The Fall cometh and we all have allergies (particularly #ragweed) to deal with. It always amazes me how much information about #fall allergies can be found on the internet–some true, but much isn’t close to giving you good information about how to treat your allergies. In fact, if you’ll remember, I asked where most of you get your medical information and 100% said “from a medical journal”. I’m not sure I believe that result or there wouldn’t be so many allergy myths in Tulsa! I’ve often wondered, why does it make any difference to have good medical information about how to best treat your allergies? I know this may surprise you, but only 30% of people actually have allergies. The rest….non-allergic rhinitis, sinusitis, medication allergies, and a whole host of alternative diagnoses.
So why should you care about correct medical information?
- If you assume you have “allergies”, you may spend lots of money on antihistamines like Zyrtec, Claritin, and Allegra only to waste your money on pills you don’t need or medications that don’t do you any good. When patients find out they don’t have allergy, it’s a natural conclusion they have wasted lots of money influenced by advertisements.
- You can also get hurt by the wrong medical information. Take the diagnosis of asthma. Not everyone who wheezes or coughs has asthma. Some will have #vocal cord dysfunction, others sinusitis, but if you treat non-asthma conditions with too many steroids, the long-term problems are substantial. I unfortunately have seen too many patients on steroids for 20 years that don’t even have asthma.
- Because I’ve practiced allergy & asthma in Tulsa for > 10 years, I hear many misconceptions about peanut allergies, testing for food allergy, and what’s available for treatment of allergies–you need to go outside and have the best fall ever.
So let’s get started with the myths of testing for food allergy. I’m sorry I can’t give you any celebrity endorsement for the best way to determine if you have a #food allergy, but I can tell you it’s not Dr. Oz. (By the way, he has to find a new medical fact or procedure five days a week, and NOTHING changes that fast). Be that as it may, good research has been completed and published about food allergy and the video is worth your next 3 minutes.
Myth #2 is nothing can be done about outdoor pollen allergy, so you might as well stay inside. I rely on my colleagues from Wichita (who have moved by the way) to show us a nice video they put together for allergy immunotherapy or “allergy shots.” Wichita, KS is also often #1 in pollen counts during surveillance across the nation. No wonder they have the video! No patient should have to stay indoors during the pollen season because medications don’t work. Allergy shots can give you a quality of life that allows you to attend your grandchildren’s T-ball games and watch your cheerleader during the football season without carrying your Kleenex. Allergy shot patients feel better than other family members with allergy who don’t take shots and I often hear about that one!
From time to time, I get the privilege of presenting new research on allergy topics including peanuts. Lots of internet buzz on peanut oral immunotherapy (OIT) can be searched almost to the point of cult beliefs. Talk with 10 allergist and you’re likely to get 10 different opinions on how to diagnose peanut allergy and who should get #peanut OIT. As with any new therapy, no single doctor, clinic or investigator has all the answers and a frank discussion with the family is always the best alternative. As I have shown on my slides below, peanut OIT is probably not a permanent solution to peanut allergy as the allergic symptoms and risk for anaphylaxis may return once the daily dosing of peanut is discontinued. Another important point to remember about peanut OIT is the frequency of epinephrine use when advancing through the acceleration phase of peanut treatment. This means that as peanut dosing is increased during the first day and subsequent “updosing” days, the use of epinephrine may approach 25% or three times the rate of simple avoidance of peanut as treatment. Why take the risk? Peanut OIT is effective and quality of life is important to most families that wish to avoid accidental peanut anaphylaxis.