If you’re like me, I don’t think of allergies during the holiday season. But wait. Spring season here in Tulsa is less than 3 months away, and this year we’ll probably have a #COVID-19 vaccine by the time Spring hits in full bloom. I’m quite amazed at the ignorance surrounding the use of allergy shots, even by physicians.Continue reading
A clinical trial is underway at National Jewish Health to see if eating small, gradually increasing amounts of three of those allergens, along with a medication, can prevent a severe reaction.
Much is now being published about food allergy–the main question for researchers is can patients be desensitized to foods safely? At Warren Clinic the answer is yes! We’re working with a product called Palforzia which gives you small amounts of peanut over the course of one day and then every 2 weeks thereafter–it’s working great and patients really love the idea of tolerating the food (peanut) they have dreaded for so many years.
But there is much more to treating food allergy than just desensitization. The above article reports a study at National Jewish Health that adds a common asthma medication, Xolair, to food challenges. This process would be especially helpful for those patients with multiple allergies as Jeremiah in this report can’t tolerate > 6 foods. That is a bummer! Be thankful you don’t have that many food allergies, but also be thankful for new research that is looking for a cure!
As the holidays approach, our travel will be limited by #COVID-19, but we still may visit relatives with #cats, and you’re allergic! Researchers from Nestle Purina Research in St Louis MO may have part of the answer. As cats groom (which they do all the time), Fel d 1 is distributed within the hair coat and can then be shed with the #cat hair and dander. Not good news if you suffer from cat allergy. And worse news for your relatives!Continue reading
This is short and sweet–days off until Jan 2021 for Dr. Wiens include December 23, 24, and of course Dec 25th. Have a great holiday season and enjoy Turkey day and Christmas!
Much of my medical office day is explaining to patients what they DON’T have rather than treating #allergy. Allergy has become the explanation for all medical disease. For instance, it’s rare for allergy to cause lack of attention, abdominal cramping (because of food allergy), or even constipation, but patients want allergy testing nonetheless. What are some “non-allergy” conditions that you’re likely to spend money you don’t need because of excessive testing?Continue reading
I need an outlet for my questions, comments, or we hope are a few complaints or improvements as I like to call them. I’m sure you would appreciate any opportunity to communicate with me as well. I have changed many things over the years based on recommendations and questions from patients and colleagues alike. Use the comments section below for your writing space and I’ll delete the old messages so this section will always remain at the top of the page.
Last month, I shared several videos with you that pertained to treatment of #asthma with biologicals. I hope you listened to the lives of patients just like you who can now “do life” with their family and friends not having to fear the next asthma attack. But it’s not so easy to change our habits on treating asthma. We’ve been trying for years to get patients to use preventative care (ie, inhaled steroids) and that method even in clinical studies is no more than ~50% effective. So what’s next?Continue reading
Who would have thought in March 2020 that we would still be dealing with COVID-19? Well, I have news for you we are. It’s time to find out more about how you feel about COVID. I want you’re opinion on this life-altering condition with “the COVID poll”:
What else would you tell me about COVID-19 that you’d never tell your doctor or state representative: use the comments section at the end of this poll. Thanks for the input.
The first video reflects one of our first biologicals to date, that being mepolizumab or (Nucala). As you will hear, before Nucala, we had nothing to use for asthma except the dreaded steroids. Here’s what I like about Nucala:
1. One of the first anti-IL 5 medications to hit the market to reduce asthma exacerbations.
2. Dosing is easy: 100mg every month and it’s not based on weight
What I don’t like about Nucala:
1. Maybe we should be dosing on weight. Several studies that are now looking at Nucala for treatment of EoE find the 300 mg dose works better than the current 100mg.
2. Blocking IL-5 molecule only may not work as well as blocking the receptor itself or blocking other cytokines (IL-4; IL-13)
I will verify that responses you’re about to hear do happen all the time with mepolizumab (Nucala) and it’s been a great addition to our asthma treatment.
What is the magic bullet of medical treatment? How about a biological that treats two or more diseases at one time? Dupilumab (Dupixent) is one such medication and I agree with Dr. Castro’s interpretation of the data on dupilumab–after all, he wrote the study. Here’s what I like about Dupixent:
- Blocks 2 cytokines, both IL-4 and IL-13
- Treats 3 different diseases: asthma, nasal polyps, and atopic dermatitis.
- If you can’t get approved through your insurance, the company has a very good patient assistance program that makes Dupixent affordable for most patients.
Xolair, xolair, xolair. This biological has been around since my days back in Kansas. I have to admit, when Xolair was first released 20 years ago, I thought “who would use this type of medication?” Not only was I wrong, but Xolair has now set the standard for the use of monoclonal treatment of allergic disease, asthma, and urticaria. But I can’t compete with the video on Xolair….enjoy!
The last biological I mention is one that wasn’t the first on the scene, but has made it’s impression with a unique mechanism for getting rid of allergic inflammation: why not block the eosinophil IL-5 receptor directly? What do I like about Fasenra?
- Gets rid of eosinophils quickly–you notice within several weeks many times when Fasenra makes you feel better.
- After the first 3 doses, you only have to use Fasenra every OTHER month–pretty cool schedule compared to a daily inhaler.
- Reduces both exacerbations of asthma AND the need for corticosteroids.
Ok..it’s time we learn the “why” of using spacers, because most patients don’t use them on a regular basis. Spacers do several things for your pocketbook and your asthma:
- This spacer below can be purchased for < $10 on-line at Amazon. That’s almost better than a used toilet roll cardboard! Yes, we used to use and recommend I might add this “makeshift” spacer for patients because the others were too expensive.
- Your asthma inhaler is much more effective when you use a spacer, because the aerosol is delivered deep into the lungs where you need it–in the small airways. Make sure you don’t use a spacer with dry powder –not needed here. For example, Advair has both dry powder and aerosol; the choice is yours, but no spacer for the dry powder.
- If you’re using an aerosol or MDI, you may find that only 1 puff is needed–you save money with similar results, but check with your doctor first before making that kind of switch.
- Now you know why we harp on you to use your spacer–saves money and better results.
Go out (or order from home) and get you one today! Leave me a note on how it works. Happy breathing–Dr. Wiens