Adventures of an Allergist Mommy

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...

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...

Thanks to the JCAAI for the following alert: The CDC has received reports of fraudulent emails (phishing) referencing a CDC sponsored State Vaccination Program. The messages request that users must create a personal H1N1 (swine flu) Vaccination Profile on the cdc.gov website. The message then states that anyone that has reached the age of 18 has to have his/her personal Vaccination Profile on the cdc.gov site. The CDC has NOT implemented a state vaccination program requiring registration on www.cdc.gov . Users that click on the email are at risk of having malicious code installed on their system. CDC reminds users to take the following steps to reduce the risk of being a victim of a phishing attack: •Do not follow unsolicited links and do not open or respond to unsolicited email messages. •Use caution when visiting un-trusted websites. •Use caution when entering p...

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...

Son #1 has been going through a phase where he insults my parenting skills whenever I make him do something he doesn't want to. I know he doesn't mean it, but it still smarts. Here are a few examples: me: "Put your toys away, or I'll take them away." him: "You're a bad mommy!" me: "TV off, kiddo. You've watched enough." him: "I'm not going to be your son anymore!" me: "I know you don't want to leave, but we have to go home now." him: "I don't want to go home with you. Just send me to outer space. I'll live with the friendly aliens." Now, I know these statements make my kid sound like a spoiled brat, but to be honest, he's actually a very well-behaved little boy. I've come to recognize this phase as proof that my child understands that threatening to withdraw affection is the worst punishment you can inflict on someone who loves you. This is an important lesson, because i...

There's something about cooking with your kids which makes the holidays feel more holidaylicious. And just like all kids, mine are enamoured of the kitchen (especially since Disney's "Ratatouille"). Used to be, if you wanted to bake an allergy-friendly holiday dessert, you had to pull out a cookbook, make substitutions, and hope for the best. Not my style. Although I love it when other people slave away all day in the kitchen, I'm not really a "from scratch" kind of gal. So, you can imagine my delight when a patient's mother introduced me to Cherrybrook Kitchen ( http://www.cherrybrookkitchen.com ), which has created a line of dairy, egg, and peanut-free mixes for cookies, cakes, brownies, pancakes, and more. (Frostings, too!) They're now even offering wheat and gluten free items. Best of all, the result is something even someone without allergies would like to eat... Thanks, Cherrybrook! Now I can make goodies for my son's class with...

As we approach Thanksgiving in the midst of a raging healthcare reform debate, I'd like to share what I think is good about healthcare in America these days... I'm thankful that I practice medicine in a country where I have access to the most helpful and novel innovations with which to heal my patients. I'm thankful for compassionate nurses and assistants who put the patient first. I'm thankful for experienced and competent managers who keep small medical practices running during difficult economic times. I'm thankful for front desk staff who are always friendly and helpful, even though they have numerous stressors. I'm thankful for intelligent, thoughtful colleagues with whom I can discuss complex medical questions. I'm thankful for sane, grounded colleagues with whom I can share my frustrations. I'm thankful for the social media networks which allow physicians from all over the nation to interact as though we were neighbors. I'm thankful for inform...