Food allergy “testing” is usually a bad idea

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!

The Pediatric Insider

The Pediatric Insider

© 2015 Roy Benaroch, MD

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…

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Spring is Right Around the Corner!

#allergies, #american-college-of-allergy-asthma-immunology, #asthma

Here’s What Measles May Look Like.

 

 I never thought in medical school I would have to remember what Koplik’s spots look like but with the recent measles outbreak, here ya go!

koplik illustrationKopliks spots for measles

#conjunctivitis, #coryza, #cough, #fever, #kopliks-spots, #measles, #vaccination

Do You Care if Your Doctor is Board-Certified?

Boards, boards the medical test,

The more you study the more you jest,

The more you jest, the more you scream

Can Boards just be another scheme?

Taken with great artistic license from “Beans, Beans, the Musical Fruit” (http://en.wikipedia.org/wiki/Beans,_Beans,_the_Musical_Fruit)

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

#abai, #board-certification, #medical-school, #medical-training

Do you Pick Your Nose?

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.”

OTC nasal spray

OTC nasal spray

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

#allergy-medication, #nasacort-aq

What Do Doctors Read?

New Year’s resolutions, gotta lose weight, exercise more.  It does get a bit annoying to read all of our good intentions and then we fall off the wagon one more time!  As I look ahead to 2015, I begin my term (one year) as president of Tulsa County Medical Society (TCMS).  No resolutions I can’t keep, just hard work and lots of meetings.  The best way for me to share my thoughts and vision for 2015 is to let you in on my first newsletter of the year.  (unabridged)

TCMS

It’s Monday morning and I haven’t rested well from the weekend. With a full schedule at the office, I don’t have time for interruptions. I check my e-mail first thing in the morning and today I wish I hadn’t. I have four prior authorization phone calls to complete today, and two of them have already been denied. “What?” I asked as the insurance representative informed me that the patient in question didn’t qualify for the CT sinus study because they hadn’t been on antibiotics for 2 months. “Aren’t we supposed to use antibiotics judiciously?” I asked. But my troubles today were just beginning. Continue reading

#medical-society, #medicine, #tulsa

Running with asthma

Keep up the good work! No excuse for not exercising.

lissy webb

I’ve had asthma for as long as I can remember. I can also remember as a child being told that it was likely that I’d just ‘grow out of it’. But I got older and older, and now here I am at 26, still an asthmatic.

Like most people, I have certain triggers that make asthma worse. The biggest trigger I have is cold weather. Asthma is a major problem for me in winter – the cold air coupled with spending more time indoors with central heating on full blast plays havoc with my ability to breathe comfortably. 

It makes training so much harder – the running in general is harder, with inhaler breaks mid run. Harder runs in turn lead to dreading runs, which in turn leads to missed runs. It’s a vicious cycle.

I remember once being at a BBQ, and getting out and using my inhaler. Bemused…

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Is it legal to buy drugs online or import them from another country?

Many asthma patients will inquire about this for cheaper inhalers. Good article.

PharmacistAnswers

Is It Legal To Buy Drugs Online Or From Outside Of The United States?

     ​Consumers always want to find the best price to purchase their goods and medications are no different. The drugs that treat our many illnesses and disease states can help us lead healthier and better lives, but they can also come at an enormous cost. We now live in a digital age, where many of our purchases that once took place in brick and mortar stores, now take place online. There has always been a sort of stigma regarding online pharmacies. Are their prices too good to be true? Are they safe? Will you get the same medication online as the medication that is at your CVS down the street? The big questions though are those concerned with the legality of it all. There are two legal questions that people always want answered. The first is if it is even legal to buy drugs online. The second is, if it is legal to buy drugs online, can…

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What to Make of Dr. Oz and his Detox? Not much

Unfortunately, this has been my experience as well with allergy related topics. It’s difficult to come up with a new topic for your TV show EVERYDAY!

gutsandgrowth

Although my exposure to Dr. Oz has been limited, he is not one of my favorite TV doctors. He often offers opinions in areas where he clearly is not an expert.  By presenting himself as a doctor who is knowledgeable in so many areas, he has the potential of undermining the credibility of physicians more broadly.  A recent report provides some welcome pushback and at the same time indicates that “detox” treatments are unlikely to be helpful.

Here’s the link: Detox treatments by DrOz and others lack evidence, benefit  – CBC

An excerpt:

Despite bold promises that the treatments would purify, detoxify and boost energy and optimize organ function, the cleanses lacked any scientific evidence of efficacy, or clear idea of what toxins they would actually diminish…

“In looking at the medical literature on these things, there has never been a properly conducted scientific investigation of any of these treatments…

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USA Today just can’t stop talking about allergies!

Want to know how to improve your make-up skills during allergy season?  Look at this YouTube:

Here’s the article link. Early allergy in Tulsa! Look at Tulsa which is in the “high” range for this Spring’s pollen count!

#allergies, #allergy, #pollen, #tulsa-oklahoma