OPEN SEASON ON ALLERGIES : DOCTORS DRAW ON ARRAY OF TREATMENTS TO BATTLE ANNUAL SNEEZING, WHEEZING.

Byline: Diana E. Lundin Daily News Staff Writer

Sneezing every few minutes and battling a stuffy nose, May Porter scoured the aisles at a Woodland Hills drug store this week in search of something to relieve her allergy symptoms.

``I don't know what to do,'' she lamented, picking up a box of over-the-counter antihistamines. ``This makes you sleepy. I've got to function. If this keeps up, I'm going to the doctor.''

It's the beginning of hay fever season, marked by hundreds of thousands of Californians who suffer from sneezing, itchy eyes and stuffed-up noses. The warm April temperatures following steady winter rains have brought on an onslaught of both tree pollens and the people who are allergic to them.

Like accountants, allergists are especially busy this time of year.

``It's lingering misery,'' said Dr. Eugene Kenigsberg, chief of the allergy department at Kaiser Permanente Medical Center in Woodland Hills. ``It's picking up. It hasn't hit the full stride yet. April is usually the month we get the most requests for consultations.''

Make no mistake, allergies can be debilitating. Allergic rhinitis, or hay fever, accounts for 3.5 million lost work days, 2 million missed school days and $154 million in lost wages every year, according to the Allergy Medical Clinic in Los Angeles.

Causing all those sniffles and sneezes among the 15 percent to 20 percent who suffer from allergies are the microscopic particles of pollen from eucalyptus, maple, sycamore, acacia, oak and walnut trees. Coming up are mulberry and olive trees.

``I'm the tree pollen poster boy,'' said Howard Lubin, 47, of Chatsworth. ``There are 13 trees native to the state of California, and I'm allergic to every one of them. I don't stand a chance. Wherever you go in California, something is in bloom.''

Lubin is right, agreed Dr. Jonathan Corren, assistant professor of clinical medicine at the University of California, Los Angeles, and director of the Nasal and Sinus Disease Center.

``California seems to be particularly a problem because we have a very long growing season,'' he said. ``It starts somewhere in early February and extends all the way through November because it's very warm. We don't really have a true frost. Because of that long period of exposure, it gives people more of an opportunity to become allergically sensitized.''

An estimated 600,000 people in the Los Angeles metropolitan area are seriously affected by airborne allergens, said Andrew Kress, vice president of Surveillance Data Inc., a Philadelphia-based company that tracks seasonal illnesses in 50 regions nationwide.

``Based on what's in the air, we're seeing a big increase in allergy sufferers,'' Kress said. ``It should peak in the next two to three weeks, then it will start to decline by about mid-May.''

Just to be followed by the grass pollen season in July, followed by the ragweed pollen season in September.

According to the Los Angeles chapter of the Asthma and Allergy Foundation of America, the major allergens right now are pollen from pine, sycamore, juniper, cedar, mulberry, ash, oak, willow, poplar, cottonwood and chinquapin.

Mold spores have been a problem, but are tapering off some. Grass pollens are at a moderate level, while weeds are classified as minor.

Classic hay fever symptoms include sneezing, congestion, a runny nose, fatigue, itching eyes, scratchy throat, postnasal drip, coughing and, in asthmatic patients, wheezing.

``In California, there are a lot of people who don't fit into that classic category, who have allergies but tend to have more predominately congestion with runny nose,'' Corren said. ``Sometimes, it's difficult to make the diagnosis.''

People with asthma and allergies have a much harder time during allergy season, said Dr. Brian Greenberg, pediatrician and allergist. Greenberg has seen a spike recently in pediatric patients at both his office and the emergency room at Encino-Tarzana Regional Medical Center, where he is vice chairman of pediatrics.

``Any child who is clearly having trouble breathing with their chest needs to have medical attention,'' he said. ``Not all children with asthma are also allergic, but a fairly high percentage have allergies that make their asthma worse. It's an illness that needs constant vigilance.''

For adults, over-the-counter medications can offer some relief for mild symptoms, which often mimic those associated with colds. But if antihistamines or nasal sprays are needed on a daily basis, a doctor should be consulted.

``The difficulty with things that are over the counter is that they are very often sedating,'' Corren said. ``People will take these medications and find that they can't work, can't drive, which compounds the problem.''

Physicians can prescribe some of the newer antihistamines, including Zyrtec, Claritin, Hismanal and Seldane. ``These are newer, more effective and don't have the same problems with sedation,'' Corren said.

Certain medications should not be taken together, however, and your doctor should know if you are taking antibiotics or antifungal drugs because, when combined with the allergy medicines, they can cause heart problems.

Nonprescription nasal sprays, topical decongestants such as Afrin or Four-Way Nasal Spray, can cause dependency, Corren warned.

``If those are used more than three days, a person runs the risk of developing what they call rebound congestion so that the longer they use it, as the drug wears off, the congestion comes back with a vengeance,'' he said. ``The longer they use them, the more dependent they become on the drug to keep the nose open.''

But prescription nasal sprays, or topical steroids such as Vancenase, Flonase, Rhinocort or Nasacort, work very well for allergy sufferers without fear of dependency.

``They're probably the most effective thing a doctor can give you,'' Corren said.

The sprays can be used with or without the prescription antihistamines.

But the nose isn't the only source of agony for allergy sufferers. Anyone with contact lenses and rhinitis knows a particular brand of discomfort.

``Contacts pose a special problem for people with allergies because you trap a lot of the pollens, and they secrete histamine and other chemicals behind the lens so it stays there,'' said Kenigsberg, the Kaiser Permanente allergist.

Many people have to switch from contacts to glasses, at least temporarily.

``They can use drops in the eyes when their lenses are out that may block the reaction,'' he said. ``The other recommendation is very frequent cleaning of their lenses.''

To help the itch in eyes, several over-the-counter eye drops are available, including simple irrigating solutions and plain decongestant eye drops that take the red out. They, too, can cause dependency if used for more than a few days in a row. Prescription eye drops that block the release of histamines include Crolom (cromolyn), Alomide (lodoxamide) and Livostin.

Finally, there are allergy shots, which can take from four months to a year to become effective. ``They're not a first-line treatment for the majority, but they can be very helpful,'' Kenigsberg said.

Lubin, whose allergies were so bad they kept him out of the U.S. Army during the Vietnam War, has taken allergy shots off and on since he was 9. It's been six months since his last one and, cross his fingers, he's doing OK. Still, he takes precautions. He doesn't mow his own lawn, nor does he carry in the Christmas tree for fear of an allergic reaction.

Pollen levels are at their peak during daylight hours, and allergists recommend avoiding outside activities until evening. If you can't put off gardening and yard work, Kenigsberg suggested wearing a mask and maybe even some goggles.

``As soon as you're done, take a shower and put the clothes you were wearing in the wash,'' he said.

And keep your windows closed.

``When the windows are open, indoor pollen counts can be as high as 40 to 80 percent of the outdoor levels in the home and 55 to 95 percent in a car, depending on whether you're in the front or back seat,'' he said.

CAPTION(S):

6 Photos

Photo: (1--Cover--Color) Something to sneeze at

Beatingallergies is serious business this time of year.

(2) The flowering buds of an acacia tree release microscopic pollen particles that allergy sufferers dread.

(3) Pollen from oak trees is one of the major allergens at work in the Southland, according to the Los Angeles chapter of the Asthma and Allergy Foundation of America. Pollen levels peak during daylight hours.

David Crane/Daily News

(4) With tree pollen beginning to aggravate allergies in the Southland, doctors are administering more shots to combat the often-debilitating symptoms.

(5) Before treatment begins, allergists place drops called antigens on the patient's arm to test for allergic reactions to various substances.

(6) Registered nurse Angelita Perez prepares an allergy injection at Kaiser Permanente in Woodland Hills. After tree pollen allergies peak in April, allergists should be busy again in July during grass pollen season.

Terri Thuente/Daily News