When speaking with an allergist, there’s a chance you may briefly forget you’re talking with a doctor and imagine you’re chatting with a botanist. These medical specialists can reel off plant names, expected dates of pollination and various plant species’ typical pollen attributes.

“One of the things we do in our training program is to literally go on a spring tree and grass walk. I take all the fellows (post-doctoral students) around, and we show them the trees that are pollinating and how full they are,” says Dr. James Wedner, chief of allergy and immunology and director of The Asthma and Allergy Center of Washington University. On these walks, he points out the oak trees’ telltale catkins—pollen-heavy flower clusters. “People get an idea of how much pollen there really is in the air,” he adds, noting that students are surprised at the number and size of the trees’ pollen-producing structures.

Once you’ve seen the millions of catkins in an oak grove, which are among the most common allergens in the Midwest, you begin to appreciate why there’s so much sniffling, sneezing and itchy eye-rubbing going on. But oak is far from the only pollen that causes spring allergy misery.

“Tree pollen season typically begins in March with the appearance of juniper, maple and elm pollens,” says Dr. Susan Berdy, an allergist with Mercy St. Louis and a member of the board of directors for the Asthma and Allergy Foundation, St. Louis Chapter. “We’ve already had a few days this year where these pollens have been measured by the St. Louis County Environmental Health Science Laboratory. Other important trees, including oak, birch, ash and mulberry, pollinate in April and into May.” And then the summer grasses begin to bloom.

People who have multiple pollen sensitivities may feel no relief all year, as the pollination cycle continues. And it doesn’t take much to cause the runny nose, sneezing, itchy eyes and aggravated asthma symptoms that develop in a highly allergic person.

“Most exposure occurs outdoors, but during periods of high pollen production the indoor environment isn’t necessarily safe, either,” says Dr. Douglas Berson, an allergist on staff at St. Luke’s Hospital. “We open windows or drag pollen in on our clothing or hair, so limiting outdoor exposure can be helpful, but taking care of the indoor environment also can be helpful.” He recommends keeping windows closed, installing HEPA filters on air-conditioning units and running HEPA air purifiers indoors, and washing clothes and hair immediately after being outside.

Home remedies, such as neti pots or saline nasal sprays, can help soothe and reduce symptoms. But controlling symptoms through medication is the mainstay of surviving allergy season for a severely allergic person. “The best thing to try first is a 24-hour acting antihistamine that can be obtained over the counter, such as Claritin, Allegra or Zyrtec,” says Dr. James Temprano of Mercy Clinic Allergy and Immunology. Nasal steroid or antihistamine sprays and eye drops also may be helpful. “When these agents fail, it’s time to see your primary-care physician or allergist for further treatment and possibly testing.”

If you live in the Midwest, you’ll be exposed to pollen. But you don’t have to move to Alaska to survive the spring allergy season. A little awareness, some prevention, a dash of home remedy, a dose of allergy medicine and a visit with your doctor if you still feel miserable will see you through the spring with minimal discomfort.

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