Health Tips from The Expert: Made Utari Rimayanti

This piece is a shout out to all fellow Indonesians who are familiar with allergic rhinitis—a form of allergy that affects your nose more than any other system in your body (some people have itchy skin, some have asthma, some have red, blotchy eyes; take your pick guys, allergy is awesome!).

Before my departure to Melbourne, I was panicking since the medication for my allergies, a form of nasal steroid spray called Avamys, was in fact one of the full page list from Australian border control website containing banned medications. Thus, when I successfully smuggled my desperately needed meds, I was elated. That is, until I found out that I was having nosebleeds as a side effect from the steroids combined with the dehumidified winter air in Melbourne. What am I to do?

I tried going without the medication for 3 days. Normally, I would be sneezing the ever loving hell out of my nose by this point. Since I seem to be doing okay, I continued the withdrawal trial for a week. Lo and behold! My nosebleed continued for another week.

Strangely enough, after I discontinued my meds for another week (a fortnight in total—an unforgivable offence if done back in Denpasar) I was fine. No sneezing, no runny nose (at last, my nose can walk at a normal pace), no congestion, no nosebleed. All that anxiety during my flight to Melbourne—my unfounded fear of being deported before I even step one booted foot on Melbourne soil—was for nothing. As of now, (hey, I don’t wanna jinx it) I am completely free of any allergic rhinitis symptoms that usually plague me in cold air back in Denpasar.

Thus, the ultimate question is: how is this at all possible? If allergies occur mostly in cold air, how am I surviving this ghastly Melbourne winter without nary a sneeze? Johnny English once said, “If I tell you that, I’m afraid I’m gonna have to kill you,” to which Natalie Imbruglia replied, “I’d like to see you try.” So try I will.

Allergy is casually defined as aberration of normal immune reaction in response to an allergen. Most of the time, this allergen is a form of protein expressed in the surface of nearly everything (remember high school biology lessons about lipoprotein that constitutes our cell membrane? That’s one of them pesky allergenic proteins). Sometimes, allergy can be triggered by naturally occurring substance (ever watch House MD, season 1, episode 4? The nun was unfortununly allergic to copper—get it?)

A common misconception is that allergic rhinitis—allergy that affects your nose causing nasal congestion, sneezing, rhinorrhea (which is just my obnoxious medical way of saying runny nose)—is caused by cold weather. While it is true that in cold weather our nose gets congested more easily (this warming mechanism is vital in ensuring your lungs don’t get frozen by over-inhalation of winter air), it is misguided to think that cold air is an allergen. Cold air is not the culprit, although it does cause many of the similar allergic rhinitis symptoms to appear.

Although there is no research comparing the exact atmospheric composition of Denpasar and Melbourne, I am nevertheless inclined to believe that the cause of my allergy amelioration is the clean air in Melbourne, and the fact that I have to walk everywhere (no one would even dream of walking even 200 meters in scorching, humid Denpasar air). First, air pollution. Contrary to popular belief, the cause of “dust allergy” is not the sort of dust that you find on the side road—that type of dust is most commonly composed of sterile and inert material that have limited allergenic potential—it’s the house dust you need to watch out for (which mainly consists of protein-rich shed skin cells and dead outer shells of a plethora of invisible house pests). However, air pollution does play a part in exacerbating allergy—which is why your doctor would normally recommend you to use a mask while driving your motorbike in Indonesia. Polluted air impedes the ability of respiratory immune system to recognize allergen and other offenders alike—which is the main reason why the body normally just launch into a full-blown siege: an indiscriminatory, generalized inflammation all over respiratory canals.

Second, is the increment in my daily exercise regimen. Exercise or any kind has been shown to help shift the body’s immune response from “allergy loving” to “neutral”. In some cases, it has even been shown to be “allergy indifferent”, essentially causing the allergen that used to cause all sorts of chaotic allergic response to sing “Somebody That I Used To Know” in E flat. I won’t profess to be an expert of walking in Melbourne (although I did walk 2.5 hours non-stop the other day—not bragging, just an overly proud statement of fact); but I do think that walking in Melbourne is not something that you would consider a hardship. After a few weeks of adjustment period (during which I found out that google maps walking time estimation is based on bule with longer leg reach and faster pace—thanks a lot G-man, I had to multiply that time estimate by a factor of 2 to accommodate my short legs and snail-like pace!) I was able to go nearly everywhere just using my own feet. This ubiquitous practice is arguably essential in normalizing my immune response, shifting it from “j’adore allergie” to Theoden, King of Rohan’s memorable meme, “You Have No Power Here!”.

Overall, here is the take home message for my friends fellow allergy sufferers in Indonesia and Melbourne (or wherever you currently are while reading this blog): see ya suckers! I am clean, babes! Although, I do still have 3 batch of Avamys if anyone’s interested (seriously, call me if you need them).

On a more serious note, you may not have a similarly awesome experience that I have in regards to your allergy, and to that, I say hang in there! There aren’t many cures to allergy, and it is going to be the bane of our existence for a long period to come considering the hygiene hypothesis (look it up, I’m running out of space here). In the immortal words of the philosopher Mick Jagger, “you can’t always get what you want, but if you try sometimes, you find you’ll get what you need!”. There are things you can do to help alleviate your symptoms (let me know if you want me to cover it in the next article). Who knows, one day you might even solve this conundrum and cure allergy once and for all (and earn millions while you work at it).

Until next time,

Doctor Dee

Kontributor: Made Utari Rimayanti

Contact her on her via FB Made Utari Rimayanti

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