Making the Most of Your Spring Allergy Visit

spring ov

Spring is the busiest time of year at your allergist’s office as patients begin experiencing the first symptoms of seasonal allergies, or ‘hay fever.’

An estimated 35 million Americans suffer from allergies to pollen and mold, according to the American Academy of Allergy, Asthma & Immunology.

Symptoms include sneezing, a stuffy or runny nose and itchy, watery eyes.

Did you know?

  • Each year, more than 12 million doctor’s visits result from allergic rhinitis. Symptoms from seasonal allergies are among the primary reasons people miss school or work.
  • Allergists are the best doctors to diagnose and treat allergies and asthma. Find an allergist in your area at http://www.aaaai.org.
  • Allergy shots can reduce symptoms in up to 85% of patients with seasonal allergies. Ask your allergist if they can work for you.

If you’re planning to see an allergist/immunologist this spring, make sure you get the most from your appointment by writing down your questions and concerns ahead of time. Let your allergist know if:

  • You have any new symptoms or symptoms that are worse than in previous years. Be sure to mention if you experience coughing, difficulty breathing or loss of sleep, as these can be signs of asthma.
  • You have missed school or work due to allergy or asthma symptoms. It’s very important that you report any related hospitalizations or visits to the emergency department. Your allergist can help you gain better control of your allergies and asthma.
  • You are taking any medications, even if they are over-the-counter. This includes any herbal supplements. This information will help your allergist/immunologist prescribe safe treatments.

You might also want to ask these questions:

  • Am I currently on the best treatment plan?   With proper treatment, most allergies and asthma can be managed so they do not interfere with life.
  • What steps can I take to avoid allergy symptoms?  There maybe simple changes you can make to prevent reactions.
  • What other treatment options are available?  This may include allergy shots, less expensive medications or home remedies.

Article provided by: AAAAI

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Asthma and Winter Sports

WINTER SPORTS

Whether you are preparing to compete in the Winter Olympics or enjoying winter sports on your own, exercise-induced bronchoconstriction (EIB) should not force you to be a spectator in your favorite sporting activities. EIB happens when the tubes that bring air into and out of your lungs narrow with exercise, causing symptoms of asthma. An estimated 300 million people worldwide suffer from asthma, according to the World Health Organization, and strenuous exercise can make it worse for many people. Some people with EIB do not otherwise have asthma, and people with allergies may also have trouble breathing during exercise.

Symptoms

Breathing problems from EIB usually begin within five to 20 minutes of exercising. Symptoms include wheezing, a tight chest, cough, shortness of breath and, in rare cases, chest pain.

Triggers

People with EIB are sensitive to low temperatures and dry air. Air is warmed and humidified by the nose, but during physical activity people breathe through their mouths. This allows cold, dry air to reach the lower airways and lungs without passing through the nose, triggering asthma symptoms. Air pollutants, high pollen levels and viral respiratory infections may also be triggers. Other causes of symptoms with exercise may be that you are out of shape, have poorly controlled nasal allergies or vocal chord issues.

Diagnosis

An allergist / immunologist will begin by getting your health history, doing a breathing test (called spirometry). If a breathing test points to potential asthma, your physician may give you a drug to inhale. If breathing test numbers improve after inhaling the medicine, then the diagnosis of asthma is more likely. If your breathing test is normal, your physician may request an additional test called a bronchoprovocation challenge test. For this test, you will exercise. Both before and after exercising, your physician will test the amount of air forced out of the lungs with a spirometry test. If you exhale air less forcefully after exercise, then the problem may be EIB.

Treatment

The first step is to develop a treatment plan with your physician. EIB associated with more generalized asthma is prevented with controller medications taken regularly or by using medicines before exercise. When EIB symptoms occur, they can be treated with rescue medication. In addition to medications, warm-ups and cool-downs may prevent or lessen EIB symptoms. It is a good idea to limit exercise if you have a viral infection, when temperatures are low, or pollen and air pollution levels are high.

Recommended Activities

The goal of an asthma treatment plan is to keep symptoms under control so that you can enjoy exercising or sports activities. However, there are some activities that are better for people with EIB. For instance, swimmers are exposed to warm, moist air which does not tend to trigger asthma symptoms. Walking, leisure biking and hiking are also good sporting activities for people with EIB. Team sports that require short bursts of energy, such as baseball, football and short-term track and field are less likely to cause symptoms than sports that have a lot of ongoing activity such as soccer, basketball, field hockey or long-distance running. Cold weather activities such as cross-country skiing and ice hockey are more likely to make symptoms worse, but with proper diagnosis and treatment, many people with EIB can participate and excel in almost any sport or activity.

Article provide by: AAAAI

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Allergies, Asthma and Winter Holidays

holiday allergies
With the arrival of winter, seasonal allergic rhinitis (hay fever) and asthma sufferers can breathe relief as most outdoor allergens disappear until spring. But holiday gatherings and spending more time indoors exposes many people to different allergen triggers.
Food Allergies During the Holidays
Food plays a central role in many events. If you have a food allergy, these functions can be difficult to navigate. Be sure to ask about the ingredients used to make each dish. Be aware that cross-contamination can occur during preparation. If you think the foods served pose too much risk, or if you just don’t feel comfortable eating foods provided by others, you don’t have to. Bring your own snacks or eat before you arrive.
Even if you take every precaution, there’s still a slim chance of an allergic reaction. Have your autoinjectable epinephrine (EpiPen/Auvi-Q) at-hand just in case.
Other Holiday Triggers
Holiday decorations, travel and stress can all present challenges for people with allergies and asthma. Here are some of the most common triggers to be on the lookout for:
• Does your Christmas tree make you sneeze or cause shortness of breath? It’s unlikely that you are allergic to the tree itself, but the fragrance may be irritating. Some trees may also be home to microscopic mold spores that trigger asthma or allergies, causing symptoms like sneezing or an itchy nose. Use an artificial tree or, if you must have the real thing, let the tree dry in a garage or enclosed porch for a week and give it a good shake prior to bringing it inside. Another option is if you have a leaf blower: blow onto tree before bringing tree inside,
• Follow directions carefully when spraying artificial snow or flocking. Inhaling these sprays can irritate your lungs and trigger asthma symptoms.
• If you leave your pet behind when traveling for the holidays, you may experience allergy or asthma symptoms on your return home. Dubbed the “Thanksgiving Effect” this phenomenon occurs when a person loses tolerance to her own pet after being away for a few days.
• Be aware that stress can lead to asthma attacks. Chemicals released by the body during stressful times can cause the muscles around your airways to tighten, making it difficult to breathe.
Article provided by: AAAAI/RAP

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Egg Allergy and the Flu Vaccine

FLU

Flu season is here and so is the need to be protected by getting vaccinated. This vaccine contains a very small amount of egg protein, so before giving it health providers ask if you are allergic to eggs. But do you really know if you are allergic to egg? Could you have egg intolerance?

Food allergies affect millions of adults and children. On the flip side, many people think they are allergic and unnecessarily avoid certain products.

The big difference between a food intolerance and allergy is an allergy can cause a serious or even life-threatening reaction. This is why it is important to know if you have an allergy or intolerance to egg when you receive a flu vaccination. An allergist / immunologist has specialized training to properly diagnose your reaction to eggs or other foods.

Food intolerance happens in the digestive system and occurs when you are unable to properly breakdown food. This could be due to enzyme deficiencies, sensitivity to food additives or reactions to naturally occurring chemicals in foods.

An allergic reaction involves the immune system. If you have an allergy to eggs, your immune system overreacts by producing antibodies called Immunoglobulin E (IgE). These antibodies travel to cells that release chemicals, causing an allergic reaction.

Studies show that even individuals with confirmed egg allergy can receive the flu vaccine with certain precautions.

If you or your child’s reaction to eating eggs is hives only, the vaccine can be administered in the primary care provider’s office with a 30 minute observation period afterward. If the reaction to eating eggs involves other symptoms such as difficulty breathing or lightheadedness, the vaccine should be administered in an allergist’s office, again with a 30 minute observation period afterward.

Did You Know?
There is a difference between having a food intolerance and a food allergy.

To the Point
Studies show that flu vaccines can be safely administered to egg allergic individuals, wither in the primary care provider’s office or allergist’s office depending on the severity of the allergic reaction to eating eggs.

Article provided by: AAAAI

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Avoid the Danger of Anaphylaxis this Halloween

Halloween 2Ghosts and goblins aren’t the only scary things your children might encounter this Halloween. For parents of kids with food allergies, Halloween treats—from candy to cookies—can be frightening too. Common allergens such as peanuts, tree nuts, milk and egg are often ingredients in Halloween treats. Some kids may experience a rash or red, itchy skin, vomiting, a stuffy, itchy nose, or diarrhea or stomach cramps if they eat a food to which they are allergic. For children who are severely allergic, a single bite of these foods may cause a life-threatening reaction called anaphylaxis. An anaphylactic reaction typically affects more than one part of the body, and can happen very quickly. Signs of anaphylaxis include: • A lump in the throat, hoarseness or throat tightness • Trouble breathing, wheezing or chest tightness • A tingling feeling in the hands, feet, lips or scalp Other symptoms of anaphylaxis include dizziness, confusion and shock. If you or your child experience any of these symptoms, use your autoinjectable epinephrine and call 911 immediately. A Safe Halloween Having food allergies doesn’t mean having to skip all Halloween fun. Follow these tips for a safe holiday: • Plan food-free Halloween activities. Fun alternatives include costume contests, games and pumpkin carving. • Don’t let your food-allergic child trick-or-treat alone, and always make sure they carry their autoinjectable epinephrine with them. • Verify that adults or friends with your child understand his or her food allergies and what to do in an emergency. • Be cautious of “fun size” candy, which may contain different ingredients than regular size packages. • Teach your child how to politely say no to food that may not be safe, especially homemade items such as cookies and cupcakes.

Helpful Resources • Allergy-Free Zone Signs • Anaphylaxis Action Plan • Anaphylaxis Wallet Card To the Point Be cautious of “fun size” candy, which may contain different ingredients than regular size packages.

Article provided by: AAAAI

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Avoid the Danger of Anaphylaxis this Halloween

Halloween 2Ghosts and goblins aren’t the only scary things your children might encounter this Halloween. For parents of kids with food allergies, Halloween treats—from candy to cookies—can be frightening too.

Common allergens such as peanuts, tree nuts, milk and egg are often ingredients in Halloween treats. Some kids may experience a rash or red, itchy skin, vomiting, a stuffy, itchy nose, or diarrhea or stomach cramps if they eat a food to which they are allergic. For children who are severely allergic, a single bite of these foods may cause a life-threatening reaction called anaphylaxis.

An anaphylactic reaction typically affects more than one part of the body, and can happen very quickly. Signs of anaphylaxis include:
• A lump in the throat, hoarseness or throat tightness
• Trouble breathing, wheezing or chest tightness
• A tingling feeling in the hands, feet, lips or scalp

Other symptoms of anaphylaxis include dizziness, confusion and shock. If you or your child experience any of these symptoms, use your autoinjectable epinephrine and call 911 immediately.

A Safe Halloween
Having food allergies doesn’t mean having to skip all Halloween fun. Follow these tips for a safe holiday:
• Plan food-free Halloween activities. Fun alternatives include costume contests, games and pumpkin carving.
• Don’t let your food-allergic child trick-or-treat alone, and always make sure they carry their autoinjectable epinephrine with them.
• Verify that adults or friends with your child understand his or her food allergies and what to do in an emergency.
• Be cautious of “fun size” candy, which may contain different ingredients than regular size packages.
• Teach your child how to politely say no to food that may not be safe, especially homemade items such as cookies and cupcakes.
Helpful Resources
• Allergy-Free Zone Signs
• Anaphylaxis Action Plan
• Anaphylaxis Wallet Card

To the Point
Be cautious of “fun size” candy, which may contain different ingredients than regular size packages.
Article provided by: AAAAI

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ALLERGY HEADACHE

o-HEADACHE-facebook
While the majority of headaches are not a sign of a serious or life-threatening illness, they often affect quality of life. There are occasions where allergies or sinus problems can lead to a person to have headaches.

Headaches associated with nasal symptoms are common and may be due to sinus disease in and around the nasal passages. A sinus headache is hard to identify since headache specialists consider true sinus headache to be fairly rare. Recent studies suggest that patients who appear to have sinus headaches frequently have migraines.

People wth have headaches that seem to originate in the sinus should be carefully evaluated by a physician. Making the right diagnosis is important because primary headache disorders like migraines need a very different treatment compared with allergy headaches.
Acute sinusitis is defined as 3 months duration, commonly associated with allergic rhinitis, and can occasionally lead to headaches. Patients may also describe experiencing “sinus headaches.” However, it is controversial whether constant blockage of the nasal passages caused by allergic inflammation can lead to chronic headaches. Patients who experience blocked nasal passages should visit an allergist for testing. An allergist can diagnose your allergies and help you manage your symptoms. Treatment strategies could include steps to avoid specific allergens, medications or allergy immunotherapy (allergy shots).

The criteria below are used by physicians to diagnose rhinosinusitis headaches:
1) A headache in the front of your head with pain in one or more areas of the face, ears, or teeth and clinical or laboratory evidence of acute or chronic rhinosinusitis. For example, your doctor might do a nasal endoscopy, which lets him or her see what is happening in your nasal and sinus passages.
2) Headache and rhinosinusitis symptoms that occur at the same time.
3) Headache and/or facial pain that goes away within seven days after decreased symptoms or successful treatment of acute or chronic rhinosinusitis.

The majority of people with self-diagnosed sinus headaches are really suffering from migraines, which is why it is important to see a doctor to get a correct diagnosis. Research also supports a link between migraine and allergy, so your physician will consider both migraine headache and sinus headache if you are experiencing headaches and allergic rhinitis.

Article Provided By: AAAAI

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Eye Allergies

eye allergy

Also called allergic conjunctivitis or ocular allergy, eye allergy occurs when something you are allergic to irritates the conjunctiva. This is the delicate membrane covering the eye and the inside of the eyelid.

Like all allergies, allergic conjunctivitis starts when the immune system identifies an otherwise harmless substance as an allergen. This causes your immune system to overreact and produce antibodies called Immunoglobulin (IgE). These antibodies travel to cells that release chemicals which cause an allergic reaction. In this case, allergic reactions include eyes that water, itch, hurt or become red or swollen.

The most common causes of allergic conjunctivitis are seasonal allergens such as pollen and mold spores. People with seasonal allergic rhinitis (hay fever) normally notice their symptoms worsen when they go outdoors on days with high pollen counts.

Indoor allergens such as dust mites and pet dander can also cause eye allergies year-round. If you suffer from this type of allergy, you may notice your symptoms worsen during certain activities such as cleaning your house or grooming a pet.

Eye allergy symptoms can be very annoying. Yet they pose little threat to eyesight other than temporary blurriness. Unlike conditions such as pink eye, allergic conjunctivitis is not contagious.

However, red, itchy, burning and puffy eyes can be caused also by infections and other conditions that can threaten eyesight. If your symptoms are related to an eye allergy, chances are you will have problems in both eyes.

Typical symptoms include: •    Watery eyes •    Itchiness •    Sensitivity to light •    Redness •    Grittiness •    Eyelid swelling

These symptoms can occur alone or along with allergic rhinitis nasal symptoms. They typically appear shortly after exposure to the allergen.  Symptoms resulting from seasonal outdoor allergens tend to be worse than if your symptoms are due to indoor allergens such as dust mites or pet dander.  Symptoms may be reduced if you are taking allergy medications such as antihistamines, which suppress the allergic reaction. If dust or pet allergic, use a vacuum with a HEPA filter to reduce dust in your home or try keeping pets out of the bedroom to reduce exposure to their dander.

If pollen and other seasonal allergens are causing your misery, here are a few helpful suggestions:

  • Wear a hat with a wide brim to reduce the amount of allergen that blows into the eyes.
  • Sunglasses can also help reduce the amount of allergen that lands in the eyes.
  • Apply saline eye drops to the eyes after being outdoors to wash away allergens from the ocular lining.

Over-the-counter antihistamine pills and eye drops are often used for short-term treatment of eye allergy symptoms. However, prolonged use of some eye drops may actually make your symptoms worse. Your doctor may prescribe stronger medications if your symptoms are long-lasting. Corticosteroid eye drops are effective, but they often have side effects, even when used only for a short time. Use of this medication should be managed by an ophthalmologist due to the risk of side effects, such as glaucoma (increased ocular pressure), cataracts and infection.

Depending on what is causing your eye allergy symptoms, immunotherapy (allergy shots) can be very effective in providing long-term resistance to the triggering allergens.

The first step toward relief from annoying eye allergy symptoms is a proper diagnosis. An allergist / immunologist has specialized training and experience to accurately determine what is causing your symptoms and identify the best treatment approach that can help you feel better and live better.

 

Article provided by: www.AAAAI.org

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Stinging Insect Allergy

bee stingMost of us develop redness and swelling at the site of an insect bite. Yet people who are allergic to stinging insect venom are at risk for a much more serious reaction. This life-threatening reaction is called anaphylaxis .
Understanding differences in symptoms between a normal reaction and an allergic reaction can bring peace of mind. It is also important to have an accurate diagnosis so you can manage your condition and be prepared for an emergency.
An allergic reaction occurs when the immune system overreacts to an allergen. In stinging insect allergy, the allergen is venom from a sting. Most serious reactions are caused by five types of insects:
• Yellow jackets are black with yellow markings, found in various climates. Their nests are usually located underground, but sometimes found in the walls of buildings, cracks in masonry or in woodpiles.
• Honeybees have round, fuzzy bodies with dark brown and yellow markings. They can be found in honeycombs in trees, old tires or other partially protected sites.
• Paper wasps are slender with black, brown, red and yellow markings. They live in a circular comb under eaves, behind shutters or in shrubs and woodpiles.
• Hornets are black or brown with white, orange or yellow markings. Their nests are gray or brown and are usually found in trees.
• Fire ants are reddish-brown ants living in large mounds, mostly in warmer climates. They attack with little warning, inserting highly concentrated toxins that cause burning and pain.
Symptoms
Most people develop pain, redness and swelling at the site of an insect sting. This is a normal reaction that takes place in the area of the bite.
A serious allergic reaction occurs when the immune system gets involved and overreacts to the venom, causing symptoms in more than one part of the body such as:
• Swelling of the face, throat or tongue
• Difficulty breathing
• Dizziness
• Stomach cramps
• Nausea or diarrhea
• Itchiness and hives over large areas of the body
This severe allergic reaction is called anaphylaxis.
Insect stings can cause serious symptoms that are not allergic. A toxic reaction occurs when the insect venom acts like a poison in the body. A toxic reaction can cause symptoms similar to those of an allergic reaction, including nausea, fever, swelling at the site of the sting, fainting, seizures, shock and even death. A toxic reaction can happen after only one sting, but it usually takes many stings from insects.
Serum sickness is an unusual reaction to a foreign substance in the body that can cause symptoms hours or days after the sting. Symptoms include fever, joint pain, other flu-like symptoms and sometimes hives.
Diagnosis
If you think you might be allergic to stinging insects, an accurate diagnosis is essential. An allergist / immunologist has specialized training and skills in determining the cause of your symptoms. Your allergist will conduct a thorough health history followed by allergy testing to determine what, if any, allergens put you at risk for serious reactions to stinging insects.
Avoiding contact with stinging insects is the key to successfully managing this allergy. These steps can help:
• Insects are most likely to sting if their homes are disturbed, so have hives and nests around your home destroyed. Because this activity can be dangerous, you should hire a trained exterminator.
• If you spot stinging insects, remain calm and quiet, and slowly move away.
• Avoid brightly colored clothing and perfume when outdoors. Many stinging insects are searching for food and could confuse you with a flower.
• Be careful outdoors when cooking, eating or drinking sweet beverages like soda or juice. Cover food and drinks to keep insects out.
• Wear closed-toe shoes outdoors and avoid going barefoot to steer clear of stepping on a stinging insect.
• Avoid loose-fitting garments that can trap insects between material and skin.
If you have an anaphylactic reaction, inject epinephrine immediately and call 911.
After a serious reaction to an insect sting, make an appointment with an allergist / immunologist. With proper testing, your allergist can diagnose your condition and determine the best form of treatment.
Immunotherapy (allergy shots) may be effective long-term treatment for stinging insect allergy. Your allergist will give you shots containing small doses of your allergen, allowing your body to build a natural immunity to the trigger.

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Skin Allergy Overview

skin allergy

Irritated skin can be caused by a variety of factors. These include immune system disorders, medications and infections. When an allergen is responsible for triggering an immune system response, then it is an allergic skin condition.

Atopic Dermatitis (Eczema)
Eczema is the most common skin condition, especially in children. It affects one in five infants but only around one in fifty adults. It is now thought to be due to “leakiness” of the skin barrier, which causes it to dry out and become prone to irritation and inflammation by many environmental factors. Also, some people with eczema have a food sensitivity which can make eczema symptoms worse. In about half of patients with severe atopic dermatitis, the disease is due to inheritance of a faulty gene in their skin called filaggrin. Unlike with urticaria (hives), the itch of eczema is not caused by histamine so anti-histamines do not control the symptoms. Eczema is often linked with asthma, allergic rhinitis (hay fever) or food allergy. This order of progression is called the atopic march.

Allergic Contact Dermatitis
Allergic contact dermatitis occurs when your skin comes in direct contact with an allergen. For instance, if you have a nickel allergy and your skin comes in contact with jewelry made with even a very small amount of nickel, you may develop red, bumpy, scaly, itchy or swollen skin at the point of contact.

Coming in contact with poison ivy, poison oak and poison sumac can also cause allergic contact dermatitis. The red, itchy rash is caused by an oily coating covering these plants. The allergic reaction can come from actually touching them, or by touching clothing, pets or even gardening tools that have come in contact with the oil.

Urticaria (Hives)
Hives are an inflammation of the skin triggered when the immune system releases histamine. This causes small blood vessels to leak, which leads to swelling in the skin. Swelling in deep layers of the skin is called angioedema. There are two kinds of urticaria, acute and chronic. Acute urticaria occurs after eating a particular food or coming in contact with a particular trigger. It can also be triggered by non-allergic causes such as heat or exercise, as well as medications, foods or insect bites. Chronic urticaria is rarely caused by specific triggers and so allergy tests are usually not helpful. Chronic urticaria can last for many months or years. Although they are often uncomfortable and sometimes painful, hives are not contagious.

Angioedema
Angioedema is swelling in the deep layers of the skin. It is often seen together with urticaria (hives). Angioedema many times occurs in soft tissues such as the eyelids, mouth or genitals. Angioedema is called “acute” if the condition lasts only a short time such as minutes to hours. Acute angioedema is commonly caused by an allergic reaction to medications or foods. Chronic recurrent angioedema is when the condition returns over a long period of time. It typically does not have an identifiable cause.
Hereditary angiodema (HAE) is a rare, but serious genetic condition involving swelling in various body parts including the hands, feet, face, intestinal wall and airways. It does not respond to treatment with antihistamines or adrenaline so it is important to go see a specialist.

Skin conditions are one of the most common forms of allergy treated and managed by an allergist / immunologist, a physician with specialized training and expertise to accurately diagnose your condition and provide relief for your symptoms.

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