Is Hillary Clinton shocked, or just allergic?

A photo President Barack Obama and other senior officials watching the operation live from the White House situation room has become one of the most striking images of the raid that killed al Qaeda leader Osama bin Laden. In it, Secretary of State Hillary Clinton is shown with her hand over her mouth.  It now seems that this gesture may have a more innocent meaning. When asked about the photo during a visit to Rome, Secretary Clinton reported:

“Those were 38 of the most intense minutes. I have no idea what any of us were looking at that particular millisecond when the picture was taken. I am somewhat sheepishly concerned that it was my preventing one of my early spring allergic coughs. So it may have no great meaning whatsoever.”

If seasonal allergies were the cause of Secretary Clinton’s gesture, she would hardly be alone. According to the Asthma and Allergy Foundation of America:

  • An estimated 50 million Americans suffer from all types of allergies (1 in 5 Americans) including indoor/outdoor, food & drug, latex, insect, skin and eye allergies. Allergy prevalence overall has been increasing since the early 1980s across all age, sex and racial groups.
  • Allergy is the 5th leading chronic disease in the U.S. among all ages, and the 3rd most common chronic disease among children under 18 years old
  • Approximately 40 million Americans have indoor/outdoor allergies as their primary allergy. (Many people with allergies usually have more than one type of allergy.) Approximately 10 million people are allergic to cat dander, the most common pet allergy. The most common indoor/outdoor allergy triggers are:  tree, grass and weed pollen; mold spores; dust mite and cockroach allergen; and, cat, dog and rodent dander.

Allergic rhinitis is a collection of symptoms, mostly in the nose and eyes, which occur when you breathe in something you are allergic to, such as dust, dander, or pollen.

An allergen is something that triggers an allergy. When a person with allergic rhinitis breathes in an allergen such as pollen or dust, the body releases chemicals, including histamine. This causes allergy symptoms such as itching, swelling, and mucus production.
The pollens that cause hay fever vary from person to person and from region to region. Tiny, hard to see pollens more often cause hay fever. Examples of plants commonly responsible for hay fever include:

  • Trees (deciduous and evergreen)
  • Grasses
  • Ragweed

The amount of pollen in the air can play a role in whether hay fever symptoms develop. Hot, dry, windy days are more likely to have increased amounts of pollen in the air than cool, damp, rainy days when most pollen is washed to the ground.

Symptoms that occur shortly after you come into contact with the substance you are allergic to may include:

  • Itchy nose, mouth, eyes, throat, skin, or any area
  • Problems with smell
  • Runny nose
  • Sneezing
  • Tearing eyes

Symptoms that may develop later include:

  • Stuffy nose (nasal congestion)
  • Coughing
  • Clogged ears and decreased sense of smell
  • Sore throat
  • Dark circles under the eyes
  • Puffiness under the eyes
  • Fatigue and irritability
  • Headache
  • Memory problems and slowed thinking

The best treatment is to avoid what causes your allergic symptoms in the first place. It may be impossible to completely avoid all your triggers, but you can often take steps to reduce exposure.
Treatments for allergic rhinitis include:

Antihistamines

Antihistamines work well for treating allergy symptoms, especially when symptoms do not happen very often or do not last very long.

Antihistamines taken by mouth can relieve mild to moderate symptoms, but many can cause sleepiness. Some may be bought over the counter, without a prescription. Talk to your doctor before giving these medicines to a child, as they may affect learning.
Newer antihistamines cause little or no sleepiness. Some are available over the counter. They usually do not interfere with learning. These medications include loratidine (Claritin) and cetirizine (Zyrtec). Other antihistamines are available by prescription. Azelastine (Astelin) is a antihistamine nasal spray that is used to treat allergic rhinitis.

Corticosteroids

Nasal corticosteroid sprays are the most effective treatment for allergic rhinitis. They work best when used nonstop, but they can also be helpful when used for shorter periods of time. They are only available with a prescription from your doctor. They are safe for children and adults.

Decongestants

Decongestants may also be helpful in reducing symptoms such as nasal congestion.
Nasal spray decongestants should not be used for more than 3 days. Overuse of nasal decongestants can cause rebound congestion  and, for some people, a vicious cycle of overuse and dependence that feels like an addiction.
For more information, click here to go to the Resounding Health Casebook on Allergies.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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