by Jessica Pupillo Contributing Editor for St. Louis Kids Magazine
Maria Kopff, of Green Park, remembers days when she wouldn't let her son Brendan go outside at all. During the spring and fall, his allergies and asthma made it too difficult to breathe outside.
"It was really tough when the pollen was blowing," Kopff said. A few times Brendan had such trouble breathing due to an asthma flare-up that Kopff had to rush him to the emergency room or her pediatrician's office for breathing treatments.
“When he did have a flare up, he wouldn't go to school the next day or two, so we could watch his breathing," Kopff said. "It just took a lot out of him."
Diagnosed with asthma at age 5, Brendan struggled with his breathing until he started seeing an allergist about three years later. Asthma is major health concern for many St. Louis area kids. It's the most common chronic health condition among children, according to the Asthma and Allergy Foundation of America.
Dr. Michael Borts, an allergist with Allergy, Asthma and Sinus Care in South St. Louis County determined that Brendan is allergic to "pretty much everything," Kopff said. Grass, dust mites, pet dander, pollen, mold and more all trigger allergic reactions. It's very common for asthmatic children like Brendan to also suffer from allergies.
"Childhood asthma is an allergic disorder in many cases," said Dr. Leonard Bacharier, clinical director of the division of pediatric allergy, immunology and pulmonary medicine at St. Louis Children's Hospital and Washington University School of Medicine. "Eighty to 90 percent of kids with asthma also have allergies." On the flipside, only a minority of children with allergies also have asthma, he said.
Upon Dr. Borts' diagnosis, Brendan began using a peak flow meter to monitor his asthma. He began using a daily inhaler in addition to a fast-acting inhaler, and he started taking allergy pills during allergy season.
Kopff also made the tough decision of starting Brendan on allergy shots. Allergy shots require a multi-year commitment, Kopff said. At first, Brendan received shots in both arms every week. Now that he's been getting shots for almost four years, he's down to shots just once a month.
Since managing his asthma and allergies, Brendan's quality of life has improved dramatically, Kopff said.
"We haven't been to the ER in a few years," she said. The child who couldn't spend much time outside is now active in all kinds of sports, both in the gym and on the grassy field.
This story appears in the Spring, 2009 issue of St. Louis Kids Magazine.
Correction: In the print version of the story, we misspelled the Kopff's name. We apologize for the error.
How to Help Your Kids Survive St. Louis' Allergy Season
It's an all-too-familiar spring call-and-response:
"Ah-choo!"
"Bless you."
Even before the trees bloom and the grass goes neon, St. Louisans with allergies know spring is in the air, literally. Kids are no exception to the sneezing, itching, congestion and sinus pressure of seasonal and respiratory allergies. When kids also have asthma, allergies can be elevated from an inconvenience to a medical emergency.
It's no wonder parents begin worrying about allergies in their children at a young age. We enlisted two local allergy specialists to help us explore the causes, symptoms and treatment of allergies.
What causes respiratory allergies?
Allergy symptoms are the body's response to a substance it perceives as a foreign threat, according to Dr. Manoj Warrier, an allergist at Allergy, Asthma and Sinus Care Center.
"The rates of allergic diseases are going up in all the developed areas of the world," said Dr. Leonard Bacharier, clinical director of the division of pediatric allergy, immunology and pulmonary medicine at St. Louis Children's Hospital. "People are calling it an allergy and asthma epidemic."
Nobody really knows what causes allergies and why they are on the rise, Bacharier said. Although there are many theories, none have been proven, he said. What experts do know is that allergies are a genetic disorder. When parents have allergies, he said, their kids are also likely to develop allergies as well.
What are the symptoms of respiratory allergies and how do you diagnose them?
Allergy symptoms often mimic those of an upper respiratory virus. A child with respiratory allergies will likely have clear nasal drainage, congestion, sneezing and watery eyes, Warrier said.
Parents should look for patterns in symptoms, Warrier said. For example, if your child's symptoms appear in April each year—the worst month for allergies in St. Louis—you're likely dealing with allergies instead of a virus.
Typically, allergy symptoms don't appear in kids until after the first year of life. But even if allergies aren't present at age 2, they can occur at any age. "Kids can grow into allergies, and they can grow out of them," Warrier said.
Allergies can be diagnosed through a clinical history of symptoms, a blood test or a skin prick test. But allergists caution that tests don't always pick up developing allergies.
"Allergy symptoms may show up before the test becomes positive," Bacharier said. "Negative tests in young children aren't always lifetime passes from ever developing allergies."
What's the best course of treatment?
When possible, the best treatment is to avoid the allergen, Bacharier said.
"Depending on the allergen, there are a variety of strategies," he said. For example, for pollen allergies, close the windows during the fall and spring and run the air conditioner or heater. Bathe your child every night to remove allergens that have built up on the body. Wash sheets in super hot water to reduce dust mites. If your child is allergic to the family pet, find the animal a new home, he recommends. Medications, including antihistamines and nasal steroids, can control the symptoms.
The only treatment that can potentially cure allergies is allergy shots, or immunotherapy, Warrier said. Shots carry the risk of a severe reaction, so physicians generally don't consider shots until the child is at least 5 years old and has the communication skills to indicate if they're having a reaction to the shot. Parents also must be willing to bring their child in for shots on a regular basis.
Can you prevent respiratory allergies?
There are no known ways to prevent allergies in children. While some doctors once thought breastfeeding cut down on allergies, it's now believed that it only delays the onset of allergies, Warrier said.
Resources for St. Louis families The St. Louis chapter of the Asthma and Allergy Foundation of American assists uninsured and underinsured children, birth through age 22, with allergy and asthma medication and nebulizers. Call 314-645-2422 or visit www.aafastl.org for details.
