how well inhaled anti-inflammatory medications (such as steroid inhalers) are working and can provide further guidance regarding when to increase or decrease medication dosages. This will be helpful in determining patients minimal effective dose of medicine.

Additionally, this valuable tool will be useful in distinguishing asthma from other diseases not associated with nitric oxide elevation such as vocal cord dysfunction, gastroesophageal reflux disease, pulmonary embolism, and acute respiratory illness. This test will assist the clinician in determining the severity of asthma as well as offering insight into patients’ compliance in use of medications. While asthma symptoms may he intermittent, the inflammation of asthma is persistent. Exhaled nitric oxide testing can serve as a marker providing objective evidence of ongoing disease activity even in the absence of symptoms.

Another great benefit of eNO testing is its usefulness with young children who are not always able to understand and follow directions with other methods of pulmonary function testing. The test requires no preparation, is very easy to complete (taking only a few minutes), and is non-threatening for both children and adults. Patients are provided a sterile mouthpiece
that is connected to the eNO device. They will be asked to breathe in slowly followed by a slow, steady exhalation. A computer screen will assist in prompting patients regarding when to take a deep breath and when to exhale. That’s all there is to it!

A patient’s personal history continues to he the most reliable tool in diagnosing and evaluating asthma; however the addition of exhaled nitric oxide testing can augment disease management when used in combination with other conventional diagnostic options (such as pulmonary function testing). Being able to evaluate the level of airway inflammation in asthma
can now more accurately assess treatment responses and ultimately improve quality of life. Allergy, Asthma and Immunology is pleased to have the capability of measuring exhaled nitric oxide in our offices. As health care providers, we are excited when new methods of managing asthma and IMPROVING YOUR HEALTH are available.

Please check our website at or call the office at 480-614-8011 for more information.


Avoiding Allergy Triggers

Comments Off on Avoiding Allergy Triggers Written on April 15th, 2011 by
Categories: Allergies, Allergy Advice, Allergy Articles
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Now that spring has arrived, we are all enjoying the warmer temperatures of the season and spending more time outdoors. With that comes higher pollen counts and an increase in allergic symptoms. Allergic disease affects 50 million Americans and is the 5th most common chronic condition in the United States. Allergic disease can develop at any age and is frequently an inherited trait. If one parent has allergies, the risk of the child developing allergies is 48%, and if both parents have allergies, the risk grows to 70%.

Symptoms of allergic disease are the result of events occurring in the immune system (the body’s defense mechanism against harmful substances). In an allergic individual. the body recognizes allergens (i.e. pollens, pet dander, mold spores, dust mites) as harmful substances and subsequently a cascade of events ensues in an attempt to remove the offending allergen from the body’s tissues and bloodstream. Chemicals such as histamines. are released from special cells in the body producing the classic symptoms of allergic rhinitis (“hay fever”) such as nasal itching, sneezing, nasal congestion, runny nose, and itching or tearing of the eyes. Other conditions associated with allergies include asthma and eczema.

In Arizona, allergies cause severe and prolonged symptoms due to the extended growing seasons. The spring and fall months are typically the seasons when pollen counts are highest and symptoms are most severe. Some of the biggest allergens during this time of year include olive, ash, and mulberry trees, bermuda grass and ragweed. Citrus trees are blamed for symptoms but typically are not a problem as pollination occurs through the “birds and the bees”.


One of the biggest things an allergic individual can do is to avoid offending triggers.

POLLEN: To avoid pollen exposure, keep doors and windows closed and run air conditioning, which cleans, cools and dries the air.

Change air conditioning and furnace filters regularly. Avoid sleeping with bedroom windows open and keep car windows closed. Pollens can become trapped in hair and clothes, so remember that taking a quick shower and changing clothes after being outdoors can be beneficial. Recognize as well that pets trap pollen in their fur after being outdoors so washing your hands after interacting with pets and avoiding touching your eyes is important. Avoid yard work if possible and wear a mask when cutting grass. Air purification systems (such as a HEPA filter) can offer benefit as well. These are best kept in the bedroom as most people spend more hours of the day in the bedroom than any other space in their home. Pollen counts are highest in the late afternoon, so avoid outdoor activities during this time of the day.


PETS: There are no “non·allergenic” cats or dogs. Ideally if a person is allergic to pets, the animals should be eliminated from the home or kept outdoors. If this is not possible, keep pets out of the bedroom and bathe them on a weekly basis to reduce the dander in the home.


DUST MITES: While less of a problem in Arizona due to low humidity. dust mites can be avoided by purchasing special encasements for pillows and mattresses. These can be purchased from on-line allergy supply stores. Bedding should be washed on a weekly basis using hot water rather than warm or cold water. If practical, replace carpets with linoleum, hard wood floors, or tile. Keep the number of pillows and stuffed animals to a minimum.


MOLDS: Molds can be found both inside and outside of the home. Promptly repair any leaks or water damage within the home. Indoor molds are frequently found in the bathroom, basement or other damp areas. Do not use carpet in these areas and watch for mold growth so it can be cleaned promptly. Use an exhaust fan or open windows to remove moisture after showers. Mold can also be found in the soil and on the leaves of houseplants as well as in damp compost piles, therefore wear a mask while raking leaves and keep indoor plants to a minimum.


If avoiding the offending trigger does not manage symptoms, one should seek the advice of an allergist to obtain an accurnle diagnosis, a treatment plan that works, and educational information to help manage symptoms. The allergy specialist may complete skin testing (if appropriate) and discuss treatment options, including the use of medications, such as nasal sprays, antihistamines, or decongestants. Allergy shots, also called “immunotherapy”, are an option and are given to increase ones tolerance to the allergens that provoke symptoms. Be ready for the spring season this year. Remember, the right care can make the difference between suffering with an allergic disease and feeling better.