The polar vortex is over and allergy season is ready to take its place.

More patients have been showing up to the doctor's office with allergy symptoms such as "itchy and watery eyes, runny and congested noses, puffy and inflamed sinuses, violent sneezing fits, severe headaches, coughing and even difficulty breathing," an Asthma and Allergy Foundation of America news release reported.

"Nearly 45 million Americans are living with nasal allergies and 25 million have asthma," Doctor Clifford W. Bassett, Medical Director of Allergy and Asthma Care of NY and an Ambassador for the Asthma and Allergy Foundation of America (AAFA), said in the news release. "Allergy and asthma patients already have a chronic sensitivity to things like pollen, mold and other airborne allergens, but they can also be more susceptible to rapid changes in temperature, moisture, and air quality."

"A blending of the winter and spring means these patients are at risk of multiple symptoms simultaneously. But with the proper planning and early treatment, patients can prepare and find relief," Basset said.

AAFA's recent annual Spring Allergy Capitals report ranked the 100 most difficult cities to live in when it comes to seasonal allergies.

For the third time in 12 years Louisville Ky. was deemed the number one most allergy-ridden state.

 For the first time Dallas ranked number seven and Richmond Va. ranked number eight; this is up from a ranking of 23 and 22 respectively.  New York jumped from number 43 to 13 and San Antonio, Texas went from 24 to 15. The largest leap went to Virginia Beach, which went from number 66 to number 20.

Los Angeles fell the most this year, going from number 38 to 77.

"No matter what time of the year it is, and no matter what Mother Nature sends our way, people with allergies need to be prepared and proactive to avoid allergy misery," Dr. Bassett said. "Now we have the ability to prevent symptoms before they even occur, but patients have to take the first step to visit their doctors and to get ahead of their disease."