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
Several months ago, I asked you what was missing from your treatment of #allergy. To my surprise, 50% of respondents wanted more information on food allergy, compared to only 36% who wanted cheaper medications for their #asthma. So I listened and here are some stories I find interesting about food allergy. Please share your stories with me by adding your comments at the end of this blog. Unfortunately, people don’t really think food allergy is a real health problem. Continue reading
I was in my doctor’s office today (yes, I go to the doctor as well) and she asked me if I was taking my #medications. Of course, I said “yes, the ones that are in my chart”, not really having that photogenic list in my head. As we talked, I realized my confession of what my doctor wanted to hear got the priority over what I was really doing. Busted for lying, but not intentional.
I wish it wasn’t so difficult to take care of our bodies. I always overestimate how much I #exercise and how little I eat. Scales don’t lie, so I just don’t weigh myself. Isn’t it a good thing I only see my dentist every 6 months? I only have to lie about flossing twice a year!
#Asthma, however, is no laughing matter. Your asthma control and cost of keeping you out of the hospital depends on how often you take the medications prescribed to CONTROL your asthma not just treat it. The solution is simple, yet very difficult to actually perform correctly. Here’s the issue with asthma–which inhaler do I use when it’s prescribed by my asthma doctor? I’ll bet you confuse the use of controller medications with reliever medications and now that more new inhalers are on the market it’s even more difficult to do the right thing.
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.
I have a story for you….but first, “traditional” medicine is trying very hard to work with other methods for treating asthma. The web page below reviews treatment of asthma using something other than “inhalers“. Now on to the story….
I am a member of the Complementary Medicine Committee of the American Academy of Allergy, Asthma, & Immunology (that’s a mouthful). We met last month to discuss better ways to “integrate” traditional health care with Chinese medicine for instance. Another member of the group had studied accupressure in China before coming to the United States 20 years ago. When she first arrived, while on rounds she intervened using accupressure with a parent experiencing asthma. The “attack” stopped immediately. Later on that day, her attending physician who happened to be the chairman of Pediatrics, called her in his office and let her know that further intervention using accupressure would not be tolerated and she would be dismissed from the training program if this ever happened again.
I’m glad times have changed and this type of intimidation is rare; what are your thoughts about integration of traditional and other forms of complementary medicine? The government is putting together a great effort to see this happen. See below.
From Medscape Allergy & Immunology by Marrecca Fiore
Ever wonder what other allergists are reading? After sorting through the long list of articles published on Medscape during the past year, it seems our member audience of allergists and clinical immunologists was most interested in:
- Food allergies
The top 10 articles list is comprised of the most-read content of 2011. If you missed any of these articles, please take a look at them now. Thanks Marrecca for your work on compiling the list.
The List–I’ll comment when appropriate!
10. Office-Based Oral Food Challenge Safely Diagnoses Food Allergy
A letter published August 11th in the Journal of Allergy and Clinical Immunology said that food challenges can be safely done in a physician’s office as long as certain precautions are taken.
- Precautions include having resuscitative equipment in office during the challenge.
- What foods do you challenge to? I’d start out with egg, milk, wheat to name a few.
- Some exciting potential for “desensitization” and oral tolerance as well.
9. Pathophysiology of Itch and New Treatments
As highlighted in this paper, the pathophysiology of itch is diverse and involves a complex network of cutaneous and neuronal cells. The article explains current treatments as well as experimental and promising therapies.
- Patients would rather have ANY symptom except itching.
- Be careful! Itching can be a result of correctable causes….like elevated bilirubin. Don’t miss this one.
Dr. Matthew Fenton from NIAID and Dr. Hugh Sampson, past president of AAAAI, review the food allergy guidelines and discuss how these principles should guide clinical practice.
- The most important guideline to follow–please avoid a food “panel” which misleads many patients to think they have a food allergy & you may just have an irrelevant positive test.
7. The Itch That Rashes
A 2-year-old presents with a persistently itchy rash. What is the most appropriate management?
6. Common Variable Immunodeficiency at the End of a Prospering Decade: Towards Novel Gene Defects and Beyond
This review highlights the most important publications of the past year, with an emphasis on novel findings in genetics and the immunophenotype of CVID.
5. Molecular Diagnosis of Peanut and Legume Allergy
Peanut- and legume-induced allergic reactions can be fatal and can significantly impair the quality of life of patients and their families. This paper reviews and discusses recent studies on the molecular diagnosis of peanut and other legume allergy.
4. I’m Struggling to Live on $160,000 a Year: MD Lament
Most people who don’t have “MD” or “DO” after their name would assume that $160,000 is a good annual income. However, many physicians find it a challenge to live on that amount. Why can some manage easily while others are struggling to pay the bills?
3. Hymenoptera Venom Immunotherapy
Hymenoptera stings can induce allergic systemic and occasionally fatal reactions. What is the best treatment?
- Bee sting shots are >90% effective & I’ve learned much about allergy shots for pollens based on research for bee stings.
2. Influenza Vaccine: Guidelines for Those With Egg Allergy
Vaccine expert Paul A. Offit, MD, explains the new influenza guidelines for individuals with egg allergy.
- The bottom line: Flu shot is probably safe even in patients with egg allergy. This was taboo only 5 years ago….the more you know, the less you know!
1. New Test for Peanut Allergy a Step Forward
Measuring antibody levels of 2 peanut protein components in patients may be a better predictor of allergic reactions than current diagnostics.
These articles did not make our Top 10, but they came close.
Can Inhaled Corticosteroids Prevent Asthma Exacerbations?
ICS therapy is the mainstay of asthma treatment, but can it also be used as a preventive measure?
Helping Families Manage Food Allergy in Schools
School can be a frightening place for food-allergic children and their parents. Are physicians providing the best information to help them?
Food allergy is an increasing problem in homes and schools. How do we determine who is at increased risk for anaphylaxis?
As always, if you have difficulty reading or obtaining any of these articles, let me know–I’ll be glad to help.
The Academy website is www.aaaai.org. Over 6,000+ attendees from all over the world to present the most recent advances in allergy and asthma. Yours truly even has an abstract on the correlation between BMI and FEV1. Yes I know, if you understood that we might all be in trouble!
Monday, I’ll start with a case report on a teenager that can’t swallow….are you sure you have the right specialty? How does this have anything to do with allergy/asthma? Stay tuned.
Tomorrow starts the American Academy of Allergy, Asthma, & Immunology national meeting in Orlando. Great fun and food, but more importantly, great new information about allergy. If you watch the news at all, you’re bound to hear about natural products for your health. Organic anyone?
Read this blog about a patient who only THOUGHT she had allergy; it was really volatile organic compounds (VOC) causing her symptoms of sneezing and nasal irritation that made her think she had allergies.
Case reports like Mary’s are helpful to instruct allergists in the best treatment methods for our patients with rhinitis. Sometimes it’s allergic and sometimes it isn’t.
Take the following report for instance:
They may smell sweet, but popular air fresheners can cause serious lung problems.
That’s the message from a new study presented at the annual meeting of the American College of Allergy, Asthma and Immunology (ACAAI). Home fragrance products often contain volatile organic compounds (VOCs) that include such nasty chemicals as formalehyde, petroleum distillates, limonene, esters and alcohols. (Download a copy of the presentation here)
Exposures to such VOCs — even at levels below currently accepted safety recommendations — can increase the risk of asthma in kids. That’s because VOCs can trigger eye and respiratory tract irritation, headaches and dizziness, as Dr. Stanley Fineman, ACAAI president-elect, pointed out:
This is a much bigger problem than people realize. About 20 percent of the population and 34 percent of people with asthma report health problems from air fresheners. We know air freshener fragrances can trigger allergy symptoms, aggravate existing allergies and worsen asthma.
And if you hope that “all-natural” fragrance products can give you a nice scent without the chemicals, Fineman has bad news for you — even products marketed as organic tend to have hazardous chemicals. That shouldn’t be surprising since fragrance products don’t eliminate bad smells; they just cover them up, and that usually requires something strong.
Fineman suggests that you’d be better off simply opening up your window and letting fresh air in — though that advice might not work well where I live. OK, I get it!
The study also gives some much-needed attention to the problem of indoor air pollution. While air freshener-related asthma is certainly a health hindrance in the developed world — at least among those who like to live in artificially sweet-smelling homes — indoor air pollution is a major health catastrophe for much of the developing world, one that leads to the premature deaths of nearly 2 million people a year according to the World Health Organization. The majority of those affected are very poor women and children who might spent hours cooking food over a wood-burning fire in a hut with little ventilation.
To read more about indoor air pollution and how to avoid it, see: http://healthland.time.com/2011/11/08/why-air-fresheners-can-trigger-respiratory-problems/#ixzz1dnQJp6cD
At the bottom of this handout from the American Academy of Allergy, Asthma, and Immunology, you’ll find the table that should help you determine if you have a cold or allergies….call me if questions.