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Cold or allergy? Diagnosis can be tricky

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Dr. William Dolen plopped 4-year-old Jadon Wrights on an exam table Monday, then reached for a scope hanging on the wall.

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Dr. William Dolen tells 4-year-old Jadon Wrights to open wide so he can get a look at his throat at the Pediatric Allergy Clinic at Georgia Regents Medical Center.  MICHAEL HOLAHAN/STAFF
MICHAEL HOLAHAN/STAFF
Dr. William Dolen tells 4-year-old Jadon Wrights to open wide so he can get a look at his throat at the Pediatric Allergy Clinic at Georgia Regents Medical Center.

“Which ear should I look at first?” Dolen asked Jadon, who pointed to his left ear.

“Is that your left or your right?” his mother, Julmacia, quizzed him.

“Left,” Jadon said.

“Good job,” she said.

While Dolen examined Ja­don, who appears to be suffering from allergies, he asked how the mother tells the difference between a cold and allergies when he has sniffles.

“When he’s on Claritin and it happens throughout the day, it seems like it’s more of a cold,” she said,

This time of year, similar early symptoms can make it hard to discern the difference, Dolen said.

With a mild winter and allergy season already begun, more misery is ahead for allergy sufferers, said Dolen, the interim chief of the division of allergy/immunology/rheumatology in the Depart­ment of Pediatrics at Georgia Re­gents University.

In the first day or so, a cold and allergies will both produce a clear runny nose and sneezing, he said.

Over the next couple of days, the nasal discharge from a cold will turn thicker and might be accompanied by a low-grade fever, he said. A cold might last a week or two but show signs of improving in the second week, Dolen said. Allergies could persist a lot longer, as long as the irritant is around, he said.

Dr. Poneh Davoodi, an allergy fellow at GRU, said she is already seeing children whose parents can’t figure out whether the symptoms point to a cold or allergies.

“They come into this clinic, they’ve already been to their pediatrician and now they are kind of at a loss as to what else this could be,” she said.

If it is allergies, it is likely caused by tree pollen, notably alder, elm and maple, Dolen said.

“Those would surely be pollinating now,” he said. “Even though it’s a little cold, it’s the lengthening of the days that signals the trees to start pollinating, not so much the weather.”

This year there could be another complicating factor, he said.

“What’s different this year is that we never really had a killer frost to end the weed pollen season,” Dolen said. “And then the winter has been unusually warm. We’re seeing pollen on the hoods of our cars, which is very unusual for this early in the season.”

Two or three years ago, there was a “genuine pollen storm” when the pollen was particularly thick, and the signs point toward another, he said.

If allergies hit every year around this time or start in March with the grass pollen season, the best thing to do is to be prepared, Dolen said.

“Get yourself on the medicines you’re going to need before the pollen actually starts coming out,” he said. “It’s easier to prevent the inflammation from starting than it is to treat the inflammation once it’s set in.”


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