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Every spring, my consult room fills with itchy eyes, streaming noses and people apologising for sneezing mid-sentence.Hay fever season is well and truly here (yuck).But there's something I'm bringing up with almost every one of those patients right now, and it's not tissues.It's thunderstorm asthma.

Victoria's grass pollen season usually runs from 1 October to 31 December and it brings the risk of thunderstorm asthma with it.Unfortunately, this year could be a big one. After Victoria's wettest winter since 2016, forecasters say Melbourne could see more high and extreme pollen days than last spring.

Here's the short version of how it works.On high pollen days, some grass pollen grains burst into tiny particles that get concentrated in the wind gusts just before certain thunderstorms. They're small enough to be breathed deep into the lungs, and they can trigger sudden, serious asthma symptoms, sometimes in people who have never had asthma in their lives.

That last part is why I keep raising it.Many of the people most at risk think of themselves as "just hay fever people." If spring leaves you sneezing, you're in the group I want to be prepared.

Melburnians who remember November 2016 know how quickly this can escalate.Thousands of people needed urgent care within hours, and in one hospital's review, many of the adults treated had never been diagnosed with asthma.

So here's what I'd suggest, as your friendly neighbourhood GP:

Come and see me (or your own GP) for a written asthma action plan and a medication check. Only about one in three Australians with asthma has one, and inhaler technique matters too.Get your hay fever properly treated, not just tolerated.Take your asthma medication as prescribed, even on good days.Keep a reliever on you through spring, even if you rarely need it.Download the VicEmergency app and set up a watch zone. On high-risk days, head inside and close the windows before the storm arrives. The wind gusts before the storm are the dangerous part.Learn asthma first aid. With a blue/grey puffer: sit the person upright, give 4 separate puffs with 4 breaths after each, wait 4 minutes, give 4 more if needed and call 000 if breathing still isn't normal. If your reliever is a combination inhaler, your action plan will tell you what to do instead.

It's one of those rare health risks where a bit of preparation genuinely makes a difference, and it takes one appointment.That's less time than you'll spend hunting for tissues this spring, I'd bet!

Stay well, team. If you need me, you know where to find me.

Dr Billy Stoupas, The General Practitioner, Hughesdale