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
Category Archives: Nothing to sneeze at….
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 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
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.
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.
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.
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
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!
© 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!
Here’s What Measles May Look Like.
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
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.”
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
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)
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