While nature is beautiful, sometimes it can reek havoc on our immune systems. Photo courtesy Flickr/swallowtailgardenseeds

As I made my morning drive to work the other day, I recalled last spring and how I needed to get my car washed because yellow pollen and dust covered everything.

When I arrived to work, the clinic was busy as usual, but an unusual number of patients had medical concerns or complaints typical for this time of year. Within the first hour, I had three patients with three different medical presentations but all for the same reason: seasonal allergies.

Many patients had a combination of vague symptoms, including headaches, sore throats, runny noses, dizziness and light headedness, fatigue, uncontrollable sneezing and itchy eyes. Interestingly enough, many could not tell the nurse that they were suffering from allergies, although allergies cause many of those symptoms.

My first patient was a 32-year-old schoolteacher. She complained of having a headache and feeling tired for the past two weeks, but she did not have fever or chills. She did, however, report occasional sneezing. When I evaluated her inner ear during the physical exam, I discovered that she had a bulging tympanic membrane, which happens when fluid collects in the middle ear cavity. She also had a boggy nose, which often points to chronic allergies. The results of her physical exam were characteristic of allergic rhinitis with sinus congestion. I prescribed a decongestant, antihistamines and a steroid nasal decongestant. A week later her symptoms had resolved, and she thanked us for the great care.

The second patient was a 24-year-old mechanic. He complained of two weeks with irritated eyes and a runny nose, but like the teacher, he had no fever or chills. He feared that chemicals had gotten into his eyes from working underneath a car, but a detailed eye exam showed no abnormal findings. He did, however, have symptoms consistent with seasonal allergies. I prescribed him an oral antihistamine, a steroid nasal spray and topical ophthalmic antihistamine eye drops. Like the teacher, the mechanic returned a week later to report that his symptoms were gone, and he thanked us for the care.

The third patient was a 41-year-old secretary who complained of a persistent cough that had hug on for two weeks, but again, she had no fever or chills. She reported that the cough was dry, and not phlegmy.

I remember that she looked at me with frustration, saying, "This dry cough is driving me and everyone on my job crazy!"

My physical exam revealed the characteristic findings of allergic rhinitis due to seasonal allergies. I told her cough was the result of postnasal drainage. I prescribed antihistamines, a leukotriene inhibitor, which is used to treat allergies, and a nasal steroid.

The presentations of all three patients are all too familiar this time of year. Some allergy sufferers can get effective relief with over-the-counter remedies, such as Flonase steroid nasal spray and antihistamines such as Zyrtec, Allegra and Claritin. Others will require something stronger. Only licensed medical providers can prescribe many decongestants in Mississippi, including pseudoephedrine. (The Legislature enacted that law to cut down on the medication's use in crystal methamphetamine manufacturing.)

With proper assessments and treatments, patients can live comfortably during this time of year when plants rejuvenate and pollen fills the air. One set of symptoms I always ask about is fever and chills, which are not part of a typical allergic reaction. If you develop a fever, don't delay a visit to your medical provider, who may determine that you have an infection requiring antibiotics.