Adventures of an Allergist Mommy

My younger son and I both have asthma. Although we are well controlled, we still carry rescue medication with us everywhere. Even well-controlled asthma can flare severely under the right (or wrong) circumstances. I was especially cautious during a recent family vacation to Colorado. Living in the Midwest, we were unaccustomed to the thin mountain air, and I worried that my 3 year old might have his enjoyment of the trip ruined by asthma symptoms. So when our agenda was modified to include a steep 1.2 mile hike to view a pristine lake nestled close to the mountaintop, I wondered aloud if we should leave him behind at the hotel with his grandparents. My husband (who does not have asthma) glibly replied, "Relax, he can handle it!". "Easy for you to say," I retorted. "What are we going to do if he has an asthma attack halfway up the mountain?" Dear hubby didn't need to reply. My fearless son overheard the conversation and chimed in: "I want ...

On May 20, 2012, I was pleased to offer a free asthma screening for our local community as a volunteer for the American College of Allergy, Asthma & Immunology's Annual Nationwide Asthma Screening Program. This is the 16th year of the Nationwide Asthma Screening Program, the ACAAI's public service campaign to find adults and children who are at risk for undiagnosed and uncontrolled asthma. Our screening was a wonderful experience, and we were able to identify a number of individuals whose respiratory symptoms are likely to improve with comprehensive allergy and asthma care. We've been asked to return for additional screenings, and I plan to do so this summer and fall. Many thanks to Medical Device Depot for donating the spirometry turbines, without which this screening would not have been possible. If you are looking for a free asthma screening in your area, please click here to learn more!

Last week, my 3 year old, whose asthma is generally very mild, needed a few treatments of his albuterol inhaler. Because he is unaccustomed to having the spacer device on his face, the process of administering the medication was a bit of an ordeal. When I say a bit of an ordeal, I mean kicking, screaming, tears flowing, hyperventilating -- you know, nothing I can't handle. I finally got the puffs in him, and swore to myself that we weren't going through that again. By that point, we were already late for daycare, so I left the inhaler and spacer on the coffee table and whisked the kids off to school. That evening, as I was preparing dinner, I heard a strange musical noise, and turned to find Son #2 using his spacer as a vuvuzela. Here was the same child who only that morning was so vehemently resisting his treatment, now dancing around the kitchen with his spacer and inhaler attached to his face. The sound might have been as annoying as anything coming out of the World Cu...

In case anyone has ever wondered why comprehensive asthma education is important, please watch the following clip.  Hilarious! http://www.4shared.com/file/136718954/bedbbcbe/dr_house_best.html

One of my nurses snapped the following photo today... funny and sad at the same time.

Eyjafjallajokull (ay-yah-FYAH-lah-yer-kuhl). Say that five times fast! No matter how you pronounce it, this volcano has been in the news and in water-cooler conversations around the world. It has affected travelers, governments, and reportedly, even a rhinoceros who got stuck en route! On Friday, the World Health Organization issued a warning for patients in Europe with asthma and other respiratory problems, claiming that the ash cloud released by the volcano could be "very dangerous" for them due to the abrasive and corrosive nature of volcanic dust particles. However, they have since toned down this warning. The tiny particles of volcanic ash which are most likely to cause these issues are still very high up in the atmosphere- too high to cause significant problems for individuals on the ground (except in the immediate vicinity of the volcano). A low-pressure weather system expected over Iceland later this week may push the ash cloud towards the Arctic and prompt rain w...

The dangers of environmental tobacco smoke (ETS) have been well-documented. Environmental tobacco smoke has been associated with increased risk for not only asthma and ear infections, but also with meningitis and sudden infant death syndrome. Young children are particularly susceptible to these ill-effects. The risk is not limited to second-hand smoke, however. Third-hand smoking occurs when an individual is exposed to an environment in which someone has been, but is not currently, smoking. Quoting from the Pediatrics article "Beliefs About the Health Effects of 'Thirdhand' Smoke and Home Smoking Bans" by Jonathan P. Winickoff, MD, MPH et al: " Research has documented the association between smoking in the home and persistently high levels of tobacco toxins well beyond the period of active smoking. These toxins take the form of particulate matter deposited in a layer onto every surface within the home; in loose household dust; and as volatile toxic comp...

A Japanese study published in the European Journal of Allergy and Clinical Immunology (link: http://www3.interscience.wiley.com/journal/123251237/abstract?CRETRY=1&SRETRY=0 ) shows what many of us in the allergy world have suspected for a long time- mom's prenatal diet does have an impact of the risk of atopic manifestations in offspring at 16-24 months of age. The study evaulated over 700 Japanese mother-child pairs. A diet-history questionnaire evaluated maternal consumption of fruits, vegetables, and antioxidants during pregnancy (at week 17). Atopic symptoms were evaluated based on criteria from the International Study of Asthma and Allergies in Childhood (at aged 16-24 months). The study found that higher maternal intake of green and yellow vegetables, citrus fruit, and β-carotene during pregnancy was significantly associated with a reduced risk of eczema, but not wheeze, in the offspring. Maternal vitamin E consumption during pregnancy was significantly inversely relat...

At the end of every patient visit, I let my patients know when I would like to see them again. For some patients, the visits are infrequent- once a year for a well-controlled patient with nasal allergies. However, for asthmatics, I recommend more frequent visits. Lately, I've begun noticing that my chronic asthma patients occasionally look at me sideways when I tell them that I expect to follow-up with them every 3-4 months to document asthma control and adjust medications. There have been a few disgruntled phone calls after a patient learns that only 3 months worth of refills have been submitted to the pharmacy, instead of the standard 6-12 month supply. It has occurred to me that my patients are not alone in their confusion as to why their physician can not bear to be apart from them for more than 12 weeks at a time, so let me explain myself: 1. I am not secretly in love with you. 2. I am not trying to get paid for shooting the breeze with you quarterly. 3. I am not in cahoot...

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...

OK- both boys have a barky cough, Son #2 has been having some mild stridor (that whistling noise you hear after a croupy child is crying and takes a deep breath), and just yesterday, the daycare informed me that my musical little one need albuterol during the day, and felt "so much better" afterwards. I think the respiratory goblins have arrived at my home. Serves me right. Although I always tell my patients to resume their child's respiratory controller medicine around one month before their "bad season" is due to begin, I deliberately ignored my own advice and tried to hold out for as long as I could before resuming Baby's inhaled steroid this fall/winter. This I did despite knowing better than anyone that my child is probably destined to become asthmatic. Why did I make such a ridiculous decision? Am I concerned about medication side effects? At the low doses of controller medication that my 16-month old requires, hardly. Is the medication too expensi...

The evidence is mounting that the fungus responsible for athlete's foot and ringworm- trichophyton, may be playing a role in severe asthma... A Japanese study published in the Journal Chest examined rates of allergic sensitivity to this fungus in asthmatics and non-asthmatics, as measured by presence of IgE antibody in the blood specific for trichophyton. 32.4% of patients with severe asthma were sensitized to trichophyton, 15.8% of patients with moderate asthma were allergic, and only 4.9% of patients with mild asthma were sensitized. Interestingly, the rates for allergic sensitization to other common environmental allergens (cat, dog, mixed molds) did not differ significantly between the different groups of asthmatics. Similar associations between trichophyton and asthma have been noted in Venezuela and Turkey as well. Antifungal treatment in these patients has been shown to improve asthma severity. Bottom line? Although probably not a major issue for well-controlled asthmatic...

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...