Adventures of an Allergist Mommy

So, returned from a trip to Son #1's dentist this morning... At our last visit ~6 months ago, he was found to have areas of decalcification ("almost-cavities") between his molars. At that point, he was still not the best at cooperating with tooth-brushing and used to swallow the toothpaste, which meant that we couldn't use fluoride-based toothpaste. We were instructed to optimize the brushing, start flossing, and switch to fluoride toothpaste. We did great! Well, the flossing could have been a little better, but otherwise, we did great! Twice a day, without fail, spending plenty of time focusing on the molars. Very limited juice, candy only on Halloween and birthdays... our only weakness was ice cream, but he always drank water afterwards. Despite our best efforts, half of the areas of decalcification have progressed to cavities, and now we're facing having the teeth fixed with a pulpotomy and the placement of ugly stainless steel crowns, which will remain un...

Researchers from the Netherlands have reported in the March issue of Allergy that supplementation with a mixture of short-chain galacto-oligosaccharides (GOS) and long-chain fructo-oligosaccharides (FOS) appears to decrease total levels of the allergic antibody IgE, as well as IgG subclasses 1, 2 & 3, while increase levels of the "blocking" antibody IgG4. These oligosaccharides are known as "prebiotics", and they supply a nutrition source for the "good bacteria" (probiotics) that colonize our gastrointestinal tracts shortly after birth. The microbial environment in the gut may be an important factor in the risk of developing allergic disease, such as atopic dermatitis (eczema). The interesting thing about this study is that it demonstrated that despite the overall decrease in antibody levels, the immune response to vaccinations was preserved. This is important, because antibodies are essential to protecting us from infection, and a decrease in allerg...

Just visited my husband's grandmother in the hospital today... being a physician gives me a slightly different perspective when I am on the "patient-side". Being hospitalized is always stressful, even when for a joyous occasion such as for the birth of a child. You're out of familiar surroundings, usually not in the best of health, sometimes in pain, and certainly NOT in control of what happens to you, at least not in the way that you are accustomed to being. You and your family are eager to get home as soon as possible. Under these circumstances, the inefficiencies and "unique" communication issues in our healthcare system can be frustrating at best. So, here are my insider tips for optimizing communication in the hospital setting. 1) Please be patient. I know, not what you want to hear. But it's important to realize that the physicians and nurses caring for you and your loved ones are also responsible for the medical care of many other patients a...

A study in the April issue of the Journal of Allergy and Clinical Immunology reveals that prenatal maternal anxiety, especially late in pregnancy, is associated with higher rates of asthma in children at approximately 7 years of age. Why might this be the case? Maternal stress hormones, such as cortisol, may have a negative-feedback effect on the developing fetal adrenal glands, leading to relatively low levels of anti-inflammatory hormone production in the child. Makes one wonder... knowing that women tend to display higher levels of anxiety than men during times of economic downturns... will the current economic crisis result in increased pediatric asthma rates a few years down the road? One can only speculate, but it certainly makes the case for prenatal yoga!

Further evidence that hormonal influences really do affect allergic disease... A European study published in the Journal of Allergy & Clinical Immunology has shown an increased risk of asthma in normal weight (odds ratio 1.45) and overweight (odds ratio 1.91)women using oral contraceptives. Lean women (with a body mass index of >20 kg/m2) taking OCPs, however, were less likely than their non-OCP-taking counterparts to have asthma. These findings support the theory that metabolic status may influence how susceptible a woman is to the effect of sex hormones on the airways. However, the study authors take care to note that women should not abruptly discontinue OCPs without first discussing their concerns with their physician, as the health risk of an unexpected pregnancy may be greater than the small increase in asthma risk associated with oral contraceptives. I agree. But although I won't be recommending blanket discontinuation of OCPs, I'll definitely consider that poss...

It's a bird, it's a plane... it's an allergy-bot! Weather News, a Japanese weather information company, has installed hundreds of globe-shaped light-emitting "robots" throughout the country, which estimate pollen levels and glow a different color based on the concentration of pollen in the air. Allergy sufferers can tell with a quick glance how miserable their day is likely to be, and can also sign up for pollen counts to be text-messaged to their cell phones each morning... Although not nearly as George Jetson-like in its appeal, allergic folks state-side can also access up to date pollen conditions from the National Allergy Bureau. We don't use robots, though. Pollen counts in the U.S. are done manually, by volunteers! To access airborne allergen information for your area, visit the National Allergy Bureau website .

Since the recent American Academy of Allergy, Asthma & Immunology conference in Washington D.C., much has been made of studies describing oral immunotherapy for peanut, egg and milk. These studies have demonstrated that some food allergic children can eventually tolerate ingestion of significant amounts of their trigger food after a protocol or gradually increasing oral doses of that food. You may have seen this story on the morning/evening news programs, or read about it in your local paper or online. Certainly, parents of my patients have been coming in asking if I can provide this therapy for their food-allergic children in my office. They are invariably somewhat disappointed when my answer is: "Sorry, not yet." Let me explain why. Although the prospect of inducing some measure of tolerance to a food allergen is exciting, there are a number of things to keep in mind: 1) To date, the peanut immunotherapy studies have evaluated relatively small numbers of children ( 2)...