I’ve always wanted to be a doctor. My second grade teacher can tell you that; but you’re not here for a history lesson. My dream came true at the University of Kansas School of Medicine followed by training in Allergy/Immunology at Children’s Mercy Hospital in Kansas City. I will never be disappointed with the privilege of caring for patients, but it takes hard work and recommendations change. My passion is to understand the underlying “cause” of annoying symptoms such as sneezing, wheezing, not breathing through my nose, and generally not feeling up to my potential. This website will be used not only to share information about allergy, asthma, and recurrent infections, but I’ll put important educational material right at your fingertips–finally all in one place!
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The following YouTube video describes a process called “Rush Immunotherapy” conducted in Ohio. It’s now a more common way to deliver #allergy shots and reduces the total number of shots required to achieve clinical relief from your #allergies. Some caveats about #RUSH Immunotherapy need to be included and your bullet list is below the video.
I would make the following corrections to this video:
1. Unfortunately, you can’t answer all questions about immunotherapy (allergy shots) in a 3 minute news clip.
I love weather! Growing up on a farm in Kansas brought a variety of weather right to my front doorstep, and that must be one reason I became an allergist.
You have to be part botanist to do this job anyway, with monitoring pollen counts, making allergy recipes for allergy shots, and knowing what is pollinating at what time of the year. Oklahoma makes predicting weather patterns quite a challenge. One minute it’s 80 degrees outside and 24 hours later the temperature has dropped back to 50. We fluctuate from drought to 5 inches of rain in 1 week. How are you supposed to take care of your lawn, much less predict the pollen counts? Here’s some clues that might help you anticipate “bad pollen” days based on the weather patterns in Tulsa; and better yet, you might do better than the weatherman! Weather plays an important role in how much pollen is produced, its distribution and how much pollen is in the air at a given time. (for the full article on weather and pollen counts go to: http://www.weather.com/health/allergy/news/how-weather-impacts-spring-allergies) Allergy symptoms are often reduced on rainy or windless days because pollen does not circulate as much during these conditions. Pollen tends to travel more with warm, dry and windy weather, which can increase your allergy symptoms. Pollen counts vary by time of day, season and weather conditions. Rain, wind and temperature are all important factors to consider when determining if pollen counts will be high, moderate or low on a particular day. Overall, pollen counts tend to be higher in the morning, as well as on warm, dry and windy days. Conversely, lower pollen levels are also typically observed during a stretch of cold and wet days. The National Institue of Heath Medline Plus recommends saving outside activities for late afternoon or after a heavy rain when pollen levels are lower. First, if we’re measuring pollen, what is it we’re measuring? The American Academy of Allergy Asthma & Immunology defines pollen as tiny grains needed to fertilize many kinds of plants.
Pollen from plants with colorful flowers usually do not cause allergies. Plants that produce a powdery pollen can easily be spread by the wind and can cause allergy symptoms. Spring allergies are often caused by tree pollen, summer allergies by grasses, and fall allergy by weed pollen. Pollen is transported in the air and enters our respiratory system, triggering an allergic reaction technically called allergic rhinitis. According to the National Institute of Allergies and Infectious Diseases, a branch of the National Institute of Health, approximately 35 million Americans complain of upper respiratory symptoms related to pollen. So how does weather conditions impact spring, summer, and fall allergies? Continue reading Wacky Oklahoma Weather→
Thanks Dr Benaroch for your insights from a pediatricians standpoint. We see patients everyday that have been told based on a “test” that their child has food allergy. The percentages vary, but a majority of children that are found to have a food allergy by testing, tolerate the food just fine after challenge. What are the exceptions? Peanut, tree nut, milk, and egg anaphylaxis should always be asked during patient histories. This is why meeting your patient and asking directed questions is so important!
People like tests. You get numbers, and maybe a printout, and there’s science and blood and things just feels more… serious, when testing is done. You can picture Marcus Welby (or perhaps a more modern physician), looking solemn, declaring “We’d better run some tests.”
Are medical tests magical and mysterious, and can they unlock the secrets of life? Usually, no. And among the worst and most misunderstood tests we do are food allergy tests.
A few recent studies illustrate this well. A review of about 800 patients referred to an allergy clinic found that almost 90% of children who had been told to avoid foods based on allergy testing could in fact eat them safely. The study, bluntly titled “Food allergen panel testing often results in misdiagnosis of food allergy” also found that the positive predictive value of food allergy blood…
At first glance, I thought to myself, do we really need another quick acting inhaler? As I thought about inhaler technique and how we use our Ventolin MDI’s, most of use suck on the end of the inhaler which is the wrong technique to use. (all of the medication deposits on the back of the throat) Why not use the appropriate inhaler that’s meant to actuate with your breath anyway? ie, sucking on the inhaler is what you’re supposed to do!
This article is in press and will be published in Annals from the College of Allergy, Asthma, and Immunology next month. I thought the study is very interesting given the “push” for oral desensitization. I just returned from the AAAAI annual meeting and it appears that patients with food allergy can become “desensitized” or cured, however, that comes with a cost of potential anaphylaxis during treatment. Think of it like the use of allergy shots which are very effective, but you can develop anaphylaxis after an allergy shot that will need additional treatment such as epinephrine. The question I have is, “should this therapy with foods be used at home where parents and patients don’t know much about giving epi?”
Here’s the summary–>Asthma patients are at risk for more severe reactions and less likely to reach full desensitization during milk oral immunotherapy, according to a study in Annals of Allergy, Asthma and Immunology. Researchers in Israel studied 194 subjects 6 years and older with IgE-mediated cow’s milk allergy, with and without asthma, undergoing milk oral immunotherapy. Regardless of severity, subjects with asthma had more reactions and injectable epinephrine use during induction, and more home treatments with immunotherapy. Moderate to severe asthma also was associated with a lower likelihood of reaching full desensitization
What does it mean for your doctor to be board certified? Let’s start from the beginning of how your doctor becomes educated in the first place. Believe me, it’s hard enough for your doctor to keep track of the next test to take, much less keep track as a patient. Medical education begins in college as wannabe doctors take prerequisite college courses to prove their mettle in hopes of securing a medical school interview. Successful applications for medical school require a competitive GPA, good scores on standardized tests (MCAT), glowing references, and a first-rate impression during interviews. You would think that would be grueling enough to become a doctor, but there’s more! Once you’re accepted into medical school, you must take a series of exams to demonstrate that you are competent to become “board-certified”. Continue reading Do You Care if Your Doctor is Board-Certified?→
Over-the-Counter Allergy Medications Warrant Caution for Some
Nasal allergy sprays can now be purchased without prescription.
The next time you’re at the local pharmacy, you may be surprised to see your prescribed allergy nasal spray available over-the-counter. Many drug manufacturers are pushing for this move to make finding relief easier for some of the 50 million Americans with allergies. But this warrants caution for some.
“Allergy sufferers may no longer need a prescription for certain allergy nasal sprays, but they might need an allergist’s advice. Some medications merely mask symptoms without tackling the root of the allergy. And often patients will find what medication once suppressed their symptoms, no longer does.”
The over the counter availability of this new nasal spray may lead to questions from local Tulsa allergy sufferers. To help eliminate confusion, Dr. Lynn Wiens, along with the American College of Allergy, Asthma and Immunology (ACAAI) have answered the seven most common questions. Continue reading Do you Pick Your Nose?→
An apple a day might keep the doctor away, but what is modern hospital medicine really like? Follow Dr. Benjamin Kirkland - a Doctor working in Australia - through the pinnacles and pitfalls of everyday hospital medicine!