Adventures of an Allergist Mommy

Dear Food Allergy Families, Please consider participating in the following study intended to explore the psychosocial coping needs of families with food allergy. As anyone who is living with food allergies understands, the psychological impacts of living with a potentially life-threatening condition are incredibly important, but sadly, often given short shrift in the context of limited time available during healthcare maintenance visits. Participating in this study is an opportunity to contribute to our knowledge base about the strategies families utilize to cope with the diagnosis. Thank you! -AllergistMommy ____________________________________________________ We want to invite you to participate in an exciting study researchers from Northwestern University Feinberg School of Medicine are conducting to explore the thoughts, emotions, and coping strategies individuals and families have and use as they manage food allergies. Led by Ruchi Gupta, MD, MPH, the goal of this r...

It's that time again... Back to School! I, for one, relish the newly found silence in my home in the afternoon. I am also happy in the confidence that my boys are learning and playing and enjoying school again. I like knowing that the sweltering days of summer will soon transition into pleasant autumn evenings. However, I know that back to school season brings on very different emotions for parents of children with life-threatening food allergies. These feelings range from fear and anxiety at being separated from a child with medical needs, to frustration with the necessary mounds of paperwork that constitute school health forms, and apprehension about what some might term "the little things": Will my child have someone to sit with at lunch? What if someone at the middle school starts a food fight, and throws a PB& J? How will my 5 year old handle it, when at the end of a long day of kindergarten, a classmate shares cupcakes with everyone as a birthday treat (eve...

UPDATE: The post you see below was deleted/censored from the comments section by "The Doctors" website. Attempts to repost have also been met with deletion, and there has not been any response from the producer of the program, Jay McGraw.  Recently the Program "The Doctors" aired a segment advising their viewers to tell a "little white lie" and fake a butter allergy when eating out to avoid the ~120 calories from butter added to vegetables and other prepared items. Read it here:  http://thedoctorstv.com/main/show_synopsis/1012?section=synopsis As a food-allergic individual, and physician for hundreds of allergic patients, my jaw dropped at the irresponsibility of this suggestion. Read my response to them below, and tell me... what are your thoughts about their recommendation to fake a food allergy? ---------------------------------------------------------------------------------------------- As a practicing board-certified allergist, m...

Illinois experienced an unusually mild winter. I'm pretty sure I saw buds on the trees in my office parking lot a full month ago. I had been preparing myself for a gangbuster of a tree season this spring, and Mother Nature has not disappointed me. My boys and I suffer from tree pollen allergies. More than birds chirping or flowers blooming, I have come to associate boogery sleeves and sneezing with the onset of spring. But these are the typical symptoms, which are easily recognizable as allergy-induced. What I'd like to address in this post are some lesser known symptoms of seasonal allergies, which may also be rearing their ugly heads this spring. Red eyes and runny noses aside, there are plenty of other ways that allergies can make us miserable. Especially in children, who already have a hard time translating physical symptoms into words, some of these symptoms are easily overlooked. So, dear reader, I present to you a few somewhat obscure allergy symptoms to be on the l...

The past few years have seen increasing interest in potential strategies to reduce the risk of allergy and asthma in young children. One particularly popular topic has been that of early pet exposure potentially decreasing the risk of animal allergy. Indeed, I am often asked by parents of my young patients if I recommend adding a furry pet to the household. However, it has been unclear how early in life the pet exposure needs to occur in order to modify risk.  A recent analysis of data from the Detroit Childhood Allergy Study sheds some light on this important question. It was published in the July 2011 issue of the peer-reviewed medical journal Clinical & Experimental Allergy. (Clin Exp Allergy. 2011;41:920-922) Annual interviews from 1987 through 1989, and follow-up interviews at age 18 years, were used to assess study subjects' exposure to indoor dogs and cats. After analyzing pet exposure during the first year of life, specific age ranges, and cumulative lifet...

 Ah, back to school... kids get back into a routine, and mom gets her life back, right?  WRONG! For most moms, back to school is anything but relaxing. However, for some of us "chosen ones", it's even more tiring: Is this the time of year when you struggle to drag yourself out of bed, despite hitting the sack as soon as you put the kids down for the night? Is your focus during the day so scattered that it takes you 3 times longer than usual to accomplish even relatively simple tasks? And when it's finally time for bed again, are you shocked to see a face 10 years your senior staring back at you in the mirror, with dark circles and puffiness? Many tired moms attribute these seasonal symptoms to the stresses associated with "Back to School".  However, if you're an allergy-mom like me, remember: your kids got those allergy genes somewhere, and you probably had a little something to do with it! As parents of kids with allergies and asthma, we are often...

For nearly a century, doctors have known that the best way to control environmental allergy symptoms is by retraining your immune system to tolerate substances that you are currently over-reacting to. This is known as “immunotherapy”.   Until recently, immunotherapy required multiple small injections over a period of time (subcutaneous immunotherapy). Although allergy injection treatment is very safe and effective, weekly trips to the doctor for shots are not always convenient for today’s busy families. This means that many patients are not able to take advantage of allergen immunotherapy’s numerous health benefits, such as decreased need for medications, improved hay fever and asthma control, prevention of asthma in high-risk children, and a better night’s sleep. Sublingual immunotherapy, or allergy drops, can offer the benefits of immunotherapy to a wider array of patients. These drops are made from the same FDA-approved allergen extracts used in allergy injection treatme...

Son #2 woke up this morning looking like a streetfighter! Dramatic swelling of the eye(s) such as this can occur for a variety of reasons: 1. Allergic reaction to ingested food or drug (generally affects both eyes) 2. Direct contact with environmental allergen or food allergen (can affect one or both eyes) 3. Hereditary or acquired angioedema (can affect one or both eyes) 4. Injury (usually affects one eye) 5. Low protein levels (generally affects both eyes) 6. Infection (generally affects one eye) 7. Insect bite (can affect one or both eyes) In this case, my little one endured a mosquito bite at the outer corner of his left eye yesterday afternoon.  It was mildly swollen at the time, and became progressively worse as the night wore on. Does this mean he has a mosquito allergy? Actually, no more than anyone else.  Certain areas of skin, such as around the eyes and on the lips, are more loosely attached to underlying tissues and muscles than skin elsewhere on the b...

Have an expired epinephrine autoinjector and don't know how to dispose of it properly? Here's an opportunity to donate your expired medication to a good cause! AllergySense is collecting expired epinephrine autoinjectors for use as training devices at hospitals and clinics in the U.S. and Canada. As a thank you - for each autoinjector you donate, you'll be entered in a drawing for some nice prizes! Here's the link: http://www.allergysense.com/promo_epi.php

Time flies- it's been a whole year since the first Allergist Mommy blog post! In that time, I've enjoyed sharing my perspective on the latest developments in pediatric allergy. It's nice to have an audience other than my husband for my musings. I haven't asked, but I think he also appreciates that I have redirected my educational efforts away from him. :) In the past year, you've learned how (against the odds) Son #1 outgrew his peanut allergy. You've read about Son #2's eczema and developing asthma. You've seen how underneath the cool exterior, physicians are parents too. We worry about our kids the same way our patient's parents do. And we make the same mistakes that everyone does. That said, I hope I've also shed some light on the fact that while we certainly don't have all the answers, physicians can help shed some light on the mystery that is modern medicine, and be valuable guides to help parents and children navigate the challen...

Over the past few years, it has become increasingly common for physicians to recommend saline nasal lavage (or sinus rinsing) to patients. The concept that rinsing allergens and pollutants out of the sinonasal cavities will decrease inflammation is certainly an attractive one. Patients, especially those with chronic sinusitis, would report getting gobs of ugly mucous out with each rinse- so the exercise was cathartic, as well. So, it was an easy step to go from recommending "as needed" use to recommending daily preventative use. Turns out, it may have been a step off a cliff. A recent study from Georgetown University Hospital School of Medicine suggests that although as-needed use of saline irrigation is beneficial, daily long-term use of nasal saline irrigation (NSI) by patients with recurrent rhinosinusitis (RS) can increase the frequency of acute infection by as much as 60%. Why is this? The researchers postulate that daily sinus irrigation depletes the sinonasal cav...

GlaxoSmithKline has recalled a batch of H1N1 vaccine that appears to be associated with a higher than normal rate of allergic reactions. Six individuals in Canada experienced allergic reactions after receiving the vaccine from this batch, but no other countries have reported similar adverse events. This batch (lot number A80CA007A) was distributed in Canada, and consists of 170,000 doses (the majority of which have already been administered). It was shipped in late October. Important points: • This affected batch was not distributed in the United States. The affected Canadian batch has been recalled. • Allergic reactions to a vaccine occur within 30 minutes to an hour after vaccination, so those who received the affected vaccine do not need to worry about the potential for a lingering reaction. • People with asthma are at high risk of serious complications from influenza infection, including H1N1. Vaccination can significantly reduce this risk. • Most individuals with egg allerg...

Halloween is an exciting time for children... costume parties, silly music, bags and bags of CANDY... Yep. It's the candy part that gets our undies all in a knot. Never mind the damage all that sugar does to those little teeth (Here's an idea-our dentist buys back candy at $1 per pound and sends it to our troops overseas!). For the parent of an allergic child, the concern is more about the damage that the hidden food allergen might do to our kids. The zombie costumes are ghoulish enough- do we really need to amp up the freakishness with hives and giant swollen lips? The American Academy of Allergy, Asthma & Immunology offers some Halloween tips here: http://www.aaaai.org/patients/elements/1008/08halloween_checklist.stm I think these ideas are a great start, but I do doubt the practicality of distributing your own safe snacks to neighbors in advance of trick-or-treating. (Not really fair to expect them to keep track- or even be able to recognize your kid if he or she is in...

On Sept. 16, 2009, Adamis Pharmaceuticals Corporation announced that Walgreens will begin to offer its epinephrine pre-filled syringes (Epi PFS) as a generic alternative to epinephrine autoinjectors. Certainly, it is wonderful to have a lower-cost alternative to EpiPen and TwinJect. (Tier 1 co-pay on Aetna and Cigna!) Many parents cough up $70 or more out of pocket for epinephrine autoinjectors that end up being thrown away. Now, don't get me wrong- I think it's much better to spend the money and throw it away than not spend it and be without life-saving medication if you should need it. But when you need one for home, one for school, one for grandma's house, etc... it adds up. On top of that, I like to prescribe epinephrine for my immunotherapy patients, and they aren't thrilled about the co-pay either, especially when the prescription is only a precaution. However, just because the medication inside the syringe is the same doesn't mean that device is equivalen...

I have a special interest in the treatment of severe eczema, and for years have been recommending to my patients treatments designed to reduce the burden of the bacteria known as staphylococcus aureus. Staph aureus, as it is commonly known, colonizes the skin and nose of up to 90% of patients with atopic dermatitis, or eczema. This not only can lead to infections in inflamed skin, but can also contribute to worsening of eczema when patients develop an allergy to the toxins produced by the bacteria. The mainstays of antibacterial therapy for control of staph aureus colonization are: oral antibiotics, nasal antibiotics, and dilute bleach baths. The traditional thinking has been that implementing these measures would reduce the bacterial burden, thereby improving the condition of the skin. Now, a fascinating study in the September issue of Pediatrics has turned the traditional wisdom on its head. Sure enough, patients treated with the anti-staph cocktail therapy had better outcomes t...

The following post is courtesy of the American College of Allergy, Asthma & Immunology (ACAAI) and the Allergy & Asthma Network- Mothers of Asthmatics. Thank you! The Food and Drug Administration (FDA) is warning healthcare professionals and the public about a shipment of a nebulizer medication that was recently stolen. The American College of Allergy, Asthma and Immunology (ACAAI) and Allergy & Asthma Network Mothers of Asthmatics (AANMA) urge patients using the nebulizer medication Albuterol Sulfate Inhalation Solution 0.083% to check the medication's lot numbers (see "What to look for," below). Police reported that on approximately Aug. 5 a tractor-trailer containing a 35,760-carton shipment of Albuterol Sulfate Inhalation Solution 0.038% belonging to the RiteDose Corporation was stolen in McKinney, TX. Anyone who comes across this product should notify the authorities immediately (see contact information below). The product is now illegal and may no...

Short post today: My son and I shared a Reese's peanut butter cup yesterday. As parents of peanut-allergic children know, this is no small victory. I am hopeful that in the not too distant future, oral immunotherapy will make the above scenario a reality for more children.

Image via Wikipedia Epinephrine is the first-line medication for the immediate treatment of anaphylaxis (sometimes referred to as "killer allergy"). Intramuscular injection of epinephrine is superior to subcutaneous injection in terms of how fast peak plasma levels of the life-saving drug are achieved. Consequently, epinephrine auto-injectors are deigned to deliver the medication to the large muscle of the anterior thigh (called the vastus lateralis). A recent study published in the July issue of the Journal of Pediatrics, however, suggests that intramuscular injection may not be achieved in a significant percentage of children with the current needle lengths of epinephrine auto-injectors (EpiPen and TwinJect). Ultrasound measurements of the thickness of subcutaneous tissue in children indicated that the needle lengths of the auto-injectors may be too short to penetrate into the muscle. When the outcome that one is attempting to prevent is death, this is no small issue. ...

Here's some food for thought: Researchers in New Zealand are studying whether eating butter instead of margarine can help to reduce the risk of allergies and asthma. They are currently recruiting children to take part in a study examining the effects of butter and an enriched butter made from cows fed fish oil on eczema. Read about the study here: http://www.nzherald.co.nz/health/news/article.cfm?c_id=204&objectid=10585257 Apparently, you don't need to eat a stick of the stuff to obtain benefit- 10grams (just a few pats) may do the trick! Just wait until this gets out- my dad (who refuses to even touch anything that's not "real butter" because it "just doesn't taste right") and father-in-law (who forwards me emails about how margarine is "one molecule away from plastic") are going to be thrilled.

If you have a child or children with food allergies, consider participating in the Children's Memorial Hospital Food Allergy Study . "The Children’s Memorial Food Allergy Study is a large, family-based food allergy study and holds great potential for scientific discovery and clinical translation. It is gaining momentum with the support of the National Institutes of Health (NIH), the Chicago Community Trust, Food Allergy Initiative , and generous donors. " Your participation will advance knowledge regarding the genetic basis of food allergy, environmental contributors to food allergy, the possibility of predicting and/or preventing food allergy, and the optimal treatments for this condition. Participation will not alter your child's current medical treatment. This is an excellent opportunity to contribute to the knowledge about a condition that affects so many of our children. For more information, visit http://www.childrensmrc.org/allergy/ , call 1-888-573-1833 or...