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
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.
I know you’ve been there before….waiting in the doctor’s office for your appointment and some smartly dressed man or woman barely has to say hello to the receptionist and walks right by your seat, straight to the doctor’s office. “Hey, that’s not fair,” you say to yourself as you dig your nose into that outdated magazine trying to mask the irritation. “My time is just as valuable as theirs is, put me to the front of the line!” As a patient, my frustration with the #health care system only percolates at the injustice. Isn’t the cost of #medication so high in America because of all the drug companies? If there were no drug reps, wouldn’t my doctor have a better and certainly more unbiased selection of medications? Granted, the goal of any #pharmaceutical company (employer of drug reps) is to make profit, but they can’t do that unless a product (medication) works well and is taken as directed. In the end, drug companies want you to be adherent to medications prescribed so they’ll work, you get better, all of which is good for the bottom line. Almost sounds too good to be true when everybody wins, but hang on and I’ll show you how this is possible. Continue reading Drug Reps Will Give You Asthma
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
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!
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
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?”
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
We all know the cost and hassle of taking care of asthma, especially for children. And yes, we’ve tried many different methods to get kids to use their inhalers at all, much less to get them to use their inhalers correctly.
Don’t think you have asthma….try the following:
1. Reflux can mimic symptoms of asthma with cough & wheeze
2. You might need a Aridol challenge test to be sure.
3. Don’t forget about sinus infection which can mimic coughing.
4. Make sure you’ve performed lung function! (PFTs)
5. Vocal Cord Dysfunction can sneak in as a cause of cough & wheeze.
[worldnow id=9641386 width=400 height=300 type=video]
By Stephanie Stahl
PHILADELPHIA (CBS) — One in 12 people have been diagnosed with a breathing disorder and the numbers are growing every year. But experts say many people are being misdiagnosed, and in some cases, the drugs they’re prescribed are doing more harm than good. 3 On Your Side Health Reporter Stephanie Stahl explains.
More than 25 million Americans have been diagnosed with asthma. But experts say not all of those people actually have it.
“Patients are often misdiagnosed with asthma, much more often than anyone typically realized,” said Dr. Sally Wenzel, a Pulmonologist. She says studies have shown 25 to 30 percent of asthma patients are misdiagnosed.
When Deb Bushe came to Dr. Wenzel for help with her asthma she learned she didn’t have it.
“I was very surprised when I was told I didn’t have asthma,” said Deb. For 15 years Deb…
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Without a doubt, driving on ice and snow should be reserved for the experienced drivers only. We don’t need more wrecks on Hwy 169 that what we already have to endure. But when the forecast for a winter storm brings on a run for bread and milk, we may have gone a bit too far. We have our own version of Black Friday…it’s called snow storm panic! Here I was shopping at Target to get a few items I really did need. Usually, my wait at the pharmacy is very short, but last night I guess EVERYONE thought it was important to get their medications filled before the storm arrived in case medications would no longer be available. Come on, pharmacies stay open even in Minnesota. Did you happen to go down the bread aisle? Nothing left and not a snowflake on the ground. No wonder you can’t yell fire in a theatre. The most shocking behavior, however, found in Oklahoma in preparation for a winter storm is to cancel school before it even starts to snow. Will you catch us off guard and unprepared? Not a chance. No wonder our kids have never seen snow or had a chance to make those lovely snow angels. They’re never in it. All joking aside, we did have a pretty nasty snowstorm 2 years ago with almost 20 inches in one night. That amount of snow shut the city of Tulsa down for a week! Could it happen again? Sure could, but the video below is enough for me:
Now, you’re probably wondering if I always pontificate about a totally irrelevant topic such as how Tulsans prepare for snow storms. Fortunately, this can have some relevance to cold weather illness:
- Asthma can be a real problem during the cold weather. Inhaling cold air causes drying of the airway wall and more severe bronchospasm that moderate temperatures. Don’t think that coughing and shortness of breath is just cold air; it may be your asthma getting out of control. Learn how to cover your nose and mouth with a scarf or mask, even if you’re outside for a short period of time. And most of all, use your regular inhaler (controller) during the winter months if cold air or upper respiratory infections are triggers for your asthma.
- Another problem with the winter season is trying to figure out if I have a cold, flu, sinus, or allergy problems. Let me make this much easier for you. Most ragweed is done pollinating by the end of October, so without much pollen in the air, your sneezing and coughing is probably not due to allergy (no exposure). A cold usually lasts < 1 week and any congestion or runny nose that doesn’t resolve from one Saturday to the next is probably a sinus infection. Why does this matter? Sinus infections should be treated with the “all or nothing” approach as any infection left in the sinuses will only result in more infection. Catching the flu makes you feel terrible and you’re already coughing. What could be worse? Add a fever with muscle aches and your diagnosis is most likely some type of influenza. Good motivation to get your flu shot!
- Am I Allergic to the Cold? I’m glad you asked. Cold-induced hives stays hidden for most of the year and comes out with a vengeance during cold weather. Some instances can be life-threatening and this condition is nothing to take lightly. Cold-induced urticaria of course, responds best to a vacation at Key West, but if you don’t have the luxury or flexibility to do that, antihistamines are still the backbone of treatment. Be careful when shoveling snow as shortness of breath and chest tightness may be associated with hives and a cold-induced reaction.
Although you must be careful with cold weather illness, you have to do something outside or you’ll get cabin fever. The link below is from AAAAI on how to control your asthma and still participate in winter activities. It’s a good read in front of the fireplace with a cup of hot chocolate. In the meantime, I’m heading for the slopes!