Tuesday, December 21, 2010

Advice for Treating Common Colds

From the National Center for Complementary and Alternative Medicine

Director's Page
Josephine P. Briggs, M.D.

Echinacea—What Have We Learned and Where Are We Going?

December 20, 2010
Everyone gets colds. Doctors' offices are packed with patients seeking relief from symptoms or looking to treat occasional more serious complications. There are also countless home remedies, and store shelves are filled with over the counter medicines and herbal supplements. Among the latter is echinacea—a popular herbal supplement made from the stems, leaves, or roots of the purple coneflower.
As we head into the cold and flu season, it's not surprising that the press has given a lot of attention to the NCCAM-funded study by Barrett et al. in the Annals of Internal Medicine. Although the authors noted that there were small trends in the direction of a benefit from echinacea—an average half-day reduction in duration, or an approximate 10 percent decrease in severity—they concluded that this dose and formulation of echinacea does not significantly change the course of the common cold.
These results and conclusions are consistent with a large body of previous clinical research. That studies of herbals are often not definitively positive or negative is a challenge that we are attempting to address as a major theme of our upcoming strategic plan (to be released in early 2011): the need for basic and translational research on natural products. In particular, the plan calls for better understanding of biological effects and the development of biomarkers or other translational tools prior to the initiation of lengthy, complex, and expensive clinical trials. With such knowledge and tools it will be possible to design clinical studies that test mechanistic hypotheses at the same time that we study clinical outcomes. For example, inclusion of biomarkers derived from basic and translational research would greatly increase insight, particularly into "negative" or equivocal studies.
For now, the best advice for treating the common cold is to stay home, get plenty of rest, and drink lots of fluids.

Monday, August 16, 2010

Allergists Offer Ragweed Survival Guide

Allergists Offer Ragweed Survival Guide  
The start of back-to-school season also marks the start of ragweed misery for one in five Americans. Find relief from the sneezing, stuffy nose and watery eyes caused by this pesky weed. Follow these tips from the American College of Allergy, Asthma and Immunology (ACAAI):
Start taking allergy medications in early August. 
Get treated for pet allergies year-round to make ragweed allergies more  

      tolerable. New research suggests allergies to dogs, cats or dust mites  
      "prime" the system, making hay fever suffering even worse. 
Stay inside between 5 a.m. and 10 a.m. If you must be outside, wear a  

     National Institute for Occupational Safety and Health (NIOSH)-approved
     N95 respirator mask. 
Protect your eyes with glasses or sunglasses that fit close to your face. 
    Steer clear of air pollutants.

Thursday, June 3, 2010

Back to Basics

It looks like Summer is here!  It's hot and humid and everything is green.  There are 4 basics of successful allergy management which I share with every patient. One is often overlooked.  Can you guess which one?
1. Avoidance - if you know what you are allergic to, and can reasonably avoid it, then cut your exposure.
2. If you get an allergeen in your nose, eyes or skin - wash it out (or off!).
3. Take your allergy medicine as directed.
4. Allergy shots (immunotherapy) can build up your immunity so your allergy symptoms last for a shorter period of time and you may need less allergy medicine.

If you guessed (2), you are right!

Often overlooked, but can make a big difference.  If your eyes are itchy and burning, use a long-lasting lubricant eye drop which does not contain any drugs.  I have several good recommendations for my patients.
If your nose is itchy, and you are sneezing a lot, use saline nasal spray or a NetiPot to wash all the bad stuff out!

Monday, May 10, 2010

Whare are you? Whare am I?

It's been a while since I've posted.  That's mainly because I don't want to post for the sake of posting! Forgive the rant! It's Monday morning at 9am and my 9am patient has not shown up!  During the past weeks I've had so many prospective patients take the first and last slot of the day, and then not show up.  If you can't make your appointment or change your plans just simply call.  You will be doing a great favor not only to me but to the other patients who can only come in before or after work.

Monday, March 15, 2010

Pet Allergies and Travel Again

Question of the Week from AAAAI

Posted 3/15/2010
How do I prepare for plane travel if I have allergies to pets?

Cats and dogs are allowed in plane cabins which for some people may cause allergy symptoms, such as itchy and watery eyes, sneezing, coughing, wheezing and hives. If you are extremely sensitive to pets, you must have a plan in place, which often may include pre-treatment of your allergy and asthma condition by your allergist. Even when you have tolerated an allergen such as from a cat and/or dog, a subsequent exposure may provoke an asthma attack or a more severe allergic reaction, at that time.

Flying with pets has caused enough of a concern that in an editorial by the Canadian Medical Association Journal, a complete ban of pets on planes was recommended. The Canadian lung association also reported that more than three-quarters of those polled in a survey wished that airlines offered pet-free flights.

It is essential to have the proper prescribed medications on hand in your carry-on if you suffer from pet allergies, especially if you find yourself soaring at 30,000 feet with pets on your flight!

Please talk to me about this if it is a concern for you.

Thursday, March 11, 2010

Eczema in Early Childhood May Influence Mental Health Later

Eczema in Early Childhood May Influence Mental Health Later

ScienceDaily (Feb. 10, 2010) — Eczema in early childhood may influence behavior and mental health later in life. This is a key finding of a prospective birth cohort study to which scientists of Helmholtz Zentrum München contributed. In cooperation with colleagues of Ludwig-Maximilians-Universität (LMU), Technische Universität München (TUM) and Marien-Hospital in Wesel, North Rhine-Westphalia this study followed 5,991 children who were born between 1995 and 1998.

The study has been published in the current issue of the Journal of Allergy and Clinical Immunology.
Researchers, led by Assistant Professor Jochen Schmitt of Dresden University Hospital, Dr. Christian Apfelbacher (Heidelberg University Hospital) and Dr. Joachim Heinrich of the Institute of Epidemiology of Helmholtz Zentrum München, discovered that children who suffered from eczema during the first two years of life were more likely to demonstrate psychological abnormalities, in particular emotional problems, at age ten years than children of the same age who had not suffered from the disease. "This indicates that eczema can precede and lead to behavioral and psychological problems in children," Dr. Heinrich explained.
Children whose eczema persisted beyond the first two years of life were more likely to have mental health problems than children who had eczema only in infancy.
Within the framework of the GINIplus study, scientists tracked the family history of the children, collected data on their physical health and emotional condition at age 10 years and gathered information on their daily lives. Questions were asked about the course of disease -- also in early childhood -- with special focus on diseases such as eczema, asthma, allergic rhinitis, stress tolerance and behavioral abnormalities.
Eczema is a non-infectious skin disease characterized by scaling itchy skin rashes. It is the most common skin disease in children and adolescents. Children who suffer from eczema are known to have an increased predisposition for hay fever and allergic asthma. Eczema symptoms are accompanied by a broad spectrum of secondary symptoms, such as sleep disorders.
"We suspect that it is mainly the secondary symptoms that have a long-term effect on the emotions of the affected children," Joachim Heinrich said. The authors of the study therefore recommend documenting the occurrence of eczema as potential risk factor for later psychological problems in the children's medical records, even if the actual primary disease abates and disappears during the course of childhood.


Have you ever thought what it must be like to pump gas all day long? Apart from inhaling fumes constantly, the only conversation is "Fill with regular" or "$20 of premium"...and so on.  Compare this to a visit to the barber (or hairdresser) where we try to fill the void with small talk. So now that I use the same gas station every time, I try to greet the attendant with a smile and hello and try to make some conversation beyond the needs of my gas tank. To date reward is a big smile and "my" attendant who hurries over to serve me each time I fill up.

Monday, March 8, 2010

Back Again!

It's been a while since I have posted. first, the Winter is generally quiet on the allergy scene, and there has not not been much news. Second, I follow the readership statistics and I am only seeing a few readers, so I am thinking about changing the focus of this blog to add more short comments on new drug developments, the passing scene and life in general. If you can give me feedback, I would love to know what you would like to see in this blog that you don't find somewhere else.

Sunday, February 7, 2010

Scratching the Surface

From the American Academy of Allergy, Asthma and Allergy:

Scratching the surface on skin allergies

Do you often suffer from red, bumpy, scaly, itchy, inflamed/blistered or swollen skin? Dry skin, sunburn or an insect bite may be the cause. Or, you may have a skin allergy. The most common skin allergies include eczema, hives/angioedema and contact dermatitis.
Eczema usually affects the face, elbows and knees. The red, scaly, itchy rash is more common in infants and those who have a history of allergies or asthma. Older children and adults with eczema often experience rashes on the knees or elbows (often in the folds of the joints), on the backs of hands or on the scalp.
Triggers include allergens, overheating or sweating, emotional stress, food and contact with irritants such as wool, pets or soaps.
Preventing the itch is the main treatment goal. Applying cold compresses and topical steroid and calcineurin inhibitor creams are the most effective. Antihistamines are often recommended to help relieve the itchiness. In severe cases, oral steroids are prescribed.
Hives and Angioedema
Hives are red, itchy, raised areas which may be triggered by food, latex or drug allergies. Hives can also result from non-allergic sources like rubbing of the skin, cold, heat, physical exertion or exercise, pressure and sunlight. Hives usually go away within a few days. Chronic hives can linger for months to years.
Angioedema is a swelling of the deeper skin layers that sometimes occurs with hives. Angioedema appears on the eyelids, lips, tongue, hands and feet and is typically not red or itchy-just swollen.
The allergens that trigger hives may take days to leave the body, so an allergist/immunologist may prescribe antihistamines or in severe cases, steroids. Other tips for symptom relief are cool showers, applying a cool compress or wearing loose/light clothing.
Contact Dermatitis
Contact dermatitis is often more painful than itchy. It is characterized by an itchy, red, blistered reaction from poison ivy, nickel, perfumes, dyes, latex products or cosmetics. Some ingredients in medications can cause a reaction, most commonly neomycin, an ingredient in antibiotic creams.
Allergic contact dermatitis reactions can happen 24 to 48 hours after contact. Once a reaction starts, it takes 14 to 28 days to go away, even with treatment.
Contact dermatitis can be treated by scrubbing the skin with soap and water after exposure and using prescribed antihistamine and cortisone medications. Calamine lotion, oatmeal baths/milk soaks and cool compresses can offer relief.
  • About 27% of children who have food allergies also have eczema or skin allergies.
  • Contact dermatitis leads to approximately 5.7 million doctor visits each year.
  • More than 3,700 substances have been identified as contact allergens.

To the Point

Skin allergies are painful and unpleasant but an allergist/immunologist can relieve symptoms and possibly control them.

Wednesday, January 13, 2010

Are you allergic to cockroach?

Banish cockroaches

A protein in cockroach droppings triggers symptoms. Clean practices can help.
  • Vacuum or sweep the floor after meals.
  • Take garbage and recyclables out frequently.
  • Keep food in containers with tight lids.
  • Wash dishes right after use with hot, soapy water.
  • Clean under stoves, refrigerators or toasters where loose crumbs can hide.
  • Clean stove tops, surfaces and cupboards regularly.
  • Block areas where roaches can enter, such as
    • Crevices
    • Wall cracks
    • Floor gaps
    • Cellar and outside doors
    • Drains

Air Canada ordered to create nut-free zones

OTTAWA — The country's largest airline has been ordered to create a nut-free zone on flights to accommodate passengers with serious nut allergies.

The government agency overseeing airline consumer complaints on Thursday gave Air Canada 30 days to come up with a plan to create a "buffer zone" for each aircraft type when passengers with nut allergies warn them ahead of time.

In addition to proposing the size of the zone, Air Canada must also tell the Canadian Transportation Agency what it deems adequate advance notice to institute the specified nut-free area in the cabin.

The agency issued the directive in response to applications by two passengers, who argued that Air Canada lacked a formal policy to deal with travellers with peanut or nut allergies.

The agency ruled that the passengers in question, Sophia Huyer and Melanie Nugent, are considered persons with a disability, so the airline must lift any obstacles to their mobility through a formal policy.

The decision, however, provides Air Canada with an out.

The airline can suggest another option to accommodate passengers with nut allergies if buffer zones constitute an "undue hardship, such as significantly affecting the commercial viability of its service."

But any proposed policy will have to be reviewed and approved by the agency, it said in a statement Thursday.

Air Canada spokesman Peter Fitzpatrick said the airline is reviewing the newly released decision, and will have more to say later.

"We are now studying the ruling and its conclusions and we will respond with a submission within the time frame set out by the agency," he said in a statement Thursday.

Gwen Smith, editor-in-chief of Canadian magazine Allergic Living, spearheaded a campaign to get Air Canada to develop clear policies on allergies to minimize the risk of inflight allergic reactions.

Smith said Thursday she's pleased the agency has laid out a formal policy to reduce that risk after the letter-writing campaign didn't move Air Canada to act on its own.

"We need some formal policies. It really is risky. We found studies showing that up to one in 10 people with nut and peanut allergies were having reactions on flights, so this is significant," said Smith.

She just hopes the public "doesn't confuse" this decision with the debate swirling around newly instituted security-related measures and inconveniences placed on airline travellers.

"What people need to know is that this is not over the top. There are real reasons when you're 35,000 feet in the air and you have the kind of medical condition that can come on incredibly rapidly, this is sort of akin to somebody having a heart attack, and in fact that can be a symptom of anaphylaxis," said Smith.

Air Canada does not serve peanuts on any flights, but it does serve other nut snacks. Almonds and cashews can also be purchased from its On Board Cafe.

During the proceedings, the airline argued that it would be impossible to guarantee that meals served on flights are free of peanuts or other foods to which a person may be allergic; some meals are prepared by sub-suppliers, Air Canada pointed out.

Besides, the airline can't be responsible for passengers who may bring peanuts or other nut products on board, Air Canada argued.

In its decision, the agency says it recognizes that "for operational reasons," it may not always be possible to provide a buffer zone when a passenger does not provide advance notice.

In such instances when advance notice is not provided, and where Air Canada is unable to institute a nut-free zone at the last minute, the airline could place the passenger on the next practicable flight to give it time to institute a buffer zone, the decision states.

I wonder when airlines will create dust-free zones ... and noise-free zones... and mold-free zones.........

Tuesday, January 5, 2010

More on Cat Allergy

Why are cats so allergic? One reason is that we get closer to cats than to other furry pets. That's why I ask how many cats you have. The record so far is 14. Can you beat that? I then ask if the cat comes into your bedroom. Does the cat jump on the bed? Does the cat sleep on your pillow? If you cannot bear to dismiss Mr. Whiskers from your bedroom, then change the bedlinen frequently, and wash your bed linen at a high temperature often so remove the cat protein.

Winter Reflections and To Do List

Happy New Year! It's cold out and the pollen counts are down to virtually zero. In fact many pollen counting sites shut down until the spring. So it's actually a good time to think about planning for the upcoming Spring and Summer. If you were thinking of starting on allergy shots, please remember that it will take a while for you to build up the dosage to the final maintenance dose, so starting now would give you a head start and the prospect of significant relief by the Summer.  Also, all the environmental control measures that I talk about for dust and mold take a while to deliver their maximal benefit, so there's no day like to today to start!   When you spend time indoors with the heating on, your environment is often drier than at other times of year. Low humidity is a common reason for nasal symptoms, so you might want to check the humidity in your house by buying an inexpensive hygrometer.