Category Archives: Allergies

Myth is, after all, the never ending story.

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.

  1.  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!
  2. 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).
  3. 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.
  4. There has to be a cause to my hivesperhaps 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:

  1. Can I get over asthma?
  2. Isn’t everyone allergic in Oklahoma? I’ve come to the right state;
  3. Food allergy–https://www.usatoday.com/videos/travel/experience/food-and-wine/2018/07/07/these-foods-can-help-you-feel-cool-heat/36661435/

If you don’t believe me, here’s an hour long lecture on “Allergy myths” given by Dr. Dave Stukus (teaches at Ohio State University) at the following link:

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Something about numbers

I for one am tired  how my health score is tied to my existence as a person rather than who I really am.   “How to keep up your credit score, what income bracket I’m in, what’s my IQ” are nagging reminders that I may not be anything more than just a number and not a unique person on this planet. Health care is fast approaching this same pigeonhole similar to banks and retailers, but it’s not all bad. Ever heard of personalized medicine?

#Personalized medicine has some pretty awesome benefits on the horizon, but “what’s the catch?”  My cholesterol has to be below 120, cigarettes at zero, and my daily cups of coffee can’t be over 5 if I have any hope of living past 80;you just can’t get away from numbers.

According to Wikipedia, Personalized medicine, also termed precision medicine, is a medical procedure that separates patients into different groups—with medical decisions, practices, interventions and/or products being tailored to the individual patient based on their predicted response or risk of disease. So if numbers and health are an integral part of the future of health care, is there such a thing as an allergy or asthma number? Wouldn’t it be nice to find out which asthma inhaler is best for you based on “personalized medicine?” Or what if you suffer from chronic hives and can’t find the cause? Personalized medicine involves many more diseases that just asthma and allergy–just look at the link below, but I have a list as well. Continue reading Something about numbers

Four reasons I still practice Allergy in the Information Age

Ever notice how everyone has #allergies these days?  I kid you not, almost everyday, a patient will tell me that #Tulsa (where I practice) has more allergies than any other place in the country.  The irony of it all, is so did patients in Kansas, and patients say the same thing in Virginia and Texas.  You get my point–we all love to be known as the Allergy Capital of the World! Maybe it’s because allergies make us feel so miserable, and we love to hear stories about how to deal with the nemesis.  Or maybe we want some “inside information” to share with our friends & family who also suffer from allergy. Whatever the reason for our obsession with allergy, you can’t argue with the fact that good allergy advise is not only helpful for better quality of life, but it’s crucial in making sure that allergy sufferers avoid heeding the WRONG advice for treating #hay fever. This is the passion I experienced in order to complete a fellowship training in allergy– I wanted to be able to interact with patients about their #allergic symptoms on their journey to good health. But wait, why practice a specialty that has so much incorrect information on-line and no doubt, “everyone’s an expert in allergy” when you could be doing real medicine to treat someone’s heart attack? Here are four reasons I still practice allergy for your consideration: Continue reading Four reasons I still practice Allergy in the Information Age

Dear Doctor…..

                             

Dear Doctor,

Thanks for all your help with my #allergies, but I have a bone to pick with you.  A few minutes into my visit and you’re talking about “rhinitis” and “IgE” and “desensitization”.  By the time my brain catches up with you, our visit is over and I don’t feel like I really understand what condition I  have.  Could you slow down and explain what you mean by all that medical riff-raff?

Signed,

Confused and a bit rushed Continue reading Dear Doctor…..

Tulsa is the Allergy Capital of the Nation

Tulsa is the #allergy capital of the nation.  You wouldn’t believe how many times in a day I hear that!  and it makes sense…countless numbers of patients return to Tulsa and find their #allergies are now out of control. But is this really true?  Does anyone even keep track of which city in America has the highest pollen counts and can thus claim to be the most miserable #pollen city in America? Continue reading Tulsa is the Allergy Capital of the Nation

What Else About Allergy is Out There?

It’s difficult to find good material on the internet related to the practice of #allergy. Here is one such blog site: http://blogs.medscape.com/garystadtmauer.  This blog originates from New York and the practice website is http://www.cityallergy.com.  I will periodically post comments & articles from Dr. Stadtmauer’s blog and I’ve included one below about the coexistence of systemic allergy (that’s a positive skin or blood test) and LOCAL allergic rhinitis which has all the signs & symptoms of allergy, but guess what–skin & blood testing is all negative.  Very frustrating for #patients to experience allergy symptoms, but go in to their local allergist and find nothing. I wish treatment would be more satisfactory, but as you can imagine, it’s unknown what allergens to mix up for your allergy recipe if all testing is negative.  Continue reading What Else About Allergy is Out There?

It’s allergy season and what can I do?

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.

Continue reading It’s allergy season and what can I do?

Wacky Oklahoma Weather

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.

Nothing like the harvest!
Nothing like the harvest!

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.

This is ragweed pollen floating around in the air
This is ragweed pollen floating around in the air

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