The Asthma and Allergy Foundation of America named May National Asthma and Allergy Awareness Month. It also ranked Oklahoma City No. 7 in its list of worst metro areas for allergies in 2016, including Citizen Potawatomi Nation east of city limits.

Maggie Troxell is a CPN Health Services family nurse practitioner, treating individuals between 8 months and 80 years old and their allergies.

Environmental triggers include smoke, pollen, fungi, dog dander, dust mites and cockroaches. Many intensify in the spring.

“As the trees bloom and the flowers bloom, and things start irritating our patients, they come in with things like stuffy noses that are running constantly, itchy throats, itchy ears, a little bit of a cough,” Troxell said. “Eyes are draining and itchy and red.”


Many patients find relief following a simple plan, Troxell said.

She emphasized starting medications early in the season as soon as symptoms appear. Too often, people discontinue their recommended treatment as symptoms improve, causing cycles of irritation.

Avoiding known environmental causes prevents initial flare-ups. Asking family members to complete household chores such as vacuuming, pet bathing and mowing reduces exposure.

CPN health care providers prescribe prescription drugs available at Tribal pharmacies, which can relieve seasonal irritations. Sufferers can purchase over-the-counter antihistamines; however, they should consult their primary care doctor before using medication for extended periods.

Patients of CPN Health Services experiencing more severe or extended problems receive Oklahoma Allergy and Asthma Clinic referrals for more extensive testing.

“Based on that, they may add other medications,” Troxell said. “They may add allergy immunotherapy, which is basically allergy shots or allergy drops.”

Troxell recommends nasal saline and irrigation devices, such as the neti pot.

“What you’re doing with those is actually directly washing the allergen, the trigger, from the nose and from the sinus passages,” she said. “So, those are both very good.”


Signs of asthma include coughing, wheezing, tightness in the chest and shortness of breath. The chronic disease causes inflamed bronchial tubes — the lung’s air path — according to the American Academy of Allergy, Asthma, & Immunology, a group of medical specialists dedicated to the field’s research.

Citing Centers for Disease Control and Prevention data, Troxell said a quarter of million Oklahoma adults have asthma.

“They need to be under care,” she said. “They need to be seen routinely, not just when they’re having flares.”

While seasonal allergies can intensify symptoms, asthma affects patients year-round. CPN Health Services offers a pulmonary function test. It evaluates lung function by measuring a patient’s airflow limitations and lung capacity. It begins by getting a base reading before administering a bronchodilator such as albuterol and waiting for results.

“We’re looking for marked improvement in their lung function,” Troxell said. “And that can be fairly diagnostic for asthma.”

Bronchodilators decrease air passage swelling, which reduces wheezing and shortness of breath. The CPN pharmacies carry them and several other treatments. Doctors also prescribe oral steroids for severe asthma.

Many people’s allergies and asthma affect their quality of life, and Troxell helps improve her patients’ situation every day.

“If you’re coughing or draining all night, and you’re fatigued during the day,” Troxell said, “come see your provider.”