"Dust Allergies" with Dr. Nicholas Kolinsky

and welcome to the dr bob show when you wake up in the morning how are your sinuses do you have a stuffy nose do you have drainage do you have sniffles you wish your nose would be open you wish it wasn't causing so much problems could it be something in the bedroom that's making your nose get stuffy during the night could it be allergies could it be dust allergies could it be dust mites we're talking we're going to be talking about dust mite allergy and how they cause problems with our health especially during the night my guest is dr nick kalinski dr kolinsky is a board-certified allergist and he deals with dust mite allergies every single day he'll be answering our questions hello i'm dr robert overhold i'll be your host for the next 30 minutes on the dr bob show later on we'll be talking about how important your sleep is to staying healthy and staying happy a lot of information for you you'll want to stay tuned [Music] we're talking with dr nicholas kalinski board-certified allergist and we're going to be talking about dust mites which will cause much more problems to your health than you really realize nick welcome to the dr bob show thanks dr bob it's good to be back it's good to have you back now tell me what is a dust mite so a dust mite is a microscopic creature and it's actually related to the spider so it's an arachnid and it lives off the ambient humidity in the air okay so it doesn't actually drink water and then it feeds off human and animal dander as well as mold it likes dark damp warm places so it's pretty prevalent so that makes it fairly prevalent prevalent in a bedroom the humidity level in the bedroom is the same as the rest of the house do you have to change the humidity if you're going to want to get rid of dust mites what do you do ideally yes sir so you want the humidity level to be below 40 ideally because dust mites can't really thrive since they're feeding off that ambient humidity in the air you're going to want to do other things like wash your bedding and sheets in the hottest temperature possible but ideally greater than 130 degrees fahrenheit you can use dust mite proof encasements that are these zipper um i happen to bring one of those with us here so fantastic this is a um an encasement for a pillow it looks like a pretty large pillow to me that's right but what are the characteristics that you're looking for in a cover that goes over the pillar so this right here it's going to have a zipper on it it has to have a zipper that's definitely key that's going to seal the dust mites in and that's the goal okay where the dust mites can't really get to you and you can't get to the dust mite since it relies on you to live is it the actual dust mite we're allergic to or is it their fecal pellet or is it theirs the scale on their skin or is it all the about so it's generally both the dust mite and the fecal pellet but more so the fecal pellet and how big is a dust mite we're talking my microns so really really small microscopic so three to four microns which is bitty bitty bitty so the covers are made where anything around that range won't get through to your nose right so it encapsulates or it covers locks in makes it where the dust mite droplet can't get to the nose now if you didn't have a cover and you were breathing in dust mite droplets or pellets how would it cause allergy reactions so generally what happens is that an individual is exposed to dust mites and some people develop ige or the allergy molecule that's specific to dust mite and what ends up happening is is that you have these cells called mast cells and ige sits on the border of those mast cells and on re-exposure to dust mites that allergen or the dust mite will bind to the ige that's bound to the mast cell and when that happens the mast cell bursts or degranulates it releases things like histamine leukotrienes things that cause the edema swelling mucus stuffy nose runny nose cough sneeze all those other symptoms so all the when somebody wakes up with stuffy nose nasal congestion sneezing itching nose blowing their nose you have to think of the possibility of dust mite allergy could it be other things it definitely could i mean it's all in the history okay so if someone keeps waking up in the morning they don't have a pet and they have congestion they don't have other things like reflux obstructive sleep apnea you you ask a lot of questions and then you ask more questions and then you do some testing and then you arrive at a diagnosis of course a lot of people like to have their pets sleep with them and so a lot of people are allergic to their pet that's very very common while we're on that topic one thing that they can do is get a high efficiency filter or a hepa filter that's really good actually for dust mite or for dust mite and for pet allergy but more so for pet do you put those filters in the bedroom with the person sleeping or do you put it on your on the main filter so ideally you want it in the bedroom where the person is sleeping the reason for that is because dust mite allergen is very heavy and so whenever you move the sheets or you jump on the bed the dust mite allergen kind of goes up in the air and it'll stay in the air for about 15 minutes but then it falls whereas animal allergen or cat allergen especially it's very light and buoyant and so that's going to be really filtered out through that hepa air filter and that's going to be a very effective thing to do so allergies in the bedroom are pretty prevalent definitely and can be a huge problem do medications help in that type of allergy is it any different from ragweed hay fever or from grass pollen hay fever or from problems with mold spores they produce same type allergy reaction is the treatment the same right it is relatively the same there are some exceptions like as far as maybe a sublingual immunotherapy tablet for dust mite but in general you're still going to use your nasal spray a nasal corticosteroid is is at the top you've got your nasal antihistamines on a scale of one to ten ten being the best nasal sprays are probably a seven or an eight whereas allergy pills might be a two or a three so if there's one thing to focus on it's a nasal spray correct technique things like that so let's talk about nasal spray let's talk about a cortisone nasal spray how do you spray it what does it really do to get the person better and why is it better than the pill so i think it's very important to know the correct technique you can give someone the best medication in the world if they use it incorrectly they're not going to get the right effect so you don't spray it in your ear you don't spray it in your ear you spray it in your nose and here's how you do it so the septum is that wall in the middle and so you want to aim away from the septum so left side towards the left ear right side towards the right ear so you can actually put the nozzle into the nose and then aim toward the top of the ear on that side why do you do why do you stay away from the septum so the reason for that is because the septum is highly vascular which means it has a lot of blood vessels in it and some of those nasal steroids like flonase nasocort rhinocort can irritate the septum and cause nosebleeds so that's a very important detail so you get sort of a raw nose and you get minor bleeding that has crusting and bothers the patient definitely can so you teach the patient to spray toward the outside does that do just as good in its activity against the allergic reaction um well you want to use a nasal spray more often than not it's going to work better regularly so you might already have an allergic reaction or you might have symptoms and then start to use your nasal spray you might get better but you wouldn't get as you know better or if you were to use it earlier or if you use it on a continuous basis so more often than not is what i recommend but i use my nasal spray almost every day so when you use a nasal spray if it's a cortisone nasal spray do you use it at nighttime before you go to bed or do you use it in the morning when you first get up when your nose is stuffy right so i'm actually dust my allergic i'm allergic to cats dogs pollen so it all depends on the history yeah i know i know right so i know i'm gonna get my dust my exposure primarily at night in my bed and so i'm gonna definitely have my nighttime dose but then i'm also pollen allergic and so of course i know i'm gonna get my pollen exposure during the day so i'll use it twice a day one to two sprays each side if you're using two sprays each nostril morning and night are you more likely to get some side effects most definitely i think with the higher doses you definitely could and that's why it's so important and i go over it with every patient every visit the correct technique because i think it's that important you know and a lot of times you tell the patients so much give them so much information that they're it's easy for them to understand that when they're in the doctor's office with me and they walk out they say now what did he say so i think it's so good and so nice and so good for the patient that you reinstruct them each time on how to use a nasal spray now you mentioned there are pills to use are they effective also they are effective and that's what we'll be talking about when we come back the pills are effect effective but not as effective as the sprays can use them both should you use them both we'll talk about it [Music] we're talking with dr nick kalinski board certified allergist we're talking about dust mite allergies and how they cause problems more than we think they feed off the scale of human skin as we shed our skin every day they like high humidity they don't do well if we give them a low humidity and they like stuffed furniture where they seem to live better nick is that right so far that's correct so far so let's look at the set right here tell me what you see in here that could have a lot of dust mites even here in the studio so definitely this carpet i would say so for sure we've got a carpet on the floor so carpet the dust mite likes to live in carpet yes they do uh any special type of carpet that they don't like or it's the humidity what's in the carpet that bothers so sometimes what can happen you're going to have your dead skin cells are going to slough off and be on the carpet there's going to be animal dander if you get your carpet steamed there might be a lot of humidity down there moisture going to be good for dust mites and mold so carpet's just not a good idea if you're an allergic individual especially to dust mite and mold so in the bedroom we take the carpet out a throw rug is that okay a throw rug too it's a problem yeah so you got to have cold toes when you jump out jump out of bed in the morning so what else do you see in here you got the carpet right and then of course we have this furniture here with a cloth covering yeah and the cloth covering here is a dead giveaway for what's bad because dust spots are going to be there right right so when we pound on those rub those lay our heads on those when we watch television we're really close up to the dust mite and if we're allergic to dust mite droplet we'll have problems there what else do you see so we've got the curtains back here behind me and so curtains are another thing that's going to collect a lot of dust and so ideally you want to remove curtains and then also this ornate type of decoration back here that's going to collect a lot of dust and it's very difficult sometimes to dust something like that it looks great i love it but it's it's going to be tough to dust so how about the headboard when we lay down on our bed at nighttime what's a bad headboard a bad headboard is going to be like a bookshelf or a bookcase something that's got a lot of levels on it it's going to collect a lot of dust and it's just going to fall off and and you know triple all over you and all that kind of stuff and so i think it's going to cause a lot of symptoms or about the bedside table what should what should that be like so it should be clear it shouldn't be cluttered if you got a bunch of stuff on there you got your cell phone your you know coaster your glass of water maybe who knows a book everything else so you want to keep that clean keep that simple keep the headboard clean and simple and not ornate because anything that you can do to cut down on your exposure to dust mite may well help the degree of allergic problems that you have the vinyl covers for the pillow can you get those at any department store usually you can generally so a place like amazon or online is a good source just be sure that you kind of read into it make sure it's got a zipper that's a common mistake i've seen but yes you can get it a lot of places why is the zipper a mistake to not have one right well you're just wanting to be sure that you seal in that dust mite if you don't have it a zipper or if it's just going to kind of have the elastic band that wraps around you're not really going to get that good seal there's going to be plenty of dust mites that's going to be able to get around that and when you lay down on that pillow poof the air will come find its way right to your nose that way so it's really important to that you mentioned washing in the hot cycle 130 degree temperature it seems to scald and kill the dust mite so that pretty much covers it the medications that you would use at nighttime we talked about cortisone spray spray it toward the outside how how much when you spray it how much do you sniff so you really don't want to give you that aggressive sniff otherwise it's going to drag the medication the back of the throat you're going to swallow it but we want it to stay in the nose okay so you spray to the side and the soap doesn't fall out on your face and do it that way what pills are good did you take those in the morning take those at nighttime so as far as oral antihistamines you can take it in the morning or at night it just kind of depends on your symptoms if you're going to get that dust my exposure at night i'll probably take it at night my favorite one is probably allegra just because it's the least sedating so if you have to wake up and go to school go to work drive heavy machinery it's probably a good idea to use a medication like that so there's three or four non-sedating antihistamines right allegra is the one that you found that causes less sedation zyrtec 14 of people can get sleepy with this as i remember claritin um zyzol and the claritin is sort of a weak weekend history when you compare it to the others in the studies that i've read um nothing against clairton and claritin clear that's a good and history and some people think it's best for them so we've got an antihistamine we've got the nasal sprays if that's just not doing enough then what's the next step in trying to get the patient better so that their stuffy nose is being driven that way by dust mite allergy what can what else can we do so if we're looking for a cure the best thing that we could do is immunotherapy and there's really two main types that i use one would be subcutaneous immunotherapy or the allergy shot the other would be sublingual immunotherapy or a pill or a desmite tablet and the dust mite tablet it's indicated in people that are 18 years of age up to 65 the first dose is given in the office it goes underneath the tongue so you want to be sure to take it out a little so the little foil and then put it underneath your tongue wash your hands that way you don't rub your eyes especially if you're allergic and then it's going to sit there for about a minute and you cannot swallow for a minute and you can't eat or drink anything for five minutes and then they stay for 30 minutes and they're able to go is it effective it is effective it's not as effective as the allergy shots but it is effective so the allergy shots tell me about those how do they work what are their benefits so the goal of the allergy shot is basically to make you immune or desensitize you to the thing that you're allergic to so in this case dust mites we start out at a really really low dose or diluted dose and then increase that dose over time in a safe way to where we get to a therapeutic effective dose to decrease symptoms decrease reliance on medications decrease risk factors for other comorbid conditions things like asthma something like that and so it can be very effective now you mentioned asthma and we were talking about a bad nose and about allergic rhinitis and the stuff he knows in congestion can dust mite allergy precipitate cause asthma it definitely can actually studies show that if you are exposed to a high degree of dust mite allergen it can increase your risk of developing asthma up to five times so that's pretty significant that's why it's so important to see a board certified allergist get the appropriate testing the appropriate treatment because these types of things could be preventable so board certified allergist has had the training of a year or two usually a two-year program where they understand the skin testing and putting somebody on immunotherapy or allergy shots the difficulty with the shots uh the patient have difficulty with them so hopefully not you know i try to do a lot of education up front we are giving the individual something that they're allergic to so you can have some local itching at the side of the injection i'm on shots myself so i know the the feeling so i'm able to share that with my patients but in general it's very well tolerated very effective and and safe so it makes the next step up and it's what we really want to go to and it can prevent you from getting asthma is that right correct yes are there further benefits to working around the head of the bed as far as dust and mold um you're afraid you have to work do you have to consider mold allergies yes yeah you definitely i was leading in that's what we're going to be talking about when we come back are there other things other than dust mite and pet dander in the bedroom that can be causing your problems and making you miserable we'll answer those questions and see what you can do [Music] we're talking with dr nick kolinsky board-certified allergist and we've been talking about dust mite allergies and where you can find dust mites in a house and how they cause the allergic problems including allergic noses and allergic lungs so we can get asthma and we can get allergic rhinitis that's there every single day if you go in your bedroom every single day but we find dust mites in other parts of the house too well if a person has a moldy house or a damp house or a house that has a high humidity where does mold play a part in that person's allergies so mold's going to be really anywhere where it's going to be humid exactly like you said to a basement kitchen bathroom especially and so anytime you see any mold no matter what color it is no matter what it looks like you're going to want to try to get rid of it and it can definitely cause allergies same symptoms that we're familiar with with the dust mites or with pollen the wheezing coughing stuffy nose itchy watery eyes a bunch of drainage so it's a real problem when people have allergic problems with allergic nose symptoms and with allergic lung symptoms how do they feel in general what's their well-being do they feel crummy they definitely feel crummy they're not sleeping well and when you don't sleep well nothing else goes well it makes it difficult when you eat food because you can't you can't eat food with your doses all the stuff it makes it's a very very difficult problem and i think yes not enough time is spent on the implications of having underlying nose allergies what about school do people perform well children do they perform poorly or better in school because of allergies poorly definitely myself included when i was younger i had allergies and i definitely had more trouble focusing in school once i saw an allergist and was diagnosed and put on the right nasal sprays everything changed for me and i was really thankful for that so do you think it's because when your nose is stuffy you're not breathing well and you're actually not sleeping well and therefore you don't perform well the next day exactly difficult to focus pay attention things like that asthma how much indoor allergy to dust and mold and pets and we'll talk a little bit about pets also where does that enter into the person's health to getting asthma what are the chances if somebody has an allergic nose that they'll end up getting allergic lungs so it definitely is higher i think that those things that you mentioned those allergens huge huge risk for asthma and asthma exacerbations and symptoms and so it's very important to identify those so if we identify them then we can treat them with medications and we can put them on immunotherapy will immunotherapy allergy shots help somebody with asthma they definitely will yeah and so they make it where the allergen doesn't trigger the problem as good right it must be a great feeling to be an allergist and to be able to identify what's making somebody sick and not feel well and put them on a program that makes the patient feel better it's the best it's the most rewarding thing i've ever experienced especially when you see your patients come back next time and they're smiling and they feel so much better it's awesome yeah you know those very things you said is why i ended up going into allergy i was going into cardiology and then when i trained in the allergy department people came in sick and miserable and walked out feeling good and breathing like a human so it's a great thing to be able to do to help the patient identify what's their problem what's allergy skin testing like so the skin test i've actually had it done myself since i'm on allergy shots it's a really simple in-office procedure it's done the day of the first visit what we do is we take a little plastic toothpick we dip it in the allergen so in this case maybe dust mite solution or mold solution and then we prick the back we read that test after 15 minutes and then for what's negative on the back we do a more sensitive test called an intradermal test and that's done on the upper arm so what does the positive allergic reaction look like it looks almost like a little mosquito bite so it's going to be this red kind of welted up area it's palpable so you can feel the border and then also it's got some erythema redness around it and when you get the skin testing you've taken the history then you can make up the extract that you're using for immunotherapy correct nick klinsky you're a great teacher you really really are i have enjoyed learning from you on this show and i thank you for coming to dr bob shaw hope you'll come back again well thank you dr bob i learned a lot from you so appreciate it um great show a lot of information for you now we're going to be talking about how taking care of allergies can also improve your overall health it makes it where you can go outside and exercise if your allergy is causing asthma you may have exercise induced asthma you have to talk to your doctor about some medications you can use before you go out and exercise and so that will make you more productive and feel better when you're able to exercise on a regular basis it also cuts down on anxiety on pressure on your blood pressure helps you feel better and perform better be sure that you're sleeping well and we talked on the show about having a stuffy nose how it can make you not sleep well not rest well and when you don't sleep well you don't perform as well during the day we're learning more and more about sleep hygiene about the importance of getting a good night's sleep and we'll do a whole show on sleep hygiene and what you and i can do to be able to sleep better during the night be sure that your nutrition is good you need to look at what you're eating and see why you're eating certain foods more fruits more vegetables less fatty fried food when you combine all of those and when you eat a smaller quantity of food you'll find that your weight will lower itself to the weight that you want to where you feel like you're in better shape so it's that exercise it's that eating properly it's getting seven and a half hours sleep and most of all what is it we like in the dr bob show is that laughter in your life can you make or teach somebody how to be happy well actually you can you can do that by reading things that are comfortable to you by talking with people by telling funny stories by reading the comic strips in the newspaper the more you expose yourself to laughter and to happiness your immune system will work better actually fighting off infection is much much better and much easier when you're a happy person so stay happy have fun you'll be healthier and the people around you will also [Music] [Music] [Music] you

Channel: Dr. Bob Show Archives

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Length: 26min 52sec (1612 seconds)

Published: Mon Sep 19 2022