十幾年前住泰瑞鎮時，有一陣子感冒老是不好，鼻涕流個不停，最後不得不去看醫生。老醫生拿個小電筒在鼻孔照一下，篤定的說：
「是過敏，不是感冒。」
「怎麼可能？」（那時好像不是過敏季節）。
「甚麼東西都可能引起過敏：花、草、貓、狗、塵埃 ……，很多妳想不到的。」
他開了過敏藥。可是我不相信，認為他過甚其詞，或是「偷懶」，把所有講不出原因的毛病都歸罪於過敏。所以也沒有用那過敏藥。
搬到磐石郡，第一次要自己整理院子。買了除草機來除草，除完之後第二天全身發癢，這回相信是過敏了。癢過兩天消了，慶幸還不嚴重，可是周末又要除草，隔天又癢起來。這樣搞了幾星期，最後決定請人來除。
免去除草工作以後，皮膚不癢了，可是春天一到，照樣涕泗縱橫，不得不相信老醫師的診斷。那時來美六、七年，很多人說就是要等這麼久才會出現過敏症狀。看了另一位醫生，他建議一種不需要處方的藥，吃了稍微好一點。
可是第二年，原來的藥就不管用了，於是聽朋友建議換另外一種。因為每年春天容易感冒，有時搞不清楚到底是哪個原因引起的諸多不適。
有次去看醫生，提起這情形，他說改用鼻噴劑好了。我說鼻噴劑也試過，沒用。他說這處方的噴劑 Rhinocort Aqua 效果比較好，試試果然不錯，就連續用了兩三個春天。可是慢慢發現鼻黏膜似乎受到影響，鼻子乾燥得受不了。又換了另一種噴劑 Astelin。
幾年前聽說中醫的針灸有效，也去試了一下。沒有完全根治，必要時還是要用鼻噴劑補助。不過夜裡足冷的毛病倒消除了。保險不包含以針灸治過敏，而每兩星期去看一次的費用不便宜，所以試了一兩個春天就放棄了，還是以噴劑為主。
過敏時除了打噴嚏、流鼻水，也常附帶皮膚癢。鼻子的問題解決時，往往皮膚也不癢了。可是這幾年又多一項眼睛症狀，口服和鼻噴劑都沒有幫助。以前不知道這也是過敏引起的，以為是睡眠不足或空氣乾燥，多休息一下就好了。
兩年前有次回台正好眼睛紅到可怕的地步，去某教學醫院掛急診。醫生大概沒有看過因過敏而引起眼睛紅的病人，開了含有消炎成分的眼藥，點過之後疼痛難忍。我把藥擱在一邊，過一兩天紅眼自動消除，這才想到可能是過敏引起的。
過幾星期耳朵又有點不舒服，想拿這藥來噴一噴。還好先看了說明，是 Patanase - Nasal Spray，噴鼻子的藥！過兩天小兒子回來，聽到這事大笑，問我：「妳沒真的拿來噴耳朵吧？」
我說：「我怎麼想得到去看耳朵結果拿回來的是噴鼻子的藥？」
他說：「因為耳朵和鼻子是相通的。醫生認為妳的耳朵痛是鼻塞引起，所以給你噴鼻子的。」
好吧，算他們有道理。我沒有錯噴耳朵，當時也沒鼻塞，留到今年春天正好拿來噴鼻子。
鼻噴劑和 Zyrtec 都是一天服（噴）一次的，在過敏嚴重時，我錯開三種不同的藥，但是不到半天就用了另一種，已經到病急亂投醫的地步了。
至於眼睛癢，除了點眼藥水，方便時也洗一下眼睛四周，但幫助似乎不大。過敏嚴重時，整天在淚眼婆娑中渡過。不知是眼睛揉太多還是眼淚流太多，眼眶四周的皮膚都覺得刺痛。
還好去華府和植物園看櫻花時過敏沒這麼嚴重，要不然多掃興。上星期五涕泗縱橫的度過一天。星期六鼻子好一點，但眼睛矇矓得看不清電腦螢幕。週末除了上教堂和買菜，足不出戶，星期天終於好一點。可能溫度下降也有關係吧。
在台灣提到過敏，通常是濕度或其他原因，和花粉比較沒有關係。在網上找到這一篇和花粉過敏有關的訪談，原文刊於
http://walnutcreek.patch.com/articles/the-season-of-flowers-and-misery-qa-with-allergy-specialist-10
Dr. Kenneth Lien is Chief of Allergy at Kaiser Permanente in Hayward. Here's what he had to say. (Questions and answers have been condensed and edited for clarity.)
連肯尼醫生是凱瑟醫療組織的過敏科主任（應該是華裔，但不知道中文名字）。以下是對他的訪談，翻譯時省略了幾段地區性資料。
Patch: People often use the term “hay fever” or just “allergies” for the kind of seasonal allergies a lot of people get in the spring. What's the correct term and what are the symptoms?
問：人們常用「乾草熱」或「過敏」來描述很多人春天患的過敏，到底正確的名稱是甚麼？有甚麼症狀？
KL: Allergic rhinitis is the correct term. It means an allergic inflammation of the nose. People use hay fever because a lot of people suffer from allergies during grass season.
The symptoms often times mimic colds: nasal congestion, runny nose, post-nasal drip, coughing, sore throat, fatigue, swollen, red eyes.
When you have allergies, it's more than just the nose that's involved, it's kind of like a whole body reaction.
連：正確的名稱是過敏性鼻炎，指鼻子因過敏而發炎。稱「乾草熱」是因為很多人在長草的季節發病。症狀很像傷風感冒：鼻塞、流鼻涕、咳嗽、喉嚨痛、疲倦、水腫、眼睛發紅。當你有過敏時，不只鼻子不舒服，整個身體都會起反應。
Patch: Is it a false reaction? Because pollen doesn't really harm us, right?
問：這是不是錯誤的反應？花粉並不真的傷人，對吧？
KL: Basically it's an immune response. A person will make antibodies to things he or she is exposed to. Pollen behaves like a foreign body, and when it gets into the nasal mucosa or conjunctive area of the eye, your body has cells there that are basically trying to fight off this foreign invasion of pollen.
連：基本上這是免疫反應。人對外來物質會產生抗體。花粉是外來物質，當它接觸鼻黏膜或眼結膜時，妳的身體細胞會設法抵抗花粉的入侵。
Patch: Why do some people develop allergies while others don't? And why do some people seem to develop allergies all of a sudden?
問：為什麼有人過敏、有人不會？為甚麼有些人似乎突然間就產生過敏了？
KL: Basically, a lot of it is hereditary. You inherit the genetic profile to develop allergies; you inherit a mutation in the chromosome. And if exposed to pollen, you become sensitized; you develop antibodies and have an allergic reaction, usually locally.
連：基本上這是遺傳。你遺傳到會產生過敏、會改變的基因。當接觸花粉時妳變得敏感，身體產生抗體而引起過敏反應，這反應只針對當地的花粉。
It usually takes a few years before allergies start to blossom (in a person).
一個人通常要經過幾年過敏才會顯現出來。
There are many theories on why allergies have gotten worse over the last few decades. There's the hygiene hypothesis, which is the idea that our environments have gotten so sterile that the body's immune system is no longer used to fight off bacteria; for example, from the soil. So now the body switches to fighting off pollen.
為什麼近年來過敏日趨嚴重？這有很多理論。一個假設認為我們的環境消毒得太徹底，免疫系統沒有細菌可以抵抗，就轉而抵抗花粉。
Another theory is that pollution is actually a factor in driving allergies. Diesel particles have been found in the lab to stimulate your body to produce antibodies, regardless of the pollen count in those areas.
另一個理論認為過敏是汙染造成的。實驗室從刺激身體產生抗體的物質中找到燃料油成分，不論那個地區有多少花粉。
A lot of people from India and other places where the air pollution is worse come here and say, "Why are my allergies worse here?"
很多從印度或其他空氣汙染嚴重地區來的人常問：「為什麼我在這裡過敏更嚴重？」
In polluted areas, your body makes antibodies. And when your body is later exposed to pollens, those antibodies start reacting to the pollens. I think that has more credibility than the hygiene hypothesis.
在污染地區，妳的身體會製造抗體。一旦接觸花粉，那些抗體就來抵制花粉。我認為這比過度衛生的假設更有道裡。
Patch: What is producing the most allergy-provoking pollen this spring in the Bay area?
問：今年春天舊金山最會產生過敏的花粉有哪些？
KL: Mostly trees: oak, juniper, cypress, mulberry. The strong rain we've had has pushed back allergy season. It seems like it will be a very bad year because of the rain and wind.
In the Bay Area, not only tree season, but grass season, is bad. That peaks in early May and generally lasts until early July. Fourth of July weekend is usually the unofficial end of allergy season.
連：大多是樹：橡樹、杜松子、柏樹、桑樹。（在美東，會產生過敏的樹更多，其中之一是連醫師未提到的楓樹）。最近的大雨推遲了過敏季，但雨和風可能讓今年的過敏很嚴重。
不只樹，草也讓人過敏，高峰期是從五月初到七月初。七月四日的周末通常是過敏結束的日子。
Patch: Flowers don't cause allergies?
問：難道花不讓人過敏嗎？
KL: Flowers are usually not a problem because they are insect-pollinated. So their pollen tends to be sticky and viscous. It doesn't travel on the wind and get into your nose.
A lot of people think flowers bother them, but it's probably the fragrance, not the pollen, that can cause a reaction in nose.
連：蟲媒花通常不是問題。她們的花粉比較黏而帶汁，不會被風吹進妳的鼻子。很多人受不了花，那可能是香氣刺激鼻子，不是花粉。
Patch: How widespread is the reach of allergy-provoking pollen? Can people living in neighboring towns have different levels of allergic reactions?
問：會引起過敏的花粉能散佈多遠？住在相鄰市鎮的人過敏程度可能不同嗎？
KL: The pollen count changes in different neighborhoods depending on the dominance of trees. But the wind can also carry pollen from 50 miles up to 150 miles away.
連：花粉數量因樹種而不同，風可以把花粉吹送到 50至150英里遠的地方（80～240公里）。
問：從哪裡可以找到某一天空氣中有哪種花粉？
You can look up the pollen counts from those stations on the website of the American Academy of Allergy, Asthma and Immunology: http://pollen.aaaai.org/nab/.
You can also punch in your zip code on pollen.com and get a four-day allergy forecast.
連：妳可以從美國過敏、哮喘和免疫學院的網站（http://pollen.aaaai.org/nab/）查詢花粉量，也可以用pollen.com 打入由地區號就可以查詢。
Patch: How can I find out what exactly I'm allergic to?
問：我怎麼查出對甚麼過敏？
KL: You can have a skin test done. It's the most sensitive test to find out what you're allergic to. We actually scratch the skin with the protein extracts of different things we're testing for, and if it makes a little bit of swelling, that's how we know.
連：妳可以做皮膚測試，這是最準確的方法。我們把皮膚抹片和粹取的蛋白質混合，會起腫脹反應的就是對那種物質過敏。
Patch: What treatments do you recommend to your patients? And are there any negative effects of using the standard pharmaceutical allergy treatments long term?
問：你建議病人做甚麼治療？長期用藥有沒有副作用？
KL: The mainstay for treatment is a nasal steroid spray. They are prescription only, not yet available over the counter. They're mainly used to reduce inflammation in the nose. The safety profile is excellent for nasal steroids. They have been found to be safe with long-term use.
連：大多數人使用含類固醇的鼻噴劑，他們必須經過處方，不能自行購買。這種藥主要用於緩和鼻子的發炎。噴鼻類固醇很安全，可以安心長期使用。
The second thing is antihistamines. Many of them are over the counter now. If your symptoms are just mild and generalized, an antihistamine by mouth would be a great first-line agent.
第二種藥是抗組織胺，大多不需要處方。如果症狀輕微，口服抗組織胺是很好的第一線藥品。
If your nose if completely blocked, a nasal steroid is better.
如果鼻塞很嚴重，類固醇鼻噴劑比較好。
You can also get allergy shots. It's a way of fooling your immune system or actually building tolerance to an allergen. We give weekly injections of higher and higher doses of protein extracts of pollens or whatever you're allergic to.
也可以接受預防注射，這是「愚弄」免疫系統的方法，同時讓身體接受過敏原。每星期注射一次會產生過敏的花粉球蛋白，劑量逐漸增加。
Patch: For how long do you have to get the shots?
問：要注射多久呢？
KL: Weekly during the build-up phase, which lasts six to nine months. Then a monthly shot for three to five years. The shots can help you for up to 10 years after that.
There's also an oral equivalent of an allergy shot that's being studied right now. The results look promising.
連：在增強期間每星期注射一次，連續注射六到九個月。以後每個月一次，打三到五年。注射後可以維持十年的效力。現在還在研究口服過敏「疫苗」，效果蠻樂觀。
Patch: What about non-pharmaceutical treatments?
問：有沒有非藥物式的醫治方法？
KL: You can use a sinus rinse. A good homemade recipe is 8 ounces of warm water, ¼ teaspoon of sea salt or kosher salt and a pinch of baking soda. The neti pot (a small pot with a spout used to flush out the nasal passages) is popular. It's very safe to use two to three times a day.
連：你可以洗鼻子。把 8盎斯溫水，1/4茶匙海鹽，一小撮蘇打粉混合。用一種小壺來洗鼻子。一天洗兩三次都可以。
Patch: What other practical tips can you give for reducing exposure to pollen?
問：請問還有甚麼減少接觸花粉的建議？
KL: Windows should stay closed throughout allergy season. If you're allergic to trees blooming in the spring, you should keep windows closed starting in March. If you're allergic to grass and weeds, keep them closed in summer and fall.
If you need to open them, do it late in the afternoon because the pollen count is usually down then. Also, try to re-circulate the air in your car (as opposed to pulling in outside air).
連：過敏季節窗戶必須緊閉。如果你對春天樹開花過敏，應該從三月就把窗子關起來。如果對草類過敏，夏天和秋天必須關窗。如果想開窗戶，必須在傍晚時分，那時花粉通常比較少。還有，車子的空氣調成循環，不要吸進外面的空氣。
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