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

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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?

Do Vaccines prevent Cancer?

This article appeared in KevinMD’s blog and has a very interesting chain of comments.  From just reading the article you would think that certain #vaccines prevent #cancer.  I would like to think that’s true, but nothing is so simple in medicine.  The “cause and effect” relationship to what we do is always the elusive holy grail.  This is somewhat of a brainiac article, so buyer beware!

Ouch! but is it worth the pain?
Ouch! but is it worth the pain?

Continue reading Do Vaccines prevent Cancer?

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

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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First new dry powder inhaler for quick relief!

At first glance, I thought to myself, do we really need another quick acting inhaler?  As I thought about inhaler technique and how we use our Ventolin MDI’s, most of use suck on the end of the inhaler which is the wrong technique to use.  (all of the medication deposits on the back of the throat)  Why not use the appropriate inhaler that’s meant to actuate with your breath anyway?  ie, sucking on the inhaler is what you’re supposed to do!

Give the dry powder a try!
Give the dry powder a try!

Here’s the link to the article if interested–http://www.pharmatimes.com/Article/15-04-01/FDA_OK_for_Teva_s_acute_asthma_inhaler.aspx

Is Milk Allergy Desensitization Ready for Prime Time?

This article is in press and will be published in Annals from the College of Allergy, Asthma, and Immunology next month.  I thought the study is very interesting given the “push” for oral desensitization.  I just returned from the AAAAI annual meeting and it appears that patients with food allergy can become “desensitized” or cured, however, that comes with a cost of potential anaphylaxis during treatment.  Think of it like the use of allergy shots which are very effective, but you can develop anaphylaxis after an allergy shot that will need additional treatment such as epinephrine.  The question I have is, “should this therapy with foods be used at home where parents and patients don’t know much about giving epi?” 

milk

Here’s the summary–>Asthma patients are at risk for more severe reactions and less likely to reach full desensitization during milk oral immunotherapy, according to a study in Annals of Allergy, Asthma and Immunology. Researchers in Israel studied 194 subjects 6 years and older with IgE-mediated cow’s milk allergy, with and without asthma, undergoing milk oral immunotherapy. Regardless of severity, subjects with asthma had more reactions and injectable epinephrine use during induction, and more home treatments with immunotherapy. Moderate to severe asthma also was associated with a lower likelihood of reaching full desensitization