By Michelle Brusio, MSN RN, CCM
A -Choo! As we anxiously wait for the start of spring and summer, we can be plagued with seasonal allergies, and a time when asthma symptoms worsen. May is Asthma and Allergy Awareness Month, a time to increase education on asthma, its causes, symptoms, and how to manage them all. Over 100 million people in the United States have asthma and or allergies, and 4000 deaths a year are related to most being preventable. Some people may have more than one allergic condition, including allergic rhinitis (hay fever), food allergies, eczema, and asthma.
Allergies are considered one of the most common chronic diseases with no cure. An allergy occurs when our body’s immune system sees something harmful and overreacts. This could be pollen, pets, latex, mold, medications, insects like bees or wasps, and food. Symptoms of allergies include a runny nose, watery eyes, sneezing, rash, or even hives. More serious symptoms may be life-threatening and require emergent medical intervention. These symptoms can include facial swelling and/or swelling in your mouth or throat, and trouble breathing.
Asthma causes your airways to become swollen and inflamed, which makes it hard to breathe. Asthma must be managed and controlled by medications, avoidance of triggers, and preparations to treat exacerbations. Symptoms of asthma include wheezing, chest tightness, and shortness of breath. Many people are surprised to hear that coughing is also a common symptom. Going from a warm gym to the cooler outside can trigger coughing or wheezing.
Food allergies affect over 33 million people in the United States, and 40% of children have more than one food allergy. There are nine major food allergens; however, dozens of other foods are also noted as allergens. Food allergies can be very dangerous due to mislabeling, cross-contamination of allergens, and delayed allergic reactions.
People with allergies and asthma must seek a provider to diagnose and support treatment and prevention. Allergy testing, symptom management, medication management, effectiveness of the plan, and follow-up visits are essential in managing triggers and exacerbations. They need a well-thought-out and mindful plan.
Protecting the health of our communities, especially children with asthma, is reducing barriers to affordable treatments and health care coverage. People with allergies and asthma must work with their provider to diagnose and support treatment and prevention. Allergy testing, symptom management, medication management, plan effectiveness, and follow-up visits are essential in managing triggers and exacerbations. Asthma and allergy regimes require a daily commitment to medications, avoiding allergies, and being well-versed in using rescue inhalers and/or EpiPens. Having an asthma and/or food allergy plan in writing and sharing it with caregivers, schools, and others is essential to recognize symptoms when they get worse and what to do in an emergency.
Anxiety over asthma, allergies, and food allergies is common. The fear of being exposed to an allergen, having an allergic episode, and the impact on one’s daily life can be a challenge. Some ways to improve overall health include encouraging mindfulness exercises, relaxation techniques, ongoing education on avoiding triggers and having an action plan, a healthy diet and exercise, and even seeking professional help to manage anxiety.
Case managers must educate our patients or clients diagnosed with allergies and asthma to ensure understanding of the importance of setting up a daily regimen in their care. Teaching patients to avoid triggers, manage emergencies, and use rescue medications is crucial for preventing exacerbations and emergency room visits. Another important aspect is to ensure that the patient/client or caregiver advocates for the person with allergies, especially while dining out, ordering food, or having an outside picnic.
Join me at the CMSA national conference in June, where I will present "It’s All About the Big Mac—A Lesson in Food Allergies and Food Insecurity." This is a story about my family’s journey. See you there.
References
Food Allergy Research and Education (2025). Facts and Statistics.
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Bio: Michelle Brusio, MSN RN, CCM has been a RN for 26 years and in Case Management for 20 + years. She is currently the Clinical Manager for Population Health, Care Transformation Organization and Primary Care at University of Maryland Upper Chesapeake Health. Michelle has acute care, payer, primary care, and outpatient case management experience. She loves to mentor other case managers and is always looking for ways to be a better leader to her team. Michelle serves on several local committees including the Geriatric Assistance Information Network, The Harford County Advisory Board on Aging, and recently asked to join a committee to find the next Health Officer for Harford County. Michelle also serves on several CMSA committees and is currently pursuing her Doctorate in Nursing. On a personal note, Michelle is a fierce allergy mom and advocate and recently became a certified pet therapy team with her dog, Gunnar Henderson.