Adventures of an Allergist Mommy

A recent article in the Wall Street Journal ( Is Your Kid Truly Allergic? Tests Add to Food Confusion) recently highlighted the inherent problems with over-calling food allergy in children on the basis of serum IgE testing. I was impressed with the article, and encourage parents of allergic children to read it: http://tinyurl.com/yb5fw5s This is an issue that most allergists run into on a fairly frequent basis- a parent walks into the office with bloodwork ordered by another physician. Tests returned as "positive" for multiple foods, so for the past 3 months, parents have restricted all these foods (generally there's always something that's a pain in the butt to eliminate, like soy or wheat). Now we have a child who is still as symptomatic as ever, and cranky to boot. When I tell the parents that their child in all likelihood is not allergic to all of the eliminated foods, the reactions are a mixture of relief and annoyance: "That's great news, but why di...

Short little post to get me back into blogging after a small hiatus: I've been thinking a lot about the legacy that we leave for our children. For some, the legacy they leave is material in nature: a substantial inheritance to start them on their way, a business to provide them a livelihood, a home in which to raise their own families... For others, it is memories of wonderful times together: family vacations, heartfelt conversations, carefully preserved photographs and videos... I hope to leave both of these for my sons, but the more I think about it, the more I want my legacy to be a way of thinking about themselves and the world around them. Anyone who knows me knows that my children don't really resemble me- they are miniatures of their father (I was simply the vessel). So, since the only thing they seem to have inherited from me is a predisposition for allergies and asthma, I'm hoping to instill in them my life philosophy. So, I decided to sum up into a single statem...

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...