All Clear

April 25, 2011

Miami City Ballet principal Jennifer Kronenberg found herself right in the middle of Coppélia when her allergy medication started wearing off. Her nose began to run as she stood perfectly still impersonating a doll. “I was humiliated,” remembers Kronenberg. Luckily, Dr. Coppelius thought it was hysterical, and she has lived to laugh about it now, and get longer-acting allergy drugs.


Like some 20 percent of the population, Kronenberg suffers from seasonal allergies. In spring and fall, pollen and other airborne allergens from plants or fungi can cause a runny nose, itchy eyes, and breathing difficulties. “You don’t sleep well when you can’t breathe,” says Dr. Joshua Septimus, an internist at the Methodist Hospital in Houston, “and your immune system is stressed because it’s fighting the allergies like an infection.”


For years, dancers had to choose between suffering and medications with a plethora of side effects. Nearly all the medications made users sleepy, or worse, jittery. Luckily today’s generation of medications has enabled dancers to beat back symptoms with fewer side effects. And by using a more strategic approach to medication, dancers now have better control over their symptoms during a long day of class, rehearsal, and performances.


There are several mainstays for allergy treatment, including nasal steroid spray, decongestants, and the old standby, antihistamines. Nasal sprays only treat symptoms like a runny nose. And decongestants like Sudafed, though popular, have drawbacks. While effective in shrinking swollen nasal passages, they are similar to amphetamines and can contribute to nerves and sleeplessness. Another option, immunotherapy, can be cumbersome. These scheduled shots ward off symptoms before they start, but going regularly to the allergist can burden already over-scheduled dancers.


Most doctors recommend antihistamines as the best approach, especially when the problem is more systemic. Plus the second generation of antihistamines on the market, in such brands as Claritin, has been formulated to avoid severe drowsiness. Septimus recommends Claritin for dancer patients, though for nighttime he recommends Benadryl, a stronger and older antihistamine. “It dries out mucus and helps you sleep,” he says. “But make sure you get a good eight hours of rest before you drive anywhere.”


Timing is one key to successful medications. “Don’t wait until you feel symptoms,” Septimus says. “Start your meds before you need them.” Heading the problem off means that you will not have to play catch-up mid-performance with a compromised immune system. Current pollen counts are readily available online (on sites like Doctors advise starting medications before the count soars and staying on them until symptoms subside.


Some dancers use several different medications. Since childhood, Toni Leago Valle, the artistic director of the 6 Degrees dance company in Houston, had to deal with severe allergies. “I couldn’t breathe or sleep well,” she says. “My head was clogged and I was always tired.” Much of her dance life was spent on Claritin-D, a combination decongestant and antihistamine that brought her symptoms into line, though she admits the decongestant made her a bit jittery.


Kronenberg has her medications down to a science. She usually takes Zyrtec, another one of the second generation of antihistamines. “When I have to perform, I prefer to use Claritin RediTabs,” she says, since Zyrtec can make her a little sleepy. “Though not as effective as Zyrtec, they work quickly and don’t leave me feeling sluggish or shaky.”


Allergy-prone dancers should watch what they eat and drink. Septimus warns that alcohol and caffeine don’t help. Alcohol is dehydrating, leaving the body more vulnerable to allergy symptoms. It also interferes with deep sleep, which is when the body does its repair work to strengthen the immune system. And caffeine will only make you more tense if you are taking a decongestant already.


Kronenberg takes her sniffles in stride. “When you balance everything—the joy, the sorrow, the hard work of dancing—dealing with allergies is just one more obstacle to overcome. Dancers are very adept at finding ways to supersede any challenge that life throws our way, even allergies.”


Nancy Wozny had to skip ballet on the days she had allergy shots. Today she writes about arts and health in Houston.