I recently found an article on the accuracy of #medical information on #Facebook–it was 85% (wrong that is). With this much misinformation at our fingertips, no wonder medical advances seem to be muted…obesity, cost of medical care, gun violence, heart disease. If you’re relying on the internet for your medical information, perhaps this link on how to counteract medical-misinformation might be helpful.
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Flying home from San Francisco spending some time at the AAAAI (American Academy of Allergy, Asthma, and Immunology) was a powerful reminder of how thankful I am for the opportunity to practice allergy here in the Midwest. National meetings give you updates of new procedures, opportunities to meet colleagues, and just a general good time getting out of the routine. What’s new for allergy here in Tulsa is more use of #biologicals (for #asthma), more #food challenges/treatment, and more aggressive treatment of #hives. I’m excited to get started, so let’s go!
When it comes to asthma, it’s not easy fighting the myths of Facebook, Google, or e-mail campaigns. And why are we so resistant to the diagnosis of asthma for our kids and ourselves? For asthma, if you don’t make the correct diagnosis, you’ll never implement the proper treatment. By that I mean, you’re not likely to use prevention, but instead will wait for an asthma attack and then rush in to treat the symptoms. Health care providers are responsible for this phenomenon just as much as patients. Go to any emergency room or urgent care with an asthma attack and you’re likely to receive steroids, antibiotics and the admonition to “see your primary care doctor”. The problem is that patients feel better after steroids and guess what? they never seek medical attention for the prevention of #asthma. After practicing asthma medicine for over 25 years, consider the following reasons for why our asthma treatment often fails to meet the “standard of care” according to published #asthma research:
Asthma attacks don’t happen all at once. If I can get through an asthma attack in September, what’s the big deal of one course of steroids per year? This paroxysmal nature of asthma makes proper treatment very difficult because we tend to have a very short memory about our last asthma attack.
As a general rule, we all resist preventive care. Do you miss a regular dental floss or exercise session? As difficult as it seems to continue with good preventive care, think how much more difficult it is to take an inhaler everyday to prevent asthma! Antibiotics are so successful after 10-14 days that we can stop therapy and recover back to our original health. Asthma isn’t the same disease process and many times one attack leads to never ending asthma.
Can I get over asthma? The short answer is usually not. Asthma is a disease of inflammation which means the airways over react to allergy, infections, or irritation. In short, this means lungs with asthma are forever inundated with “triggers” that cause wheezing, coughing, and typical asthma symptoms. If you don’t use preventive inhalers for the next attack, you can be assured it will come.
Excuse my ranting and raving about myths in #allergy, but it’s true our minds need to “get in gear” for what we believe. Does it really make sense and does information we believe come from reliable sources? Let’s try and debunk a few myths about allergy while it’s fresh in your mind.
Once I start allergy shots, I’ll never have any problems. #Allergy immunotherapy or “allergy shots” are very helpful to relieve symptoms of #hay fever such as sneezing, runny nose and even wheezing, but they don’t cure everything. For instance, if you have sinusitis, don’t count on your shots to cure your symptoms–you have to treat the sinuses for relief. This may include antibiotics/prednisone for one month at a time, or even surgical intervention. This is the reason I will often obtain a CT scan of the sinuses before starting allergy shots–to make sure I’m not missing an infection or anatomical obstruction in the sinus cavities. You wouldn’t expect the patient below to improve with allergy shots because they have a concha bullosa on the left side causing obstruction of nasal airflow. Not a good remedy for allergy shots!
Benadryl is the antihistamine of choice–pick an ER and you’re likely to find #benadryl used like candy. Medical conditions like #hives and unknown #allergic reactions should be treated with antihistamines, but benadryl, really? Better antihistamines are available OTC and include Zyrtec and Xyzal. They’re stronger, more potent and last up to 24 hours instead of 4-6 hours like cousin benadryl. Next time you get benadryl, substitute with a better antihistamine and see what happens. (I think you’ll be pleased).
Nasal spray addiction–Here in America, we don’t like using #nasal sprays. Europe has no problem sticking lots of objects up their nose, but in this country, we’d rather take a pill than use the more effective nose sprays. Every single study that compares nasal sprays with antihistamines, finds that nasal sprays such as corticosteroids work much better for allergies than pills and sometimes even allergy shots. WORD of CAUTION: Nasal sprays such as Afrin or 4-way spray can be addictive and harmful to your health. I’m only comparing nasal sprays with antihistamines and #topical steroids which don’t have addictive potential.
There has to be a cause to my hives—perhaps the most frustrating medical condition of all time is #hives. That pesky rash that can range from a few bumps to your body being covered from head to toe with incredible itch associated with difficulty breathing and swelling. Most patients come in to the office hoping to find a cause or trigger to avoid and thus cure the hives. Unfortunately, the cause for hives is never found in 70% of cases, only leading to more frustration and disgust. I will usually look for allergy, bone marrow problems (tryptase) and alpha gal sensitivity, but that’s about it for finding a cause. Symptom control is key with antihistamines and Xolair, but if you stop your medication, the hives are likely to return.
No, I’m not done with allergy myths, but part 2 is coming up later. Those topics to include the following:
Can I get over asthma?
Isn’t everyone allergic in Oklahoma? I’ve come to the right state;
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