DR. HOOK- Ah-choo: Allergies nothing to sneeze at

Miss Teen USA is so predictable. Want to know the secret? Diane Sawyer was Miss Teen USA and she had the common link: blond hair. I never bother tuning into the beauty pageant until the end because there's no reason to see them skimp along the stage in a bathing suit (that would be traumatic for me. I still have dreams I'm caught in public in my footie pajamas), and give the same answers, "I want to be a brain surgeon and fight for world peace."

No, no, no! It all comes down to the five finalists in their evening gowns. If you don't have blond hair that's set to hold the tiara, you're doomed like Rosanne singing the National Anthem. The two finalists hold hands in a sisterly way to make sure they don't reach for a knife to knock off each other, and the winner is named: the blond with the big bust! It's like algebra. 

This year, I again predicted everyone's placement, including Miss Teen Virginia; I named Miss Teen Montana to be the winner– without watching all the preceding nonsense. Pamela Anderson, eat your heart out!

 Seasonal Allergic Rhinitis (aka hay fever or allergies) is just as predictable. Every year starting around August, people come to my office and sneeze on my Armani tie.

"Dr. Hong, I– ah, ah, achoo!– think I have a cold. My nose is runny, my sinuses feel like the Hindenburg, my throat is scratchy, my eyes are itchy, and my ears are blocked." Well, it could be a cold since the common cold peaks in September, but more often than not, it's seasonal allergies.

 School teachers commonly say, "Doc, I need an antibiotic because every year when school starts, the kids give me a cold." Hmm, every fall this happens? Sounds more like seasonal allergic rhinitis if you ask me, but many people don't believe me!

 When I see postnasal drip going down someone's throat like Niagra Falls (sans the thrill-seeking person in a barrel), when I find an internal nose lining that looks pale and boggy, or a crinkle on the nose from wiping the nose too often, or dark circles under the eyes– I think allergic rhinitis.

 So first, if the person isn't immuno-compromised or doesn't have uncontrolled diabetes, I offer them a nasal steroid. Nasal steroids, like Flonase and Rhinocort, block allergic reactions in the nose. The catch is they have to be used every day to be effective, taking two weeks to fully kick in. I give all my patients typed instructions, and I mention this, but I would say 50 percent don't take the nasal steroid everyday or for at least two weeks. Then they call and whine, "The nasal steroid is like blowing wind up my– uh, nose."

 Non-sedating antihistamines, like over-the-counter Claritin, can be very useful– especially if combined with a nasal steroid. (Hypertensive folks: stay clear of the "D" because decongestants can raise your blood pressure.) Sedating antihistamines like Benadryl are more effective– if you can get out of bed. Astelin nasal antihistamine is also a real treasure for many allergic people. Prescription Singulair, a leukotriene inhibitor, is very good as well and keeps people from wheezing. 

 Sneezing, itchy eyes, and scratchy throats are never any fun. So it's good to prepare yourself every fall with good medicine for the hay-fever season– just like Miss Teen USA contestants need to prepare to win by becoming blond enough to blind the judges– permanently.

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