No, it's not snow. The white stuff are cottonwood seedlings which signal grass pollen season in the Midwest.

Sunny days and warm weather are just around the corner. Those of us that live in the Midwest have already begun to feel the impact of tree pollen and molds. Winds from the south not only give us some days of relief from the bitter winter cold, but also expose us to allergy triggers from afar (tree pollen and mold spores).

I have posted articles addressing the how to's on preparing for spring allergy season. See some of the links below for review.

Here is a short video discussing allergy triggers and patient decision-making.

Posting on tips: Preparing for Spring Allergy Season

You don't have to suffer from your allergies through spring, summer and fall if you have a plan. A good plan begins with knowing what you are allergic to. Your plan should be a joint effort between you and your doctor. A good plan allows some patient preferences (particularly in selecting medication) combined with sage advice from you health provider on when and how to take your medication. There should also be emphasis on environmental controls. There are things you can do to avoid outdoor allergen exposure that should not include staying indoors. See the above links. And tell me what you think!

Proventil HFA, the yellow inhaler, was one of the first of the newer fleet of inhalers to hit the market. It gets favorable marks for being senior to most of the inhalers of its class.

ProAir HFAis the red inhaler that delights doctors and patients because 200 doses are contained within the free samples as well as the prescription canisters. Furthermore, although not being much less expensive than some of the others, many insurances accept it as tier 2. When it first came on the scene it was on average, less expensive than the other albuterol inhalers. Recent reports indicate the gap has closed considerably (ProAir HFA, like many medications, has gone up in price). ProAir HFA, unlike all the others in this class, only requires 3 priming sprays whereas the others require 4.

Ventolin HFA, the blue inhaler, is the only one with a dose counter. I find this feature invaluable. Reliever inhalers are usually used as needed. How are patients supposed to keep up with how many doses have been used? There is no accurate way to tell without having a dose counter. Additionally, the makers of Ventolin HFA have a 64 dose canister that is less expensive than the 200 dose one. This means, those additional inhalers left at school or at grandmas, that never get even half used up before expiration no longer have to be tossed with so much medicine left inside. People with well controlled asthma would be better off with the 64 dose canister if they rarely need reliever inhalant.

Xopenex HFA, the light blue inhaler with the burgundy cap, is a more purified form of albuterol which has been associated with fewer complaints of jitteriness, tremor and palpitations. It requires more frequent priming depending on the frequency of use. Four priming sprays must be done if it has not been used in three or more days. Some insurance companies charge higher co-pays for this brand.

Maxair Autohaler, the big, light blue inhaler with a white tab, still contains albuterol with CFC. The makers of this inhaler have been given extra time to convert to HFA since they have a unique device (the inhaler kicks out the dose of inhalant after you begin to inhale, making it much easier to use correctly). You should re-prime this inhaler if it has not been used in more than 3 days. The good news is, it has 400 doses in the prescription inhalers (WOW!).

I posted an article on the new breed of HFA articles 2 years ago click on the title:

The New HFA Inhalers…

Okay, what are your thoughts on the above brands of reliever inhalers?