DEAR DR. DONOHUE: For the past two springs, my 13-year-old son has had what I think is hay fever. He sneezes and rubs his nose constantly. What would make him more comfortable? Do allergy shots work? I don’t want to commit him to an entire life of shots. – B.W.

ANSWER: Hay fever’s typical symptoms are sneezing, a runny nose and itchy, watery eyes. The nose and throat often itch. Because the nasal linings are swollen, breathing through the nose is difficult.

Hay fever is an allergic reaction. When an allergen – in your son’s case, pollens – lands in the nose, a series of things happen that culminate in the release of histamine and other body chemicals. The chain of events begins with antibodies reacting with the allergen – here, pollen. The released body chemicals create the itch, the sneezing and all the other symptoms of hay fever.

In early spring, from March through May, tree pollens are at their peak and are the prevalent allergen. In June and July, it’s grass pollen. From mid-August through October, ragweed is the major pollen.

Avoidance of allergens is the best treatment, but practically speaking, that’s all but impossible. Antihistamines can quiet symptoms, and the newer ones like Allegra, Claritin and Zyrtec provoke less drowsiness than the older ones. Cortisone nasal sprays open up nasal passages and soothe the nasal lining. Names include Beconase, Nasarel and Nasonex.

Immunotherapy – allergy shots – do work, and they are not given lifelong. Usually they’re given for three to five years and then, if symptoms are controlled, they’re stopped. On top of that, hay fever is not routinely a lifelong condition. Ordinarily it starts during childhood or adolescence, and it wanes in adulthood. No matter what treatment is chosen, it is not likely to be forever.

DEAR DR. DONOHUE: My granddaughter is 12 and has just been put on medicine for epilepsy. Is it inherited? I don’t know of any other family member who has it. What happens during a spell? How will it affect her life? – G.B.

ANSWER: In a few instances, there’s a genetic predisposition to epilepsy, but not in most cases. If one child in the family has it, then the odds of another child having it increase by a factor of two. That is not an indication of a strong genetic influence.

During an epilepsy seizure, there is a sudden discharge of electrical energy in the brain. Brain cells – in fact, all nerve cells – generate electric current. The type of seizure that occurs depends on what part of the brain and how much of the brain are affected by the current. With some kinds of epilepsy, the person falls to the ground and the arms and legs thrash during the seizure. The whole affair does not last long. In other forms of epilepsy, the seizure is so brief and the signs are so subtle that onlookers don’t realize anything has taken place.

Most people who have epilepsy lead very active, very fulfilling lives.

DEAR DR. DONOHUE: What can I do to lower my CPK? My doctor’s office told me that mine is high, but didn’t tell me what to do about it. – O.G.

ANSWER: CPK is creatine phosphokinase, a muscle enzyme. High levels indicate muscle damage. The damage can be mild. Too much exercise can raise the level. Even a shot of medicine into a muscle can cause a spike in CPK.

There’s nothing you can do to lower the reading. You have to find out how high it is and what the significance is.

It’s ridiculous of your doctor’s office to call and tell you that your CPK is high without telling you what to do about it. Call the office back and demand to speak with the doctor. If you still don’t get an answer, then find another doctor.

DEAR DR. DONOHUE: What’s ischemic heart disease? – W.F.

ANSWER: “Ischemia” (is-KEY-me-uh) and “ischemic” are favorite medical words that mean tissues or organs are not getting enough blood. It’s often used with heart disease. Arteriosclerotic heart disease, coronary artery disease and angina are ischemic heart diseases.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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