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!

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.

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.

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.

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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.

Connections

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.

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.

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
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.

DID YOU KNOW?

• 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.