What’s Causing Your Asthma?

Could it be one of these non-allergic asthma triggers?

by Stephen Apaliski, MD

Breathing in the fumes that scented lotions give off can trigger your asthma, so seek out unscented versions.

While allergic asthma trig­gers only cause problems for people who are allergic to them, non-allergic triggers can be called equal opportunity offenders. What do I mean by this? When you are allergic, it is like having the key that turns the switch that starts the engine of asthmatic in­flammation. No key (no allergy), no inflammation.

With non-allergic triggers (espe­cially the irritants listed below), no key is necessary. The irritant itself pushes a start button that turns the engine on directly. In short, if you have asthma, any of the triggers listed here can harm or affect you. You need not be allergic.

Irritants
Chemical Odors Many people with asthma cannot use cleaning agents with strong odors without triggering their asthma. Using lower irritant cleaners or delegating the task to someone else if possible (now that’s a side benefit!) are the two means of avoiding these potent triggers.

There are some individuals, how­ever, who work in jobs and industries where exposure to chemicals happens often. Certain chemicals in the work­place produce occupational asthma. Symptoms associated with occupa­tional asthma are worse when you are at work, and better when you’re away from it. If you discover a connection between worsening asthma and chemi­cals used in your job, you will need to either use a specialized breathing pro­tection device (like a respirator) in the workplace, or you may actually have to change jobs to prevent serious long-term health problems.

Perfumes and Scents Asthma can be triggered by breathing in the fumes that these substances give off. These are not just perfumes or colognes that you spray or daub on your body. Also included are the scents that may accompany the detergents, soaps, and lotions you use to care for your skin or clothes. Unscented versions of these products are plentiful in the market­place, and they are worth seeking out to ensure that you don’t unintentionally trigger your asthma.

Tobacco smoke and asthma do not mix. If you have asthma, you absolutely should not smoke.

Dr. Stephen Apaliski

Of course, sometimes you may end up on the elevator with someone drenched in perfume or cologne. The best approach here is to quickly put as much clean air space between you and the offending agent as you can. This may mean stepping to a new spot in the elevator or exiting the elevator on the next floor.

Smoke Tobacco smoke and asthma do not mix. If you have asthma, you absolutely should not smoke. Similarly, if you live with a smoker, that person should smoke outside the home, and never while riding in your vehicle. Neither rolling down a car window nor cracking open the back door of the house while someone is smoking is going to do the trick.

Other potential sources of smoke exposure include campfires, wildfires, and fireplaces, as well as some bars and restaurants, although over time fewer and fewer commercial establish­ments are allowing smoking indoors.

Air Pollution Here in Texas, espe­cially in the summertime when the air is hot and there is very little wind, we have elevated ozone levels in the air. Unfortunately, this phenomenon is not limited to Texas; elevated ozone levels can be seen in many parts of the nation, especially in urban areas.

Ozone, a gas that cannot be seen or smelled, is a respiratory tract irri­tant, even to people without asthma. For convenience, the government grades ozone levels from green to yellow, orange, and red, where green represents the lowest level, and red, the highest level.

Ozone levels seem to be at their highest levels during traffic rush hour in the late afternoon and early eve­ning. If you have asthma, ozone levels above green – especially above yellow – require your attention. During these times, outdoor physical activity should be limited. In addition, keeping win­dows in your home and vehicle closed with air vents closed or on recirculate should help. Ozone levels and alerts are readily avail­able and are typically part of the weather forecast on local radio and television stations. You can also check the air quality forecast for your area at AirNow.gov.

Interestingly, ozone gets the most press, but it is only one of many compo­nents of air pollution that can produce problems. Others include sulfur diox­ide and diesel exhaust particles. The total Air Quality Index (which takes into account not just ozone but these other pollutants as well) ranges from green (safe) to maroon (hazardous). Staying aware of this daily reading can guide your decision on whether to go outdoors or stay inside on any given day.

Medications
Aspirin and NSAIDs Some peo­ple have asthma triggered by aspirin or aspirin-like drugs, such as ibuprofen or naproxen. This class of drugs is known as NSAIDs (non-steroidal anti-inflammatory drugs).

In some people, asthma is triggered by gastro-esophageal reflux, sometimes just called reflux or heartburn.

NSAIDs are more likely to be a problem as a trigger if you have nasal polyps and chronic sinusitis with asthma. In general, I have my asthma patients – even those without nasal polyps and chronic sinusitis but who have had problems with aspirin in the past – avoid NSAIDs. For most people with asthma and NSAID sensitivity, acet­aminophen is a safe alternative medicine to treat pain. It is best to discuss this issue with your personal physician.

In some cases, aspirin is absolutely required as a medication. In such sit- uations, a procedure known as oral desensitization can be successfully accomplished under the guidance of an allergist. Oral desensitization is the graded ingestion of aspirin, beginning with extremely low doses and progress­ing to higher and higher doses, until one reaches the standard dose, which he or she must remain on without inter­ruption every day to remain desensitized. As one might expect, this procedure does have its risks, and allergic reac­tions can be seen as the dose is raised during the process.

Beta-Blockers These medications are frequently used in the treatment of heart disease, hypertension, migraine headaches, and glaucoma. They work by blocking a cell receptor known as the beta-receptor. If asthma worsens after beginning these types of medicines, an alternative drug needs to be used.

Other Situations
Gastro-Esophageal Reflux (GERD) In some people, asthma is triggered by gastro-esophageal reflux, some­times just called reflux or heartburn. Reflux can irritate the lungs directly or cause nasal disease and sinusitis that worsen asthma.

Most times, GERD is accompanied by symptoms such as heartburn, but not always. Most cases cannot be simply cured by avoidance of certain foods. In severe cases, surgery may be necessary.

Sinusitis Sinusitis, a bacterial in­fection of the sinuses, is a common complicating factor for asthmatics. Sinusitis is treated with antibiotics. Often brought about by allergens, smoke, and other irritants, it can often be prevented by avoiding the offend­ing substance. The use of some form of nasal wash with saline may help as a natural, non-medication method to treat or prevent sinusitis. In the long term, usually medications – and some­times allergy shots – may be needed to successfully treat the allergies that can lead to recurrent sinus infections.

Lastly, one important consideration is to get the influenza vaccination every fall. Influenza infection can cause ma­jor asthma problems; immunization reduces the risk.

Pregnancy While it is in the strict­est sense not an asthma trigger, I wanted to take a few moments to discuss asthma and pregnancy. In two-thirds of pregnan­cies, asthma stays at the same level or improves, but in one-third of women, it worsens.

For pregnant women with asthma, the biggest risk to the unborn baby is not from the medications needed to control it but from uncontrolled asthma itself. An obstetrician and allergist work­ing together as a team is the best way to maximize control of the mom’s asthma and minimize risk to the unborn baby.

Exercise and Asthma Vigorous exertion will produce symptoms in many people with asthma. This is often referred to as exercise-induced bron­chospasm, or EIB for short. Asthma symptoms commonly begin six to eight minutes into a vigorous workout. Typically, the symptoms stop with ces­sation of exertion and administration of medications.

So, is my recommendation to avoid any type of physical exertion in people with asthma and EIB? Certainly not!

History is full of stories of elite athletes with asthma who successfully competed in their sport. Often, the on­set of EIB symptoms can be prevented by the use of a bronchodilator inhaler 15 to 30 minutes before physical exer­tion. If you also use other medications for asthma, it is very important that you take them as directed to help prevent problems with EIB.

The times I do recommend avoid­ing vigorous exertion for asthmatics is when they are already fighting some type of illness or asthma flare-up, or when outdoor pollution levels are elevated. Exercising here may make problems worse and recovery may take longer.

Avoidance
There are many non-allergic factors that can trigger asthma. The most po­tent means of preventing problems is following a path of strict avoidance.

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Julie Bowen

Gets Serious about Anaphylaxis Awareness

by Jessica Webb

Emmy award-winning actress Julie Bowen keeps us laughing weekly as Claire Dunphy, the strong-willed but caring matriarch on ABC’s hit comedy Modern Family. But when her oldest son, Oliver, experienced anaphylaxis (a severe, life-threatening allergic reaction) after exposure to pea­nut butter and a simultaneous bee sting, this real-life mother of three learned that allergies are no joke.

Though Oliver, a toddler at the time, had tried peanut butter before with no issues, after this particular exposure, paired with the bee sting, he experienced an anaphylactic reaction. His face swelled up immediately, and it was clear some­thing was wrong. Julie’s family was lucky; sometimes the signs of anaphylaxis are less apparent. Here, in an interview with Coping® magazine, Julie shares her fam­ily’s story and stresses the importance of recognizing and being prepared for an anaphylactic reaction.

How did you react when you found out that Oliver had an anaphylactic reaction?
I was very frightened. My husband was on the phone with me while they were in the emergency room, and the minute Oliver had the epinephrine injected, he was better. It was immediate, so there was no doubt that this was an anaphy­lactic reaction. I had heard stories about this, but I just thought allergies were a “helicopter mom’s” problem. I thought, “Oh, my kids are healthy and strong; that’s not going to happen.” And my other two kids don’t have any allergies.

What daily precautions does your family now take to ensure Oliver’s safety?
We keep an epinephrine auto injector with us at all times, and he has one at his school. If he goes off on a play date, we put one in his backpack. I like la­beling, so I put on a label that says “medicine here.”

We want him to live a healthy, normal, athletic life where he can run around outside and not feel limited.

Have you had to make any major lifestyle changes?
I have to wash my hands after handling certain nuts, but I try not to have those in the house. And we don’t live in a bee-free world, so we just have to be careful and make sure we have his epinephrine auto injector with us and make sure it’s up to date. We want him to live a healthy, normal, athletic life where he can run around outside and not feel limited.

Do you worry about him attend­ing school?
Luckily, his school is very aware of potential life-threatening allergic reac­tions. His preschool is nut free to begin with, but the world isn’t bumblebee free. It’s important that the caregivers, teachers, and coaches – the people who are around kids a lot – know the signs and symptoms of anaphylaxis. Unlike what happened to my child, which was very dramatic and sudden, it can be more subtle, and we need the people who are watching out for our kids to know what’s going on.

Does Oliver understand how serious anaphylaxis is?
He does. We don’t try to scare him with it. We just want him to be aware of it and understand that we know how to treat and avoid it. He has become his own best advocate. Any time there is a new food introduced to him, he always asks what’s in it, especially with cereal bars, cookies, muffins, and cakes – things that nuts are frequently put into. We are always looking out for him, but especially at a birthday party or something like that. It’s im­portant to ask and to check.

What message do you have for parents of children with potentially life-threatening allergies?
It can be frustrating, but with some simple precautions, it certainly isn’t impossible to live with a child who has these allergies. Know what medications your child needs, and don’t introduce a new food to your kid when you are off on a tropical island, away from any kind of medical help. If you suspect that your child has an allergy, you should go see your doctor immediately and discuss it with him. I’m not a doctor; I don’t even play a doctor. All I am is a con­cerned mom who had a bad experience and found out the proper way to treat my child.

 

Julie Bowen has joined with Mylan Specialty L.P. to launch Get Schooled in Anaphylaxis™, a health initiative aiming to increase aware­ness of and preparedness for life-threatening allergic reactions. “Anaphylaxis is a long, crazy word, and a lot of kids don’t know it or how to say it, but it doesn’t have to be scary,” Julie says. “We want to make sure that peo­ple are educated, aware, and know how to treat it and how to avoid their allergic triggers.” Learn more at www.Anaphylaxis101.com.

This article was originally published in Coping® with Allergies & Asthma magazine, Winter 2012-2013.

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Eat Well. Breathe Well.

Nutrition Advice for People with Asthma

An important part of a healthy lifestyle is good nutrition. Good nutrition involves choosing healthy foods that can work to heal and repair your body and make it stronger against disease.

It’s important to include a variety of foods in your diet. Each of the food groups provides nutrients that are important to you, and foods in one group can’t replace those in another. Choose a variety of foods within each food group, and eat small amounts of fats, oils, and sweets. Talk with your doctor or dietitian about your specific nutritional needs. If you have asthma, eating a healthy diet can help you feel and breathe better.

Managing Mealtime
Shortness of breath at mealtimes can make eating hard work. If you use all your energy preparing a healthy meal, you may find yourself unable to eat or enjoy what you have prepared. If you have asthma, it’s important to conserve your energy in order to get the most from your meals.

Many people with asthma feel more short of breath when their stomach is full. This is because the diaphragm cannot work as well when the stomach is full. You can satisfy your nutritional needs, keep your stomach comfortable, and help your diaphragm to work better by eating smaller, more frequent meals. Eating small, frequent meals also reduces the chance of reflux. In addition, plan to eat before you are too hungry or tired. It’s important to refuel before you hit empty.

If you have asthma, eating a healthy diet can help you feel and breathe better.

Relax at mealtime. Breathe evenly while you are chewing and eating. Stop eating if you need to catch your breath.

Use prepared foods to save time and energy in the kitchen. Frozen meals, prepared foods, or take-out meals from a restaurant can make your life easier. However, the sugar, salt, or fat content of these foods may be higher than homemade. Be sure to ask if you are following a special diet. You can also double or triple your favorite recipes when cooking to keep your freezer full for times when you don’t feel like cooking.

When it comes to meal preparation, do the tasks that require the most effort when you have the most energy. For example, many people would agree that grocery shopping is a tiring task. This chore can be done when you feel freshest, in the morning or after a rest. Better yet, have a friend or family member pick up your groceries for you.

Don’t stand in the kitchen when you can sit. Bring your chopping, cutting, and mixing projects over to the kitchen table and sit while you prepare the food, or keep a barstool by the kitchen counter.

Avoid that “too full” feeling by eating less of the foods that cause gas. Common offenders include asparagus, beans, broccoli, Brussels sprouts, cabbage, carbonated drinks, cauliflower, cucumbers, melons, garlic, raw onions, peas, peppers, radishes, rutabagas, sausage, spicy foods, and turnips. Keep a food diary to find out if they are a problem for you.

Steroids and Nutrition
Some people with asthma take steroid pills on a regular basis. Steroid pills are strong medicines that decrease swollen airways. They also have some nutritional side effects to be aware of. Steroid therapy has the potential to interfere with the way the body uses specific nutrients, including calcium, potassium, sodium, protein, and vitamins D and C.

If you take steroid pills for asthma, it is very important to eat a well-balanced diet. A healthy diet can make up for some of the nutritional effects of steroid therapy.

Over a long period, steroid pills can increase the risk of osteoporosis (loss of calcium in the bones). Therefore, you should eat foods high in calcium, such as dairy products. In addition, limit salt and foods that are high in sodium, and decrease the amount of cholesterol and fats in your diet to prevent other side effects. Take certain supplements, such as calcium, and a multivitamin. Talk with your doctor or dietitian about specific concerns regarding steroids and your diet.

Asthma and Reflux
Many people with asthma also have gastroesophageal reflux, or GERD. In this condition, the muscle between the esophagus and stomach is weak, and stomach contents and acid back up into the esophagus. This may or may not cause symptoms. Many people with GERD can experience heartburn, pain, sore throat, swallowing problems, chronic cough, a choking sensation, and aspiration. Excess weight and dietary habits can contribute to reflux. Here are a few recommendations to decrease your risk of reflux and heartburn:

• Lose weight. Excess pressure in the abdomen can cause stomach contents to back up into the esophagus.
• Avoid overeating. Choose several small meals rather than three large meals.
• Avoid eating for two to three hours prior to bending over or lying down.
• Avoid foods that aggravate reflux, including fatty foods, citrus and tomatocontaining products, chocolate, mint, spicy foods, carbonated beverages, caffeine, and alcohol.

 

Source: National Jewish Health, NationalJewish.org

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2012.

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The Myths and Truths About Fall Allergies

Just when many Americans are hoping to catch a break from summer’s record heat waves, hay fever season is in full bloom. Each year, ragweed pollens begin surfacing in mid-August. Symptoms of hay fever, or allergic rhinitis, often mirror those of a cold, including a runny nose, sneezing, and nasal congestion.

“Many people mistake their seasonal symptoms for a cold instead of rhinitis due to several allergy myths,” says allergist Stanley Fineman, MD, president of the American College of Allergy, Asthma & Immunology. “Knowing the truth about allergies and how to prevent flare-ups can mean having a comfortable, symptom-free hay fever season.” Here are some myths and truths you should know about hay fever season to help you feel great, be active all day, and sleep well at night.

Myth: I’m miserable all hay fever season, but there’s nothing I can do except suffer through it.
Truth: There are many treatments available to ease your symptoms, including over-the-counter and prescription nasal sprays, medications, and allergy shots (also called immunotherapy). There also are new treatments on the horizon, including one for asthma triggered by ragweed allergies, so stay tuned. In the meantime, track your allergy symptoms with MyNasalAllergyJournal.org and visit with your allergist to find relief.

Myth: I’ve never had a problem with hay fever, so I must be sneezy and stuffy because of a cold.
Truth: Anyone can develop an allergy – including ragweed allergy – later in life. Scientists think it may be that you’ve always had the allergy, but it might have taken exposure to another allergen to trigger your symptoms. If symptoms are persistent, lasting more than two weeks, you probably have allergies. Colds evolve, usually starting with a stuffy nose, throat irritation, and lowgrade fever. Common allergy symptoms include itchy eyes and nose, as well as sneezing, but the mucus is typically clear.

Myth: I should start taking my hay fever medication at the first sneeze and stop at the first frost.
Truth: Ragweed usually blooms around mid-August (a little later in the south), but it’s best to stay ahead of the itching, sneezing, drippy nose, and wheezing and begin taking medication before symptoms start. The symptoms can linger until the end of the season, so wait until a few weeks after the first frost to stop taking medication.

Myth: My hay fever and pet allergies have nothing to do with each other.
Truth: If you are allergic to ragweed in addition to your dog or cat, you may experience even more symptoms during hay fever season. People with ragweed allergies who also are allergic to cats or dogs develop symptoms faster and more severely, according to a study published in the Annals of Allergy, Asthma & Immunology. Your best bet? Treat pet allergies year round to help make hay fever more manageable. Your allergist might also prescribe allergy shots.

Myth: Hay fever makes me sneeze and sniffle, but my tingly, itchy mouth must be caused by something else.
Truth: Actually, many people who are allergic to ragweed have oral allergy syndrome, also called pollen-food allergy syndrome. It means your body is having an allergic reaction to the proteins that are similar in ragweed pollen and certain fruits, vegetables, and nuts – such as banana, cucumber, melons, zucchini, and sunflower seeds. It’s quite common, and it is rarely serious. Usually it only causes an itchy, tingly mouth, throat, or lips. But sometimes it can cause a stomachache and, very rarely, a life-threatening reaction called anaphylaxis. In the event of an emergency, seek medical attention. Follow up with your allergist, who might prescribe epinephrine.

 

To learn more about allergies and asthma, take a relief test, and find an allergist, visit AllergyandAsthmaRelief.org.

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2012.

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Autumn Has Arrived!

Don’t Let Hay Fever Spoil It

Known to most people as hay fever, allergic rhinitis is a common medical problem affecting more than 15 percent of adults and children. It takes two different forms:

♦ Seasonal
Symptoms of seasonal allergic rhinitis occur in spring, summer, and early fall. They are usually caused by allergic sensitivity to pollens from trees, grasses, or weeds or to airborne mold spores.

♦ Perennial
People with perennial allergic rhinitis experience symptoms year-round. It is generally caused by sensitivity to house dust mites, animal dander, cockroaches, and mold spores. Underlying or hidden food allergies rarely cause perennial nasal symptoms.

Some people may experience both types of rhinitis, with perennial symptoms getting worse during specific pollen seasons. There are also non-allergic causes for rhinitis.

No hay. No fever. So why hay fever?
Hay fever is a century-old term that has come to describe the symptoms of allergic rhinitis, especially when it occurs in the late summer. However, the symptoms are not caused by hay (ragweed is one of the main culprits) and are not accompanied by fever. So the term allergic rhinitis is more accurate. Similarly, springtime symptoms are sometimes called rose fever, but it’s just coincidental that roses are in full bloom during the grass-pollinating season. Roses and other sweet-smelling, showy flowers rely on bees, not the wind, for pollination. Not much of their pollen gets into the air to cause allergies.

Once allergic rhinitis is diagnosed, treatment options include allergen avoidance, taking medications for symptom relief, and immunotherapy.

Is there any escape?
A common question from people with allergic rhinitis is Can I move someplace where my allergies will go away? Some allergens are tough to escape. Ragweed (which affects 75 percent of people with allergic rhinitis) blankets most of the United States. Less ragweed is found in a band along the West Coast, the southernmost tip of Florida, and northern Maine, but it is still present. Even parts of Alaska and Hawaii have a little ragweed.

Allergists seldom recommend moving to another locale as a cure for allergies. A person may escape one allergy to ragweed, for example, only to develop sensitivity to grasses or other allergens in the new location. Since moving can have a disrupting effect on a family financially and emotionally, relocation should be considered only in an extreme situation and only after consultation with your doctor.

Can allergic rhinitis cause other problems?
Some known complications include ear infections, sinusitis, recurrent sore throats, cough, headache, altered sleep patterns, fatigue, irritability, and poor school performance. Occasionally, children may develop altered facial growth and orthodontic problems.

How is rhinitis treated?
Once allergic rhinitis is diagnosed, treatment options include allergen avoidance, taking medications for symptom relief, and immunotherapy.

♦ Avoidance
A single ragweed plant may release one million pollen grains in just one day. The pollen from ragweed, grasses, and trees is so small that the wind may carry it miles from its source. Mold spores (which grow outdoors in fields and on dead leaves) also are everywhere and may outnumber pollen grains in the air even when the pollen season is at its worst.

While it’s difficult to escape pollen and molds, there are ways to lessen exposure. Keep windows closed and use air conditioning in the summer, if possible. Automobile air conditioners help, too. Don’t hang clothing outdoors to dry. Pollen may cling to towels and sheets. The outdoor air usually is most heavily saturated with pollen and mold between 5 a.m. and 10 a.m., so early morning is a good time to limit outdoor activities. Wear a pollen mask when mowing the lawn, raking leaves, or gardening and take appropriate medication beforehand.

♦ Medication
When avoidance measures don’t control symptoms, medication may be the answer. Medications help to reduce nasal congestion, runny nose, sneezing, and itching. They are available in many forms, including tablets, nasal sprays, eye drops, and liquids.

♦ Immunotherapy
Allergen immunotherapy, known as allergy shots, may be recommended for people who don’t respond well to treatment with medications, experience side effects from medications, have allergen exposure that is unavoidable, or desire a more permanent solution to their allergic problem. Immunotherapy can be very effective in controlling allergic symptoms.

There are many hay fever remedies, and each person’s treatment must be individualized based on the frequency, severity, and duration of symptoms and on the degree of allergic sensitivity. It’s important to talk to your doctor about ways to reduce your fall allergy symptoms.

 

Source: American College of Allergy, Asthma & Immunology, AllergyandAsthmaRelief.org

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2012.

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Traveling with Food Allergies

Research local restaurants where you will be staying. Call ahead and ask to speak to a manager about your needs, fully explaining how dangerous your or your child’s food allergies can be.

Whether you’re traveling for business or pleasure, careful preparation can make your trip safe and enjoyable. As always, communication is key.

When making special requests, give as much lead time as you can to trip organizers and airline, hotel, and restaurant staff. Bring a kit with all your medications, including antihistamine, extra autoinjectors, and copies of your emergency medical plan. Let your doctor know you’re traveling, and ask if he’ll be available to fax or call in a prescription for additional autoinjectors should you need them.

On The Plane
Always check the latest rules about what you can carry onboard. There may be different regulations for domestic and international flights. To know before you go, visit TSA.gov.

Just as you compare carriers for the most reasonable airfares, it’s also important to find out how accommodating they are to people with food allergies. It’s a good idea to make your reservations directly with the airline – rather than booking through an agent or online – so there’s no confusion later on.

Explain your situation clearly and politely. If you or your child has a peanut allergy, ask if the airline can serve pretzels rather than peanuts on your flight. And ask if it’s possible for the flight attendants to vacuum the area where you will be sitting before anyone boards the plane. This is helpful in case peanuts were served on previous flights. Try to get all communications in writing (ask for faxes, and print out email communications). Confirm and reconfirm, and keep a record of each person you spoke with.

Before booking your stay, call and speak to a hotel manager or director and explain the accommodations you require.

Check in early so you can speak to representatives at the gate as soon as possible. After you have checked in, explain your situation to the gate agent, who can then remind the flight crew about it. Once you board the plane, remind the head flight attendant as well.

Keep an eye on small children with allergies. Even if flight crews clean the area where a child is sitting, food often falls into cracks and spaces not reachable by a vacuum. If children reach for a toy they dropped or are curiously exploring the plane, they risk coming in contact with a hidden danger. Bring wet wipes to wipe down the seat, armrests, window areas, seatbelt clasps, and tray table where you’ll be sitting.

Bring extra medications and carry them with you at all times. When flying, you should always bring extra doses of your autoinjector. Bring a letter for carrying self-injectable epinephrine, signed by your doctor, which will allow you to bring your medication onboard. Keep your medical kit under your seat – if you should need it during your flight, you won’t have to struggle to get it out of the overhead bin.

Bring your own food and pack extra in case flights are delayed. Even if peanuts aren’t served as a snack, the other meal or snack options might contain offending ingredients. It’s best to bring a container of foods that you know are safe to eat.

Restaurants
Research local restaurants where you will be staying. Call ahead and ask to speak to a manager about your needs, fully explaining how dangerous your or your child’s food allergies can be. Can the eatery accommodate you without a risk of cross contamination? Will the person you spoke with be at the restaurant while you’re there? If not, ask for the name of the staff member who is aware of the circumstances.

Let your doctor know you’re traveling, and ask if he’ll be available to fax or call in a prescription for additional autoinjectors should you need them.

If all else fails, ask the restaurant if it is possible for you to bring your own bag of pasta for them to boil. It may not be the most memorable meal you’ve ever had, but at least you’ll be able to enjoy being with family, friends, or colleagues.

Remind a manager or the head waiter about your allergies before you are seated. Present your server with a copy of your food allergy restaurant card so that he or she can share it with the chef. If the wait staff doesn’t seem to understand your situation, always trust your gut and seek out another staff member or manager. In fact, there may be times when the safest choice is to not eat there at all.

All-Inclusive Resorts
Before booking your stay, call and speak to a hotel manager or director and explain the accommodations you require. Try to speak to the same resort manager every time, but make sure that other management is aware of the situation. Find out if the resort has a doctor or nurse on site and if they’re available full time.

Ask that every restaurant, café, snack shop, etc., be made aware that a guest with food allergies is staying on the premises. (However, it is still your responsibility to make your server aware of your food allergies every time you dine.)

Don’t assume that just because one eatery at the location has “safe” food, that they all do. Ask about ingredients and preparations at every restaurant, café, and snack shop every time. Even if you’ve stayed at a resort before and had a safe experience, many things may have changed since your last visit. Take precautions as if this were your first visit.

Traveling Abroad
Find out if there are local doctors in the area who specialize in allergy treatment. Will they be able to write you a prescription for additional autoinjectors or medications if you need them? Where is the closest hospital?

Ask your doctor to write a prescription that you can carry with you. Learn the generic and brand names in the countries you’ll be visiting. Ask for recommendations for restaurants, hotels, and activities. Does your doctor treat others who have had good experiences at certain places?

Bring several copies of your authorization of emergency treatment, emergency medical plan, and food allergy restaurant cards in both English and the language of the countries where you will be. Make sure they are with you at all times.

Language barriers can be tough to deal with, but chances are there is someone who speaks English working at the hotel. With many Internet translation services available, email can be an effective way to correspond.

Bring non-perishable food that is safe for you to eat. Dried pasta and allergen-free snack bars are good options. Don’t assume that the same products manufactured in other countries will contain the same ingredients.

 

Reprinted by the permission of Food Allergy Initiative from faiusa.org, copyright © 2012 Food Allergy Initiative. All rights reserved.

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2012.

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It’s Summer!

Skip the Allergies, Not the Fun

Millions of Americans have nasal allergies, commonly known as hay fever. Often fragrant flowers are blamed for the uncomfortable symptoms, yet they are rarely the cause; their pollens are too heavy to be airborne.

Allergy symptoms appear when the immune system reacts to an allergic substance that has entered the body as though it was an unwelcome invader. The immune system will produce special antibodies capable of recognizing the same allergic substance if it enters the body at a later time.

When an allergen reenters the body, the immune system rapidly recognizes it, causing a series of reactions. These reactions often involve tissue destruction, blood vessel dilation, and production of many inflammatory substances, including histamine. Histamine produces common allergy symptoms such as itchy, watery eyes, nasal and sinus congestion, headaches, sneezing, scratchy throat, hives, and shortness of breath. Other less common symptoms are balance disturbances; skin irritations, such as eczema; and even respiratory problems, like asthma.

Many common substances can be allergens. Pollens, food, mold, dust, feathers, animal dander, chemicals, drugs (such as penicillin), and environmental pollutants commonly cause many to experience allergic reactions. Your doctor can help determine the substances causing your discomfort.

One of the most significant causes of allergic rhinitis in the United States is ragweed. It begins pollinating in late August and continues until the first frost. Late springtime pollens come from grasses, and early springtime hay fever is most often caused by pollens of trees. Flowering plants rarely cause allergy symptoms.

Reducing Your Exposure

♦ Wear a pollen mask when mowing grass or cleaning house (most drugstores sell them).
♦ Change your air filters in heating and air conditioning systems and vacuum cleaners regularly, or install an air purifier.
♦ Keep windows and doors closed during heavy pollen seasons.
♦ Wipe down pets as they return inside to remove pollen from their fur.
♦ Use saline nasal rinses to cleanse your nose and sinuses of the offending allergens.
♦ Rid your home of sources of mildew.
♦ Try not to allow dander-producing animals into your home and bedroom. However, if you have a pet, ask your doctor for suggestions on how to enjoy your pet while also enjoying a life free of allergies.
♦ Replace feather pillows, wool blankets, and wool clothing with cotton or synthetic materials.
♦ Enclose mattress, box springs, and pillows in a plastic barrier.
♦ Use over-the-counter antihistamines and decongestants as needed and as tolerated.
♦ Sleep with the head of the bed tilted upward. Elevating it helps relieve nasal congestion.
♦ Discuss your hay fever and

Certain allergens are present all year long. These include house dust, pet dander, and some foods and chemicals. Symptoms caused by these allergens often worsen in the winter when the house is closed up.

Mold spores also cause allergy problems. Molds are present all year long and grow both outdoors and indoors. Dead leaves and farm areas are common sources for outdoor molds. Indoor plants, old books, bathrooms, and damp areas are common sources of indoor mold growth. Mold is also common in foods.

Allergies are rarely life threatening, but they often cause lost workdays, decreased work efficiency, poor school performance, and a negative effect on quality of life. Considering the millions of dollars spent on anti-allergy medications and the cost of lost work time, allergies cannot be considered a minor problem.

For some allergy fighters, symptoms may be seasonal, but for others, allergy symptoms produce year-round discomfort. Symptom control is most successful when multiple approaches are used simultaneously to manage the allergy. They may include minimizing exposure to allergens, desensitization with allergy shots or drops, and medications. If used properly, medications, including antihistamines, nasal decongestant sprays, steroid sprays, saline sprays, and cortisone-type preparations, can be helpful. Even over-the-counter drugs can be beneficial.

If you are experiencing allergy symptoms, schedule an appointment with your doctor. Aside from gathering a detailed history and completing a thorough examination of your ears, nose, throat, and head, your doctor can offer advice on proper environmental control. He or she will also evaluate your sinuses to determine if infection or a structural abnormality (deviated septum, polyps) is contributing to your symptoms.

In addition, your doctor may test to determine the specific allergen that is causing your discomfort and can help you develop a management plan that will help make life more enjoyable. In some cases, allergy shots or allergy drops may be recommended.

 

Source: American Academy of Otolaryngology – Head and Neck Surgery, entnet.org

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2012.

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Putting Your Finger on the Asthma Trigger

If you have asthma, you can minimize your symptoms and improve your quality of life by avoiding your asthma triggers and working with your doctor to develop a treatment plan.

Triggers
People with asthma have recurrent episodes of airflow limitation, often from inflamed airways that become narrowed, making it more difficult to move air in and out of their lungs. This can cause wheezing, cough, chest tightness, and shortness of breath. It is important to understand what triggers your symptoms and what makes them go away.

♦ Tobacco smoke, which is an irritant, often aggravates asthma. No one should smoke around you, in your home, or in your car. Your asthma may also be irritated by strong odors or fumes, weather changes, and air pollution.

♦ Viral and bacterial infections, such as the common cold and sinusitis, can make asthma worse.

♦ Strenuous exercise or exposure to cold, dry air can trigger asthma.

♦ Acid reflux, even if you do not experience heartburn, is also an asthma trigger. This diagnosis can be hard to make, and treatment is different from most asthma medications, so talk to your doctor.

♦ Some medications can cause or worsen asthma. These include aspirin or other non-steroidal anti-inflammatory drugs (such as ibuprofen) and beta-blockers (used to treat heart disease, high blood pressure, migraine headaches, and glaucoma).

♦ Even eating certain foods can trigger wheezing in some people. If any foods seem to trigger an asthma attack, avoid eating that food and talk to your doctor.

♦ Emotional anxiety may also increase your asthma symptoms and trigger an attack. Proper rest, diet, and exercise are important for your overall health and can help in managing asthma.

♦ Many people with asthma have allergies, which can trigger asthma symptoms. Common allergens include house dust mites, animal dander, molds, pollen, cockroach droppings, and foods. Your doctor can identify what you are allergic to and recommend ways to avoid exposure to your triggers.

Treatment and Management
Asthma has different causes in different people; therefore, individualized therapy is wise. Personalized plans for treatment may include environmental control measures to avoid your asthma triggers, medication, an asthma action plan, and a partnership among you, your family, your doctor, and other healthcare providers.

Many people with asthma have allergies, which can trigger asthma symptoms.

Since asthma is a chronic disease, it requires ongoing management. This includes using proper medications to prevent and control your asthma symptoms and to reduce airway inflammation. There are two general classes of asthma medications: quick-relief and long-term controller medications. Your doctor may recommend one or a combination of two or more of these medications.

Quick-relief medications are used to provide temporary relief of symptoms. They include bronchodilators and oral corticosteroids. Bronchodilators, generally called “rescue medications,” open up the airways so that more air can flow through. Bronchodilators include betaagonists and anticholinergics and come in inhaled, tablet, liquid, or injectable forms. There are some corticosteroids designed for short-term use that are swallowed or given by injection and that work a bit more slowly to help treat particularly bad inflammation in your airways.

Long-term controller medications are important for many people with asthma and are taken on a regular basis (often daily) to control airway inflammation and treat symptoms in people who have frequent asthma symptoms. Inhaled corticosteroids (there are many different ones), cromolyn or nedocromil, and leukotriene modifiers can help control the inflammation that occurs in the airways of most people who have asthma. One medication may work better for you than another. Your doctor can help guide you.

Inhaled long-acting beta2-agonists are symptom controllers that open your airways and may have other beneficial effects, but in certain people, they may have some risks. Current recommendations are for them to be used only along with inhaled corticosteroids. Methylxanthines provide modest opening of the airways and may have a mild antiinflammatory effect. Theophylline is the most frequently used methylxanthine. Leukotriene modifiers are also used for airway opening. Omalizumab is an injectable antibody that helps block allergic inflammation. It is used in people with persistent allergic asthma.

Your asthma medications may need to be adjusted as you and your asthma change, so stay in close touch with your doctor. The better informed you are about your asthma triggers and management, the better your asthma symptoms will be. Together, you and your doctor can work to ensure that asthma interferes with your daily life as little as possible.

 

Source: American Academy of Allergy, Asthma & Immunology, www.aaaai.org

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2012.

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Staying Active with Asthma

Staying active and exercising has many benefits to your overall health and well-being, but if you have asthma, you may feel the need to limit your activity to avoid symptoms. Understanding your symptoms and how to manage them is the first step to creat­ing an asthma management plan to keep you in the game.

When we exercise, we breathe harder, which causes water loss from our lungs. This water loss drops the temperature of our lungs and can cause asthma symp­toms. Symptoms may include coughing, wheezing, a feeling of chest tightness, and shortness of breath. You may experience symptoms once you begin exercising, or soon after it ends. How­ever, asthma doesn’t have to keep you on the sidelines.

Create an Asthma Management Plan
The first step to starting any exer­cise plan is to talk with your healthcare provider. Let him or her know what sports and physical activities you would like to participate in, and discuss the symptoms you experience during exer­cise. Remember to share any concerns or fears you may have. Together, you can create an asthma action plan that keeps you in the game and not on the sidelines.

Consider physical activities that have periods of inactivity, such as baseball.

Keep medications on hand. Your doc­tor may recommend that you take your quick-relief medicine prior to activity to help avoid asthma symptoms. Keep your quick-relief medicine close by in case you have trouble breathing. Stop activity and use your quick-relief medi­cine as soon as you begin to have asthma symptoms. Make sure to take your med­ications as prescribed.

Assess your symptoms daily, as well as before exercising. The key to keeping your asthma well controlled is to monitor your symptoms every day. If prescribed by your healthcare provider, a peak flow meter reading can show signs of asthma symptoms before you feel them.

Start Exercising
Find the exercise that’s right for you. Consider physical activities that have periods of inactivity, such as baseball. Swimming is often a good choice since the warm, moist air may keep symptoms away. It’s important to warm up and cool down. Ease your body into physical activity with a long warm-up routine and make sure to cool down afterward. When working out in the gym, lower the intensity of your training by increasing the number of rest periods between repetitions and machines. If you begin to feel symptoms, stop activity immediately, take your quick-relief medication, and follow your asthma action plan.

Keep your trainer informed. Share the steps on your asthma action plan with your trainer. Your asthma action plan should specify what to do in case of a breathing emergency, as well as make suggestions to modify your activ­ity depending on your peak flow meter readings. It’s important to communicate with your trainer if you need longer warm-ups and cool-downs or additional rest periods during activity.

Be careful when exercising indoors. Local gyms will keep you warm during your winter workout and cool during the summer, but they may increase your risk of being exposed to asthma triggers, as well as germs. When choos­ing a gym, ask what types of cleaners and disinfectants are used since bleach and strong odors from cleaning chemi­cals can cause asthma symptoms. Make sure the pool area is well ventilated and doesn’t have the strong smell of chlo­rine. A well-ventilated gym will reduce your exposure to mildew, mold, and other asthma triggers.

If you plan to move your physical activity outside, scope out the envi­ronment first and be aware of any obvious triggers. Look for areas that aren’t close to major highways with increased automobile exhaust. Monitor air quality forecasts before heading outside. Air pollution can be very high in the summer, and those with asthma and other lung diseases are at higher risk for being harmed by air pollution.

Stay Healthy
Remember to get a yearly flu shot. One of the main causes of asthma episodes is a respiratory in­fection, like the flu. Make sure to clean your gym equipment prior to use and wash your hands frequently. If you smoke, make a plan to quit.

 

Source: American Lung Association, www.lung.org.

This article was originally published in Coping® with Allergies & Asthma magazine, May/June 2012.

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Don’t Kill the Birthday Girl

by Sandra Beasley

There are only two birthdays that stand out in my memory as dis­tinct, chronologically certain events. One: my sixteenth birthday, when we watched Ferris Bueller’s Day Off. That was the year my friend Elizabeth, while using the swing anchored to the underside of our second-story deck, pushed off so hard that the whole she­bang – girl, swing, unhooked chains – went sailing twenty feet out into the woods behind our house. Two: the year I got diagnosed with mononucleosis, too late to cancel an Italian-themed dinner party. So I stood in front of a stove for two hours – achy, glands swollen, stone-cold sober – cooking pasta for two dozen while my friends went through six bot­tles of wine. That was, undoubtedly, my twenty-first birthday.

Beyond that, it blends into a murky party. Which years did we go to Chuck E. Cheese’s? When did I get my Rain­bow Brite doll? Which years were my father home, and which years had the army sent him off to the War College, Saudi Arabia, Bosnia?

There is one constant in my birthday memories. When it came time for a cake, my mother would bring out whatever Sandra-friendly sweet she’d designed. Some years it was sunflower-margarine Rice Krispies treats, and some years it was an applesauce-and-cinnamon-raisin Bundt cake. I’d get my serving. Then we’d dish out the real dessert of cake or brownies or pie a la mode for everybody else. After singing, after blowing out candles, after presents had been opened, after everyone had eaten, someone would say it: “Now, don’t kill the birthday girl.”

When it came time for a cake, my mother would bring out
whatever Sandra-friendly sweet she’d designed.

Which meant no kisses, no hugs, no touch of a hand or mouth. From that point onward, anyone who touched me ran the risk of giving me hives, or worse. Even today, it’s a phrase I repeat as part joke and part prayer. Don’t kill the birthday girl.

It’s the same at every holiday. My uncle Jim is notorious for forgetting about my allergies, holding out a dish of ice cream and asking, “Want a bite?” He’s the fun bachelor uncle, the one who rides a motorcycle and would give a little girl a windup sewer rat, complete with blinking red eyes, as a Christ­mas gift.

Once upon a time, it would fall on my mother to protect me at the end of the night, when the aunts and uncles and cousins were making the rounds for good-byes. Now I step to the side on my own. Everyone understands why I avoid con­tact. Yet I can’t help but wish it wasn’t their last impression of me before the long drive home.

I am allergic to dairy (including goat’s milk), egg, soy, beef, shrimp, pine nuts, cucumbers, cantaloupe, honeydew, mango, macadamias, pistachios, cashews, swordfish, and mustard. I’m also aller­gic to mold, dust, grass and tree pollen, cigarette smoke, dogs, rabbits, horses, and wool. But in particular, I am one of the 15 million Americans who have been diagnosed with food allergies, a figure that includes 8 percent of all children. Even with so many of us in the conver­sation, there are huge disconnects in the dialogue. Parents who have never met a food they couldn’t eat struggle to empathize with their child’s allergies. Those crusading for community accom­modation misguidedly conflate allergies with intolerance and confuse discomfort with anaphylaxis. Advocacy groups focus on youth allergies and largely ignore the complexities faced by those who grow into adulthood, travel, marry, and must figure out how to raise children of their own. There are multiple dimen­sions of data out there, but no one has set the gyroscope spinning.

Allergies are quirky beasts. Unlike many syndromes, they are primarily sorted according to their outside cata­lysts. (Have you ever heard someone claim to have type-peanut diabetes? Eggplant flu?) Allergies are widespread – and widely misdiagnosed. There is a whole range of symptoms and degrees of sensitivity, and these symptoms can change for any given individual at any time. For those with allergies like mine, each day requires vigilance in terms of what we do, the company we keep, and where we sit in relation to that bowl of mixed nuts. One person’s comfort food is another person’s enemy. One person’s lifesaver is another’s poison.

I thought my family’s habit of calling the foods I can eat “Sandra-friendly” was unique, until I saw a book by Emily Hendrix called Sophie-Safe Cooking: A Collection of Family Friendly Recipes That Are Free of Milk, Eggs, Wheat, Soy, Peanuts, Tree Nuts, Fish, and Shellfish. The more I have read, the more I real­ize a whole culture of catchphrases has emerged in addition to the key medical terminology. Safe, friendly, free: these words come up over and over again in literature about allergies.

Don’t kill the birthday girl. Leftover omelet clings to the edge of a breakfast plate. Butter greases the stir-fry. Walnuts go commando in an otherwise tame brownie. There’s a reason they’re called allergy “attacks”; you never know where a food can be lurking.

But those with food allergies aren’t victims. We’re people who – for better or for worse – experience the world in a slightly different way. This is not a story of how we die. These are the sto­ries of how we live.

 

Sandra Beasley is an author and poet who lives in Washington, D.C., where her prose has been featured in the Washington Post Magazine.

Excerpted with permission from Don’t Kill the Birthday Girl, by Sandra Beasley, copyright © 2012 Broadway Books, a division of Random House, Inc.

This article was originally published in Coping® with Allergies & Asthma magazine, May/June 2012.

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5 Surprising Summer Allergy & Asthma Triggers

Summer means barbeques, festi­vals, and other outdoor activities, and if you experience allergic reactions to grass pollens, you might be running for cover. However, seasonal allergies can also affect those without pollen sensitivities due to unexpected summer staples, such as certain fruits and vegetables, campfires, and changes in the weather.

“Although symptoms may not always be severe, summertime allergies and asthma are serious and, in some cases, deadly,” says allergist James Sublett, MD, chair of the American College of Allergy, Asthma, and Immunology Public Relations Committee. “However, these conditions shouldn’t damper summer fun. Proper diagnosis and treatment involves more than just relieving symp­toms; it can find the source of your suffering and stop it.”

By planning, seeing an allergist, and knowing the causes of allergy and asthma, even those with the most sensitive noses and lungs can enjoy summer festivities. Here are five surprising summer allergy and asthma triggers, as well as some sug­gestions for coping with them.

Toasting marshmallows or sitting out at a bonfire is a lot less fun if it results in an asthma attack.

1 Summer Fruits and Veggies
An otherwise healthy snack can mean an oral allergy syndrome for people whose lips begin to tingle after sinking their teeth into a juicy peach – or melon, apple, celery, or other fresh fruits and vegetables. People with common grass allergies can also have this condition, which is a cross-reaction between similar proteins in certain fruits and vegetables and the allergy-causing grass, tree, or weed pollens. The simple solution is to avoid the offending food, or just put up with the annoying but short-lived (and seldom dangerous) reaction. If symp­toms are bothersome, see an allergist to identify the offending pollen and develop a treatment plan to find relief.

2 Changes in the Weather
Be it sti­fling humidity or a refreshing cool breeze, sudden changes in the weather can trigger an asthma attack. Wind can spread pollen and stir up mold, affect­ing those who have grass or tree pollen and mold allergies. Your doctor can help you develop an allergy and asthma action plan to ensure your symptoms are kept in check no matter the season or the temperature.

3 Campfire Smoke
Toasting marsh­mallows or sitting out at a bonfire is a lot less fun if it results in an asthma attack. Smoke is a common asthma trigger. Sit upwind of the smoke and avoid getting too close to help prevent an asthma flare-up.

4 Stinging Insects
As if the pain isn’t bad enough, it is possible to develop a life-threatening allergic reaction to the sting of yellow jackets, honeybees, wasps, hornets, and fire ants. Cover up when gardening or working outdoors, avoid brightly colored clothing, forget the per­fume, and take caution when eating or drinking anything sweet, all of which attract stinging insects. Be especially careful with open soft drink cans. Your doctor might advise carrying epineph­rine for emergency relief in the event of being stung. See an allergist for skin testing to identify the offending insect and ask about allergy shots, which can provide life-saving protection.

5 Chlorine
Although not an allergen, the smell of chlorine from pools or hot tubs can be an irritant and cause flares of either allergy-like eye and nose symp­toms or asthma in some people.

Are You Making Your Allergies Worse?

Air filters, summer breezes, pro­crastination, and self-medication – each can delay relief from a stuffy nose, sneezing, sniffling, or other allergy symptoms. Be on the lookout for the following allergy-aggravating culprits.

Using the wrong air filter
Using an air filter to keep your home pollen-free is a good idea, but be sure it’s the right kind. Whole-house filtration systems do work, but change the filters regularly or you could be doing more harm than good.

Opening your windows
When your windows are open, the pollen can drift inside, settle into your carpet, furniture, or car upholstery, and continue to torture you. So keep your house and car windows shut during allergy season.

Procrastinating
You may think you can put off or even do without medication, but the next thing you know, you’re stuffed up, sneezing, and downright miserable. Instead, get the jump on al­lergies by taking your medication before the season gets under way.

Self medicating
Perhaps you’re not sure exactly what’s making you feel awful, so you switch from one medication to the next hoping for relief. Your best bet is to see an allergist, who can determine just what’s triggering your symptoms and suggest treatment. You might even benefit from allergy shots, which can stop your symptoms altogether.

 

Source: American College of Allergy, Asthma & Immunology, AllergyandAsthmaRelief.org

This article was originally published in Coping® with Allergies & Asthma magazine, May/June 2012.

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Your Guide for Asthma-Friendly Travel

If you or a loved one has asthma, navigating travel and different environments can be tricky. With a little preparation, your travel can be more asthma-friendly.

Asthma Travel Pack
Create an asthma travel pack to ensure you have all of the medicines and instructions you need in one, easily accessible place. When creating your asthma travel pack, consider including

• copies of your asthma action plan;
• an extra written prescription in case medication is lost or destroyed;
• insurance card and healthcare provider contact information;
• both quick-relief and controller medications (enough to get you through your stay, and extra in case you get held over unexpectedly);
• a spacer or chamber, if prescribed by your doctor; and
• a peak flow meter, if prescribed by your doctor.

Store your asthma travel pack and medicines at the correct temperature. Medicines may be exposed to extreme temperatures if they are stored in luggage checked at the airport or in your car. If your child is traveling without you, ensure his or her caregivers have access to the asthma travel pack and understand its contents, how to follow the instructions on the asthma action plan, how to administer medicines, and what to do during a breathing emergency. If you are prone to frequent asthma symptoms or will be gone for an extended period, it’s important to know where you can get medical attention if needed. Ask your healthcare provider to recommend a doctor or healthcare facility close to where you’ll be staying.

Prepare for Temperature Changes
When on vacation, you may be going from a warm to a cold climate, or vice versa. Extreme changes in temperature can trigger asthma. Try to stay indoors if it’s hot or humid outside, and wrap a scarf around your nose and mouth if it’s very cold.

Whether you are staying in a hotel or at grandma’s house, you may be exposed to the same triggers found in your home, and possibly new triggers.

Fly with Confidence
According to the Transportation Security Administration, www.tsa.gov, nebulizers are permitted in both check-in and carry-on luggage. It’s best to pack your nebulizer, quick-relief, and other asthma medicines in your carry-on, even during short flights. It’s important to have your medicine with you at all times. You never know when you may get stuck on the plane, or if your suitcase will get lost.

Choosing a Place to Stay
Whether you are staying in a hotel or at grandma’s house, remember that you may be exposed to the same triggers found in your home, and possibly new triggers. Complete this checklist when considering lodging:

Request a Smoke-Free Environment
Choose a hotel that is completely smokefree. Cigarette and cigar smoke can travel through the heating and cooling systems into your room. If a smoke-free hotel is not available, stay in a nonsmoking room on a nonsmoking floor. If you are staying with family or friends, ask to stay with those who don’t smoke. If residents do smoke, ask them to smoke outside.

Reduce Allergens
Some hotels now offer rooms that minimize allergens. They may be furnished with hardwood floors instead of carpet, have shades instead of fabric drapes, and use hypoallergenic linens.

Go Fragrance Free
If strong odors trigger your asthma, ask for a hotel room without scented soaps, lotions, or cleaning products. If you’re a houseguest, ask your host not to burn candles or incense, or use air fresheners.

Staying Warm
If you’re traveling to a colder climate, you may gather around the fireplace or warm your housing accommodations with wood-burning stoves, but their smoke can trigger an asthma episode. Kerosene and gas space heaters can also worsen asthma symptoms.

Reduce Exposure to Pets
If pet dander is a trigger, ask for a hotel room that has not housed pets. If those hosting you have pets, ask that the pet stay out of the room you are staying in to reduce your exposure. Wash your hands after touching the pet to remove any dander.

Bring Your Own Bedding
If you use a special pillowcase or mattress covers to reduce dust mite exposure, consider bringing them with you. Hypoallergenic “sleep sacks” are designed to use when staying in hotels to protect you from allergens, and can be purchased at stores that sell bedding.

Watch Out for Chlorine
Swimming is great exercise, but chlorine and other chemicals found in pools can trigger asthma. Make sure the pool area is well ventilated and doesn’t have a strong chlorine or chemical odor.

Managing Stress
Emotions can run high when you travel. Stress, excitement, anger, crying, and even laughing really hard can trigger an asthma episode. Practice deep breathing to help reduce stress and excitement. Try to stick to your regular exercise routine, eat healthy, and get plenty of rest.

 

Source: American Lung Association, www.lung.org, 1-800-LUNGUSA

This article was originally published in Coping® with Allergies & Asthma magazine, March/April 2012.

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Gardening the Allergy-Friendly Way

For many people with seasonal allergic rhinitis (hay fever), getting their hands dirty in the garden has consequences. Sneezing, itchy eyes, congestion, and other reactions can turn yard work into misery. However, with a few simple precautions, allergies don’t have to stand between you and your garden.

The best times of day to be outdoors are when the pollen levels are lower. This is typically on rainy, cloudy, and windless days. Pay attention to pollen counts in your area by subscribing to the email alerts available from the National Allergy Bureau at aaaai.org/nab. The NAB provides the most accurate and reliable pollen and mold levels from approximately 78 counting stations throughout the United States, two counting stations in Canada, and two in Argentina.

Allergy-Friendly Plants
♦ Cactus
♦ Cherry trees
♦ Dahlia
♦ Daisy
♦ Geranium
♦ Hibiscus
♦ Iris
♦ Magnolia
♦ Rose
♦ Snapdragon
♦ Tulip

Allergenic Plants to Avoid
♦ Ash
♦ Cedar
♦ Cottonwood
♦ Maple
♦ Oak
♦ Johnson grass
♦ Rye grass
♦ Timothy

Avoid touching your eyes or face when doing yard work. You may also consider wearing a mask to reduce the amount of pollen spores that you breathe in.

Leave gardening tools and clothing – such as gloves and shoes – outside to avoid bringing allergens indoors. Showering immediately after gardening may also help reduce symptoms.

Certain flowers, trees, and grasses are better suited for the gardens of people with outdoor allergies (see sidebar). The best way to determine which plants trigger your allergic reactions is through skin testing. Your doctor can help you develop strategies to avoid troublesome plants and pollen and can prescribe medication to alleviate symptoms.

Allergy shots may offer permanent relief from allergy symptoms. Check with your doctor to see if this is an effective treatment for you.

 

Source: American Academy of Allergy, Asthma & Immunology, www.aaaai.org

This article was originally published in Coping® with Allergies & Asthma magazine, March/April 2012.

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Ready or Not, Spring Allergy Season is Here

Allergies are diseases of the immune system that cause an overreaction to substances called allergens. People who have allergies can live healthy and active lives.

Good allergy treatment is based on the results of your allergy tests, your medical history, and the severity of your symptoms. It can include three different treatment strategies: avoidance of allergens, medication options, and immunotherapy (allergy shots).

Avoiding Your Allergens
The best way to prevent allergy symptoms and minimize your need for allergy medicine is to avoid your allergens as much as possible and to eliminate the source of allergens from your home and other environments. For tips on allergen avoidance, talk to your doctor.

Some people don’t take allergy medicines because they don’t take their symptoms seriously. The result may be painful complications.

Medication
Some people don’t take allergy medicines because they don’t take their symptoms seriously. The result may be painful complications, such as sinus or ear infections. Don’t take the risk. There are so many safe prescription and nonprescription medicines to relieve allergy symptoms. Following is a brief list of medications taken for allergies. They are available in nonprescription and prescription form:

Antihistamines and decongestants are the most common medicines used for allergies. Antihistamines help relieve rashes and hives, as well as sneezing, itching, and runny nose. Decongestant pills, sprays, and nose drops reduce stuffiness by shrinking swollen membranes in the nose.

It is important to remember that using a nonprescription nasal decongestant spray more than three days in a row may cause the swelling and stuffiness in your nose to become worse, even after you stop using the medicine. This is called a rebound reaction. Some nonprescription “cold” medicines combine an antihistamine, a pain reliever like aspirin or acetaminophen, and a decongestant. Aspirin can cause asthma attacks in some people. Don’t take a chance. If you have asthma, talk with your doctor before taking any nonprescription allergy medicine.

Eye drops may provide temporary relief from burning or bloodshot eyes. Using allergy eye drops that contain antihistamines can reduce itching, tearing, and swelling.

Corticosteroid creams or ointments relieve itchiness and halt the spread of rashes. Corticosteroids are not the same as anabolic steroids that are used illegally by some athletes to build muscles. If your rash does not go away after using a nonprescription corticosteroid for a week, see your doctor.

Corticosteroid nasal sprays help reduce the inflammation that causes nasal congestion.

Cromolyn sodium prevents the inflammation that causes nasal congestion. Because it has few, if any, side effects, cromolyn can be safely used over long periods of time.

Oral corticosteroids may be prescribed to reduce swelling and stop severe allergic reactions. Because these medications may cause serious side effects, you should expect your doctor to carefully monitor you.

Epinephrine comes in pre-measured, self-injectable containers, and is the only medication that can help during a life-threatening anaphylactic attack. To be effective, epinephrine must be given within minutes of the first sign of a serious allergic reaction.

Immunotherapy (Allergy Shots)
When it is not possible to avoid your allergens and treatment with medications alone does not solve the problem, immunotherapy can often prevent allergy symptoms. It involves giving a person increasingly higher doses of an allergen over time. For reasons that we do not completely understand, the person gradually becomes less sensitive to that allergen. This can be effective for some people with hay fever, certain animal allergies, and insect stings. It is usually not effective for allergies to food, drugs, or feathers, nor is it effective for hives or eczema.

 

Source: Asthma and Allergy Foundation of America, www.aafa.org

This article was originally published in Coping® with Allergies & Asthma magazine, March/April 2012.

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Skin Allergy Mobile App Available

CARD app from Preventice uses Mayo Clinic expertise to help allergy sufferers

For people who suffer from skin allergies, shopping for something simple like laundry detergent, shampoo or lotion can be a gamble that lands them in the doctor’s office. In fact, a National Ambulatory Medical Care survey conducted in 1995 estimated that 8.4 million people visit their doctor because of skin allergies, or contact dermatitis. Furthermore, allergic reactions to skin care and cosmetic products were the second most frequent dermatologic diagnosis.

But thanks to a new mobile health application from Preventice, Inc., life just got easier for people with skin allergies.

Introducing CARD for iPhone, Smartphones and tablets The CARD application is the first publicly available application based on a technology licensed between Mayo Clinic and Preventice. CARD combines the world-class medical expertise and research of Mayo Clinic with the cutting-edge mobile technology and cloud-computing platform of Preventice.

CARD – which stands for Contact Allergen Replacement Database – gives physicians and patients instant access to information about chemicals, preservatives and fragrances in skin care products that cause allergic reactions. CARD allows patients to:

• Create safe-shopping lists based on their allergies
• Use the CARD database to find safe products
• Print shopping lists
• Save photos to share with their physician to improve diagnosis and treatment
• Create personal journals of any reactions
• Receive notification of product formulation changes

The Preventice CARD application gives consumers access to the world’s most recognized contact allergy database, which contains more than 8,000 known ingredients found in more than 5,500 commercial skin care products. Developed by Mayo Clinic in 1999, CARD is available for the first time to physicians and patients worldwide.

“The occurrence of contact dermatitis is increasing and product labeling remains an issue, despite the growth of all-natural products,” said Jon Otterstatter, Preventice co-founder, president and CEO. “Physician and patient response to the CARD application has been extremely positive, and patient stories reinforce the real-life value that CARD offers.”

“The Preventice CARD System represents an essential clinical tool for discovering and avoiding skin-care products that cause allergic reactions,” said James Yiannias, MD, Mayo Clinic. “Dermatologists at Mayo Clinic have used CARD for years to recommend safe skin care products and have found it typically increases patient compliance and makes patient diagnosis and education more efficient.”

Download CARD from iTunes using “Preventice Card” in the search.

 

This article was originally published in Coping® with Allergies & Asthma magazine, Winter 2011-2012.

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Seven Tips to Successfully Quit Smoking in the New Year

This holiday season, countless Americans will make the New Year’s resolution to quit smoking in 2012. While quitting smoking is extremely difficult – six out of 10 smokers require multiple quit attempts to stop smoking – preparing a quit-smoking plan can greatly improve a person's chance for success. The following are proven tips and resources from the American Lung Association that have helped thousands of people give up smoking for good:

1. Talk to your doctor or pharmacist about the various types of treatments and different over-the-counter and prescription medications that are available to help you quit smoking.
2. Look into the different options available to help smokers quit. Visit www.lung.org/stop-smoking or call 1-800-LUNG-USA (1-800-586-4872) for suggestions.
3. Take time to plan. Pick your quit date a few weeks ahead of time and mark it on the calendar. If you can, pick a day when life's extra stresses are not at their peak, such as after the holidays. Mark a day on the calendar and stick to it.  As your quit day approaches, gather the medications and tools you need and map out how you are going to handle the situations that make you want to smoke.
4. Get some exercise every day. Walking is a great way to reduce the stress of quitting. Exercise is proven to not only combat weight gain but also to improve mood and energy levels.
5. Eat a balanced diet, drink lots of water and get plenty of sleep.
6. Ask family, friends and co-workers for their help and support. Having someone to take a walk with or just listen can give a needed boost.
7. You don't have to quit alone. Help is available online and in your community. Consider joining a stop-smoking program like Freedom From Smoking® (www.ffsonline.org) from the American Lung Association.

"Research shows that people who develop a support system and use programs like Freedom From Smoking® Online have greater success in quitting for good."

“Quitting smoking is the single most important step smokers can take to improve their health,” said Norman H. Edelman, MD, chief medical officer of the American Lung Association. “The start of a fresh New Year is a great time for smokers to implement their plan to quit smoking – and reap the health and financial benefits of a smokefree lifestyle.”

Helping Americans quit smoking remains a public health priority for the American Lung Association. Its Freedom From Smoking® group clinic program #&8211; which began in 1981 and includes a comprehensive variety of evidence-based cessation techniques – has helped hundreds of thousands of smokers quit. The American Lung Association more recently introduced Freedom From Smoking® Online, a highly successful, self-paced online adaptation of the group clinic that is available 24 hours a day.

“Smokers don’t have to go it alone when they attempt to quit smoking,” added Dr. Edelman. “In fact, research shows that people who develop a support system and use programs like Freedom From Smoking® Online have greater success in quitting for good, compared to those who try to quit “cold turkey.”

 

Source: American Lung Association, www.lungusa.org

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Researchers Engineer a New Way to Inhibit Allergic Reactions Without Side Effects

Researchers from the University of Notre Dame have announced a breakthrough approach to allergy treatment that inhibits food allergies, drug allergies, and asthmatic reactions without suppressing a sufferer's entire immunological system.

The therapy centers on a special molecule the researchers designed, a heterobivalent ligand (HBL), which when introduced into a person's bloodstream can, in essence, out-compete allergens like egg or peanut proteins in their race to attach to mast cells, a type of white blood cell that is the source of type-I hypersensitivity (that is, allergy).

"Unlike most current treatments, this approach prevents allergic reactions from occurring in the first place" says Basar Bilgicer, assistant professor of Chemical and Biomolecular Engineering and Chemistry and Biochemistry and principal investigator in Notre Dame's Advanced Diagnostics & Therapeutics initiative.

Michael Handlogten, lead scientist on the paper and a graduate student in Dr. Bilgicer's group, explained that among the various chemical functionalities he analyzed to be used as the scaffold HBL synthesis, ethylene glycol, an FDA-approved molecule, proved to be the most promising.

"Unlike most current treatments, this approach prevents allergic reactions from occurring in the first place."

Mast cells are part the human body's defense against parasites (such as tapeworms), and when working normally they are attracted to, attach to, and annihilate these pathogens. But type-I hypersensitivity occurs when the cells react to non-threatening substances. More common allergies are due to ambient stimulants, and an allergic response may range from a mild itch to life-threatening anaphylactic shock.

Tanyel Kiziltepe, a research professor in Advanced Diagnostics & Therapeutics, adds that "anaphylaxis can be caused by certain food allergens, insect stings, antibiotics, and some medicines, and we believe HBL has a very high potential to be developed as a preventative medication".

While many medicines treat allergies by weakening a person's entire immune system, this approach only disrupts the process whereby white blood cells bond with allergens in the first place.

"It also does not leave patients open to an increased risk for infections or the development of cancers," explains Bilgicer. "HBLs may be most useful in situations where it's not possible to speak to or gauge someone's sensitivity."

"For example, in an emergency, on a battlefield, or in a remote location, doctors may not be able to ask a patient about an allergy before administering penicillin. An engineered HBL could be given along with the medicine and perhaps prevent a deadly reaction from occurring."

In a normal allergic reaction, allergens bind to a white blood cell, or "mast" cell, and cause the release of inflammatory molecules. Researchers at Notre Dame have shown how non-allergenic molecules, known as heterobivalent ligands, can be designed to attach to mast cells first, preventing the allergic reaction in the first place.

 

Advanced Diagnostics & Therapeutics – a Strategic Research Investment of the University of Notre Dame – is dedicated to developing tools and technologies to combat disease, promote health, and safeguard the environment.

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Dining Out with Food Allergies

Do you know what’s in that salad? When dining out, it’s always best to double check your meal for potential allergens before you dig in.

Dining out is one of America’s favorite pastimes, but for peo­ple with food allergies and intolerances, the experience can often be frustrating and stressful. Paul An­tico, founder of AllergyEats, an online source for finding allergy-friendly res­taurants, understands these challenges firsthand from dining out with his three food-allergic children.

“Families with food allergies hope that all restaurants will cater to food-allergic diners, but some restaurants are far more accommodating than others. A growing number of restaurants have extensive food-allergy protocols in place, educating their staff about food allergies and procedures, avoiding cross-contamination, and sharing detailed information about the ingredients in each dish. Other establishments are unable – or unwilling – to prepare meals without diners’ allergy triggers, such as nuts, dairy, eggs, gluten, shellfish, and more,” Paul says.

“Unfortunately, there is no such thing as a completely allergy-safe restaurant. While many restaurants have gone to great lengths to be as allergy-friendly as possible, food-allergic individuals – or their caretakers – still need to take 100 percent responsibility for their own safety,” he adds. As the father of three food-allergic children, the founder of AllergyEats, and a proactive food allergy advocate, Paul offers the following advice based on his personal and professional experience.

Do some homework in advance.
Find dining recommendations from others within the food allergy commu­nity through an online resource like AllergyEats (www.allergyeats.com). Check menus and allergen information on res­taurants’ websites. Call the restaurant with any questions before you leave the house.

Once you arrive at the restaurant, ask your server how the restaurant will be able to accommodate your specific needs.

Try to dine at off-peak hours.
When restaurant staff is less harried, they will be better able to take the proper precau­tions with your order.

Inform the host and server about your food allergies.
Once you arrive at the restaurant, ask your server how the restaurant will be able to accommo­date your specific needs. Be very clear, but polite. If you don’t feel completely confident after speaking to the server, ask to talk to the manager or chef. Most importantly, if after speaking with the restaurant staff, you don’t feel comfort­able, leave and find another restaurant.

Ask questions.
When you speak with the restaurant staff, you should receive confident answers to the fol­lowing questions:

• What protocols do you have in place to serve food-allergic individuals?
• Which items on your menu are not safe, given my specific food allergies?
• How are diners’ allergies communi­cated to the kitchen and other staff?
• How is the kitchen set up to prevent cross-contamination?
• Is separate equipment used to prepare orders for food-allergic individuals?
• What kind of oil will be used in the preparation of my order? Is it safe, given my allergies?
• Can I see the list of ingredients for a given menu item?

Get reassurance about the safety of your food.
When you receive your meal, politely ask the server if he or she is sure that this food is safe for you and if there was any chance of cross-contamination.

Stop and look carefully at your meal.
Check to see if any of your offending allergens, such as grated cheese, pesto, or nuts, are present. This may sound obvious, but Paul has found that some restaurants follow all of the “rules” to accommodate a food allergy and then mistakenly do something as obvious as grating cheese on top of a dairy-allergic diner’s salad.

Show your gratitude.
If the restau­rant answered all of your questions and accommodated your special requests, be sure to thank them, leave a generous tip, and let them know you’ll return thanks to your positive experience.

 

Whether your experience was posi­tive, negative, or somewhere in between, log on to AllergyEats.com and rate the restau­rant. Rating a restaurant is simple and helps other food-allergic individuals determine which restaurants to visit.

Source: AllergyEats, www.allergyeats.com

This article was originally published in Coping® with Allergies & Asthma magazine, Winter 2011-2012.

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Home Is Where the Sneeze Is

When you have indoor aller­gies, it’s hard to feel like “there’s no place like home.” The good news is there are some simple steps you can take to reduce your exposure to indoor allergens.

Don’t Let Dust Get Too Comfortable
If you or someone in your household has allergies, cleaning the home is incredibly important in managing exposure to indoor allergens. Regular use of a cyclonic vacuum or a vacuum with a HEPA filter, washing items in hot water, and using dust mite-proof casings can reduce allergens.

Couches, Curtains, and Cushions, Oh My
Allergens make themselves at home in fab­rics throughout the house, such as upholstered couches and chairs, bedding, curtains, and carpets. If you can’t tear up the carpet or remove the curtains, look for cleaning products that will denature or deactivate dust mite matter and cat and dog dander in fabrics in the home.

Kick the Habit
Don’t smoke indoors at any time. This benefits everyone.

When in Doubt, Air It Out
Clean and disinfect bathrooms, kitchens, and basements regularly, and keep them well ventilated to reduce the growth of mold. Use exhaust fans or open a window when cooking or bathing.

Keep Fido Allergy-Friendly
Can’t live without pets? Bathe them once a week to reduce dan­der, and whenever possible, keep your pet out of the bedroom.

 

Source: American Academy of Allergy, Asthma & Immunology, www.AllergyandAsthmaRelief.org

This article was originally published in Coping® with Allergies & Asthma magazine, Winter 2011-2012.

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Immunotherapy Can Provide Lasting Allergy Relief

Immunotherapy treatment (allergy shots) is based on a century-old concept that the immune system can be desensitized to specific allergens that trigger allergy symptoms. These symptoms may be caused by allergic respiratory conditions, such as allergic rhinitis and asthma.

While allergy medications often con­trol symptoms, if you stop taking your medication, your allergy symptoms re­turn shortly afterward. Allergy shots can potentially lead to lasting remission of allergy symptoms, and they may even prevent the development of asthma and new allergies.

The Process
Immunotherapy treat­ment involves injecting the allergen or allergens causing your allergy symp­toms. These allergens are identified by a combination of a medical evaluation performed by a trained healthcare pro­fessional and allergy skin or blood tests.

Some people have lasting remission of their allergy symptoms with immuno­therapy, but others may relapse after discontinuing treatment.

Treatment begins with a build-up phase. Injections containing increasing amounts of the allergen are given one to two times a week until the target dose is reached. This target dose varies from person to person. The target dose may be reached in three to six months with a conventional schedule of one dose increase per visit. Or it may be achieved in a shorter period and fewer visits with an accelerated schedule.

Still Working After 100 Years

In 1911, allergen immunotherapy was introduced. The earliest published successes for allergen immunotherapy were based on the work of two English scientists, Leonard Noon and John Freeman. Recognizing that pollen was the cause of hay fever, these scientists thought that they could induce immu­nity and tolerance by injecting people who had hay fever with the pollen to which they were allergic. This idea was based on the positive results of vaccines that produced protection against infec­tious disease, such as small pox.

Over the years, we’ve learned much more about allergen immunotherapy. Among the most important findings is that immunotherapy can provide long-term symptom relief for years after treatment is discontinued. Research has demonstrated that allergy immuno-therapy can be effective in treating allergic asthma, allergic rhinitis and conjuncti­vitis, stinging insect allergy, and atopic dermatitis.

The maintenance phase begins when the target dose is reached. Once the maintenance dose is reached, the time between allergy injections can be in­creased. It generally ranges from every two weeks to every four weeks. Main­tenance immunotherapy treatment is usually continued for three to five years.

Some people have lasting remission of their allergy symptoms with immuno­therapy, but others may relapse after discontinuing treatment. Therefore, the duration of allergen immunotherapy varies from person to person.

Risks involved with immunotherapy are rare, but may include serious, life-threatening anaphylaxis. For that reason, immunotherapy should only be given under the supervision of a physician or qualified physician extender (such as a nurse practitioner or physician assistant) in a facility equipped with proper staff and equipment to identify and treat ad­verse reactions to allergy injections.

The decision to begin immunotherapy is based on several factors, including the length of the allergy season and severity of your symptoms, how well medications and allergen avoidance measures con­trol your allergy symptoms, and your desire to avoid long-term medication use. Immunotherapy will also require a sig­nificant time commitment during the build-up phase, and a less frequent com­mitment during the maintenance phase.

 

Source: American Academy of Allergy, Asthma & Immunology, www.AllergyandAsthmaRelief.org

This article was originally published in Coping® with Allergies & Asthma magazine, Winter 2011-2012.

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New Molecular Candidates for Treatment of Asthma and Allergies

Discovery provides new insights on role of histamine releasing factor in asthma and allergies

La Jolla Institute for Allergy & Immunology scientists have identified the histamine releasing factor (HRF) molecule as a promising target for developing new treatments for a number of allergic reactions including asthma.

The research team, led by Toshiaki Kawakami, MD, PhD, is also the first to clarify the role of the HRF molecule in promoting asthma and some allergies, including identifying its receptor - a major finding that answers a long-held and important question in the allergy research community.

Juan Rivera, MSc, PhD, deputy scientific director at the National Institute of Arthritis and Musculoskeletal and Skin Diseases, part of the National Institutes of Health (NIH), said the findings provide new insights on HRF's function in allergic diseases. "Importantly, this work advances both the understanding of how HRF contributes to susceptibility of certain individuals in developing allergic disease as well as begins to unravel the mechanisms involved," he said.

"What is most encouraging is the demonstration that the effect of HRF to enhance allergic responses can be blocked, thus suggesting the possibility of new therapeutic strategies in allergic diseases."

"What is most encouraging is the demonstration that the effect of HRF to enhance allergic responses can be blocked, thus suggesting the possibility of new therapeutic strategies in allergic diseases."

The research study points to the development of new therapies based on blocking HRF interactions with certain antibody (IgE) molecules, long known to be central causes of allergies. The new study also found two novel peptides (N19 and H3) as strong therapeutic candidates for blocking the HRF and IgE interactions. Peptides are protein pieces which spur various molecular actions. The two peptides inhibit the interactions of the HRF and IgE molecules, thereby stopping the allergic cascade in mouse models.

"Based on our preliminary studies, we believe these HRF inhibitors may provide a new, innovative therapeutic avenue for the treatment of asthma and some allergies," said Dr. Kawakami, lead scientist on the study, published online in the Journal of Clinical Investigation.

Hannah Gould, PhD, a professor and prominent allergy researcher at King's College in London, said the study advanced scientific understanding in several key ways. "The research community has long believed that the histamine releasing factor (HRF) played some role in triggering allergic responses and asthma in certain individuals," she said. "However, the identity of the primary binding partner, the HRF receptor, the unique characteristics of the IgE in these individuals, and the mechanisms involved in HRF activity have remained elusive until the present study by Dr. Kawakami and his team."

"These findings suggest a potential treatment for allergy and asthma patients who have HRF reactive IgE," she continued. "We can look forward to the future results of pre-clinical and clinical studies in the human system."

The prevalence of asthma has been dramatically increasing for the last few decades and has reached epidemic proportions in the U.S. and other industrialized countries. Twenty million patients suffer from asthma in the U.S. alone, including nine million children. Meanwhile, 10 to 20 percent of the population of industrialized countries suffers from some form of allergies. Both illnesses are immune system disorders.

"There is a huge need to understand these diseases and to find therapeutic interventions," said Mitchell Kronenberg, PhD, president and chief scientific officer of the La Jolla Institute, a world leader in immune system research. "Allergies and asthma are a cornerstone of the La Jolla Institute's research activities dating back to our founding scientists, who were the discoverers of the IgE molecule in the 1960s. Dr. Kawakami's latest discovery is in keeping with our history of innovation in allergy research."

Allergic reactions occur when a person's immune system reacts to normally harmless substances in the environment, referred to as allergens. When exposed to an allergen, IgE molecules activate white blood cells called mast cells and basophils. These cells release histamine and other compounds, which produces allergy symptoms that can range from uncomfortable to dangerous. In asthma, inhaled allergens can induce airway inflammation, causing wheezing, coughing and shortness of breath.

Dr. Kawakami said the HRF molecule has been studied for many years and was thought to play some role in the cellular interactions leading to allergies and asthmas. However, its exact purpose and mode of operation was previously not clear. "Nasal drainage, skin blister fluids, and some bronchial fluids were found to contain HRF secretions, so the scientific community suspected that HRF was important, but we didn't know why," said Dr. Kawakami.

HRF studies had been limited by several factors over the years, he added, including the inability to model HRF interactions in mice. In addition, Dr. Kawakami said failure to identify the HRF receptor also slowed progress. "It's very, very unusual for many years to pass between the discovery of a molecule and the identification of its receptor," he said. "In this case, 15 years had passed. Without the receptor, we couldn't understand the role of this protein in asthma and allergies."

Dr. Kawakami and his team were the first to solve this mystery in 2007 -- identifying a subset of IgE and IgG molecules as HRF receptors. This information gave Dr. Kawakami's group the critical missing piece of the HRF puzzle and enabled the researchers to map HRF's role in allergy activation.

Dr. Kawakami's team also previously discovered that tremendous heterogeneity exists in the IgE molecules. The original work, funded by NIH, provided the foundation for the latest findings on HRF's role in triggering allergies. "The differences were big in terms of affecting the activation and survival of mast cells," he said. "That's why we got interested in this molecule (HRF). Earlier studies had suggested that HRF does not bind to IgE molecules. But I was not convinced, so I decided to explore this further."

Their study results showed that 20 to 30 percent of IgE molecules can interact with HRF molecules and produce mast cell activation leading to allergies. "We think HRF is important for amplifying allergic reactions initiated by IgE and an allergen," said Dr Kawakami. The findings were published today in a paper entitled, Proinflammatory role of histamine-releasing factor in mouse models of asthma and allergy.

 

Source: La Jolla Institute, www.liai.org

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10 Things You Should Know about Mold

Molds produce tiny spores to reproduce. These spores waft through the indoor and outdoor air continually. When mold spores land on a damp spot indoors, they may be­gin growing and digesting whatever they are growing on in order to survive. When excessive moisture or water accu­mulates indoors, mold growth will often occur, particularly if the moisture problem remains undiscovered or unaddressed.

Here are 10 things you should know about mold and how you can keep it under control.

1 Potential health effects and symptoms associated with mold exposures include allergic reactions, asthma, and other respiratory complaints.

2 There is no practical way to eliminate all mold and mold spores in the indoor environment; the way to control indoor mold growth is to control moisture.

3 If mold is a problem in your home or school, you must clean up the mold and eliminate sources of moisture.

4 Fix the source of any water problem or leak you may have to prevent mold growth.

5 Reduce indoor humidity to decrease mold growth by vent­ing bathrooms, dryers, and other moisture-generating sources to the outside; using air conditioners and dehumidi­fiers; increasing ventilation; and using exhaust fans whenever cooking, dishwashing, and cleaning.

6 Clean and dry any damp or wet building materials and furnishings within 24 to 48 hours to prevent mold growth.

7 Clean mold off hard surfaces with water and detergent, and dry completely. Absorbent materials, such as ceil­ing tiles, that are moldy may need to be replaced.

8 Reduce the potential for condensation on cold surfaces, such as windows, piping, exterior walls, the roof, or floors, by adding insulation.

9 Don’t install carpeting in areas where there is a perpetual moisture problem, such as by drinking fountains, by classroom sinks, or on concrete floors with leaks or frequent condensation.

10 Molds can be found almost anywhere; they can grow on virtually any substance, providing moisture is present. There are molds that can grow on wood, paper, carpet, and foods.

 

Source: U.S. Environmental Protection Agency, www.epa.gov

This article was originally published in Coping® with Allergies & Asthma magazine, Winter 2011-2012.

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Do You Know the Warning Signs of Asthma?

Recognizing the signs and symptoms of asthma is important so that treatment and other interventions can begin early. If severe symptoms are present, it is vital to begin the appropriate treatment immediately. Accurate and timely assessment of symptoms can help you and your doctor decide if treatment should begin in the home, at your doctor’s office, or in the emergency room.

Early Warning Signs of Asthma
Early warning signs are experienced before the start of an asthma episode. By recognizing these clues, early treatment can begin. These signs can be different for each person, and they may even differ for the same person with each episode. Some early warning signs may be noticed only by the individual, while others are more likely to be noticed by other people. In ad­dition, a downward trend in peak flow numbers can be a reliable early warning sign. Additional early warning signs include breathing changes, sneezing, moodiness, headache, runny or stuffy nose, coughing, chin or throat itchiness, feel­ing tired, dark circles under your eyes, trouble sleeping, and poor tolerance for exercise.

Asthma Episode Symptoms
Asthma symptoms indi­cate that an asthma episode is occurring. Changes have taken place in the airways and airflow is obstructed. Asthma epi­sode symptoms include wheezing, coughing, shortness of breath, tightness in the chest, and peak flow numbers in the caution or danger range. Individuals with asthma experience some or all of these symptoms during an asthma episode, and action should be taken to treat these symptoms before they become worse.

Severe Asthma Episode Symptoms
Severe asthma symp­toms indicate a life-threatening emergency. These include severe coughing, wheezing, shortness of breath, or tightness in the chest; difficulty talking or concentrating; experiencing shortness of breath when walking; breathing that is shallow and fast or slower than usual; hunched shoulders; nasal flaring; neck area and between or below the ribs moving inward with breathing; a gray or bluish tint to the skin, beginning around the mouth; and peak flow numbers in the danger zone.

If any of these severe asthma symptoms occur, seek emergency medical treatment right away, as these symp­toms indicate respiratory distress.

 

Source: National Jewish Health, www.nationaljewish.org

This article was originally published in Coping® with Allergies & Asthma magazine, Winter 2011-2012.

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Talking with Your Doctor about Allergic Asthma

If you’re living with allergic asthma, you know what a physical and emotional rollercoaster ride it can feel like. The best way to smooth out the ups and downs is by working with your healthcare professional to identify the precise triggers of your asthma symp­toms. Once these are identified, you can take the appropriate steps toward effective treatment.

To identify your asthma triggers, your doctor will most likely collect your medical history, perform a physi­cal exam, and perform an allergy skin test that will help determine how sen­sitive you are to a specific allergen. If you’re like the majority of people with asthma, your symptoms are triggered by an allergic component that may re­quire special attention. Talking with your doctor about treatments specifi­cally for allergic asthma can offer the opportunity to develop a personalized treatment plan or to fine-tune one that already exists.

If you’re like the majority of people with asthma, your symptoms are triggered by an allergic component that may re­quire special attention.

A good place to start the conversation is by describing your asthma symptoms. Choose your words carefully, however. They can greatly affect your doctor’s assessment of your health and the sub­sequent course of treatment he or she recommends. Blood tests, skin tests, and readings from a peak flow meter all provide valuable information, but it’s your symptoms that point your doc­tor in the right direction.

In fact, you should review your symp­toms before you even enter the waiting room. Make sure you know how you would answer the following questions:

• What exactly are my symptoms? Have they changed recently?
• When do I find myself having them? How long do they last?
• Do they prevent me from doing normal activities like sleeping, house­work, yard work, or going to work or school?

In addition to answering questions about your asthma symptoms, you’ll most likely be asked to describe your living conditions. For example, your doctor may want to know about your home’s location, any surrounding plant life, the type of heating system you have, the type of pillow you use, the type of fabric on your furniture, and so on. De­tails like these provide valuable clues into the cause of your symptoms and suggest possible ways to reduce your exposure to an offending allergen.

The accuracy of the information you provide is essential to finding the right treatment to target the inflamma­tion involved in allergic reactions.

Remember, you are the most impor­tant part of your treatment plan.

 

Source: Asthma and Allergy Foundation of America, www.aafa.org

This article was originally published in Coping® with Allergies & Asthma magazine, Winter 2011-2012.

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The Allergy & Asthma Fighters Guide to Enjoying the Holidays

Remember that homemade items don’t come with ingredients lists.

Do allergies & asthma threaten to be the Grinch in your hol­idays? Here are some tips to help keep your season merry.

Holiday Stress
The holidays are filled with hustle and bustle, but stress can trigger an asthma attack. Shop early or late in the day to avoid crowds. If “quiet time” isn’t a part of your normal routine, now is the time to start.

Hearth Health
Fires burning in the hearth bring warmth and ambiance to a holiday get-together. However, the smoke and ash can smother the spirit for some, provoking breathing difficulties or triggering an asthma attack. Request the Yule log remain unlit.

Dusty Decorations
Clean dust from artificial Christmas trees and other hol­iday decorations before displaying them. Remember that glass, metal, and plastic decorations are easier to keep dust free than soft, fabric ones.

O Christmas Tree
Some people can be allergic to Christmas trees. Reduce your reaction by shaking your tree thor­oughly – many vendors have a machine that can do this – and allowing it to dry for a few days in a covered area before bringing it indoors.

Fido and Fluffy
Prepare for visits to homes with pets by taking your allergy or asthma medication before the visit. The medication may help reduce your reaction. You can also ask party hosts to keep pets in a separate room. When staying overnight with family or at a hotel, you can reduce allergic reactions to dust mites and pet dander by bringing your own allergen-proof pillow.

Homemade Goodies
Food is a cen­tral fixture in most holiday gatherings. Remember that homemade items don’t come with ingredients lists. If you or your child has food allergies, be cau­tious, especially around homemade treats. Foods can become tainted through cross-contamination in the baker’s kitchen or food storage con­tainers – and even a trace amount can trigger a reaction.

 

Source: American Academy of Allergy, Asthma & Immunology, www.AllergyandAsthmaRelief.org

This article was originally published in Coping® with Allergies & Asthma magazine, Winter 2011-2012.

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Food Allergies vs. Food Intolerances

by Dr. Stephen Wangen

The most common example of a food intolerance is a digestive enzyme deficiency, such as lactose intolerance, in which a person cannot properly digest milk products.

The terms food allergy and food intolerance are frequently misunderstood and misused. They cause confusion even among doctors and other members of the medical community. Although they are sometimes used interchangeably, they really refer to two different types of physiological events. With an allergy, the body’s immune system attacks something that it shouldn’t. However, an intolerance doesn’t arise from the immune system at all. It is important that we more thoroughly define these two types of reactions to food.

Allergies
Allergies are reactions that involve the immune system. The immune system is very complex and is still not very well understood. But basically, it functions like a sentinel standing guard against foreign invaders – in the case of allergies, the invaders are allergens. One weapon it uses against invaders is the production of antibodies, which cause reactions that result in the offending allergens being removed from the body, often via an inflammatory process.

Foods should not normally trigger an immune response. Unfortunately, all too often, they do, and the immune system produces antibodies that target the food and circulate throughout the body, which is why an allergic reaction can show up in such a variety of symptoms just about anywhere in the body. These antibodies in turn trigger inflammation, which can result in pain and tissue damage, leading to further symptoms. The immune response can also produce excess mucous or, in the case of celiac disease, an autoimmune reaction that damages the lining of the digestive tract.

With an allergy, the body’s immune system attacks something that it shouldn’t. However, an intolerance doesn’t arise from the immune system at all.

It is not understood why an allergy to a given substance is expressed so differently in different people. Some people get hives and swelling of the lips and tongue. Others get digestive problems, migraines, or arthritis. Each individual seems to have a unique weak point where symptoms show up first. However, more research continues to be published that demonstrates a connection between various health problems and an immune response to food.

Intolerances
Strictly speaking, food intolerance is any type of non-immune reaction to or problem with a food. The most common example is a digestive enzyme deficiency, such as lactose intolerance, in which a person cannot properly digest milk products.

Some people have an intolerance to fructose, a type of sugar molecule. A person with a fructose intolerance does not digest or tolerate this molecule well. Fructose is found in many foods, such as fruits, and is derived from foods such as corn for use as a sweetener in processed foods. It is often listed on labels as high fructose corn syrup.

Another example is when people experience stomach pain or heartburn after eating spicy food. Although this can be caused by an allergy, in most cases it is simply a negative reaction to these foods that appears to have nothing to do with the immune system. This type of reaction also does not appear to be an enzyme deficiency.

Other intolerances include reactions to preservatives (such as sulfites and nitrites), colorants (FD&C colors), and flavorants (such as monosodium glutamate and aspartame). There are certainly other food intolerances, many of which have yet to be discovered or defined. Medically speaking, we classify these poorly understood reactions to foods or food additives as intolerances; they are also sometimes called sensitivities, another poorly defined word. There is no technical distinction between an intolerance and a sensitivity. Both are catch-all terms.

 

Dr. Stephen Wangen is a nationally recognized expert in the field of gluten intolerance, a gluten-intolerant physician, and cofounder of the IBS Treatment Center.

Reprinted with permission from Healthier without Wheat: A New Understanding of Wheat Allergies, Celiac Disease, and Non-Celiac Gluten Intolerance by Dr. Stephen Wangen, copyright © 2009 by Stephen Wangen.

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2011.

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Cold, Allergies, or Sinusitis?

Cold weather is a prime time for stuffy noses, sore throats, and watery, itchy eyes. But if your symptoms last more than a week, or if they seem to turn off and on based on your surround­ings, you may be battling allergies or sinusitis. Proper diagnosis and treat­ment can lead to a quicker recovery.

Colds are caused by a virus, whereas allergies are caused by exposure to allergens. Colds and allergies can both lead to sinusitis, which occurs when the sinuses become swollen and block mucus from draining, leading to pain­ful pressure and infection.

Sinusitis can last for months, even years, if not properly treated. A doc­tor can diagnose sinusitis through a physical examination, but diagnosis may also require allergy testing, X-rays, or use of a fiber-optic scope.

Colds are the most common cause of sinusitis, but people with allergies or asthma are more likely to develop sinusitis.

Colds are the most common cause of sinusitis, but people with allergies or asthma are more likely to develop sinusitis because their nasal and sinus tissue can become swollen when they breathe in triggers like dust, pollen, or smoke.

When sinusitis is caused by an in­fection, antibiotics are used to kill the bacteria. Other treatments can include decongestants, nasal sprays, hot packs, humidifiers, and saltwater rinses.

If you have allergies, there are steps you can take to reduce your risk of si­nusitis. Your doctor may recommend long-term treatments, such as allergy shots, medication to control inflamma­tion, and avoidance of allergy triggers.

Knowing whether your symptoms are caused by a cold, allergies, or si­nusitis is the first step toward choosing the proper treatment.

 

Source: American Academy of Allergy, Asthma & Immunology, www.AllergyandAsthmaRelief.org

This article was originally published in Coping® with Allergies & Asthma magazine, Winter 2011-2012.

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Soothing the Symptoms of Eczema

One common skin condition, especially in some infants and children, is atopic dermatitis, or eczema. Atopic dermatitis is difficult to treat – but it can be controlled. Atopic dermatitis can be triggered by a number of factors, including allergy and emotional stress. It involves high levels of immunoglobulin E (IgE), the major allergy antibody, and is related to the development of other allergies, such as allergic rhinitis and asthma, in most children.

In some people, inhaled allergens (such as dust mites, animal dander, and pollen) can cause flare-ups of atopic dermatitis. A bacterial, fungal, or viral infection also can cause a flare-up. Food allergies may trigger an episode in children, but rarely in adults. Atopic dermatitis is not contagious. Sometimes, though, scratching can lead to a bacte­rial infection.

Treating Eczema
Treatment begins with efforts to reduce the itching and inflammation, hydrating the skin, and removing the “flare factors,” such as infections and exposure to allergens and irritants. To soothe symptoms, bathe in warm (not hot) water for no more than three to five minutes. Use superfatted, unscented soap or a soap substitute. Pat your skin dry, and promptly apply a mois­turizer to help keep the skin hydrated. Trim fingernails to reduce problems from scratching. At night, cotton socks or gloves can be worn to prevent scratch­ing while asleep. If the rash is oozing, your doctor may prescribe a lotion to dry the rash and an antibiotic to treat infection. If the rash is on the face, do not use a corticosteroid product.

Atopic dermatitis can be triggered by a number of factors, including allergy and emotional stress.

Use a humidifier in the winter to keep skin from drying out, and avoid chemi­cals and extreme heat or cold, which can worsen eczema. Use cosmetics lightly and seldom, and avoid products with perfume, dyes, and ingredients such as urea, lactic acid, or other alpha hydroxy acids.

Avoid wool, polyester, wrinkle-resistant, flame-retardant, and scratchy fabrics in clothes and bedding. Instead, wear open-weave, loose-fitting cotton or cotton-blend garments. Wash new clothes before wearing them with mild, unscented liquid laundry detergent. Avoid liquid fabric softeners and dryer sheets. Rinse clothing and bedding thoroughly after washing to remove detergent residue.

Reduce indoor allergens, particularly dust mites, by washing bedding in hot water and removing rugs, upholstered furniture, stuffed toys, and curtains where possible. Wear gloves when doing housework. If a link with food has been diagnosed, eliminate it from your diet.

Avoid stress, which can add to flare-ups. People often feel angry and frustrated by the chronic itching. Know that with proper treatment the condition can be controlled.

Topical steroids are key for control­ling the itching and inflammation of eczema. Used immediately after bath­ing, they also help keep the skin hydrated. Antihistamines and antianxiety medi­cations may also help relieve itching. Antibiotics are used to treat complicat­ing skin infections.

 

Source: Asthma and Allergy Foundation of America, www.aafa.org

This article was originally published in Coping® with Allergies & Asthma magazine, Winter 2011-2012.

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Bid Bon Voyage to Allergies & Asthma During Your Winter Vacation

Preparation and prevention pave the way to successful travel for the millions of people who have allergies & asthma. The following tips can help you keep these conditions at bay while you’re on vacation.

Consider an Allergen-Free Desti­nation
Beaches and mountains are excellent year-round destinations for people with allergies. Ocean breezes are generally free of allergens, dust mites are fewer at elevations above 2,500 feet, and mold spores can’t sur­vive in snow. Check the weather and pollen forecasts of your desired destina­tion, and plan accordingly.

Pack Your Allergy and Asthma Gear
Bring your medications in your carry-on luggage, in their original packaging. Include quick-relief med­ications for asthma and an epinephrine auto-injector if you or a family mem­ber has food or insect sting allergies. Don’t forget topical hydrocortisone cream, an antihistamine, and your peak flow meter and nebulizer. Also, consider packing your own dust mite-proof pillowcases, and bring wipes to clean trays and tables if you have food allergies.

Talk to Your Doctor or Allergist
Checking in before departure is espe­cially important if you’ll be traveling abroad and may need vaccinations or immunizations. Also, discuss where you’re going and what activities you may do. For example, locations with elevations above 5,000 feet may make breathing difficult, and cold weather can be a trigger for people with asthma. Peo­ple with asthma should also talk with a doctor or allergist before engaging in certain activities, like scuba diving.

Check Access to Medical Care
If you’re traveling to a remote location or going on a cruise, you should ask in advance about the type of medical care available.

Prepare for the Ride
If you’re trav­eling by car, travel during early morning or late evening hours, when air quality is better and traffic isn’t as heavy. If you rent a car, ask for one in which no one has smoked. Keep your car windows closed, and use your air conditioner for temperature control. Consider get­ting your automobile’s air conditioner cleaned in advance.

When traveling by air, take an antihistamine in advance. If you’re congested, use your regular medica­tion and consider using a long-acting decongestant nasal spray before take-off and landing. Notify the airline of food allergies ahead of time. Get up frequently and walk around the cabin, drink plenty of fluids and avoid alco­hol to stay hydrated, and use a saline nasal spray once every hour to keep your nasal membranes moist.

Accommodations
To reduce your exposure to allergens when you’re away from home, request a nonsmoking hotel room. When choosing a hotel, remem­ber that air conditioners and portable air cleaners with HEPA filters and tile, wood, or seamless vinyl floors reduce airborne allergens. If you have food allergies, consider reserving a hotel room with a kitchen so you can make your own meals. If you’re traveling to a non-English speaking destination, bring translated information about your food allergies for restaurant chefs.

 

Source: American College of Allergy, Asthma & Immunology, AllergyandAsthmaRelief.org

This article was originally published in Coping® with Allergies & Asthma magazine, Winter 2011-2012.

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Have a Sneeze-Free, Wheeze-Free Winter

Spring and fall are not the only seasons that prove troublesome for those with allergies & asthma. Winter weather causes people to spend more time indoors, where a host of household allergens can be found. For people with asthma, cold air and out­door winter activities can worsen asthma symptoms. Fortunately, there are things you can do to have a sneeze-free, wheeze-free winter.

Winter Allergies
Even though freezing temperatures bring an end to seasonal pollen allergies, millions of people experience indoor allergies because of the time spent indoors dur­ing cool weather. A home can actually contribute to allergy symptoms. Some common symptoms of indoor winter allergies are sneezing; runny or stuffy nose; coughing; postnasal drip; and itchy eyes, nose, and throat. The following tips can help you keep your home free of wintertime allergens and irritants:

♦ Clean regularly.
There is no widely recognized guideline for how often you should dust and vacuum your home, but a solid cleaning once a week should help keep dust and allergen levels down. Use a damp mop for cleaning hard floors to avoid stirring up dust.

♦ Avoid exposure.
If you are the one who is experiencing allergy or asthma symptoms during the winter months, have someone else in your house do the dusting and vacuuming. When you vacuum and dust, allergens get kicked up into the air, and you can be affected if you’re around. If you can, leave the house while the cleaning is being done.

Winter weather causes people to spend more time indoors, where a host of household allergens can be found.

♦ Crack a window.
It may help to open a window or door on warmer days. Especially try to air out your house right after cleaning so the allergens and dust you’ve kicked up have a place to escape.

♦Watch out for mold.
Mold can be an irritant for some people, so be on the lookout for moisture. Good insulation can help cut down on mold by reducing condensation on cold surfaces, and dry­ing wet surfaces can keep mold from growing. Also, make sure you use your bathroom ventilation fan if you have one or crack a window while shower­ing to let the moisture escape. If you have mold, clean it up using soap and water, and then follow up with a diluted bleach mixture.

♦ Beware of gas ranges.
Using gas stoves and cooktops releases nitrogen oxides into the air. These nitrogen ox­ides can irritate the lungs of individuals with asthma or other lung health issues. If you have a gas stove, make sure you use the ventilation hood in your kitchen or crack a window while cooking.

Exercise-Induced Asthma and Cold Weather Activities
Unfortunately for people with asthma, skiing, snow­boarding, ice skating, and other winter sports have more than snow and ice in common – they also involve exposure to cold air, which is an asthma trigger for some people.

As with most forms of allergies, prevention is the best way to control exercise-induced asthma. This is also true for these winter sports. Fortu­nately, exercise-induced asthma can be controlled in most cases by using your physician-prescribed asthma in­halers before exercising. (Check with your doctor before changing any treat­ment regimen.) These are safe, easy to use, and effective.

Taking the time to warm up before exercise is important, as well. By tak­ing some time to warm up your body with light activity, you’ll have some added protection, because the body produces chemicals that protect against bronchospasm. This is not to be done instead of using your inhaler, but in addition to it. Both of these steps will lead to a better experience in these cold weather sports, as they do in all other sports.

Coughing and wheezing, followed by shortness of breath, are signs a per­son may have exercise-induced asthma. These symptoms usually appear 5 to 20 minutes after finishing the activity. Talk to your doctor if you are experi­encing these symptoms.

Additional tips for preventing exercise-induced asthma during winter sports include wearing a mask or scarf to warm cold air before breathing it; taking asthma medication 15 to 30 minutes before skiing, snowboarding, ice skating, or participating in other winter activities; and warming up 30 minutes before starting any cold-weather exercise or activity.

 

Source: National Jewish Health, www.nationaljewish.org

This article was originally published in Coping® with Allergies & Asthma magazine, Winter 2011-2012.

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New Product Available for People with Anaphylactic Allergies

A new line of handbags and accessory cases by Epi-Essentials (epi-essentials.com) is now available for those who carry epinephrine auto-injectors, more commonly known as the EpiPen;reg;. The collection combines modern style with a medical compartment that organizes a person’s epinephrine auto-injectors and related allergy medicines, such as inhalers and antihistamines.

Keep personal belongings & allergy necessities together, all in one super-cute and organized essential.

Crafted in colorful leather exteriors with the finest attention to details, dual-zip compartments (one personal, one medical) secure 2 EpiPens®, inhaler and antihistamines with instantly visible Allergy Action & Emergency Contact cards. A separate zip section for your "must-have" daily basics makes every day safe, stylish and complete.The prod­ucts are available in several colors and are versatile for the lifestyles of teens, college students, and adults.

 

This article was originally published in Coping® with Allergies & Asthma magazine, Winter 2011-2012.

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Free Tool Promotes Adherence, Lowers Cost of Asthma

Online “Asthma PACT" Helps Patients and Parents

The Asthma PACT™ (Personal Assessment and Control Tool) available at www.AsthmaPACT.org, is a free online program hosted by the Asthma and Allergy Foundation of America (AAFA) that helps patients and parents reduce the cost and suffering from asthma. The concept is simple: individuals with asthma must follow directions from their medical providers, including medications to take, to properly treat this chronic disease. The Asthma PACT helps patients and parents to identify reasons why they may be having difficulty following the treatment plan, and it gives feedback – in written and video formats – about how to manage these problems. Individuals can print their personal assessment and take it to their medical provider for further discussion. Jacqui Vok, AAFA’s Senior Educational Programs Manager, says, "Placing the Asthma PACT personalized assessment in the hands of their physicians empowers patients to get the advice they need to help them manage their asthma symptoms." The Asthma PACT is a validated asthma adherence survey that is currently being used in research projects at the National Institutes of Health (NIH).

"Each patient is their own cost center," says Andrew Weinstein, MD, a Board Certified allergist and President of Adherence Management Systems (AMS), developer of the Asthma PACT tool. "By focusing on why you have persistent symptoms, you can improve your health and reduce your cost of care." Also, according to Weinstein, the Asthma PACT "helps the patients self-identify the ‘rough areas’ and acts as a vehicle to bring potential solutions to the individual and family."

The key to education and counseling is to know why individuals are not following the directions. This is the value of the Asthma PACT in preventing sleepless nights, work and school absence and unnecessary emergency and healthcare costs.

An estimated 25 million Americans have asthma, 7.1 million under the age of 18. The annual cost of care is estimated at $19.7 billion, with 456,000 hospitalizations and 1.5 million ER visits. African Americans are three times more likely to be hospitalized or die from asthma. Inhaled corticosteroids effectively control symptoms and reduce morbidity, mortality, health care utilization and costs.

The Right Tool for a Big Problem
Weinstein treated 59 children with severe asthma in an inpatient rehabilitation setting at the Alfred I. duPont Hospital for Children. The year prior to treatment, the median cost per patient was $10,240. Each child had seven hospital days and four emergency room visits. At all four years of follow-up, median hospital days and emergency room visits were zero. The cost of care fell below $2,000 at the end of the fourth year. The key to the success of the program was the ability of the health care team to identify the difficulties that the family was experiencing following the treatment plan and helping them become successful.

These outcomes were duplicated in the outpatient setting in children with severe asthma at the same hospital and in adult patients with severe asthma referred by Blue Cross Blue Shield Delaware. Weinstein transferred the analytic questions from his adherence care model and, in partnership with AAFA, made it available online as the Asthma PACT at no charge for all asthma patients and parents.

Adherence - The Key to Controlling Healthcare Costs
Despite high-profile discussions to control healthcare costs, there is little emphasis on the contributors to high costs, nor the actions that can be taken to reduce costs. Individuals with chronic diseases such as asthma, diabetes and heart disease are responsible for more than 80% of all health care costs due to medications, physician visits, hospitalizations, emergency care, and disability caused by these diseases. It has long been observed that 45-60 percent of individuals with these chronic diseases do not follow their prescribed medication plans, called "non-adherence" or "non-compliance," which further adds an estimated $600 million to the annual cost of care in the U.S.

Experts have identified more than twenty reasons why so many asthma patients are non-adherent; however, a partial list includes - cost; comprehension of instructions; concern about side effects; lack of support; emotional response to symptoms; disagreeing with the diagnosis; and believing the medication is ineffective.

Asthma PACT Increases Adherence, Decreases Costs
The Asthma PACT includes 75 percent of these "reasons for non-adherence" and presents them in an organized way to the patient and provider. One problem area that is now beginning to be addressed by medical schools and residency programs is the lack of counseling skills by practicing physicians. The personnel in the asthma rehabilitation program mentioned above had psychological training to help the families work through the obstacles that were preventing them from consistently giving the medication. Most individuals with asthma do not have significant psychological issues and can be helped by practitioners with basic counseling skills. But the key to education and counseling is to know why individuals are not following the directions. This is the value of the Asthma PACT in preventing sleepless nights, work and school absence and unnecessary emergency and hospital care and healthcare costs.

 

Visit www.AsthmaPACT.org for more information. "Asthma PACT™" and "AsthmaPACT.org" are trademarks of the Asthma and Allergy Foundation of America (AAFA). .

This article was originally published in Coping® with Allergies & Asthma magazine, Winter 2011-2012.

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Take Action Against Asthma

Take control of your asthma and get back in action.

Taking an active role to control your asthma involves working with your healthcare team to create and follow an asthma action plan. It also means avoiding factors that can make your asthma flare up and treating other conditions that can interfere with asthma management.

An asthma action plan gives guidance on taking your medicines properly, avoiding factors that worsen your asthma, tracking your level of asthma control, responding to worsening asthma, and seeking emergency care when needed.

Asthma is treated with two types of medicines: long-term control and quick-relief medicines. Long-term control medicines help reduce airway inflammation and prevent asthma symptoms. Quick-relief, or “rescue,” medicines relieve asthma symptoms that may flare up.

Your initial asthma treatment will depend on how severe your disease is. Follow-up asthma treatment will depend on how well your asthma action plan is working to control your symptoms and prevent you from having asthma attacks.

Your level of asthma control can vary over time and with changes in your home, school, or work environments that alter how often you are exposed to the factors that can make your asthma worse. Your doctor may need to increase your medicine if your asthma doesn’t stay under control.

If your asthma is well controlled for several months, your doctor may be able to decrease your medicine.

On the other hand, if your asthma is well controlled for several months, your doctor may be able to decrease your medicine. These adjustments, either up or down, to your medicine will help you maintain the best control possible with the least amount of medicine necessary.

Asthma Action Plan
You can work with your doctor to create a personal written asthma action plan. The asthma action plan shows your daily treatment, such as what kind of medicines to take and when to take them. The plan explains when to call the doctor or go to the emergency room.

If your child has asthma, all of the people who care for him or her should know about the child’s asthma action plan. This includes babysitters and workers at daycare centers, schools, and camps. These caretakers can help your child follow his or her action plan.

Asthma Triggers
A number of common things (sometimes called asthma triggers) can set off or worsen your asthma symptoms. Once you know what these factors are, you can take steps to control many of them. For example, if exposure to pollens or air pollution makes your asthma worse, try to limit time outdoors when the levels of these substances are high in the outdoor air. If animal fur sets off your asthma symptoms, keep pets with fur out of your home or bedroom.

If your asthma symptoms are clearly linked to allergies and you can’t avoid exposure to those allergens, then your doctor may advise you to get allergy shots for the specific allergens that bother your asthma. You may need to see a specialist if you are thinking about getting allergy shots. These shots may lessen or prevent your asthma symptoms, but they can’t cure your asthma.

Several health conditions can make asthma more difficult to manage. These conditions include runny nose, sinus infections, reflux disease, psychological stress, and sleep apnea. Your doctor will treat these conditions as well.

Medicines
Your doctor will consider many things when deciding which asthma medicines are best for you. Doctors usually use a stepwise approach to prescribing medicines. Your doctor will check to see how well a medicine works for you; he or she will make changes in the dose or medicine, as needed.

Asthma medicines can be taken in pill form, but most are taken using a device called an inhaler. An inhaler allows the medicine to go right to your lungs. Not all inhalers are used the same way. Ask your doctor to show you the right way to use your inhaler. Ask him or her to review the way you use your inhaler at every visit.

Most people who have asthma need to take long-term control medicines daily to help prevent symptoms. The most effective long-term medicines reduce airway inflammation. These medicines are taken over the long term to prevent symptoms from starting. They don’t give you quick relief from symptoms.

If your doctor prescribes a long-term control medicine, take it every day to control your asthma. Your asthma symptoms will likely return or get worse if you stop taking your medicine. Long-term control medicines can have side effects. Talk to your doctor about these side effects and ways to monitor or avoid them.

All people who have asthma need a quick-relief medicine to help relieve asthma symptoms that may flare up. These medicines act quickly to relax tight muscles around your airways when you’re having a flare-up. This allows the airways to open up so air can flow through them.

You should take your quick-relief medicine when you first notice your asthma symptoms. If you use this medicine more than two days a week, talk with your doctor about how well controlled your asthma is. You may need to make changes in your asthma action plan.

Carry your quick-relief inhaler with you at all times, in case you need it. If your child has asthma, make sure that anyone caring for him or her and the child’s school has the child’s quick-relief medicines. They should understand when and how to use them and when to seek medical care for your child.

You shouldn’t use quick-relief medicines in place of prescribed longterm control medicines. Quick-relief medicines don’t reduce inflammation.

Emergency Care
Most people who have asthma, including many children, can safely manage their symptoms by following the steps for worsening asthma provided in the asthma action plan. However, you may need medical attention. Call your doctor for advice if

• your medicines don’t relieve an asthma attack.
• your peak flow is less than half of your personal best peak flow number.

Call 9-1-1 for an ambulance to take you to the emergency room of your local hospital if

• you have trouble walking and talking because you’re out of breath.
• you have blue lips or fingernails.

At the hospital, you will be closely watched and given oxygen and more medicines, as well as medicines at higher doses than you take at home. Such treatment can save your life.

 

Source: National Heart, Lung and Blood Institute, www.nhlbi.nih.gov

This article was originally published in Coping® with Allergies & Asthma magazine, May/June 2010.

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Are Allergies Making You Fuzzy?

Sneezing, wheezing, watery eyes, and a runny nose aren’t the only symptoms of allergic diseases. Many people with allergic rhinitis also report feeling “slower” and drowsy. When their allergies are acting up, they have trouble concentrating and remembering.

For instance, allergic rhinitis can be associated with decreased ability to concentrate and function, activity limitation, decreased decision-making capacity, impaired hand-eye coordination, problems remembering things, irritability, sleep disorders, fatigue, missed days at work or school, more motor vehicle accidents, and more school or work injuries.

Many parents of children with allergic rhinitis observe increased bad moods and irritability in their child’s behavior during the allergy season. Since children cannot always express their uncomfortable or painful symptoms verbally, they may express their discomfort by acting up at school and at home. In addition, some kids feel that having an allergic disease is a stigma that separates them from other kids.

It is important that the irritability or other symptoms caused by ear, nose, or throat trouble not be mistaken for attention deficit disorder. With proper treatment, symptoms can be kept under control and disruptions in learning and behavior can be avoided.

Causes
Experts believe the top two culprits contributing to cognitive impairment of people with allergic rhinitis are sleep interruptions and sedating antihistamine (over-the-counter) medications.

If you have bad allergic rhinitis, you may waken a dozen times a night.

Secondary factors, such as blockage of the Eustachian tube (ear canal), also can cause hearing problems that have a negative impact on learning and comprehension. Constant nose blowing and coughing can interrupt concentration and the learning process, and allergy-related absences from school or work can cause people to fall behind.

Sleep Disruption
Chronic nasal congestion can cause difficulty in breathing, especially at night. Waking is a hard-wired reflex to make you start breathing again. If you have bad allergic rhinitis, you may waken a dozen times a night. Falling back asleep can be difficult, cutting your total number of sleep hours short.

The average person needs about eight hours of sleep per night to function normally the next day. Losing just a few hours of sleep can lead to a significant decrease in your ability to function. Prolonged loss of sleep can cause difficulty in concentration and ability to remember things, and can contribute to automotive accidents. Night after night of interrupted sleep can cause serious decreases in learning ability and performance in school or on the job.

Over-the-Counter Medications
Most allergy therapies don’t take into account the effects of allergic rhinitis on mental functioning – they treat the more obvious physical symptoms. Some allergy therapies may even cause some cognitive or mental impairment. The most commonly used over-the-counter medications for allergy symptoms are decongestants and first-generation antihistamines, such as diphenhydramine (Benadryl®), both of which can cause sleep disturbances.

Decongestants constrict small blood vessels in the nose. This opens the nasal passageways and lets you breathe easier. Some decongestants are available over the counter, while higher strength formulas are available with a prescription. In some people, oral decongestants can cause problems with getting to sleep, appetite loss, and irritability, which can contribute to allergy problems. If you have any of these symptoms, discuss them with your allergist.

Antihistamines block the effects of histamine, a chemical produced by the body in response to allergens. Histamine is responsible for the symptoms of allergic rhinitis. First-generation over-the-counter antihistamines available in the United States also can cause drowsiness. Regularly taking over-thecounter antihistamines can lead to a feeling of constant sluggishness, affecting learning, memory, and performance. Newer second-generation antihistamines are designed to minimize drowsiness while still blocking the effects of histamine.

Solutions
The best way to control your symptoms is to avoid your triggers. This is often easier said than done. If your allergens can’t be avoided, your allergist can help you create an allergy treatment plan. Several types of nonsedating medications are available to help control allergies. If medications are not effective or cause unwanted side effects, your allergist may suggest immunotherapy, or allergy shots. Immunotherapy is used to treat allergy to pollen, ragweed, dust mites, animal dander, and other allergens. This process gradually desensitizes you to these substances by changing the way your body’s immune system responds to them.

If allergies are affecting your ability to concentrate or function, several treatment options may be beneficial. Getting allergy symptoms under control can help you sleep at night and function during the day.

If you suspect that you or a family member may have an allergic disorder, make an appointment with your allergist for proper diagnosis. Treating allergies sooner rather than later can help prevent disruptions in learning and behavior.

 

Source: American College of Allergy, Asthma & Immunology, www.acaai.org

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2011.

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Living with Asthma

Asthma is a long-term disease that requires long-term care. Successful asthma treatment requires you to take an active role in your care. Taking an active role to control your asthma involves working with your doctor and other clinicians on your healthcare team to create and follow an asthma action plan. Children aged 10 or older – and younger children who are able – also should take an active role in their asthma care.

Learn How to Manage Your Asthma
Partner with your doctor to develop an asthma action plan. This plan will help you to properly take your medicines, identify your asthma triggers, and manage your disease if asthma symptoms worsen.

If your child has asthma, all of the people who care for him or her should know about the child’s asthma action plan. This includes babysitters and workers at daycare centers, schools, and camps. These caretakers can help your child follow his or her action plan.

Most people who have asthma can successfully manage their symptoms at home by following their asthma action plans and having regular checkups.

Most people who have asthma can successfully manage their symptoms at home by following their asthma action plans and having regular checkups. However, it’s important to know when to seek emergency medical care.

Learn how to use your medicines correctly. If you take inhaled medicines, you should practice using your inhaler at your doctor’s office. If you take longterm control medicines, take them daily as your doctor prescribes.

Record your asthma symptoms as a way to track how well your asthma is controlled. Also, you may use a peak flow meter to measure and record how well your lungs are working. Your doctor may ask you to keep records of your symptoms or peak flow results daily for a couple of weeks before an office visit and bring these records with you to the visit.

These steps will help you keep track over time of how well you’re controlling your asthma. This will help you spot problems early and prevent or relieve asthma attacks. Recording your symptoms and peak flow results to share with your doctor also will help him or her decide whether to adjust your treatment.

Ongoing Care
Have regular asthma checkups with your doctor so he or she can assess your level of asthma control and adjust your treatment if needed. Remember, the main goal of asthma treatment is to achieve the best control of your asthma using the least amount of medicine. This may require frequent adjustments to your treatments.

If it’s hard to follow your plan or the plan isn’t working well, let your healthcare team know right away. They will work with you to adjust your plan to better suit your needs. You should also get treatment for any other conditions that can interfere with your asthma management.

Watch for Signs That Your Asthma is Getting Worse
Your asthma may be getting worse if

• your symptoms start to occur more often, are more severe, and/or bother you at night and cause you to lose sleep.
• you’re limiting your normal activities and missing school or work because of your asthma.
• your peak flow number is low compared to your personal best or varies a lot from day to day.
• your asthma medicines don’t seem to work well anymore.
• you have to use your quick-relief inhaler more often. If you’re using quick-relief medicine more than two days a week, your asthma isn’t well controlled.
• you have to go to the emergency room or doctor because of an asthma attack.

If you have any of these signs, see your doctor. He or she may need to change your medicines or take other steps to control your asthma.

Emergency Care
Most people who have asthma, including many children, can safely manage their symptoms by following the steps for worsening asthma provided in their asthma action plan. However, you may need medical attention. Call your doctor for advice if your medicines don’t relieve an asthma attack or your peak flow is less than half of your personal best peak flow number.

Call 911 for an ambulance to take you to the emergency room of your local hospital if you have trouble walking and talking because you’re out of breath or you have blue lips or fingernails.

At the hospital, you will be closely watched and given oxygen and more medicines, as well as medicines at higher doses than you take at home. Such treatment can save your life.

Partner with your healthcare team and take an active role in your care. This can help control asthma so it doesn’t interfere with your activities and disrupt your life.

 

Source: National Heart, Lung and Blood Institute, www.nhlbi.nih.gov

This article was originally published in Coping® with Allergies & Asthma magazine, March/April 2010.

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New Survey Reveals Emotional Impact of Food Allergy on Children

A recent survey conducted by the Food Allergy & Anaphylaxis Network and Galaxy Nutritional Foods examined parents’ perspectives on the emotional impact that food allergies have on their children.

Nearly 70 percent of the parents of children with food allergies surveyed said having a food allergy has affected their child’s quality of life, with 40 percent indicating their child’s life was impacted “somewhat,” and 29 percent “a great deal.”

The survey also asked parents about food allergy prevalence in schools and societal understanding of the medical condition. According to the survey, 47 percent of parents indicated that they were aware of one to two other children in their child’s classroom who also had food allergies. This finding is in line with the latest statistics that show 1 in 13 U.S. children have a food allergy. Additionally, the survey found that a majority of parents of children with a food allergy felt that school personnel had an “excellent” or “good” understanding of food allergy.

The survey also explored participation in everyday life events – activities that most of the general population takes for granted. For parents of children with food allergies, common events such as eating out at a restaurant, attending a birthday party, or sleeping over at a friends’ house can be concerning. According to the parents surveyed, they choose not to have their children participate in many of these everyday life events.

 

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2011.

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Get Relief from Sinus Pain

Your nose is stuffy. You have thick, yellowish mucus. You’re coughing, and you feel tired and achy. You think that you have a cold. You take medicines to relieve your symptoms, but they don’t help. When you also get a terrible headache, you finally drag yourself to the doctor. After listening to your history of symptoms and examining your face and forehead, the doctor says you have sinusitis.

What Is Sinusitis?
Sinusitis simply means your sinuses are inflamed – red and swollen – because of an infection or another problem. There are several types of sinusitis:

♦ Acute, which lasts up to 4 weeks
♦ Subacute, which lasts 4 to 12 weeks
♦Chronic, which lasts more than 12 weeks and can continue for months or even years
♦ Recurrent, with several attacks within a year

What Causes Sinusitis?
Anything that causes swelling in the nose can block the openings between your paranasal sinuses and your nose, including a cold, allergies, or a reaction to some chemical to which you’ve been exposed. The blockage causes air and mucus to become trapped within the sinuses. This may cause pain and thickened mucus.

If you have nasal allergies along with sinusitis, your doctor may recommend medicine to control your allergies.

The pain of a sinus attack arises because the trapped air and mucus put pressure on the mucous membrane of the sinuses and the bony wall behind it. Also, when a swollen membrane at the opening of a paranasal sinus prevents air from entering into the sinuses, it can create a vacuum that causes pain.

Mucus thickens because it loses its water content as it stays trapped inside the sinuses for a long time. In addition, inflammation leads to extra materials being secreted into the mucus, causing thickening.

How Is Sinusitis Treated?
If you have acute sinusitis, your doctor may recommend antibiotics to control a bacterial infection, if present; pain relievers to reduce any pain; or decongestants. Even if you have acute sinusitis, your doctor may choose not to use an antibiotic because many cases of acute sinusitis will end on their own. However, if you do not feel better after a few days, you should contact your doctor again.

If you have nasal allergies along with sinusitis, your doctor may recommend medicine to control your allergies. This may include a nasal steroid spray that reduces the swelling around the sinus passages and allows the sinuses to drain.

If you have asthma and then get sinusitis, your asthma may worsen. You should contact your doctor, who may change your asthma treatment.

Healthcare professionals often find it difficult to treat chronic rhinosinusitis successfully. They have two options to offer: medicine and surgery.

Nasal steroid sprays are helpful for many people, but most people still do not get full relief of symptoms with these medicines. Physicians occasionally recommend a long course of antibiotics, but results from clinical research do not support this kind of antibiotic use. Saline washes or saline nasal sprays can be helpful in chronic rhinosinusitis because they remove thick secretions and allow the sinuses to drain. Oral steroids, such as prednisone, may be prescribed for severe chronic rhinosinusitis. However, oral steroids are powerful medicines with significant side effects, and these medicines typically are prescribed when other medicines have failed.

When medicine fails, surgery may be the only alternative for treating chronic rhinosinusitis. The goal of surgery is to improve sinus drainage and reduce blockage of the nasal passages. Nasal surgery usually is performed to enlarge the natural openings of the sinuses, remove nasal polyps, or correct significant structural problems inside the nose and the sinuses if they contribute to sinus obstruction. Although most people have fewer symptoms and a better quality of life after surgery, problems can reoccur, sometimes even after a short period.

In children, problems can sometimes be eliminated by removing the adenoids. These gland-like tissues, located high in the throat behind and above the roof of the mouth, can obstruct the nasal passages.

Can Sinusitis Be Prevented?
There are no methods that have been scientifically proven to prevent acute or chronic sinusitis. However, some measures may help.

Keep your nose as moist as possible with frequent use of saline sprays or washes. Avoid very dry indoor environments and use a humidifier, if necessary. Be aware, however, that a humid environment also may increase the amount of mold, dust mite, or cockroach allergens in your home; this is important only if you are allergic to any of these organisms.

Avoid exposure to irritants, such as cigarette and cigar smoke, or strong odors from chemicals. Avoid exposure to substances to which you are allergic. If you haven’t been tested for allergies and you are getting frequent sinus infections, ask your doctor to give you an allergy evaluation or refer you to an allergy specialist.

 

Source: National Institute of Allergy and Infectious Diseases, www.niaid.nih.gov

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2011.

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Most States Don't Make the Grade on Asthma & Allergy School Health

Report Finds States Lack Policies to Curb Classroom Burden of Asthma and Severe Allergies

For over 7 million children with asthma, and 13 million with food allergy or other severe allergies, going to school is a daily risk affecting how well they can – or can't – manage their diseases. Now for the fourth year, the Asthma and Allergy Foundation of America (AAFA) has released its annual report assessing all 50 states and the District of Columbia on their leadership and progress on school-based policies that address student asthma and allergy health in more than 100,000 elementary, middle and high schools across the U.S.

The result: most states still don't make the grade.

Signs of Leadership
Each year, the Foundation's report, the "State Honor Roll™ of Asthma and Allergy Policies for Schools," outlines 18 school-related core policies proven to affect positive healthy school environments, then assesses each state on how many of these policies they have adopted. If a state has enacted at least 15 of the policies, it is listed on the Foundation's "Honor Roll." This year, six states achieved this distinction:

• Connecticut
• Massachusetts
• New Jersey
• Rhode Island
• Vermont
• Washington

AAFA is announcing the results of the study at an international medical conference in Boston this weekend. Full results, including detailed state profiles and charts, are available at www.StateHonorRoll.org. The report Web site also has several links to free resources for parents, advocates, schools and policymakers.

Core policies include state-wide standards for appropriate school nurse-to-student ratios, laws allowing students to carry and administer their asthma and anaphylaxis medication, indoor air quality for school buildings, smoking bans, and more.

"New England has been committed to student health, and public health overall, for decades," says Judi McAuliffe, RN, a school nurse in the Pembroke, Massachusetts, school district. "I'm not really surprised that we continue to lead the rest of the country on asthma and allergy health, I just wish others would follow," says McAuliffe. According to the Foundation, these 6 Honor Roll states demonstrate leadership on asthma and allergy school health. "They provide a blueprint for parents and patient advocates around the country," says Tom Flanagan, Chair of AAFA's national Board of Directors, and a parent of a child with severe allergies," but there has been limited progress in too few places for such a huge public health problem."

The Burden on Schools
In the United States, asthma and allergies have a major and growing affect on schools. About 10 percent of kids (7.1 million children) have asthma. It is the #2 chronic disease among children (behind obesity) and the #1 chronic cause of student absenteeism (10.5 million school days missed annually due to asthma in 2008). Last year, 185 children died because of asthma. In addition, severe allergies and anaphylaxis – the most severe type of allergic reaction – are on the rise nationwide, particularly food allergies among children, forcing schools to prepare, manage and react to the problem. Plus, millions of adult teachers and staff in schools have asthma and allergies, as well.

With so many people affected in the school setting, these diseases create a burden on schools and communities, requiring improvements to indoor air quality (IAQ), emergency procedures and prevention training for food allergies, individual health plans for students, notifying parents of pesticide spraying, student access to medications such as epinephrine auto-injectors or albuterol inhalers, campus smoking bans and cessation programs, and more.

Many States Have Few Protections
While thousands of local schools and districts may show innovation and leadership in support of students and staff with asthma and allergies, strong state-wide policies are lacking throughout the U.S., with some rare bright spots. "Four New England states, New Jersey and Washington State have been on our Honor Roll for 4 years," says Charlotte Collins, JD, AAFA's Vice President of Policy and Programs, "but the gap from coast to coast is wide, with most states simply falling short. In fact, twelve states failed to achieve even half of the core policy standards," says Collins.

Even though broad improvements in the states has not yet been seen, AAFA found that overall, most states are at least taking a few steps each to address the needs of students with asthma and allergies in the school setting. For example, most states now protect student access to their own medications, document chronic diseases, and prohibit smoking at school and on school buses. Currently, about half of the states fail to require schools to develop emergency protocols for asthma and anaphylaxis emergencies, and only five recommend that schools provide at least one nurse per 750 students.

Anaphylaxis on the Policy Frontier
"One major positive finding in this year's report is that nearly every state in the U.S. now has a law allowing students to carry and self-administer their epinephrine auto-injectors for allergic emergencies," says Flanagan. This is a major development compared to just 10 years ago when few states allowed – and in fact prohibited – such access. Wisconsin and New York still don't have this law but their legislatures are considering policies, "so those states are behind on this right now while all the other states are leading the way," says Flanagan.

Now that student self-use of epinephrine has near nationwide acceptance, other access issues have emerged. Surprisingly, states do not regulate emergency services consistently. Depending on where you live, some emergency medical technicians (EMTs) may not have access to epinephrine, or may not be permitted to administer the medication, or only permitted to assist administering a patient's own epinephrine auto-injector device. "This is a definite area of concern since school personnel rely on 911 services in these types of emergencies," says Collins.

About the Study
For the State Honor Roll report, AAFA assessed three categories of policies: Medication & Treatment policies, Awareness policies and School Environment policies. Within these categories AAFA research and policy experts, in consultation with leaders in the fields of medicine, education and advocacy, identified 18 types of "core policy standards" relating to asthma and allergies in schools across the U.S. For example, core policies include state-wide standards for appropriate school nurse-to-student ratios, laws allowing students to carry and administer their asthma and anaphylaxis medications in school, indoor air quality improvement policies for school buildings, smoking bans and cessation programs, and more.

The full report, methodology, tables, detailed state profiles, as well as back-to-school tips and tools, are available at www.StateHonorRoll.org. The 2011 report is made possible in part by a grant from Dey Pharma L.P., and individual donations to AAFA from patients, families and supporters.

 

The Asthma and Allergy Foundation of America (AAFA) is a not-for-profit organization dedicated to improving the quality of life for people with asthma, allergies and related conditions through education, advocacy and research. For more asthma and allergy statistics or support, visit www.aafa.org or call 1-800-7-ASTHMA.

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Obese Asthmatic Children Experience More Complications with Anesthesia

A study presented at ANESTHESIOLOGY 2011 found that obese asthmatic children were nearly two times as likely to have at least one respiratory complication during or after surgery compared to their lean peers.

“Respiratory problems are one of the major causes of complications and death during pediatric anesthesia,” said the study’s lead investigator, Olubukola O. Nafiu, MD “Obesity and asthma are commonly cited as risk factors for respiratory problems. This study was designed to examine whether complications were more frequent in obese children with asthma.”

"The association of obesity and asthma with an increase in respiratory complications suggests that obese asthmatic children undergoing anesthesia should receive additional evaluation and care to prevent the increased potential for complications."

The study prospectively examined 1,102 children, 107 (9.7%) obese asthmatics, 118 (10.7%) normal weight asthmatics, 309 (28.0%) obese patients and 568 (51.5%) normal weight non-asthmatics. There was no significant difference in age between or within the groups. Children in the obese-asthmatic and obese groups were more likely to have at least one respiratory complication during or after surgery compared to the other groups. Additionally, obese-asthmatic children were more likely to have a longer post anesthesia unit stay.

“The association of obesity and asthma with an increase in respiratory complications suggests that obese asthmatic children undergoing anesthesia should receive additional evaluation and care to prevent the increased potential for complications,” said Dr. Nafiu. “Future investigations into what is directly causing complications in these patients are needed.”

For more information on the impact anesthesia can have on obese patients, please visit http://www.lifelinetomodernmedicine.com/Anesthesia-Topics/Obesity-and-Anesthesia.aspx. For more information on pediatric anesthesia, please visit http://www.lifelinetomodernmedicine.com/Anesthesia-Topics/Pediatric-Obesity-and-Anesthesia.aspx.

 

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The Eyes Have It!

Allergic Conjunctivitis, That Is

Eye allergy, also called allergic conjunctivitis or ocular 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.

The most common causes of allergic conjunctivitis are seasonal allergens, such as pollen and mold spores. People with seasonal allergic rhinitis, or 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 have 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 also be caused by infections and other conditions that can threaten eyesight.

Eye Allergy Symptoms & Diagnosis
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, and 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 symptoms due to indoor allergens. Symptoms may be reduced if you are taking allergy medications such as antihistamines, which suppress the allergic reaction.

Unlike conditions such as pink eye, allergic conjunctivitis is not contagious.

The first step toward relief from annoying eye allergy symptoms is a proper diagnosis. An allergist has specialized training and experience to accurately determine what is causing your symptoms and identify the best treatment approach.

Eye Allergy Treatment & Management
If indoor allergens are causing your eye allergy symptoms, avoidance is the key to relief. 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 symptoms, medications or other treatments may be necessary to provide relief. 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, 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.

 

Source: American Academy of Allergy, Asthma & Immunology, www.aaaai.org

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2011.

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Immune Cell Plays Dual Role in Allergic Skin Disease

NIH-funded study in mice enhances understanding of atopic dermatitis

An immune cell involved in initiating the symptoms of an allergic skin reaction may play an equally, or perhaps more important, role in suppressing the reaction once it becomes chronic. This finding in mice could have future implications for the treatment of atopic dermatitis, a chronic inflammatory skin disease that affects an estimated 10 to 20 percent of infants and young children. The research is by investigators at the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), part of the National Institutes of Health.

The study, published online in the journal Immunity, and led by Juan Rivera, PhD, NIAMS deputy scientific director and chief of the Laboratory of Molecular Immunogenetics, focused on a type of cell called a mast cell. Previous research has shown that early in the course of atopic dermatitis, mast cells produce irritating chemicals, including interleukin-4 (IL-4), interleukin-5 (IL-5) and interleukin-6 (IL-6), which attract inflammatory cells to the site of the allergic reaction.

To better understand mast cells' role, the researchers developed a mouse model. After initial exposure to a chemical allergen, mice are subsequently challenged by having their ears painted with the same allergen multiple times. This model is similar to atopic dermatitis in people. Some of the mice were also engineered to be deficient in mast cells.

"The new study is an important step toward providing researchers with a valuable new insight that could eventually lead to safer, more targeted treatments."

When the scientists painted a chemical allergen one time on the ears of the mast cell-deficient mice, the reaction occurred more slowly, demonstrating that mast cells contribute to the initiation of atopic dermatitis.

"When they applied the same allergen to these mice multiple times, the reaction was considerably worse than in mice with sufficient mast cells," said Rivera. "That tells us that although mast cells may participate early on in the development of the disease, it appears that they are suppressing the late stages of the disease or when the disease becomes chronic."

In fact, when the scientists replaced the mast cells in mast cell-deficient mice, they were able to reduce the severity of the disease. The researchers were surprised that the mast cells did not have to be at the site of inflammation to control inflammation, said Rivera. In fact, the greatest effect was seen with mast cell repopulation in the spleen, a key organ in immune response.

Further investigation showed that, in late stages of disease, the mast cells underwent a change that caused them to produce a different chemical called interleukin-2 (IL-2), needed by cells which are key to suppressing inflammation, known as regulatory T cells.

"What is unusual here is that the same type of cells that can be inflammatory, can also be regulatory," said Rivera.

While Rivera says it's too early to predict the therapeutic importance of these findings, he believes they do provide new information on the understanding of atopic dermatitis and a potential caution against the development of treatments that target mast cells.

"While blocking mast cells has been considered as a treatment for the disease, it may be counter-productive, particularly in the latter stages of the disease," he said.

The researchers' next step is to see if their findings hold true in people, comparing the products of mast cells from lesions in early– and late-stage atopic dermatitis. It's possible, for example, that individuals with very severe chronic disease may not have sufficient mast cells in the skin.

Currently, the most effective treatment for atopic dermatitis is topical corticosteroids, which can have significant side effects, including thinning of the skin, if used long-term.

"In general, we need a better understanding of the disease itself to develop better therapies for it," said Rivera. "The new study is an important step toward that end, providing researchers with a valuable new insight that could eventually lead to safer, more targeted treatments."

 

Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

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Who Gets Asthma and Why?

Asthma is very common, affecting more than 22 million people in the United States. No one knows for sure why some people have asthma and others don’t. People who have family members with allergies or asthma are more likely to have asthma.

Asthma can occur at any age but is more common in children than in adults. Heredity can play a role. In young children, boys are nearly twice as likely as girls to develop asthma, but this sex difference tends to disappear in older age groups. Obesity is a newly identified risk factor for asthma.

Causes
People generally think of asthma in terms of episodes or attacks. Actually, the asthmatic condition is always present, but symptoms may be dormant until triggered by an allergen, respiratory infection, or cold weather. Other triggers may include aspirin, environmental irritants, physical exertion, and less commonly, food additives and preservatives.

Allergens are substances that cause no problem for a majority of people but that trigger an allergic reaction in susceptible individuals. Allergens are a major source of breathing problems in both children and adults. Common allergens include plant pollen, dander from pets and other animals, house dust mites, cockroaches, molds, and certain foods. When an allergic individual is exposed to one of these allergens, a complicated series of events causes the body to release chemicals called mediators. These mediators often trigger asthma episodes.

Allergens are a major source of breathing problems in both children and adults.

Cold air, smoke, industrial chemicals, perfume, and paint and gasoline fumes are all examples of environmental irritants that can provoke asthma. They probably trigger asthma symptoms by stimulating irritant receptors in the respiratory tract. These receptors, in turn, cause the muscles surrounding the airway to constrict, resulting in an asthma attack.

Viral respiratory infections are the leading cause of acute asthma attacks. Surprisingly, bacterial infections, with the exception of sinusitis, do not bring about asthma attacks. Some people with heartburn can have asthma symptoms when stomach acid backs up into the esophagus.

Aspirin and aspirin-containing products can trigger asthma attacks in susceptible individuals. Five percent of people with asthma experience a significant decrease in lung function after taking aspirin. Similar reactions can occur with other over-the-counter pain relievers, such as ibuprofen. As a general rule, people with asthma should avoid these products.

Another type of prescription medication that can cause problems is the group of drugs called beta-blockers, which often are prescribed for high blood pressure, glaucoma, migraine headaches, and angina. Beta-blockers can cause airway constriction called bronchospasm, so it is important for people with asthma to consult a physician about the use of these medications.

Although food additives can trigger asthma, this is rare. The most common food trigger is sulfites, a preservative used in products such as frozen potatoes and some beers and wines.

The Difference Between Allergic Disease and Asthma
Asthma is inflammation and obstruction of airflow in the bronchial tubes. Allergies are just one of the factors that can trigger asthma attacks. Not all people with asthma are allergic, and there are many people who have allergies but do not have asthma.

 

Source: American Academy of Allergy, Asthma & Immunology, www.AllergyandAsthmaRelief.org

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2011.

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9 Common Allergy Triggers

An allergen is an otherwise harmless substance that the immune system mistakes as being harmful. There are many types of allergens and conditions caused by them. Some people are allergic to lots of things. Some people are allergic to only one thing or to very few things. What a person is allergic to is determined by many different factors, including the environment, a person’s genes, and the way the immune system works.

Once an allergy has been identified, your healthcare provider may recommend medications or therapies to control symptoms. The next step is to decrease or eliminate exposure to the allergen. This is called environmental control. Evidence shows that allergy and asthma symptoms may improve over time if the recommended environmental control changes are made.

Here are the nine most common types of allergens.

Animals
Exposure to animal dander (dead skin that is continually shed), as well as animal urine and saliva, causes human allergic reactions to animals. These reactions can make asthma, rhinitis, and eczema symptoms worse in some people.

The dander, urine, and saliva of feathered or furry animals, such as cats, dogs, birds, and rodents, can cause allergy symptoms. Exposure to other warmblooded animals, such as horses or cattle, or to products made with feathers or down may also cause allergy symptoms.

Cockroaches
Cockroach allergies are remarkably common. Cockroach allergies may be dangerous to people with asthma, as exposure may cause severe attacks in over half of those diagnosed. Even if you’ve never seen a cockroach in your home, the allergen may be present. It is not necessarily a reflection of the cleanliness of your home. Cockroaches live in walls and other places you cannot see or easily clean. Cockroaches can congregate wherever food and warmth are present. This can include restaurants, hospitals, and bakeries, as well as upscale urban dwellings.

Dust Mites
These are microscopic animals, too small to be seen with the naked eye, that feed on human skin scales. They persist in bedding, carpets, stuffed furniture, old clothing, and stuffed toys. Dust mites are most common in humid climates. If droppings of dust mites are inhaled or come in contact with the skin, they may cause allergic symptoms and aggravate asthma and eczema.

Stinging Insects
Although less common than pollen allergy, insect venom allergy is anything but trivial – it can be life threatening. The primary offenders are most often insects that sting rather than those that bite. Stinging insects of concern include yellow jackets, hornets, wasps, bees, and ants.

Food
An allergic reaction to a food is an unpleasant reaction caused by the immune system overreacting to a food. For those who are allergic, it is important to diagnose the allergy and identify the food so that serious, and even life-threatening, reactions can be avoided. The most common food allergies are eggs, peanuts, milk, tree nuts, fish, shellfish, soy, and wheat.

Latex
A natural rubber made from the sap of a tree, latex can be found in many items, including bicycle and wheelchair tires, toys, some balloons, examining gloves, household gloves, surgical tubing, rubber bands, and condoms. The major exposure of concern is to powdered latex gloves, because latex sticks to the powder and becomes airborne when these gloves are put on, taken off, or snapped.

When someone is allergic to latex, that person is actually allergic to one or more proteins found in the sap from the rubber tree. Interestingly, these proteins – or ones very similar – can be found in banana, kiwi, avocado, potato, strawberries, peaches, and chestnuts. Therefore, people who are allergic to latex may have cross-reactions to these foods.

Medication
Allergies to medications are complicated because they can be caused by many different medications, resulting in a wide variety of signs and symptoms that may affect various organs or parts of the body. However, one characteristic of all drug allergies is that similar symptoms will occur every time soon after the offending medicine is taken. Penicillin and other antibiotics are the medicines that most commonly cause allergic reactions.

Mold
Many types of molds live in our environment. Mold grows in indoor and outdoor areas that are warm, dark, or moist. Molds reproduce and grow by sending tiny spores into the air. Inhaled spores cause allergy and asthma symptoms.

Pollen
When pollen from trees, grasses, and weeds is inhaled, it can cause allergy and asthma symptoms. Pollen may travel many miles in the wind, so trees, grasses, and weeds beyond your immediate area can cause allergy and asthma symptoms. Pollen allergies are often seasonal, and allergy and asthma symptoms occur when the amount of pollen in the air is high.

 

Source: National Jewish Health, www.nationaljewish.org

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2011.

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Brace Yourself: It’s Almost Flu Season

The flu is a contagious respiratory illness caused by influenza viruses. Most healthy people recover from the flu without complications; however, some people, such as older people, young children, pregnant woman, and people with certain health conditions (like asthma), are at high risk for serious complications from the flu. If you are at high risk from complications of the flu, you should consult your healthcare provider to learn how to prevent the flu. If you develop flu-like symptoms, seek professional medical help.

Asthma & the Flu Shot
Every year, the seasonal flu is responsible for causing complications for people with asthma. Getting a seasonal flu shot each year is a very effective way to reduce your chances of dealing with complications due to flu symptoms.

If you have asthma, you should get the flu shot when it is available. Do not get the nasal spray vaccine, which could trigger asthma symptoms or an attack. If you have asthma and get the flu, see a healthcare professional promptly because you are at greater risk of becoming severely ill with flu complications very quickly. If you care for children with asthma, get the flu vaccine to protect them.

The single best way to prevent the flu is to get a flu vaccine each fall.

The vaccine is safe. If you have asthma, your health risks are far greater in not getting the vaccine.

Allergies & the Flu Shot
If you have a severe allergy to eggs, or to any other substance that could be in the flu vaccine (such as latex or gelatin), you should check with your physician before receiving any flu vaccine. If a person reports a severe allergy to latex, vaccines supplied in vials or syringes that contain natural rubber should not be administered, unless the benefit of vaccination outweighs the risk of an allergic reaction to the vaccine. For latex allergies other than anaphylactic allergies, vaccines supplied in vials or syringes that contain dry natural rubber or natural rubber latex can be administered. Allergic reactions (including anaphylaxis) after vaccination procedures are rare.

Common Flu Symptoms
The flu usually starts suddenly and may include symptoms such as fever, headache, extreme tiredness, chills, constant cough, sore throat, runny or stuffy nose, and body aches. Diarrhea and vomiting also can occur but are more common in children.

These symptoms are referred to as “flu-like symptoms.” Many different illnesses, including the common cold, allergy symptoms, and asthma symptoms, can sometimes be similar and confusing. Always consult with your doctor to make a proper diagnosis.

If your runny nose, itchy and watery eyes, sore throat, and other common allergy symptoms are combined with an unusually high fever (100 degrees or higher), chills, severe headache, or significant aches and pains, you could have the flu. If you think your allergy symptoms might be indicative of something more severe, including the flu, you should visit your doctor for a diagnosis or treatment recommendation.

Spreading the Flu
The flu spreads in respiratory spraying from coughing and sneezing. It usually spreads from person to person, though occasionally someone could become infected by touching something with virus on it and touching his or her mouth or nose. Adults may be able to infect others one day before getting symptoms and up to seven days after getting sick. So it’s possible to give the flu before you know you’re sick, as well as while you are sick.

Flu Prevention
The single best way to prevent the flu is to get a flu vaccine each fall. A few antiviral drugs are approved for prevention of the flu. These are prescription medications, and a doctor should be consulted before they are used.

In addition, here are some easy things you can do to prevent the spread of respiratory illnesses like the flu:

• Cover your nose or mouth with a cloth or tissue when you cough or sneeze – throw it away after use.
• Wash hands often with soap and water, especially after coughing or sneezing. If you don’t have access to running water, use an alcohol-based hand cleanser.
• Stay away from people who are sick.
• If you get the flu, stay home from work and school, and limit contact with others to keep from infecting them.
• Try not to touch your eyes, nose, or mouth. This is how germs often spread.

Treating the Flu
Some antiviral drugs are approved for treatment of the flu. They are prescription medications, and a doctor should be consulted before the drugs are used. If you get the flu, get plenty of rest, drink a lot of liquids, and avoid using alcohol and tobacco. You can take medications to relieve the symptoms of the flu (but never give aspirin to children or teenagers who have flu-like symptoms, particularly fever).

 

For the most up-to-date flu information, visit flu.gov.

Source: Asthma and Allergy Foundation of America, www.aafa.org

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2011.

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Don’t Let Allergies & Asthma Haunt Halloween Fun

Halloween can be a frightful time for parents of kids with allergies & asthma. Nut-filled candy isn’t the only bogeyman that can ruin the fun. Allergy and asthma triggers can hide in other, unexpected places, too, from dusty costumes to leering jack-o’-lanterns.

“When people think of Halloweenassociated allergies, they focus on candy and often overlook many other potential triggers,” says Myron Zitt, md, past president of the American College of Allergy, Asthma and Immunology. “By planning ahead, you can ensure not only safe treats, but also safe costumes, makeup, accessories, and decorations.”

Watch out for these six sneaky triggers to keep Halloween sneeze-, wheeze- and reaction-free.

1 Tricky Treats
Food allergy triggers abound on this candy-filled holiday, and it’s not just the usual suspects like chocolate that can hide triggers. Gummy bears and other seemingly innocent candies may contain gelatin, a potential allergen that is a less common trigger. Your best bet? Consider taking your child to an allergist for allergy testing and help in developing a food allergy treatment plan. For Halloween night, have some non-candy treats for your child, such as stickers, pencils, and small toys to swap for sweets.

2 Devilish Costume Details
Watch out for nickel in costume accessories, from cowboy belts and pirate swords to tiaras and magic wands. Nickel is one of the most common causes of allergic contact dermatitis, which can make skin itchy and spoil trick-ortreating fun.

3 Haunted Hand-Me-Downs
Halloween costumes packed away in a box for months can be laden with dust mites, which trigger allergies & asthma. So unless you want your little one sneezing or wheezing from house to house, wash the hand-me-down costumes in hot water. Or consider visiting the store for a new costume.

4 Menacing Makeup
Cheap Halloween makeup may include preservatives that can cause allergic reactions. Instead, opt for higher quality theater makeup. Because it can take a few days for a rash, swelling, or other reaction to appear, test the makeup on a small area of skin well in advance of Halloween.

5 Frightful Fog
If you’re considering renting a fog machine to make your house extra spooky, think again. Fog – real or man-made – can trigger asthma in some people.

6 Perilous Pumpkins
Beware of pumpkin-carving and pumpkin pie if you think you might be allergic. Pumpkin allergies, though rare, can cause everything from itching to chest tightness and can pop up quite suddenly, even if you haven’t had a problem before. And keep in mind that pumpkin patches are often moldy and dusty, allergy and asthma triggers for some. Consider buying a pumpkin from a grocery or discount store.

 

Source: American College of Allergy, Asthma & Immunology, www.acaai.org

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2011.

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Asthma in Infants and Very Young Children

Asthma is a disease in which the airways become blocked or narrowed. These effects are usually temporary, but they cause shortness of breath, breathing trouble, and other symptoms. If an asthma attack is severe, a person may need emergency treatment to restore normal breathing. Although asthma can cause severe health problems, in most cases treatment can control it and allow a person to live a normal and active life.

How is asthma in very young children different from adult asthma?
Infants and toddlers have much smaller bronchial tubes than older children and adults. In fact, these airways are so small that even small blockages caused by viral infections, tightened airways, or mucus can make breathing extremely difficult for the child.

Asthma symptoms can look like symptoms of other illnesses or diseases. Croup, bronchitis, epiglottis, cystic fibrosis, pneumonia, bronchiectasis, upper respiratory tract viruses, gastroesophageal reflux, congenital abnormalities, or even a foreign body inhaled by the child all have some of the same symptoms as asthma.

Diagnosing asthma in very young children is difficult. Since they are not able to communicate, they cannot describe how they are feeling.

Signs of asthma in a baby or toddler include noisy breathing or breathing increased 50 percent above normal; wheezing or panting with normal activities; lethargy or disinterest in normal or favorite activities; difficulty sucking or eating; and crying sounds softer, different.

How is asthma diagnosed in babies and toddlers?
Diagnosing asthma in very young children is difficult. Since they are not able to communicate, they cannot describe how they are feeling. To help the pediatrician make a correct diagnosis, parents must provide information about family history of asthma or allergies and the child’s overall behavior, breathing patterns, and responses to foods or possible allergy triggers. Lung function tests are very hard to do with young children. Instead, the physician may see how the child responds to medications to improve breathing. Blood tests, allergy testing, and X-rays may be done to gather additional information. Using all this information, the doctor then can make the best diagnosis.

How is asthma treated in very young children?
Babies or toddlers can use most medications used for older children and adults. The dosage, of course, is lower, and the way the medication is given is different. Inhaled medications are preferred because they generally act more rapidly to reduce symptoms and produce fewer side effects.

Medications to treat asthma symptoms in infants and toddlers are usually given in a tasty liquid form or with a nebulizer. A nebulizer is a small machine that uses forced air to create a “medication mist” for the baby to breathe through a small facemask. Nebulizer treatments take about 10 minutes and are given several times each day until symptoms decrease. Although a nebulizer treatment is gentle, babies and young children often are frightened by the mask and fight the treatment at first.

Some toddlers are able to use an inhaler containing asthma medication with a spacer and mask attachment. A spacer is a small tube that holds the medication released by the inhaler fitted into it. The device allows children to breathe in the medication at their own speed.

Most people with asthma, including very young children, use a combination of medications, depending on severity and frequency of symptoms. Work with their healthcare providers to develop an asthma care plan for your child.

Can a child outgrow asthma?
Once someone develops sensitive airways, they remain that way for life, although asthma symptoms can vary through the years. As a child’s airways mature, he or she is able to handle airway inflammation and irritants better, so asthma symptoms may notably decrease. There is no way to predict which children may experience greatly reduced symptoms as they get older. New triggers may set off symptoms at any time in people who have asthma. If your child has asthma, keep quick-relief medications on hand (and up-to-date), even if symptoms are rare.

Tips for Parents
When a very young child has a chronic illness, parents can feel stretched to their limits as they try to manage. Get regular check-ups to help reduce your anxiety. Teach your toddler or preschooler to tell you when they are not feeling well.

It’s important to learn the warning signs for increasing asthma in infants and toddlers. Develop an asthma management plan with your child’s physician. Make sure the plan provides guidelines to follow if asthma symptoms get worse.

Follow your asthma care plan every day! Don’t alter from the plan until you consult your healthcare provider. Even if your child’s symptoms are gone, stick with the plan until you discuss changes with the doctor.

Above all, don’t let your child’s asthma become the focus of your relationship. If you use good healthcare practices to manage your baby’s or toddler’s asthma, you’ll be able to think less about asthma and enjoy your child more.

 

Source: Asthma and Allergy Foundation of America, www.aafa.org

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2011.

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Using Powder-Free Latex Gloves Reduces Latex Allergy Rate in Healthcare Workers

Researchers at The Medical College of Wisconsin investigating latex allergy in healthcare workers have demonstrated that the most effective public health strategy to prevent allergic sensitization is by stopping the use of powdered latex gloves. Previous medical studies pointed out this association of latex allergy to powdered latex glove use but were not able to completely confirm this link in specific workers. Reducing the use of powdered gloves reduced the allergen in the air and in air ducts at two hospitals, and prevented sensitization to latex in healthcare workers at both institutions. These findings are published in the Journal of Occupational and Environmental Medicine.

Kevin J. Kelly, MD, professor of Pediatrics (allergy/ immunology) and Internal Medicine and vice chair in Pediatrics at the Medical College, and his colleagues studied more than 800 healthcare workers at Froedtert Hospital and Children’s Hospital of Wisconsin over a 4.5-year period. Researchers tested the amount of latex allergen in the air ducts of the employees’ primary work areas before and after both institutions switched to powder-free gloves and found a significant correlation between high levels of airborne allergen and healthcare workers with a latex allergy or sensitivity.

The switch to powder-free gloves led to significant changes at both hospitals. The unique study design allowed the investigators to determine that there was a 16-fold reduction in the rate of latex sensitization among the study participants. Among the healthcare workers who were sensitized to latex at the beginning of the study, 25 percent lost that sensitivity and are no longer considered sensitized to latex. Whether these fortunate workers will redevelop latex sensitization if exposed to latex in the future is unknown.

The switch to powder-free gloves led to significant changes at both hospitals.

“This study provides the strongest evidence that allergic sensitivity to latex in healthcare workers is linked to airborne allergen exposure through powdered gloves,” Dr. Kelly says. “I believe these findings provide a roadmap for healthcare institutions that will help minimize the risks of latex sensitization to healthcare workers.”

Dr. Kelly’s team also found healthcare workers who had demonstrated latex sensitization were nearly three times more likely to leave their jobs. This phenomenon has been termed “the healthy survivor” effect and helps explain why there may be an artificial reduction in latex allergy seen in some studies, as the affected workers choose to no longer be employed without receiving workers’ compensation from a work-related exposure.

 

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2011.

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Halloween Scares for Children with Allergies & Asthma

Parents of children with food allergies are aware of the dangers lurking in Halloween treats, but little attention is paid to asthma, which can also be frightening for asthmatic children participating in Halloween festivities.

“If your child suffers from asthma and/or allergies, be aware and prepared for potential triggers to ensure a safe and fun time for all during the holidays,” says Clifford W. Bassett, MD, FAAAAI, chair of the Public Education Committee of the American Academy of Allergy, Asthma & Immunology.

The Academy offers these tips to help children with allergies & asthma safely enjoy the holiday and stay out of hospital emergency rooms:

• Beware of Costumes
  Mold, dust, and latex products can be major allergy and asthma triggers. Don’t recycle costumes from the attic or basement, and wash new costumes before wearing. Halloween masks can trap dust and mold, so keep your child mask free.
• Don’t Enter Homes
  Keep your child on the doorstep of homes while trick-or-treating. Asthma and allergy triggers in the houses of others may include cigarette smoke and pet dander.
• Watch for Weather Changes
  Cold air and humidity can make breathing difficult for children with asthma. Make certain your child is dressed appropriately for the conditions.
• Under the Weather
  If your child is not feeling well, hold off on trick-or-treating. Cold and flu symptoms can severely aggravate asthma conditions.
• Lurking Food Allergies
  Halloween can be troublesome for those with food allergies. If this includes your child, read every food label and be a “label detective” so that you know what the ingredients are before your child touches or eats the product. This also means avoiding homemade treats.
• Be Prepared
  When trick-or-treating, be prepared for an emergency. For food allergies, carry an epinephrine pen. For asthma, keep a rescue inhaler nearby.

 

Source: American Academy of Allergy, Asthma & Immunology, www.aaaai.org.

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2010.

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Back to School with Asthma

Seven Steps to Stay Healthy During the School Day

The start of a new school year is a big transition after the long summer break, especially for families of children with asthma. This back-to-school season, the American Lung Association stresses the importance of preparing and carefully monitoring a detailed action plan to manage asthma and ease the transition to the school environment.

“While new clothes and backpacks are often thought of as back-to-school necessities, it is even more essential for parents of students with asthma to work with their healthcare providers and the school to develop a comprehensive action plan detailing the various elements of good asthma control in the school environment,” says Dr. Norman H. Edelman, chief medical officer of the American Lung Association.

As the most common chronic childhood disorder in the nation, asthma affects an estimated seven million children younger than 18. It is one of the main illness-related reasons that students miss school, accounting for more than 14 million lost school days every year.

Parents should also be aware that cold and flu season is beginning as well. Influenza poses a special health risk to children with asthma, as these children often experience more severe symptoms. All children – especially those with asthma – should be immunized against influenza. Yet surveillance shows that less than half of children with asthma are vaccinated annually against influenza.

“As part of your back-to-school preparation, make sure your child with asthma gets a flu shot,” says Dr. Edelman. “Flu epidemics start and spread in schools, and the flu can lead to a serious asthma attack.

“The good news is that research has shown conclusively that getting a flu shot does not trigger an asthma attack, so there is no good reason not to get one,” he adds. According to the U.S. Centers for Disease Control, yearly flu vaccinations should begin in September, or as soon as the vaccine is available.

Even if your child’s asthma is well managed, asthma action plans should be updated each school year.

In preparation for the school year ahead, the American Lung Association urges parents who have children with asthma to complete the following checklist:

♦ Develop an Asthma Action Plan
All students with asthma should have a written asthma action plan that details personal information about the child’s asthma symptoms, medications, and any medicine required before exercise, and that provides specific instructions about what to do if an asthma episode does not improve with prescribed medication.

♦ Schedule an Asthma Check-up
Even if your child’s asthma is well managed, asthma action plans should be updated each school year, so schedule a check-up with your healthcare provider. This is critical to ensuring your child’s asthma continues to be effectively controlled, and provides an opportunity to evaluate medications and physical activity considerations. Remember to give a copy of the completed asthma action plan to your child’s school.

♦ Vaccinate Yourself and Your Child Against Seasonal Influenza
The CDC now recommends everyone over the age of six months get a flu vaccination. Protecting yourself against influenza by getting vaccinated further helps protect your child.

♦ Visit Your Child’s School Nurse and Teachers
All of your child’s teachers, coaches, out-of-school activity organizers, as well as the school nurse and office should have a current copy of your child’s asthma action plan. Discuss your child’s specific triggers and typical symptoms so that they can be prepared to effectively assist your child should an asthma episode occur outside of your presence.

♦ Know Your School’s Asthma Emergency Plan
Ensure that your child’s school knows how to contact you in case of an emergency. It is also important for parents to know the school’s history of dealing with asthma episodes. Parents should confirm that school staff – including after-school coaches and bus drivers – have attended training to learn how to respond to asthma emergencies.

♦ Advocate for Your Child
In all 50 states, students have the legal right to carry asthma medications while at school. Check with your school nurse or administrator for your school’s individual policy, and meet with your child’s healthcare provider to complete the required paperwork.

♦ Know About Prescription Assistance Services
Don’t let the cost of medicines be the reason that your child doesn’t get the necessary treatment to control his or her asthma. Talk to your local healthcare provider about low-cost or no-cost options that may be available to you. Three organizations are available to help. The Partnership for Prescription Assistance can be reached by calling (888) 4PPA-NOW. Rx Outreach also provides information on their website, rxoutreach.com. Patient Services Incorporated, www.patientservicesinc.org, also has helpful information available online. Most pharmaceutical companies offer prescription assistance programs as well.

 

Source: American Lung Association, www.lungusa.org

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2011.

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New App to Help People Dining Out with Food Allergies and Intolerances

People with food allergies and intolerances struggle to find restaurants that will accommodate their dietary requirements. Now, there’s an app for that. AllergyEats (allergyeats.com) has launched a free app for the iPhone and Android smartphones that provides peer-based feedback about how well (or poorly) restaurants accommodate the needs of food allergic customers. The AllergyEats app can be downloaded from the iTunes app store and the Android market.

 

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2011.

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Making Your House a Healthy Home

If you’re like most Americans, you spend much of your time indoors. Have you ever stopped to think about whether the air you’re breathing at home is healthy? Research has found that in some homes across America, the quality of indoor air can be worse than outdoor air. In part, this is because many homes are being built and remodeled tighter. You don’t have to be a building scientist to deal with the quality of air in your home; however, you should understand a few basics to get you started.

Biological Pollutants (like molds and dust mites)
Molds, mildew, fungi, bacteria, and dust mites are some of the main biological pollutants inside the home. Some, such as pollen, are generated outside the home. Mold and mildew are generated in the home and release spores into the air. Mold, mildew, fungi, and bacteria are often found in areas of the home that have high humidity levels, such as bathrooms, kitchens, laundry rooms or basements. Dust mites and animal dander are problematic when they become airborne during vacuuming, making beds, or when textiles are disturbed.

Allergic reactions are the most common health problems associated with biological pollutants.

Molds and dust mites thrive in areas of high humidity. Mold grows on organic materials, such as paper, textiles, grease, dirt, and soap scum. Mold spores float throughout the house, forming new colonies where they land. Dust mites thrive on dead human skin cells and are found in textiles, such as bedding, carpeting, and upholstery. When these textiles are disturbed during vacuuming, making beds, or walking on carpet, the dust particles become airborne. Pollen, plant material that enters through windows or on pets, and animal dander also become airborne when disturbed. Infectious diseases caused by bacteria and viruses are generally passed from person to person through physical contact, but some circulate through indoor ventilation systems.

Health Effects
Allergic reactions are the most common health problems associated with biological pollutants. Symptoms often include watery eyes, runny nose and sneezing, nasal congestion, itching, coughing, wheezing and difficulty breathing, headache, dizziness, and fatigue. Dust mites have been identified as the single most important trigger for asthma attacks.

Addressing the Problem
There are no practical tests for biological contaminants for use by nonprofessionals. However, there are signs to watch for. You can sometimes see and smell mold colonies growing on surfaces. Mold growth should be suspected wherever there are water stains, standing water, or moist surfaces.

Prevent mold growth by keeping basements, bathrooms, and other rooms clean and dry. Use a disinfectant to clean surfaces that have mold on them. If carpeting or furnishings become wet, they must be quickly and thoroughly dried or discarded.

Humidifiers, dehumidifiers, and air conditioning condensing units should be regularly cleaned with a disinfectant, such as chlorine bleach. Keep humidity at acceptable levels (less than 50 percent), and make sure there’s plenty of ventilation, especially in areas where moisture tends to build up.

People who are sensitive to dust mites may need to replace carpeting in their homes with hard surfaced flooring and use area rugs that can be removed and cleaned. Vacuums with high efficiency filters or central vacuum systems can help reduce the airborne dust generated by vacuuming.

Cleaning Up Mold
According to the U.S. Environmental Protection Agency, if the moldy area is less than about 10 square feet, in most cases, you can handle the job yourself, following the guidelines below. If you have health concerns, consult a health professional before starting cleanup.

If you choose to hire a contractor to do the cleanup, make sure the contractor has experience cleaning up mold. For do-it-yourself cleanup, note that the use of a disinfecting chemical or biocide that kills organisms such as mold (chlorine bleach, for example) is not recommended as a routine practice during mold remediation, although there may be instances where professional judgment may indicate its use (for example, when immune-compromised individuals are present). In most cases, it is not possible or desirable to sterilize an area; background levels of mold spores will remain, and these spores will grow if the moisture problem has not been resolved. If you choose to use disinfectants or biocides, always ventilate the area. Outdoor air may need to be brought in with fans. Never mix chlorine bleach solution with other cleaning solutions or detergents that contain ammonia because toxic fumes could be produced.

In instances when a biocide is not used, simply damp-wipe surfaces with plain water or with water and detergent solution (for wood, use wood floor cleaner); scrub as needed. Always dry completely after cleanup is completed.

In order to limit your exposure to airborne mold during cleanup, you should wear an N-95 respirator, available at many hardware stores. In order to be effective, the respirator or mask must fit properly, so carefully follow the instructions supplied with the respirator.

 

Source: Federal Citizen Information Center

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2011.

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Symptoms of Allergic Rhinitis Result in Sleep Disturbances and Emotional Burdens

Results from Teva Respiratory’s “Nasal Allergy Survey Assessing Limitations 2010” show that people with allergic rhinitis who had nasal symptoms were more likely to experience sleep disturbances, including difficulty getting to sleep and waking up during the night. Lack of a good night’s sleep can significantly affect a person’s quality of life.

Survey results suggest that the fatigue people with nasal allergies experience may be related to sleep disruption caused by the common symptoms associated with allergic rhinitis. Lack of adequate sleep and increased tiredness may also lead to people feeling “irritable” and “miserable,” which can contribute to other emotional burdens, like anxiety and depression. When nasal symptoms are at their worst, people find it difficult to get a good night’s sleep, which can negatively affect their work performance by reducing productivity, resulting in both social and economic costs.

“The negative impact that allergic rhinitis symptoms can have on a patient’s quality of sleep is considerable, as it not only affects them physically, but also emotionally,” says Gary Gross, MD, FAAAAI, of Dallas Allergy & Asthma Center in Dallas, TX. “It’s important for patients suffering from allergic rhinitis symptoms, like post-nasal drip, to understand how these symptoms can negatively affect their quality of life.”

 

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2011.

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Vitamin D Deficiency Linked with Airway Changes in Children with Severe Asthma

Children with severe therapy-resistant asthma (STRA) may have poorer lung function and worse symptoms compared to children with moderate asthma due to lower levels of vitamin D in their blood, according to researchers in London. Lower levels of vitamin D may cause structural changes in the airway muscles of children with STRA, making breathing more difficult. The study provides important new evidence for possible treatments for the condition.

The findings were published online ahead of the print edition of the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.

“This study clearly demonstrates that low levels of vitamin D are associated with poorer lung function, increased use of medication, worse symptoms and an increase in the mass of airway smooth muscle in children with STRA,” said Atul Gupta, MRCPCH, M.D., a researcher from Royal Brompton Hospital and the National Heart and Lung Institute (NHLI) at Imperial College and King’s College London. “It is therefore plausible that the link between airway smooth muscle mass and lung function in severe asthma may be partly explained by low levels of vitamin D.”

This is the first study to evaluate the relationship between vitamin D and the pathophysiology of children with severe therapy-resistant asthma.

While most children with asthma can be successfully treated with low doses of corticosteroids, about 5 to 10 percent of asthmatic children do not respond to standard treatment. These children have severe therapy-resistant asthma, or STRA, experience more asthma episodes and asthma-related illnesses, and require more healthcare services, than their treatment-receptive peers.

Although previous studies of children with asthma have linked increases in airway smooth muscle mass with poorer lung function and in vitro studies have established a connection between levels of vitamin D and the proliferation of airway smooth muscle, this is the first study to evaluate the relationship between vitamin D and the pathophysiology of children with STRA.

“Little is known about vitamin D status and its effect on asthma pathophysiology in these patients,” Dr. Gupta noted. “For our study, we hypothesized that children with STRA would have lower levels of vitamin D than moderate asthmatics, and that lower levels of vitamin D would be associated with worse lung function and changes in the airway muscle tissue.”

The researchers enrolled 86 children in the study, including 36 children with STRA, 26 with moderate asthma and 24 non-asthmatic controls, and measured the relationships between vitamin D levels and lung function, medication usage and symptom exacerbations. The researchers also examined tissue samples from the airways of the STRA group to evaluate structural changes in the airway’s smooth muscle.

At the conclusion of the study the researchers found children with STRA had significantly lower levels of vitamin D, as well as greater numbers of exacerbations, increased use of asthma medications and poorer lung function compared to children with moderate asthma and non-asthmatic children. Airway muscle tissue mass was also increased in the STRA group.

“The results of this study suggest that lower levels of vitamin D in children with STRA contribute to an increase in airway smooth muscle mass, which could make breathing more difficult and cause a worsening of asthma symptoms,” Dr. Gupta said.

The findings suggest new treatment strategies for children suffering from difficult-to-treat asthma, he added.

“Our results suggest that detecting vitamin D deficiency in children with STRA, and then treating that deficiency, may help prevent or reduce the structural changes that occur in the airway smooth muscle, which in turn may help reduce asthma-related symptoms and improve overall lung function,” Dr. Gupta said.

Before any widespread treatment recommendations can be made, however, larger studies will need to be conducted.

“The determination of the exact mechanism between low vitamin D and airway changes that occur in STRA will require intervention studies,” Dr. Gupta said. “Hopefully, the results of this and future studies will help determine a new course of therapy that will be effective in treating these children.”

 

Source: American Thoracic Society, www.thoracic.org

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Allergies, Asthma, & Pregnancy

Your Questions Answered

If you are pregnant and have asthma or allergies, you may feel uneasy about taking medications, but it is very important to keep your symptoms under control. Here are answers to some of the most common questions women have about managing allergies & asthma during pregnancy.

Q: How do you stay healthy and know which medications are best for you during your pregnancy?
A: An allergist can tell you which asthma and allergy medications are the safest and most effective to take throughout pregnancy. Make an appointment with an allergist soon after you discover you are pregnant to develop or review your personal treatment plan and to give you peace of mind.

Q: Can women with asthma have safe pregnancies?
A: Yes. With good asthma management, you can keep your asthma under control and have a healthy baby.

The risks of asthma flare-ups are greater than the risks of taking necessary asthma medications.

Q: How does uncontrolled asthma affect the fetus?
A: Uncontrolled asthma symptoms can cause a decrease in the amount of oxygen in your blood supply. The fetus gets its oxygen from your blood. Since a fetus needs a constant supply of oxygen for normal growth and development, managing asthma symptoms is very important to allow you and your baby to get enough oxygen.

Q: Is it safe to take my asthma medications?
A: The risks of asthma flare-ups are greater than the risks of taking necessary asthma medications. Studies show that most inhaled asthma medications are safe for women to use while pregnant. However, oral medications (pills) should be avoided unless necessary to control symptoms. Knowing which medications to take is a good reason to stay in close contact with your doctor so he or she can monitor your condition and alter your medications or dosages if needed.

Q: Will being pregnant affect my asthma symptoms
A: Pregnancy may affect the severity of your asthma symptoms. One study showed that asthma symptoms were worse in 35 percent of pregnant women, improved in 28 percent, and remained the same in 33 percent of pregnant women. Asthma has a tendency to get worse in the late second and early third trimesters, and many women have fewer symptoms during the last four weeks of pregnancy.

Q: Can I continue to get allergy shots during pregnancy?
A: Immunotherapy (allergy shots) is safe to take while you are pregnant. As always, your doctor will monitor your dose to reduce the risk of an allergic reaction to the shots. These reactions are rare; however, a reaction could be harmful to the fetus. Also, allergy shots should not be started for the first time during pregnancy.

Q: What should I avoid if I have asthma or allergies?
A: Whether you are pregnant or not, you should stay away from things that trigger your symptoms. This might include allergens, such as dust mites and animal dander, and irritants, such as cigarette smoke.

Healthy Pregnancy Tips

♦ You can have a healthy pregnancy if you have asthma or allergies.
♦ Managing your symptoms is very important during pregnancy.
♦ Do not stop taking your medications.

Q: Can women with asthma perform Lamaze?
A: Most women with asthma are able to do Lamaze breathing techniques without any problems. Asthma symptoms are rare during labor and delivery in women whose asthma has been managed during pregnancy.

Q: Can I breastfeed if I am taking medications for my asthma or allergies?
A: Breastfeeding is a good way to increase your child’s immunity, and it is strongly recommended. Medications recommended for use during pregnancy can be continued while nursing, because the baby gets less maternal medicine through breast milk than in the womb. Your doctor can discuss with you the best treatments while nursing.

Although these are common questions during pregnancy, each woman’s individual treatment varies. It is best to visit your allergist regularly during pregnancy so that any worsening of asthma can be countered by appropriate changes in your asthma management plan. Make sure to discuss any specific concerns with your physician to ensure the healthiest pregnancy for your well-being and that of your baby.

 

Source: American Academy of Allergy, Asthma & Immunology, www.aaaai.org

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2011.

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New Online Course Teaches Educators How to Prepare for Anaphylaxis

Food allergies affect as many as 1 in 13 children, and nearly 40 percent of children with food allergies have a history of a severe reaction. Severe allergic reactions to food can cause anaphylaxis and can be life-threatening.

Educators across the U.S. now have access to a free, interactive online course that provides a comprehensive tutorial on managing anaphylaxis in schools. How to C.A.R.E.™ for Students with Food Allergies: What Educators Should Know is a new, interactive online course that provides education for school personnel anytime, anyplace. This course uses current research evidence and expert consensus to help school personnel understand how to prevent and manage emergency situations due to food allergies. Based on the latest scientific research and expert consensus, the online course enables school personnel the flexibility to complete the program anytime and anywhere that has an Internet connection. The course is the result of a collaborative effort among the Food Allergy & Anaphylaxis Network, the Food Allergy Initiative, Anaphylaxis Canada, the Canadian Society of Allergy and Clinical Immunology, and Leap Learning Technologies.

For more information about the course and about how to let a local school know this new tool is available, visit allergyready.com.

 

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2011.

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Study Connects Gene Variant to Response to Asthma Drugs

A genetic variant may explain why some people with asthma do not respond well to inhaled corticosteroids, the most widely prescribed medicine for long-term asthma control. Researchers found that asthma patients who have two copies of a specific gene variant responded only one-third as well to steroid inhalers as those with two copies of the regular gene.

This genome-wide association study, funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health, analyzed data from over 1,000 people enrolled in five separate clinical trials that studied different steroid treatments for asthma.

The study was also funded by the National Human Genome Research Institute and the NIH Pharmacogenomics Research Network. The results appeared in the September 26, 2011, online edition of the New England Journal of Medicine.

"This finding helps to explain the genetic basis for the long-standing observation that some people do not respond well to what is a common asthma treatment," said Susan Shurin, MD, acting director of the NHLBI. "The study illustrates the importance of research examining the relationship between genetic makeup and response to therapy for asthma, and underscores the need for personalized treatment for those who have it."

In this study, people carrying two copies of the GLCCI1 variant were more than twice as likely to respond poorly to ICS treatment as participants with two copies of the regular GLCCI1 gene.

Asthma is a complex inflammatory disease that affects over 22 million people in the United States and roughly 300 million people worldwide. Many factors can influence how severely the disease affects people and how well they respond to treatments. Poor response to inhaled corticosteroids (ICS) often runs in families, suggesting that genetics plays a role in how people respond to asthma treatments.

The study first conducted a genome-wide scan of the DNA of children enrolled in the Childhood Asthma Management Program and of their parents. The genomic scan uncovered a variant in a gene called GLCCI1 that appeared to be associated with poor ICS response. Study researchers then verified this association in 935 additional people with asthma, both children and adults, enrolled in four independent ICS studies. Most of the participants in these studies were white; the results may not be applicable to persons of other ethnicities.

In this study, people carrying two copies of the GLCCI1 variant were more than twice as likely to respond poorly to ICS treatment as participants with two copies of the regular GLCCI1 gene. Those who responded poorly had an average of one-third the level of lung improvement following inhaler treatment as did people with two regular copies of the gene.

About 1 in 6 study participants had two copies of the GLCCI1 variant, which is thought to work in conjunction with other genetic and environmental factors to affect response to ICS.

More studies will be needed to understand how GLCCI1 operates in the lungs and to explore whether it contributes to response in patients of other ethnic groups.

 

The National Heart, Lung, and Blood Institute (NHLBI) is a component of the National Institutes of Health. NHLBI plans, conducts, and supports research related to the causes, prevention, diagnosis, and treatment of heart, blood vessel, lung, and blood diseases; and sleep disorders. The Institute also administers national health education campaigns on women and heart disease, healthy weight for children, and other topics. NHLBI press releases and other materials are available online at: www.nhlbi.nih.gov.

The National Institutes of Health (NIH), the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

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How to Handle an Allergy Emergency

More than 50 million Americans have some type of allergy. While the condition often makes people uncomfortable, it’s rarely dangerous unless it results in an allergic emergency. Then, allergies can be deadly.

The medical term for an allergic emergency is anaphylaxis. The condition is as serious as it sounds. Anaphylaxis is a life-threatening, severe allergic reaction that comes on suddenly and may affect many parts of the body at once. People who have allergies or asthma are at increased risk for anaphylaxis, but anyone can have a severe allergic reaction.

Symptoms
The symptoms of anaphylaxis include

• hives, itchiness, and redness on the skin, lips, eyelids, or other parts of the body;
• wheezing or difficulty breathing; h swelling of the tongue, throat, and nose;
• nausea, stomach cramping, and vomiting or diarrhea; and
• dizziness and fainting or loss of consciousness, which can lead to shock and heart failure.

Some or all of these symptoms can occur within minutes after exposure, or may develop up to two hours later. Sometimes a second reaction may occur eight to twelve hours after the first. The sooner the reaction is treated, the less severe it is likely to become.

The medical term for an allergic emergency is anaphylaxis.

Causes
The most common triggers of an allergic emergency include the following:

Food
Peanuts, tree nuts (almonds, pecans, cashews, walnuts), fish, shellfish, cow’s milk, and eggs top the list among food triggers, causing about half of all cases of anaphylaxis each year. Peanut or tree nut allergies are the most common.

Insect Stings
More than 500,000 Americans go to hospital emergency rooms each year because of allergic reactions to stings from insects such as bees, wasps, hornets, yellow jackets, and fire ants.

Medication
Penicillin is the medication that most commonly causes anaphylaxis, but other drugs, such as aspirin, anesthetics, antibiotics, and pain relievers like ibuprofen also can cause a reaction.

Latex
Up to six percent of Americans are allergic to the latex used in disposable gloves, intravenous tubes, syringes, and other products, with healthcare workers, other workers who routinely wear gloves, and children with spina bifida at greatest risk of latex-induced anaphylaxis.

Treatment
Most severe allergic emergencies or anaphylactic reactions are treated with a shot of the anti-allergy drug epinephrine (adrenaline). Other treatments also may be needed depending on the symptoms.

Be S.A.F.E.
If you are at risk of a severe allergic reaction, you should know the four steps to manage your condition and keep you S.A.F.E.

⋄ Seek immediate medical help
Call 911 and get to the nearest emergency facility at the first sign of anaphylaxis, even if you have already administered epinephrine. If you have had an anaphylactic reaction in the past, you are at risk of future reactions.

⋄ Identify the Allergen
Think about what you might have eaten or been exposed to – food, insect sting, medication or latex – to trigger an allergic reaction. It is particularly important to identify the cause, when possible, because the best way to prevent anaphylaxis is to avoid allergic triggers.

⋄ Follow up with a specialist
Ask your doctor for a referral to an allergist/immunologist, a physician who specializes in treating asthma and allergies. It is important that you consult an allergist for testing, diagnosis, and ongoing management of your allergic disease.

⋄ Carry Epinephrine for emergencies
Kits containing fast-acting, self-administered epinephrine are commonly prescribed for people who are at risk of anaphylaxis. Make sure that you carry an epinephrine kit with you at all times, and that family and friends know of your condition and your triggers, as well as how to use epinephrine. Consider wearing an emergency medical bracelet or necklace identifying yourself as a person at risk of anaphylaxis. Teachers and other caregivers should be informed of children who are at risk for anaphylaxis and should know what to do in an allergic emergency.

 

The more you know about your condition, the more able you will be to prevent or minimize future reactions. The American College of Allergy, Asthma and Immunology has additional information on anaphylaxis prevention tips, other allergy facts, and an easy-to-use allergist locator at AllergyandAsthmaRelief.org.

Source: American College of Allergy, Asthma & Immunology, AllergyandAsthmaRelief.org

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2011.

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Online Health Information – Can You Trust It?

There are thousands of health-related websites on the Internet. Some of the information on these websites is reliable; some of it is not. Some of the information is current; some of it is not. Choosing which web site to trust is worth thinking about. As a rule, health websites sponsored by federal government agencies are good sources of health information. You can reach all federal websites by visiting USA.gov. Large professional organizations and well-known medical schools may also be good sources of health information.

As you search online, you are likely to find websites for many health agencies and organizations that are not well known. By answering the following questions, you should be able to find more information about these sites. Many of these details can be found under the heading “About Us” or “Contact Us.”

Who sponsors the website?
web sites cost money. Is the funding source readily apparent? Sometimes, the web address itself may help, for example,

• .gov identifies a government agency;
• .edu identifies an educational institution;
• .org identifies professional organizations (e.g., scientific or research societies, advocacy groups); and
• .com identifies commercial web sites (e.g., businesses, pharmaceutical companies, sometimes hospitals).

Is it obvious how you can reach the sponsor?
Trustworthy websites will have contact information for you to use. The home page should list an e-mail address, phone number, or a mailing address where the sponsor and/or the authors of the information can be reached.

It’s important to find out when the information you are reading was written.

Who wrote the information?
Authors and contributors should be identified. Their affiliation and any financial interest in the content should also be clear. Be careful about testimonials. Personal stories may be helpful, but medical advice offered in a case history should be considered with a healthy dose of skepticism. There is a big difference between a website developed by a person with a financial interest in a topic and a website developed using strong scientific evidence. Reliable health information comes from scientific research that has been conducted in government, university, or private laboratories.

Who reviews the information?
Click on the “About Us” page to see if there is an editorial board that checks the information before putting it online. Find out if the editorial board members are experts in the subject you are researching. For example, an advisory board made up of attorneys and accountants is not medically authoritative. Some websites have a section called “About Our Writers” instead of an editorial policy. Dependable websites will tell you where the health information came from and how it has been reviewed.

When was the information written?
New research findings can make a difference in making medically smart choices. So it’s important to find out when the information you are reading was written. Look carefully on the home page to find out when the site was last updated. The date is often found at the bottom of the home page. Remember, older information isn’t useless. Many websites provide older articles so readers can get a historical view of the information.

Is your privacy protected?
This is important because, sadly, there is fraud on the Internet. Take time to read the website’s privacy policy – if the web site says something like, “We share information with companies that can provide you with products,” that’s a sign your information isn’t private.

Do not give out your Social Security number. If you are asked for personal information, be sure to find out how the information is being used by contacting the site sponsor. Be careful when buying things on the Internet. websites without security may not protect your credit card or bank account information. Look for information saying that a web site has a “secure server” before purchasing anything online.

Does the website make claims that seem too good to be true?
Be careful of claims that any one remedy will cure many different illnesses. Be skeptical of sensational writing or dramatic cures. Make sure you can find other websites with the same information. Don’t be fooled by a long list of links – any website can link to another, so no endorsement can be implied from a shared link. Take the “too good to be true” test – information that sounds unbelievable probably is unbelievable.

Use your common sense and good judgment when evaluating health information online. There are websites on nearly every conceivable health topic and no rules overseeing the quality of the information. Take a deep breath and think a bit before acting on any health information you find on the web. Don’t count on any one website. If possible, check with several sources to confirm the accuracy of your results. And remember to talk with your doctor.

 

Source: National Institute on Aging, www.nia.nih.gov.

This article was originally published in Coping® with Allergies & Asthma magazine, May/June 2010.

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Dey Pharma to Offer EpiPen 2-Pak® and EpiPen Jr 2-Pak® Exclusively

Dey Pharma will exclusively offer the EpiPen® 2-Pak and EpiPen Jr 2-Pak (epinephrine) Auto-Injectors to encourage people to follow recommendations by the National Institute of Allergy and Infectious Diseases, which state that people at risk for or who have experienced anaphylaxis should have immediate access to two doses of epinephrine. More specifically, the guidelines indicate that if a person responds poorly to the initial dose or has ongoing or progressive symptoms despite initial dosing, repeated dosing may be required.

The EpiPen and EpiPen Jr Auto-Injectors (0.3 and 0.15 mg epinephrine) are used for the injection of epinephrine, the first-line treatment for allergic emergencies (anaphylaxis). EpiPen Auto-Injector is used to treat signs and symptoms of an allergic emergency, some of which include hives, redness of the skin, tightness in the throat, breathing problems and/or a decrease in blood pressure. Allergic emergencies can be caused by triggers such as food, stinging and biting insects, medicines, latex, or even exercise.

You never know when an allergic emergency will occur, so it’s essential to be prepared. Make sure you speak with your health care professional about how to identify the signs and symptoms of an allergic emergency. If you, your child or someone you're caring for shows signs or symptoms of an allergic emergency, inject the health care professional-prescribed EpiPen or EpiPen Jr. immediately, then promptly call 911 and seek immediate medical attention.

EpiPen and EpiPen Jr Auto-Injectors are available in single cartons and 2-Pak cartons. It is important that patients at risk for allergic emergencies carry two doses of epinephrine. EpiPen 2-Pak provides an additional dose if needed during an allergic emergency. More than two doses of EpiPen Auto-Injector should only be administered under direct medical supervision. Talk to your health care professional if you need additional EpiPen Auto-Injector 2-Paks to keep at work, school or other locations. Each EpiPen 2-Pak also includes a training device.

While there is no safety issue with the EpiPen and EpiPen Jr single package, Dey will transition away from distributing and marketing these in the United States.

 

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2011.

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When Your Job Causes Asthma

Diagnosing and Managing Occupational Asthma

Bakers may develop an allergy and occupational asthma symptoms from exposure to various flours or baking enzymes.

Occupational asthma is caused by inhaling fumes, gases, dust, or other potentially harmful substances while “on the job.” Often, your symptoms are worse during the days or nights you work, improve when you have time off, and start again when you go back to work. You may have been healthy and this is the first time you’ve had asthma symptoms, or you may have had asthma as a child and it has returned. If you already have asthma, it may be worsened by being exposed to certain substances at work.

People with a family history of allergies are more likely to develop occupational asthma, particularly to some substances, such as flour, animals, and latex. But even if you don’t have a history, you can still develop this disease if you’re exposed to conditions that induce it. Also, if you smoke, you’re at a greater risk for developing asthma.

Prevalence
Occupational asthma has become the most common work-related lung disease in developed countries. However, the exact number of newly diagnosed cases of asthma in adults due to occupational exposure is unknown. Up to 15 percent of asthma cases in the United States may be job-related.

The rate of occupational asthma varies within individual industries. For example, in the detergent industry, inhaling a particular enzyme used to make washing powders has led to the development of symptoms in some exposed employees. About 5 percent of people working with laboratory animals or with powdered natural rubber latex gloves have developed occupational asthma.

Allergies play a role in many cases of occupational asthma.

Isocyanates are chemicals that are widely used in many industries, including spray painting, insulation installation, and in manufacturing plastics, rubber, and foam. These chemicals can cause asthma in up to 10 percent of exposed workers.

Causes
Irritants in high doses that induce occupational asthma include hydrochloric acid, sulfur dioxide, and ammonia, which is found in the petroleum and chemical industries. If you are exposed to any of these substances at high concentrations, you may begin wheezing and experiencing other asthma symptoms immediately after exposure. Workers who already have asthma or some other respiratory disorder may also experience an increase in their symptoms during exposure to these irritants.

Allergies play a role in many cases of occupational asthma. This type of asthma generally develops only after months or years of exposure to a workrelated substance. Your body’s immune system needs time to develop allergic antibodies or other immune responses to a particular substance.

For example, workers in the washing powder industry may develop an allergy to the enzymes of the bacteria Bacillus subtilis, while bakers may develop an allergy and occupational asthma symptoms from exposure to various flours or baking enzymes. Veterinarians, fishermen, and animal handlers in laboratories can develop allergic reactions to animal proteins. Healthcare workers can develop asthma from breathing in powdered proteins from latex gloves or from mixing powdered medications.

Occupational asthma can also occur in workers after repeated exposure to small chemical molecules in the air, such as with paint hardeners or in the plastic and resin industries.

The length of time you are exposed to a substance before it triggers your asthma varies. It can be months or years before symptoms occur. On the other hand, exposure to a high concentration of irritants can cause asthma within 24 hours.

Finally, inhaling some substances in aerosol form can directly lead to the buildup of naturally occurring chemicals in your body, such as histamine or acetylcholine within your lungs, which leads to asthma. For example, insecticides, used in agricultural work, can cause a buildup of acetylcholine, which causes your airway muscles to contract and tighten.

Diagnosis and Treatment
Many people with persistent asthma symptoms caused by substances at work are incorrectly diagnosed as having bronchitis. If occupational asthma is not correctly diagnosed early, and you aren’t protected or removed from the exposure, it can cause permanent changes to your lungs.

An allergist is the best qualified physician to determine if your symptoms are allergy- or asthma-related. Your allergist can properly diagnose the problem and develop a treatment plan to help you feel better and live better.

Once the cause of your symptoms is identified, you and your employer can work together to assure that you avoid exposure to the substance that triggers your asthma symptoms and to high concentrations of irritants. Also, you may need to avoid or reduce your exposure to irritants that can trigger symptoms in most asthmatics, such as smoke or cold air. In some cases, pretreatment with specific medications to protect against asthma worsened at work may be helpful. In other situations, particularly if you are very allergic to a substance in your workplace, avoiding the substance completely may be necessary.

 

Source: American Academy of Allergy, Asthma & Immunology, aaaai.org.

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2011.

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Allergies Getting Under Your Skin?

If you have red, bumpy, scaly, itchy, or swollen skin, is it because of a skin allergy? Here is a breakdown of the most common types of allergic skin conditions, what causes them, and how they can be treated.

Hives and Angioedema
Hives (or urticaria) are red, itchy, raised areas of the skin that can range in size and appear anywhere on your body. Most common are acute cases, where food or drug allergies are triggers. These hives usually go away within a few days. In cases of chronic hives, people may have them for months to years.

Angioedema is a swelling of the deeper layers of the skin that sometimes occurs with hives. Angioedema is usually not red or itchy. The areas often involved are the eyelids, lips, tongue, hands, and feet.

Food or drug reactions are a common cause of acute hives and angioedema. Viral or bacterial infection can also trigger hives in both adults and children. Physical urticaria is hives resulting from a nonallergic source: rubbing of the skin, cold, heat, physical exertion or exercise, pressure, and direct exposure to sunlight.

When certain substances come into contact with your skin, they may cause a rash called contact dermatitis.

If the cause of your hives can be identified, you should avoid that trigger. With acute hives, some drugs or foods may take days to leave the body, so your doctor may prescribe antihistamines to relieve your symptoms until that happens.

Contact Dermatitis
When certain substances come into contact with your skin, they may cause a rash called contact dermatitis. Irritant contact dermatitis is often more painful than itchy, and is caused by a substance damaging the part of your skin it comes into contact with. The longer your skin is in contact with the substance, or the stronger the substance is, the more severe your reaction will be. These reactions appear most often on the hands and are frequently work related.

Allergic contact dermatitis is best known by the itchy, red, blistered reaction experienced after you touch poison ivy. This allergic reaction is caused by a chemical in the plant called urushiol. You can have a reaction from touching other items the plant has come into contact with. However, once your skin has been washed, you cannot get another reaction from touching the rash or blisters. 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.

Nickel, perfumes, dyes, rubber (latex) products, and cosmetics also frequently cause allergic contact dermatitis. Some ingredients in medications applied to the skin can cause a reaction, most commonly neomycin, an ingredient in antibiotic creams. For irritant contact dermatitis, you should avoid the substance causing the reaction. You should also avoid spilling chemicals on your skin. Gloves can sometimes be helpful. Since these reactions are nonallergic, avoiding the substance will relieve your symptoms and prevent lasting damage to your skin.

Treatment for allergic contact dermatitis depends on how severe the symptoms are. Cold soaks and compresses can offer relief for the acute, early, itchy, blistered stage of your rash. You may also be prescribed topical corticosteroid creams. To prevent the reaction from returning, avoid contact with the offending substance. If you and your doctor cannot determine the substance that caused the reaction, your doctor may conduct a series of patch tests to help identify it.

Eczema
A common allergic reaction often affecting the face, elbows, and knees is atopic dermatitis, or eczema. This red, scaly, itchy rash is more common in young infants and those who have a personal or family history of allergy.

Common triggers include airborne allergens, such as cat dander or house dust, overheating or sweating, and contact with irritants, such as wool or soaps. In older individuals, emotional stress can cause a flare-up. For some people, usually children, certain foods can also trigger eczema. Skin staph infections can cause a flare-up in children as well. People with eczema usually have very dry skin and “allergic shiners” (an extra crease across their lower eyelids). They are also more at risk for other skin infections.

Preventing the eczema itch is the main goal of treatment. Do not scratch or rub your rash. Applying cold compresses and creams or ointments is helpful. Also, remove all irritants that aggravate your condition from your environment. If a food is identified as the cause, it must be eliminated from your diet.

Topical corticosteroid cream medications and topical calcineurin inhibitors are most effective in treating the rash. Antihistamines are often recommended to help relieve the itchiness. In severe cases, oral corticosteroids are also prescribed. If a skin staph infection is suspected to be a trigger for your eczema flare-up, antibiotics are often recommended.

 

Source: American Academy of Allergy, Asthma & Immunology, www.aaaai.org

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2011.

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Fall is Here!

Are Your Symptoms Under Control?

Now that summer has come to an end, it’s time to think about the new school year, fall allergies, and cooler weather. This is also a time when people with asthma may notice a change in their condition. Being prepared for these changes can make a big difference in keeping your or your child’s asthma well controlled.

Asthma & The New School Year
It is important for your child and the school staff to be prepared for managing asthma at school. The school staff should have information on how to help prevent symptoms and what to do if your child has symptoms.

Ask your doctor for a written asthma action plan for the school. This plan should include what medicine to use to treat asthma symptoms and changes in peak flow zones and what medicine to use as a pretreatment before exercise. Also include information on what makes your child’s asthma worse, his or her asthma symptoms, and emergency telephone numbers.

Plan a meeting with school staff. Your child also can be involved in the meeting. Take the written asthma action plan to the meeting. Helpful school staff members to have at the meeting are the school nurse, health aide, teacher, and physical education teacher. Topics to discuss at the meeting include

• What makes asthma worse, especially in the school setting
• Asthma symptoms, including your child’s awareness of symptoms
• Peak flow use (if used by your child), including technique and the use of peak flow zones
• Use of quick-relief medicine at school, including correct technique
• Who to call if the quick-relief medicine is not improving asthma symptoms or peak flow zones

The written asthma action plan will outline these steps. Discuss whether your child is responsible enough to keep the quick-relief medicine with him or her. If not, the quick-relief medicine should be quickly accessible when asthma symptoms occur at school.

Weeds and molds often cause fall allergies. Some seasons produce more pollen from weeds or mold spores because of weather conditions.

Continue talking with your child and school staff about managing asthma at school on a regular basis, even if everything is fine at school. Talk with your child’s doctor about when to keep him or her home from school due to worsening of asthma or illness. Mild asthma symptoms can often be handled at school. Talk with the school staff if your child misses school or homework.

Freedom From Fall Allergies
Weeds and molds often cause fall allergies. Some seasons produce more pollen from weeds or mold spores because of weather conditions. One of the primary weeds responsible for allergy symptoms is ragweed. A lot of rain in the spring and early summer, followed by sunny, hot days tend to produce more ragweed. Rainy days and piles of wet leaves lead to more mold growth.

If weed pollens or molds cause your allergy symptoms, plan outdoor activities for early in the day, as weed pollens are highest around midday. If you are outdoors during high pollen counts, take a shower, wash your hair, and change your clothes when you come indoors. If possible, keep windows and outside doors shut during pollen season. This is very important when pollen and mold counts are high. These counts are often reported on the TV news and in the newspaper. Stay away from wet leaves and garden trash.

Take the medicine your doctor recommends. Many different medicines are available to help control allergy symptoms when you can’t avoid the things to which you are allergic. Keep in mind that allergy medicines work best when you take them every day, and it is best to start taking them before you are exposed to high levels of pollen or mold. Most doctors recommend that you start an antihistamine when the allergy season begins and continue taking it every day until allergy season is over. When allergy season is in full swing and your immune system is in high gear, medicines are less effective and take longer to relieve symptoms.

Weathering Fall Weather
Fall is a season when a lot of weather changes can occur. Be prepared for changes in temperature and rainy days by having a sweater, jacket, or rain gear with you. With cooler weather approaching, this is also a good time to have your furnace checked and the filters replaced. In addition, it’s almost time for the yearly flu shot, so start watching for locations and times when flu shots will be given. Fall is a very busy time of year for most people. Keeping your allergies & asthma under control can help you enjoy this beautiful season.

 

Source: National Jewish Health, www.nationaljewish.org

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2011.

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Changes in Weather May Trigger Children’s Asthma

Changes in humidity and temperature result in an increase in Emergency Department (ED) visits for pediatric asthma exacerbation, according to a report published in Annals of Allergy, Asthma & Immunology.

“We found a strong relationship between temperature and humidity fluctuations with pediatric asthma exacerbations, but not barometric pressure,” says Dr. Nana A. Mireku, an allergist at Dallas Allergy Immunology private practice in Dallas, TX.

A 10 percent daily increase in humidity on a day or two before ED admission was associated with approximately one additional ED visit for asthma. Between-day changes in humidity from two to three days prior to admission were also associated with more ED visits. Daily changes in temperature on the day of or the day before admission increased ED visits, with a 10 degree Fahrenheit increase being association with 1.8 additional visits.

 

Source: Annals of Allergy, Asthma & Immunology, www.annallergy.org.

This article was originally published in Coping® with Allergies & Asthma magazine, September/October 2009.

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Living Well with COPD

Be sure to include fresh vegetables or fruit with every meal.

A healthy lifestyle is important for everyone, but it is especially important for people with chronic obstructive pulmonary disease. Here are some tips for making lifestyle changes and developing healthy habits to live a more active life with COPD.

Nutrition
Eating a balanced diet and maintaining a healthy weight are important parts of managing COPD. While it can be difficult to focus on this aspect of your life, eating well plays a big role in feeling good and staying healthy.

If you are underweight, focus on gaining weight. The average person requires approximately 50 calories per day for breathing. Individuals with COPD may expend 750 calories per day on breathing alone. This increases daily calorie requirements, making it difficult to maintain weight.

If you are overweight, focus on losing weight. There are many benefits of weight loss, including reducing shortness of breath by decreasing pressure on the diaphragm and respiratory muscles. A good weight loss program should include a variety of foods and physical activity.

Regular exercise can improve your heart, lungs, and muscles, and it can help you breathe easier and feel better.

There is no magic formula to maintaining your optimal weight. To lose weight you need to consume fewer calories than you expend, but many of us know this is easier said than done.

Try to eat small, frequent meals. This can help reduce shortness of breath caused by crowding of the diaphragm from overeating. Eating small, frequent meals also reduces incidents of reflux, which can lead to heartburn, indigestion, and discomfort with eating.

Eat a balanced diet. COPD can increase your requirements for calories and some nutrients. Proper nutrition helps your body’s immune response and aids its ability to metabolize medication properly. A balanced diet that includes every food group is essential. Be sure to include fresh vegetables or fruit with every meal.

Ask your doctor about meeting with a nutritionist to create a nutrition plan designed just for you. Not only will a nutritionist help with meal planning, but you’ll also have someone supporting and monitoring your progress.

Exercise
An exercise program is another important step in managing COPD. It is common for people with lung disease to limit physical activities because they are afraid of becoming short of breath. But regular exercise can improve your heart, lungs, and muscles, and it can help you breathe easier and feel better. Many people with COPD enjoy walking, water aerobics, and riding a stationary bike.

People with COPD often use a metered-dose inhaler before exercise to decrease shortness of breath. Some people with COPD need oxygen therapy while exercising. Portable oxygen units are available. Talk with your healthcare provider about recommending an exercise program for you.

Before starting an exercise program, always talk to your doctor about your plan to be sure that it is safe, and then speak with qualified experts about establishing a weight control program. Then, start with slow, small steps rather than attempting a quick “lifestyle overhaul.” Changing lifelong patterns is a gradual process, and succeeding in many little steps can be encouraging, where failing at a quick major change is definitely discouraging.

Giving Up Smoking
This is the single most important thing you can do to help control your disease and prevent further damage to your lungs. Cigarette smoke contains about 4,000 harmful toxins that can irritate airways and damage lung tissue. When you quit smoking, your breathing and response to your medicines may noticeably improve. Even if you have smoked many years, you will benefit from quitting. And don’t be discouraged if you have tried to quit – one time or many times – in the past. More services and quitting aids are now available to help you quit and remain smoke-free.

Make a firm commitment to quit and start thinking of yourself as someone who doesn’t smoke. Talk to your healthcare provider about quitting and making a plan to help you quit. Your doctor can discuss the use of quit smoking medicines and your treatment plan for COPD.

Consider participating in a program that provides guidance and support for learning to live without cigarettes. Every state offers free telephone counseling through the Quitline (800-QUIT-NOW). In addition, there are many online and face-to-face group quit smoking programs. Check for programs offered by the American Lung Association, American Heart Association, and American Cancer Society.

Once you stop smoking, it is important to avoid being around tobacco smoke. This will help decrease irritation to your lungs. Plus, a smoke-free environment is healthier for everyone. Discuss the importance of making your environment smoke-free with family members and friends. Encourage family members and friends who smoke to quit. If they are not ready to quit, ask them not to smoke in your home or vehicle.

 

Source: National Jewish Health, www.nationaljewish.org

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2011.

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Research Shows Heat in Chili Peppers Can Ease Sinus Problems

Hot chili peppers are known to make people "tear up,” but a new study led by University of Cincinnati allergy researcher Jonathan Bernstein, MD, found that a nasal spray containing an ingredient derived from hot chili peppers (Capsicum annum) may help people "clear up” certain types of sinus inflammation.

The study, which appears in the August 2011 edition of Annals of Allergy, Asthma & Immunology, compares the use of the Capsicum annum nasal spray to a placebo nasal spray in 44 subjects with a significant component of nonallergic rhinitis (i.e., nasal congestion, sinus pain, sinus pressure) for a period of two weeks.

Capsicum annum contains capsaicin, which is the main component of chili peppers and produces a hot sensation. Capsaicin is also the active ingredient in several topical medications used for temporary pain relief. It is approved for use by the U.S. Food and Drug Administration and is available over the counter.

"It is considered a significant advance because we don’t really have good therapies for non-allergic rhinitis."

"Basically, we concluded that the spray was safe and effective on non-allergic rhinitis,” Bernstein says of the study which showed that participants who used a nasal spray with Capsicum reported a faster onset of action or relief, on average within a minute of using the spray, than the control group.

Non-allergic rhinitis is an upper respiratory condition not caused by allergies but instead caused by environmental factors such as weather, household chemicals or perfumes; however, there are some people who have no triggers or don’t know what triggers are causing the inflammation, Bernstein says.

This is the first controlled trial where capsaicin was able to be used on a continuous basis to control symptoms. It is considered a significant advance, "because we don’t really have good therapies for non-allergic rhinitis,” says Bernstein, adding that in previous trials the ingredient was too hot to administer without anesthesia.

The study was funded by Dynova Laboratories. Bernstein, a professor in the division of immunology, allergy and rheumatology, at the UC College of Medicine, is a paid consultant for Dynova.

 

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Global Warming Extends Ragweed Allergy Season

SIx Tips to Combat Hay Fever Misery

Feel like there’s no end in sight when it comes to fall allergy misery? Blame global warming. Research suggests that with global warming, nasal allergy during the ragweed pollen season – also called hay fever or seasonal allergic rhinitis – lasts up to three weeks longer than it used to, and the further north you live, the longer you have to wait for relief.

Considered the most allergenic of all pollens, ragweed pops up in the Eastern and Midwest states everywhere starting in mid-August. One plant alone can produce up to one billion pollen grains, and each grain can travel more than 100 miles.

To help the one in 10 Americans affected by the sniffling, sneezing and itching of ragweed allergies, the American College of Allergy, Asthma and Immunology (ACAAI) and its allergist members suggest following these six steps:

• Get a jump start – Mark your calendar to remind you to take medication before ragweed allergy symptoms start. Mid-August is when the plant blooms in most of the country, but it’s a little later in the South.
• Keep the pollen outside out – Ragweed travels with the wind, so close windows in your house and car.
• Come clean – After spending time outdoors, shower, change and wash your clothes. Clean your nasal passages, too, by using a salt water rinse.
• Mask your misery – Wear a face mask when you garden or mow the lawn. Better yet, assign those tasks to family members who don’t suffer from hay fever.
• Consider a cure – If non-prescription medication isn’t doing the trick, it may be time to see an allergist who can provide more effective treatment. One option is immunotherapy – allergy shots. The treatment involves regular injections with pollen allergens. Immunotherapy can significantly lessen or get rid of nasal and eye allergy symptoms altogether. “Allergy shots can not only reduce allergy symptoms and medication use, it can prevent the development of asthma and the development of other allergies,” said allergist Dr. Myron Zitt, past president of ACAAI.
• Don’t let up too soon – Because the nasal and eye symptoms of associated with ragweed allergies can linger after the pollen can no longer be detected in the air , don’t stop your allergy medication immediately.

To learn more about asthma and allergies, including hay fever, and find an allergist near you visit www.AllergyAndAsthmaRelief.org.  

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Get the Scoop on Complementary and Alternative Medicine

Pharmacy shelves stocked with supplements – some even promising to treat allergies & asthma. Techniques such as yoga, massage, biofeedback, and acupuncture. What do these have in common? They are all considered complementary and alternative medicines, or CAM for short, and nearly 4 in 10 people use them in one form or another.

What is the difference between them? Alternative medicine is often used instead of conventional medical techniques, and complementary medicine is used along with medical approaches that are more traditional.

Do they work? Scientific evidence supports the use of some treatments or practices when used along with or in place of traditional medicine. But many others are not effective therapies and may even be dangerous, especially those that ask you to forgo treatment from your doctor. In addition, CAM can interfere with conventional medicines prescribed by your doctor – reducing benefits or increasing risks.

Unlike conventional medicines, CAM products are considered “supplements” and are not tested for safety and efficacy by the U.S. Food and Drug Administration.

Allergic Risks
If you have allergies or asthma, it is best to speak with your doctor before using CAM. Unlike conventional medicines, CAM products are considered “supplements” and are not tested for safety and efficacy by the U.S. Food and Drug Administration. Neither are they subject to quality controls or ingredient labeling laws. In addition, some manufacturers may not test their products, and there is no guarantee that you are purchasing a safe and effective form of the supplement. It can be extremely difficult to know what ingredients these supplements contain, potentially creating risk for people with food or medication allergies.

Know the Facts

• Up to 90 percent of American adults use or would consider using complementary and alternative medicines as part of their healthcare regimen.
• Tell your doctor if you are using any CAM therapies, as they may affect prescribed treatments.
• The most common reasons people use CAM are back pain, neck pain, joint pain, and depression or anxiety. Herbal remedies and deep breathing exercises are the most common complementary and alternative medicines used.

Herbal formulas can cause side effects and have been connected with severe reactions. Several cases of anaphylaxis, a life-threatening allergic reaction, have been reported from some herbal supplements. Some food supplements may also cause an allergic reaction. For example, people with a ragweed pollen allergy may also have an allergic reaction to chamomile tea.

As physicians learn more about CAM, there is agreement that some treatments can be very helpful when integrated into practices for health and well-being. For example, researchers are currently studying the effects of herbal medicines on food allergies. Early results suggest that some formulas may prevent severe allergic reactions to peanuts. Check with your doctor first to see if you should include CAM as part of your healthcare.

 

Source: American Academy of Allergy, Asthma & Immunology, www.aaaai.org

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2011.

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Air Pollution & Asthma

Your Questions Answered

Question: Could air pollution cause asthma?
Answer: In general, experts don’t think air pollution is one of the main causes of asthma, and that is because many parts of the world that have a lot of pollution don’t necessarily have higher rates of asthma. However, it is known that in urban areas of the United States, especially the inner city, there are higher rates of asthma. So air pollution may be one of the factors that cause asthma, but it’s probably not the main factor.

Question: Does air pollution affect asthma?
Answer: It’s very clear that air pollution can make asthma worse, so if you live in a city with a lot of air pollution, chances are you will have worse asthma than if you lived in a cleaner environment.

It’s very clear that air pollution can make asthma worse.

Question: What are symptoms of air pollution exposure?
Answer: Some of the symptoms of air pollution exposure include chest tightness, difficulty with . breathing in, and cough or wheezing. Certain types of air pollution, including carbon monoxide, can cause fatigue. Some types of air pollution can also cause eye irritation and nasal congestion.

Question: Who is most affected by air pollution?
Answer: The groups most affected by air pollution include children and the elderly. People with chronic diseases, such as emphysema, heart disease, and asthma, are also more susceptible than the general population. Experts have found that younger children are the most susceptible to air pollution-related changes in the lungs and that air pollution effects on health are greatest in children with under-controlled disease. Keeping a child’s asthma under good overall control with the proper use of medications and avoidance of daily triggers should help alleviate air pollution-related effects.

 

Source: National Jewish Health, www.nationaljewish.org

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2011.

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How Allergies Affect Your Child’s Ears, Nose, and Throat

Does your child have allergies?
Allergies can cause many ear, nose, and throat symptoms in children, but allergies can be difficult to separate from other causes. Here are some clues that allergy may be affecting your child.

Children with nasal allergies often have a history of other allergic tendencies. These may include early food allergies or atopic dermatitis in infancy. Children with nasal allergies are at higher risk for developing asthma.

Nasal allergies can cause sneezing, itching, nasal rubbing, nasal congestion, and nasal drainage. Usually, allergies are not the primary cause of these symptoms in children under four years old. In allergic children, these symptoms are caused by exposure to allergens (mostly pollens, dust, mold, and pet dander). Observing which time of year or in which environments the symptoms are worse can be important clues to share with your doctor.

Nasal congestion can contribute to sleep disorders, such as snoring and obstructive sleep apnea.

Ear Infections
One of children’s most common medical problems is otitis media, or middle ear infection. In most cases, allergies are not the main cause of ear infections in children under two years old. But in older children, allergies may play a role in ear infections, fluid behind the eardrum, or problems with uncomfortable ear pressure. Diagnosing and treating allergies may be an important part of healthy ears.

Sore Throats
Allergies may lead to the formation of too much mucus, which can make the nose run or drip down the back of the throat, leading to “post-nasal drip.” It can lead to cough, sore throats, and a husky voice.

Sleep Disorders
Chronic nasal obstruction is a frequent symptom of seasonal allergic rhinitis and perennial (year-round) allergic rhinitis. Nasal congestion can contribute to sleep disorders, such as snoring and obstructive sleep apnea, because the nasal airway is the normal breathing route during sleep. Fatigue is one of the most common, and most debilitating, allergic symptoms. Fatigue not only affects children’s quality of life; it also has been shown to affect school performance.

Pediatric Sinusitis
Allergies should be considered in children who have persistent or recurrent sinus disease. Depending on the age of your child, his or her individual history, and an exam, your doctor should be able to help you decide if allergies are likely. Some studies suggest that large adenoids (a tonsil-like tissue in the back of the nose) are more common in allergic children.

 

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2011.

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Cockroaches: The Little Known Culprits That Trigger Asthma Attacks and Allergies

The National Pest Management Association warns families that cockroaches are a leading trigger of allergies and asthma attacks. The pests’ saliva, droppings, and decomposing bodies contain allergen proteins known to trigger allergies and increase the severity of asthma symptoms, especially in children.

“Most people are aware of typical indoor allergens, including mold, pet dander, dust, and second-hand smoke, but they should also be mindful of any cockroach infestations in their home or other places, such as schools,” says Missy Henriksen, vice president of public affairs for the NPMA. “Cockroach allergens are typically found in areas that are hard to see, such as under appliances and sinks, so it’s important to periodically check those areas, keeping them clean and dry.”

The NPMA recommends these tips to prevent cockroaches from infesting your home:

• Seal cracks around the outside of the home to prevent pest entryways.
• Vacuum frequently and dispose of garbage regularly.
• Keep counters and floors clean and free of crumbs that attract pests.
• Pay extra attention to kitchens and bathrooms – especially under appliances and sinks – as these areas are particularly vulnerable to cockroach infestations.
• If you suspect an infestation, contact a licensed pest professional to identify the species and recommend a course of treatment.

To learn more about cockroaches and the health threats they pose, or to find a licensed pest professional, visit pestworld.org.  

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2011.

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Back on Track

How to Breathe Easier When Exercising

Are you or someone you care about running into breathing difficulties when playing sports or working out? Exercise-induced bronchoconstriction, or EIB, is a serious but treatable condition that affects as many as 9 in 10 people with asthma, as well as 10 percent of people without it. Get back in the game by knowing your risk and taking steps to prevent symptoms.

What is EIB?
EIB causes the linings of the lungs’ airways to become inflamed and swollen during or after exercise. Muscle spasms constrict airflow, making it difficult to breathe. Symptoms include shortness of breath, wheezing or noisy breathing, coughing, trouble getting a breath, chest tightness, and unusual fatigue. Symptoms may start after a few minutes of hard, continuous exercise, or may not appear until several minutes after you stop.

People with EIB and asthma should not have to stop exercising if their condition is properly treated

About 80 percent to 90 percent of the 23 million adults with asthma, including 7 million children, have EIB. One in 10 members of the general population has EIB, too. The condition also is common among elite athletes who exercise strenuously over prolonged periods.

Can I still exercise?
People with EIB and asthma should not have to stop exercising if their condition is properly treated to prevent symptoms before they occur.

What causes EIB?
Rapid breathing during exercise can cause the airways to dry out and become irritated. As a result, the airways actually get smaller, and it’s hard to get air in and out of your lungs. This is more likely to happen when you exercise in cold, dry air, or when there is a sudden change in temperature or humidity. Breathing through the mouth, which does not warm and humidify the air like the nose, can make symptoms worse.

How is EIB diagnosed?
It is important that people with EIB or EIB with asthma see an allergist to be diagnosed and treated early to help prevent damage to the lungs. When EIB is the only symptom of asthma, it may be hard to diagnose, since coughing or shortness of breath during exercise may have many causes. See a doctor when

• breathing difficulties are interfering with daily activities.
• breathing problems are decreasing quality of life.
• warning signs of asthma are present, including shortness of breath; wheezing or coughing, especially at night or after exercise; tightness in the chest; or frequent attacks of breathlessness, despite previous diagnosis and treatment for asthma.

Tips & Treatments to Prevent or Reduce EIB Symptoms

• Warm up at least 10 minutes before exercise.
• Breathe through your nose – it warms and humidifies the air.
• Use a facemask or scarf when exercising in cold weather.
• Limit exercise if you have a viral infection, such as a cold, or when the air temperature is cold. • Cool down after exercise.
• If you have EIB with allergies and asthma, avoid exercising outside when pollen counts are high or around pets if these are allergy triggers.
• If you are an elite athlete with EIB alone, cross training and some restriction of activities (for example, limiting training to 20 hours per week) may be recommended.
• Consider walking, hiking, golf, baseball, football, gymnastics, swimming, and shorter track and field events, which are less likely to trigger the condition than endurance sports such as running, biking, soccer, and basketball.
• Even if your symptoms are mild, seek treatment to prevent damage to your lungs.
• See your allergist to discuss controlling EIB with prescribed medications. Quick-relief medications are used to open the lungs’ airways shortly before exercise. A short-acting inhaler – or bronchodilator – is carried at all times when exercising to stop symptoms when they start. Long-acting medications and inhaled corticosteroids are taken twice daily and can provide 12-hour control.

 

Click here to learn more about free asthma and EIB screenings being conducted in May 2011.

Source: American College of Allergy, Asthma & Immunology, AllergyandAsthmaRelief.org

This article was originally published in Coping® with Allergies & Asthma magazine, March/April 2011.

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Teaching Your Child About Asthma

by Anthony Martinez, BS, and Richard W. Honsinger, MD, MACP, FAAAAI

Your child has just been diagnosed with asthma. Are you ready to explain this complex disease in terms your child can understand? Here are some tips.

Keep it simple.
Don’t get bogged down in the details. When explaining asthma to your child, use simple terms. Making use of diagrams can help describe the disease to your child. Asthma is a temporary blocking of airways due to tightening of muscle surrounding the airways, mucous buildup in the airways, or swelling (inflammation) of the airways.

Talk about triggers.
Diagnosing the precise cause of asthma is sometimes difficult because two or more triggers may be present in one child. Examples of common asthma triggers are

• allergens, such as pollen or pets;
• irritants, such as second-hand smoke;
• medicines (over the counter or prescription);
• exercise (known as exercise-induced asthma); and
• colds, other viruses, or respiratory infections.

Knowing what causes your child’s symptoms is important. An allergist has specialized training and experience to help determine what is causing your child’s asthma and how to treat it.

Understand treatment.
Talk to your physician about current treatment guidelines for children with asthma. Your physician should take an active role in making sure both you and your child know how to properly use an inhaler, a nebulizer, a spacer, a peak flow meter, and any other medicines or devices that are needed for proper treatment and management.

Prepare for an emergency.
Despite your best efforts, your child may experience severe asthma symptoms that make it hard to breathe. It may be necessary for your child to have more than one inhaler. A short-acting inhaler, or rescue inhaler, helps quickly relieve the tightening of the muscle surrounding the airways. This inhaler is used in addition to daily treatment prescribed by your doctor; it is not a replacement. Put a sticker on the rescue inhaler or write “Rescue” or “911” in bold along the side of the inhaler so your child can easily identify it in the event of an emergency.

 

Source: American Academy of Allergy, Asthma & Immunology, www.aaaai.org

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2011.

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Have Food Allergies? Read the Label.

Since 2006, it has been much easier for people allergic to certain foods to avoid packaged products that contain them, says Rhonda Kane, a registered dietitian and consumer safety officer at the U.S. Food and Drug Administration.

This is because a federal law requires that the labels of most packaged foods marketed in the U.S. disclose – in simple-to-understand terms – when they are made with a “major food allergen.”

Eight foods, and ingredients containing their proteins, are defined as major food allergens. These foods account for 90 percent of all food allergies:

• milk
• egg
• fish, such as bass, flounder, or cod
• crustacean shellfish, such as crab, lobster, or shrimp
• tree nuts, such as almonds, pecans, or walnuts
• wheat
• peanuts
• soybeans

The law allows manufacturers a choice in how they identify the specific “food source names,” such as milk, cod, shrimp, or walnuts, of the major food allergens on the label. They must be declared either in
• the ingredient list, such as “casein (milk)” or “nonfat dry milk,” or
• a separate “Contains” statement, such as “Contains milk,” placed immediately after or next to the ingredient list.

Some manufacturers voluntarily include a “may contain” statement on their labels when there is a chance that a food allergen could be present.

“So first look for the ‘Contains’ statement, and if your allergen is listed, put the product back on the shelf,” says Kane. “If there is no ‘Contains’ statement, it’s very important to read the entire ingredient list to see if your allergen is present. If you see its name even once, it’s back to the shelf for that food too.”

Many different ingredients can contain the same major food allergen, but sometimes the ingredients’ names do not indicate their specific food sources. For example, casein, sodium caseinate, and whey are all milk proteins. Although the same allergen can be present in multiple ingredients, its “food source name” (for example, milk) must appear in the ingredient list just once to comply with labeling requirements.

“Contains” and “May Contain” Have Different Meanings If a “Contains” statement appears on a food label, it must include the food source names of all major food allergens used as ingredients. For example, if whey, egg yolks, and a natural flavor that contained peanut proteins are listed as ingredients, the “Contains” statement must identify the words milk, egg, and peanuts.

Some manufacturers voluntarily include a “may contain” statement on their labels when there is a chance that a food allergen could be present. A manufacturer might use the same equipment to make different products. Even after cleaning this equipment, a small amount of an allergen (such as peanuts) that was used to make one product (such as cookies) may become part of another product (such as crackers). In this case, the cracker label might state, “may contain peanuts.”

“Be aware that the ‘may contain’ statement is voluntary,” says Kane. “You still need to read the ingredient list to see if the product contains your allergen.”

When in Doubt, Leave It Out Manufacturers can change their products’ ingredients at any time, so Kane says it’s a good idea to check the ingredient list every time you buy the product — even if you have eaten it before and didn’t have an allergic reaction.

“If you’re unsure about whether a food contains any ingredient to which you are sensitive, don’t buy the product, or check with the manufacturer first to ask what it contains,” says Kane. “We all want convenience, but it’s not worth playing Russian roulette with your life or that of someone under your care.”

 

Source: U.S. Food and Drug Administration, www.fda.gov

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2011.

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EPA Launches New Air Quality Forecast Service

The U.S. Environmental Protection Agency has teamed up with state and local agencies to create EnviroFlash, a free service that provides the air quality forecast to a subscriber’s email or cellphone. By knowing when the air quality is unhealthy, subscribers can take measures to protect their health and the health of their family. You can sign up for EnviroFlash at www.enviroflash.info by entering your email address and zip code. You can then choose to be notified daily or only when the air quality is unhealthy.

 

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2011.

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Asthma Associated with Increased Risk of Diabetes, Heart Disease

The Centers for Disease Control and Prevention (CDC) estimates that asthma affects approximately 24.6 million people in the United States. But are asthmatics more likely to have other chronic conditions as well? According to a new population-based study presented at the 2011 Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI), asthma appears to be linked to an increased risk of developing diabetes and heart disease.

“Asthmatics have a more allergy-prone immune environment called T-helper 2 (Th2) immune profile. This Th2 immune profile has a delicate balance with a counter-regulatory one called Th1 immune profile, which underlies proinflammatory conditions such as coronary artery disease, diabetes, rheumatoid arthritis and inflammatory bowel syndrome,” explained study author Young J. Juhn, MD, MPH. “Thus, one can hypothesize that there may be an inverse relationship between asthma and these proinflammatory conditions.”

When comparing the age- and gender-adjusted incidence of these conditions between individuals with and without asthma, the researchers found that asthma was associated with increased risks of developing diabetes and heart disease.

To examine the possible link, researchers from Mayo Clinic and Olmsted Medical Center in Rochester, Minn., performed a retrospective cohort study and enrolled asthmatics and age- and gender-matched non-asthmatics from Rochester residents between 1964 and 1983.

During the study period, a total of 2,392 asthmatic subjects and 4,784 subjects without asthma were enrolled, of which 57% were male and 98% were Caucasian. Researchers calculated age and gender-adjusted incidence rates of inflammatory bowel syndrome, rheumatoid arthritis, diabetes and coronary artery disease by using medical index codes.

When comparing the age- and gender-adjusted incidence of these conditions between individuals with and without asthma, the researchers found that asthma was associated with increased risks of developing diabetes and heart disease but not inflammatory bowel syndrome and rheumatoid arthritis. The incidence rate of diabetes in non-asthmatics was 104 per 100,000 people compared to 138.4 per 100,000 people in asthmatics. For heart disease, the incidence rate in non-asthmatics was 134 per 100,000 people versus 188.6 per 100,000 in asthmatics.

“While it’s important for clinicians to be aware of the increased risks of coronary artery disease and diabetes in asthmatics, these findings should be interpreted cautiously given the preliminary nature,” emphasized Juhn. “Given the significant proportion of people affected by asthma, we need to continue to carefully monitor the potential impact of asthma epidemiology on the epidemiology of other chronic diseases.”

The AAAAI represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic disease. Established in 1943, the AAAAI has more than 6,500 members in the United States, Canada and 60 other countries. Visit www.aaaai.org for more resources and expert advice from allergists.

 

This study was presented during the 2011 Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI) on March 18-22 in San Francisco. However, it does not necessarily reflect the policies or the opinions of the AAAAI. A link to all abstracts presented at the Annual Meeting is available at www.annualmeeting.aaaai.org.

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House Dust Mite Test on Wheezy Toddlers Predicts Asthma in Teen Years

Wheezy toddlers who have a sensitivity to house dust mites are more at risk of developing asthma by the age of 12.

Children aged one – two years with a family history of allergy, who had a positive skin prick test to house dust mites, had a higher risk of developing asthma later in life. Results showed 75 per cent of these children had asthma at aged 12 compared to 36 per cent of children without a positive skin prick test.

Lead author Dr Caroline Lodge from the University of Melbourne’s School of Population Health said the identification of house dust mites as a predictor for asthma in high risk children, is a significant step forward in identifying high risk groups on whom we can trial interventions.

“Our findings provide researchers with a more targeted group of at risk children, for investigating strategies to prevent asthma later in life,” she said.

“House dust mite sensitivity amongst wheezy toddlers could be used as a clinical tool to assist parents in understanding the risk of asthma in their children.

Previous studies have revealed that efforts to eradicate house dust mites have been ineffective.

“Although currently there is no known intervention to stop asthma developing, identifying children at higher risk may lead to more tailored treatments of wheeze in this high risk group.”

The study followed 620 children, with a family history of allergies, from birth to 12 years old. Researchers tested the children at the ages of one and two years, for single and multiple sensitivity to milk, egg, peanut, rye grass, cat and house hold dust mites and then again at the age of 12 for having asthma.

“We found in the children aged one – two years, that whatever the mix of sensitivity, if their skin reacted to house dust mites they had a higher chance of developing asthma later in life,” Dr Lodge said.

“Our study did not show house dust mite caused asthma but it highlighted a strong correlation between sensitivity and more severe wheeze and asthma.

“House dust mites are common in our environment. They are something we have to live with everyday. Previous studies have revealed that efforts to eradicate house dust mites have been ineffective.”

The study was published in the Journal of Allergy and Clinical Immunology. Collaborators involved in the study are the Murdoch Childrens Research Institute, Monash University and the Royal Children’s Hospital.

The study is part of a broader project to investigate sensitivity and allergy and their link to asthma.

 

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The Buzz on Insect Sting Allergy

When an insect stings most people, the site develops redness, swelling, and itching. However, some people are actually allergic to insect stings. This means that their immune systems overreact to the venom.

If you are insect-allergic, after the first sting, your body produces antibodies called Immunoglobulin E (IgE). If stung again by the same kind of insect, the venom interacts with this specific IgE antibody, triggering the release of substances that cause an allergic reaction.

Symptoms of a Severe Reaction
For a small number of people with venom allergy, stings may be life threatening. This reaction is called anaphylaxis. Symptoms may include two or more of the following: itching and hives, swelling in the throat or tongue, difficulty breathing, dizziness, stomach cramps, nausea, or diarrhea. In severe cases, a rapid fall in blood pressure may result in shock and loss of consciousness. Anaphylaxis is a medical emergency and may be fatal. If you have these symptoms after an insect sting, get emergency medical treatment.

Identifying Stinging Insects
To avoid stinging insects, it is important to identify them. Yellow jackets’ nests are made of a paper-maché material and are usually located underground, but can sometimes be found in the walls of frame buildings, cracks in masonry, or woodpiles.

Honeybees and bumblebees are nonaggressive and will only sting when provoked. However, Africanized honeybees (AKA “killer bees”) found in the Southwestern United States are more aggressive and may sting in swarms. Domesticated honeybees live in manmade hives, while wild honeybees live in colonies or “honeycombs” in hollow trees or cavities of buildings.

If flying stinging insects are close by, remain calm and move slowly away.

Paper wasps’ nests are usually made of a paper-like material that forms a circular comb of cells that opens downward. The nests are often located under eaves, behind shutters, or in shrubs or woodpiles.

Hornets are usually larger than yellow jackets. Their nests are gray or brown, football-shaped, and made of a paper material similar to that of yellow jackets’ nests. Hornets’ nests are usually found high above ground on branches of trees, in shrubbery, on gables or in tree hollows.

Fire ants build nests of dirt in the ground that may be quite tall (18 inches) in the right kinds of soil.

Preventing Stings
Stay away! These insects are most likely to sting if their homes are disturbed, so it is important to have nests around your home destroyed.

If flying stinging insects are close by, remain calm and move slowly away. Avoid brightly colored clothing and perfume when outdoors. Because the smell of food attracts insects, be careful outdoors when cooking, eating, or drinking sweet drinks like soda or juice. Beware of insects inside straws or canned drinks. Keep food covered until eaten. Wear closed-toe shoes outdoors and avoid going barefoot. Also, avoid loose-fitting garments that can trap insects between material and skin.

Treating Stings
If the insect left its stinger in your skin, remove the stinger within 30 seconds to avoid receiving more venom. A quick scrape of your fingernail removes the stinger and sac. Avoid squeezing the sac – this forces more venom through the stinger and into your skin. For all stinging insects, try to remain calm, and brush these insects from the skin. Then immediately leave the area. The following steps can help in treating local reactions to insect stings:

• Raise the affected limb and apply a cold compress to reduce swelling and pain.
• Gently clean area with soap and water to prevent secondary infections; do not break blisters.
• Use topical steroid ointments or oral antihistamines to relieve itching.
• See your physician if swelling progresses or if the sting site seems infected.

If you are severely insect-allergic, carry auto-injectable epinephrine. Learn how and when to self-administer the epinephrine, and replace the device before the labeled expiration date.

Remember that epinephrine is a rescue medication only, and you must still have someone take you to an emergency room immediately if you are stung. Those with severe allergies may want to consider wearing a bracelet or necklace that identifies the wearer as having severe allergies.

Consult Your Doctor
If you have had a serious reaction to an insect sting, make an appointment with an allergist. With proper testing, he or she can diagnose your allergy and determine the best form of treatment. In many cases, insect venom allergy shots (or immunotherapy) are very effective.

With a proper diagnosis, treatment plan, and careful avoidance, people with an insect allergy can feel more confident and enjoy being outdoors.

 

Source: American Academy of Allergy, Asthma & Immunology, www.aaaai.org

This article was originally published in Coping® with Allergies & Asthma magazine, May/June 2011.

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Study up for a Sneeze and Wheeze-Free School Year

Make the Grade by Avoiding Asthma, Allergy Triggers Lurking in the Classroom

The new school year means new clothes, new classes, new teachers – and the same old misery due to sneezing and wheezing for children who have allergies or asthma. From the class hamster to dust mites residing in carpet to germs from cold and flu viruses, asthma and allergy triggers lurk throughout the classroom.

It’s not so surprising, then, that back-to-school season is associated with a 46 percent increase in asthma-related emergency department visits by grade school children. And allergies and asthma account for more than 14 million school day absences. But seeing an allergist can keep kids in the classroom: studies show patients treated by allergists for asthma have better symptom control, including less wheezing and fewer absences, at lower costs.

“To keep kids focused on their studies instead of their allergy and asthma symptoms, it’s important that they see an allergist for proper diagnosis and treatment, as well as work with their parents to develop a plan for avoiding classroom triggers,” said allergist Dr. Myron Zitt, past president of the American College of Allergy, Asthma and Immunology (ACAAI).

If your child is sneezing, wheezing and itching at school and you’re not sure why, see an allergist to find out what’s causing the problem and find relief.

Make sure your child doesn’t suffer or miss school by following the below advice from the American College of Allergy, Asthma and Immunology (ACAAI) and its allergist members.

Dust and mold and pollen, oh my
Many common triggers lie in wait for the allergic student. Dust mites and other allergens multiply in the class carpet, so suggest your child sit in a chair to read a book. Mold can grow in bathrooms and other dank areas, but are easily cleaned if brought to the janitor’s attention. And ask teachers to keep windows closed this fall and next spring to keep sneeze-prompting pollens out of the classroom.

The germ incubator
It’s tough for the child with asthma to avoid germs at school, since they are pretty much everywhere from the pencil sharpener to the edge of the teacher’s desk. The best defense is a good offense, so be sure your child gets a seasonal flu shot. Washing hands regularly and using tissues and antibacterial hand sanitizers also can help.

Tag, you’re – huff, puff – it
Jumping jacks during gym, tag during recess, soccer after school – these and other common school activities can trigger exercise-induced bronchoconstriction (EIB), commonly referred to as exercise induced asthma. About 80 percent to 90 percent of those with asthma have EIB and 10 percent of people without asthma have EIB. If your child has difficulty breathing during or after exercise, see an allergist who can work with you on a prevention and treatment plan. Be sure to give teachers, from gym to homeroom, a heads up and make sure your child has medication available at school.

Fear of furry friends
Kids love class pets, but many have allergies to the hairy or furry variety. Allergic children should be reminded not to touch the pet. You also might suggest the teacher consider a non-furry pet, such as fish or a hermit crab, which offer plenty of learning opportunities without the allergy-triggering dander. Children who have pets at home also may have pet dander on their clothes, triggering symptoms in a pet-allergic child. A new seat assignment may help.

Food safety patrol
If your child has food allergies, potential problems can crop up almost anywhere, from the lunchroom to the classroom. Tell the teacher about foods that cause problems for your child. Also be sure to alert scouting and other club leaders, and suggest an allergen-free snack policy). It‘s also important to teach your child about what foods might trigger a reaction and advise them to ask a teacher or adult before eating food they are unsure about. Share a plan with teachers, coaches and the school nurse for dealing with an allergic emergency and make sure your child has medications with them like injectable epinephrine.

The back of the class
Sitting at the front of the classroom – near the chalkboard – is a bad idea for kids whose allergies or asthma are triggered by chalk dust. And washing hands after writing on the chalk board is a must.

If your child is sneezing, wheezing and itching at school and you’re not sure why, see an allergist to find out what’s causing the problem and find relief.

 

For more information about allergies in children, asthma in children, and to find an allergist or take a self-relief test visit www.AllergyAndAsthmaRelief.org.

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Allergists Update Stinging Insect Guidelines

Summer brings bees, wasps, hornets, and yellow jackets, and this year, updated advice for those who are allergic to these pesky stinging insects. The American College of Allergy, Asthma and Immunology recently published updated guidelines for diagnosing and treating stinging insect hypersensitivity. Here are three key highlights for those who are allergic.

Give immunotherapy a shot.
A growing body of research indicates that immunotherapy (also called allergy shots) is effective in preventing reactions. The treatment works like a vaccine, exposing you to increasing amounts of the stinging insect allergen to build your immune system’s tolerance to it. By eliminating the allergic reaction, the treatment also can improve the quality of life for people who are terrified of being stung. While an epinephrine injection is the most immediate way to treat an allergic reaction at the time of a sting, venom immunotherapy is the only way to actually prevent the reaction from starting.

Beware the flight of the bumblebee.
Although typically considered less aggressive, bumblebees are increasingly causing severe allergic reactions, particularly in greenhouse workers. They should be avoided as much as other stinging insects.

Watch out for risk factors.
Some people are at increased risk for serious reactions. High-risk people include those who have a history of severe or near-fatal reaction to a stinging insect; have heart disease, high blood pressure, or pulmonary disease; have had a reaction beyond the site of a sting; have asthma; take beta blocker or ACE inhibitor medications; or have frequent unavoidable exposure, including beekeepers and gardeners.

Tips for Avoiding the Stings of Summer

⋄ Keep food covered when eating outdoors.
⋄ Don’t drink beverages outdoors from cans or straws. Stinging insects are attracted to the sweetness and may crawl inside the can or straw.
⋄ Cover garbage cans stored outside with tight-fitting lids.
⋄ Avoid areas where stinging insects are swarming.

“For most people, an insect sting means nothing more than a little pain, swelling, and redness. This is a normal reaction and can be treated at home,” says Richard Nicklas, MD, ACAAI spokesperson and one of the authors of the updated guidelines. “An allergic reaction is more severe and often includes hives, itching, and swelling in areas other than the sting site. These reactions require immediate medical attention.”

Symptoms of a severe allergic reaction, also called anaphylaxis, might include not only skin symptoms, but also tightness in the chest and difficulty breathing; swelling of the tongue, throat, nose, and lips; and dizziness and fainting or loss of consciousness, which can lead to shock and heart failure. These symptoms require immediate attention at the nearest emergency room, where epinephrine will be administered.

The ACAAI recommends anyone who has an allergic reaction to an insect sting see an allergist to determine the best course of treatment. An allergist can prescribe an epinephrine kit and teach you and your family members how to administer an injection to treat severe reactions. Allergists can also determine if you are a candidate for venom immunotherapy.

 

Source: American College of Allergy, Asthma & Immunology, AllergyandAsthmaRelief.org

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2011.

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Possible Association Between Maternal Exposure to Magnetic Fields and Development of Asthma in Children

Children whose mothers had high exposure to magnetic fields (MF) during pregnancy appear to have an increased risk of developing asthma, according to a report published Online First by Archives of Pediatrics and Adolescent Medicine, one of the JAMA/Archives journals.

  According to the article, asthma is a common condition in children, affecting 13 percent of the U.S. population younger than 18 years, and having health and economic consequences. The authors note that asthma prevalence increased roughly 74 percent from 1980 to 1996 and that research on the potential risk of environmental physical exposures has been limited. Citing an increase in man-made electromagnetic fields (EMFs) from power lines, appliances, wireless networks and wireless devices, and other research possibly connecting EMFs to adverse health outcomes, they write, “This parallel increase in both EMF exposure and asthma prevalence in the past several decades warrants examination.”

Researchers observed a statistically significant linear dose-response relationship between increasing maternal median daily magnetic field exposure level during pregnancy and an increased risk of asthma in children.

  De-Kun Li, MD, PhD, and colleagues from Kaiser Permanente, Oakland, Calif., conducted a prospective cohort study to examine the association between maternal exposure to high levels of MFs during pregnancy and risk of asthma in offspring. From 1996 to 1998, the authors recruited pregnant women who were members of Kaiser Permanente Northern California in the San Francisco area. Participants wore a meter that measured their MF levels for 24 hours, and then rated whether their activities during that period were typical. Offspring were followed until they received a diagnosis of asthma, they left the health system’s care or the study period ended in August 2010.

  During the 13 years of follow-up, 130 children (20.8 percent of the study participants) developed asthma, with most cases diagnosed by 5 years of age. Researchers observed a statistically significant linear dose-response relationship between increasing maternal median daily MF exposure level during pregnancy and an increased risk of asthma in children. Every one-milligauss increase in a pregnant woman’s median MF exposure was associated with a 15 percent increase in the risk of the child developing asthma. The association was especially strong for firstborn children and those whose mothers had a history of asthma, two known risk factors for the condition.

  “In conclusion, the findings of the present study open up a new area in understanding the risk factors for asthma and the health effects of ubiquitous MF exposure, especially during pregnancy,” the authors state. “As with any epidemiological study, these findings need to be replicated. If confirmed, they have the potential to inform new intervention strategies to reduce asthma, the most prevalent chronic disease among children.”

 

This article was originally published in Coping® with Allergies & Asthma magazine, 2011.

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Your Ragweed Survival Guide

August marks the start of allergy season for as many as one in five Americans who get hay fever, also called seasonal allergic rhinitis, each year. That’s because ragweed, the main cause of hay fever, begins blooming around mid-August. And in one day, each plant can produce a million pollen grains that can travel for miles from its source.

“Ragweed can bring on sneezing, stuffy nose, and watery eyes,” says allergist James Sublett, MD, chair of the American College of Allergy, Asthma and Immunology’s public relations committee. “But there are lots of things people can do to find relief until the first freeze comes along.”

Beat symptoms to the punch.
Get a jump-start on ragweed allergy symptoms by taking allergy medications in advance, beginning the first or second week in August.

Beware of other allergies that increase symptoms.
If you’re allergic to dogs, cats, or dust mites, you may be even more susceptible to ragweed allergy. New research suggests these allergies “prime” the system, making hay fever even worse. The solution? Get treated for allergies year-round, which will make hay fever easier to tolerate.

Avoid peak exposure time.
To reduce exposure during peak pollen levels, avoid scheduling outdoor activities between 5 a.m. and 10 a.m. when ragweed pollen counts are highest.

Sidestep yard work.
People who have hay fever should avoid mowing the lawn and raking leaves, two activities that stir up pollen. If you must mow or rake, or are doing other outside activities, such as gardening, wear a National Institute for Occupational Safety and Health-approved N95 respirator mask.

Grab some shade(s).
Use style to your allergy advantage. Wear glasses or sunglasses that fit close to your face to keep pollen from irritating your eyes.

Steer clear of irritants.
Reduce your exposure to air pollutants, such as cigarette smoke, insecticides, fertilizers, gasoline fumes, fresh paint, and tar, which can worsen your symptoms.

Get tested.
Those who suspect they have hay fever or other allergies should be tested by an allergist – a doctor who is expert in diagnosing and treating allergies and asthma.

 

Source: American College of Allergy, Asthma & Immunology, www.AllergyandAsthmaRelief.org

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2011.

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Highlights of the American Thoracic Society 2011 International Conference

The American Thoracic Society 2011 International Conference was held on May 13-18 Denver, Colorado. More than 800 speakers presented over 5,500 scientific abstracts and case studies.

"The depth and breadth of research presented at the meeting is unparalleled. The conference represents the highest quality of respiratory and pulmonary science in the world. If you want people in the pulmonary community to know about your work, this venue is paramount," said Reynold Panettieri, Jr., MD.

Postponing Care Can Result in Serious Consequences for People with Asthma
Waiting to seek emergency medical care for asthma exacerbations can result in worse outcomes, including hospitalization, according to a new study. Asthmatics who delay regular medical care also were sicker when finally seen by a doctor than those who sought care when asthma exacerbations first occurred.

“An important aspect of managing asthma is for patients to realize when they can handle exacerbations with help from their regular doctors, and when they need the more intense treatment the emergency room provides,” said lead author Carol Mancuso, MD, associate professor of Medicine at the Hospital for Special Surgery, Weill Cornell Medical College in New York, NY. “It is preferable to get help early from regular doctors and avoid the emergency room. However, when intense treatment is necessary, then the sooner patients present to the emergency room the better, because then they are not as sick and are less likely to be hospitalized.”

Researchers found that asthmatics who postponed treatment were not more likely to consult physicians before coming to the emergency department than those who sought early treatment. They also were not more likely to have used beta agonists, medications that are typically prescribed to treat asthma flare-ups. But they were more likely to be sicker on arrival to the emergency room, and more likely to be admitted to the hospital for asthma than those who sought earlier care.

Study Evaluates Parents’ Reluctance to Vaccinate Asthmatic Kids
Concern over vaccine safety is one of the primary factors preventing parents from having their asthmatic children vaccinated for influenza, according to researchers. Parents who do not vaccinate their children are also less likely to view flu as a trigger for their child’s asthma, the researchers noted.

“When school starts in the fall, and during the winter season, many parents start dreading the cold and flu season,” said lead author Toby Lewis, MD, MPH, assistant professor of Pediatric Pulmonology at C.S. Mott Children’s Hospital in Ann Arbor, MI. “This is particularly true for parents of children with asthma, who recognize that ‘a little cold’ can quickly trigger an asthma attack. Fortunately, there is something that can be done to reduce the chances of getting sick from influenza, and that is getting a vaccination to help prevent this infection.”

The study found that parents who did not vaccinate their asthmatic children against influenza were less likely than those who did vaccinate to indicate that getting a viral infection was a “very important” trigger of their child’s asthma, and were more likely to be concerned about vaccine side effects and getting sick from the vaccine itself.

 

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2011.

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Don’t Let Allergies & Asthma Spoil a Summer Soiree

Six Tips to Avoid Allergy and Asthma Symptoms While Enjoying Outdoor Events

Summertime means outdoor fun at weddings, festivals, and picnics. But uninvited guests ranging from stinging insects to grass pollen can ruin the fun for people with allergies & asthma.

Allergies and asthma can lead to sneezing, wheezing, and itchiness – and sometimes more serious reactions – turning a joyous occasion sour.

“By planning ahead, people with allergies can still enjoy outdoor events,” says Dr. Myron Zitt, past president of the American College of Allergy, Asthma and Immunology.

Here are six simple tips to make summer soirees more enjoyable.

1 Treat before you go.
Take allergy medication before walking out the door. If you wait until symptoms kick in, the medication won’t be nearly as effective.

2 Go undercover.
Big, wrap-around sunglasses help keep pollen from getting into your eyes.

3 Avoid bees.
If you’re allergic to bees or other stinging insects, avoidance is your best bet. Keep your distance from uncovered food, be cautious of open soft drink cans, and resist wearing bright clothing or perfume, all of which attract bees. If someone near you gets stung, move away – some bees give off a chemical after they sting that can attract other stinging insects.

4 Be cautious at the food table.
Avoid foods in which nuts, dairy, and other common allergens can be lurking, such as mixed salads, barbecue sauces, and salad dressings. If grilling is involved, have your portion cooked on aluminum foil to avoid cross-contamination with other foods.

5 Stick to the middle.
Poison ivy can lurk in bushes and other foliage, so stay in open areas where you’re less likely to brush up against it.

6 Pay attention to ozone alerts.
High temperatures mixed with pollution can pose a problem for people with asthma. Carry a quick relief inhaler.

 

Source: American College of Allergy, Asthma & Immunology, www.AllergyandAsthmaRelief.org

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2011.

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Intersect ENT Announces U.S. FDA Approval for First Drug Releasing Implant for Chronic Sinusitis Patients

Breakthrough Treatment Improves Outcomes for Sinus Surgery

Intersect ENT, Inc., an innovator in treatment alternatives for ear, nose and throat clinicians and patients, today announced that the U.S. Food and Drug Administration (FDA) has approved the company’s Pre-market Approval (PMA) application for the Propel™ mometasone furoate implant offering localized, controlled drug delivery for chronic sinusitis patients.

Chronic sinusitis is a condition in which patients’ sinuses become swollen and inflamed, leading to difficulty breathing, facial pain or headache, and reduced sense of smell and taste. The condition is common, affecting one in seven adults in the U.S., and greatly impacts quality of life. Chronic sinusitis often requires a complex combination of surgical and medical treatments. Each year, 500,000 patients undergo sinus surgery to treat the condition. Although sinus surgery is effective, the majority of patients experience recurrent symptoms within the first year; as many as 25 percent then undergo revision surgery due to recurrent obstruction of the sinus cavity.

Propel is the first of a new category of products offering localized, controlled delivery of steroid directly to the sinus tissue. Inserted by a physician following endoscopic sinus surgery, the spring-like implant expands to prop open the sinus and gradually delivers an advanced corticosteroid with anti-inflammatory properties directly to the sinus lining to maintain sinus patency.

The Propel system has been clinically proven to prevent obstruction of the ethmoid sinus following surgery. The result is improved post-operative outcomes, reducing the need for additional surgical procedures and systemic steroids that can have serious side effects.

“The FDA approval of this innovative new product is great news for ENT clinicians and patients,” said David W. Kennedy, MD, FACS, professor of Otorhinolaryngology at the University of Pennsylvania Health System in Philadelphia, PA, a widely recognized pioneer in functional endoscopic sinus surgery. “Propel reduces the occurrence of inflammation and scarring in the post-operative period. As a result, it promises to substantially improve long-term outcomes for sinus surgery and, as my research has demonstrated, reduced scarring and inflammation correlates with absence of the need for further surgery. I believe the combination of minimally invasive techniques and local drug delivery will be the wave of the future in sinus treatment.”

“The FDA approval of Propel marks an exciting milestone for Intersect ENT as well as sinus sufferers and their physicians who will now have an important new treatment option, clinically proven to maintain the benefits of sinus surgery,” said Lisa Earnhardt, the company’s president and CEO. “We look forward to launching our product to clinicians and their patients in select US locations this fall.”

 

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Mold Exposure During Infancy Increases Asthma Risk

Infants who live in "moldy” homes are three times more likely to develop asthma by age 7—an age that children can be accurately diagnosed with the condition.

Study results are published in the August 2011 issue of Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI).

"Early life exposure to mold seems to play a critical role in childhood asthma development,” says Tiina Reponen, PhD, lead study author and University of Cincinnati (UC) professor of environmental health. "Genetic factors are also important to consider in asthma risk, since infants whose parents have an allergy or asthma are at the greatest risk of developing asthma.”

UC and Cincinnati Children’s Hospital Medical Center researchers analyzed seven years of comprehensive data for 176 children to evaluate the effects of mold exposure in early life.

"This study should motivate expectant parents—especially if they have a family history of allergy or asthma—to correct water damage and reduce the mold burden in their homes to protect the respiratory health of their children.”

The children were part of the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS), a long-term population-based study that included more than 700 children from the Greater Cincinnati area. CCAAPS looked at the effects of environmental particles on childhood respiratory health and allergy development. Participants were identified during infancy as at high risk to develop allergies based on family medical history.

Mold exposure levels were measured using a DNA-based analysis tool developed by the U.S. Environmental Protection Agency (EPA)—the environmental relative moldiness index (ERMI). The tool combines results of the analysis of 36 different types of mold into one index, which describes the mold burden in the homes. This index was used to determine the impact of mold exposure on the respiratory health of study participants.

Eighteen percent of children enrolled in CCAAPS were found to be asthmatic at age 7.

It is estimated that about 9 percent of school-age children in the United States will develop asthma; however, studies have shown that rates are often higher in children from poor, urban families. The disease cannot be accurately diagnosed until age 7 and the causes are not completely known.

”The symptoms of pediatric asthma range from a nagging cough that lingers for days or weeks to sudden episodes of shortness of breath and wheezing that require emergency treatment,” says allergist David Bernstein, MD, study co-author, UC professor of internal medicine and ACAAI fellow. "If a young child’s symptoms persist and keep coming back, that’s a clue that it could be asthma.”

According to the ACAAI, common symptoms of asthma include:

• Coughing, especially at night
• Wheezing or whistling sound, especially when breathing out
• Trouble breathing or fast breathing that causes the skin around the ribs or neck to pull in tightly
• Frequent colds that settle in the chest

"This study should motivate expectant parents—especially if they have a family history of allergy or asthma—to correct water damage and reduce the mold burden in their homes to protect the respiratory health of their children,” adds Reponen.

Funding for the current mold study was provided by the U.S. Department of Housing and Urban Development. Initial funding for CCAAPS came from the National Institute of Environmental Health Sciences. Grace LeMasters, PhD, of UC’s environmental health department, serves as the principal investigator of CCAAPS.

Coauthors of the AAAI study include Stephen Vesper, PhD, of the EPA; Linda Levin, PhD, Elisabet Johansson, PhD, Patrick Ryan, PhD, Jeffrey Burke, Sergey Grinshpun, PhD, Shu Zheng, Drs.Bernstein and LeMasters, of the UC College of Medicine; and Gurjit Khurana Hershey, MD, PhD, of Cincinnati Children’s.

 

Source: University of Cincinnati, UC Academic Health Center, healthnews.uc.edu

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Indoor Air Cleaners Ease Asthma Symptoms in Children Living With Smokers

Smoke-free homes still the best choice

A Johns Hopkins Children’s Center study of Baltimore City children who have asthma and live with smokers shows that indoor air cleaners can greatly reduce household air pollution and lower the rates of daytime asthma symptoms to those achieved with certain anti-inflammatory asthma drugs. Although the air cleaners improved the overall air quality in homes, they did not reduce air nicotine levels and did not counter all ill effects of second-hand smoke, the researchers warn.

Parents should be counseled to implement a total ban on indoor smoking and use air cleaners only as a temporary tool on the way to achieving a smoke-free household, the Hopkins team concludes in the August 1, 2011, issue of the Archives of Pediatrics & Adolescent Medicine.

“Air cleaners appear to be a an excellent partial solution to improving air quality in homes of children living with a smoker but should not be viewed as a substitute for a smoke-free environment,” says lead investigator Arlene Butz, ScD, MSN, CPNP, an asthma specialist at Johns Hopkins Children’s and professor of pediatrics at the Johns Hopkins University School of Medicine.

The study found that children living in homes with air cleaners had considerably more days without coughing, wheezing or difficulty breathing compared with children living in homes without air cleaners.

For the study, researchers followed for six months 115 children, ages 6 to 12 years, who lived in homes where one or more caregivers smoked. Each one of 41 households received two free-standing air cleaners plugged into the bedroom and living room. Another one-third of the homes got air cleaners plus at-home health education by a nurse on the dangers of second-hand smoke, and the other third got neither but were given air cleaners at the end of the study. The researchers measured air nicotine levels and air particulate matter — microscopic bits of smoke, soil, pollen, dust and spores usually floating around in the air — before air cleaner installation and six months later. They also compared asthma symptoms and cotinine (the biological marker of nicotine found in the urine) between children living in homes with and without air cleaners.

The overall air quality in homes with air cleaners showed a nearly 50-percent drop in the levels of particulate matter, although the air never reached the quality of smoke-free homes, the researchers note. Homes that received both air cleaners and visits by health coaches did not achieve better air quality than homes that got air cleaners alone. The levels of air nicotine and urine cotinine remained similar in all children, regardless of air cleaner use in the home.

The study also found that children living in homes with air cleaners had considerably more days without coughing, wheezing or difficulty breathing compared with children living in homes without air cleaners. Based on the rate of symptom reduction observed in this study, the researchers estimate that a child with asthma living in a home with indoor air filtration would, on average, have 33 more symptom-free days per year compared with a child living in a smoking household without indoor filtration. The number of symptom-free days made possible by the air cleaners was nearly the same as the number achieved with the use of a type of anti-inflammatory asthma drug in another study, the investigators note.

“Our findings show a clear link between improved asthma symptoms and the use of air cleaners, providing further evidence that air cleaners could play an important role in the treatment of children with asthma," said co-investigator Patrick Breysse, PhD, professor at the Johns Hopkins Bloomberg School of Public Health and director of the Johns Hopkins Center for Childhood Asthma in the Urban Environment.

Because smoking is a main driver of indoor air pollution, the researchers recommend the use of air cleaners even in smoke-free homes if they are part of multi-family dwellings in which second-hand smoke can easily seep in from surrounding units.

Asthma is the most common pediatric chronic illness, affecting 6.5 million children in the United States, according to the Centers for Disease Control and Prevention. More than 30 percent of children in the United States share a home with a smoker, and up to two-thirds of children in urban neighborhoods live with a least one smoker, the researchers say.

The study was funded by the National Institutes of Environmental Health Science, the National Institutes of Health and by the Environmental Protection Agency.

 

Source: John Hopkins Children's Center, www.hopkinschildrens.org

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Playing Doctor and Paying a Price?

A New Survey Finds People Are Confused Between Allergy and Sinusitis Symptoms

A new survey finds that many Americans who self-diagnose themselves with nasal allergies or sinusitis have difficulty differentiating between symptoms of the two conditions. As a result, they may be misdiagnosing themselves and potentially experiencing a more severe form of the condition known as chronic sinusitis.

According to the survey conducted by the Asthma and Allergy Foundation of America, a significant percentage of those experiencing symptoms are skipping a visit to their doctor and diagnosing themselves, even when their symptoms are severe. As a result, people may often be confusing sinus infection symptoms with allergy symptoms and not getting optimal care for their condition.

“The symptoms of sinusitis are similar to allergies, and sometimes allergies can lead to sinusitis, so it’s no surprise to learn that patients are confused,” says Mike Tringale, vice president of external affairs at AAFA. “However, there is a key difference between allergies and chronic sinusitis. If you have allergy-like symptoms that last longer than 12 weeks or symptoms that occur more than three times per year, with symptoms usually lasting more than 20 days despite treatment attempts, you may have chronic sinusitis and should see your doctor for a correct diagnosis and the right medical solution.”

Chronic sinusitis is one of the most common health problems in the United States. It’s important that those who have persistent allergies get a proper diagnosis since almost half of the respondents to the AAFA survey admit to self-diagnosing when they have symptoms. But close to two in five respondents think it’s difficult to differentiate between symptoms, and as a result, over half have misdiagnosed themselves with allergies when it actually turned out to be sinusitis.

It Could Be Chronic Sinusitis
Close to one in four respondents typically experience sinusitis more than three times a year, which means that they may actually have chronic sinusitis. Even those who might be able to correctly diagnose themselves with sinusitis could be treating the condition incorrectly.

 

For full results of the survey, go to aafa.org/sinusitis.

Source: Asthma and Allergy Foundation of America, www.aafa.org

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2011.

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New Research Presented at the 30th Congress of the European Academy of Allergy and Clinical Immunology

The European Academy of Allergy and Clinical Immunology (EAACI) and the Turkish National Society of Allergy and Clinical Immunology held the 30th Annual Congress of EAACI in Istanbul on June 11 - 15, 2011. The Congress attracted over 7900 participants from over 103 countries world wide. The scientific program was supported by 391 speakers and covered a wide spectrum of allergy, immunology and related fields in clinical science.

Exercise: A New Tool in Asthma Management
The severity and likelihood of asthma attacks, and in particular attacks brought on by exercise, can be reduced by regular, moderate aerobic activity, such as running or recreational cycling, new research shows. This new, preliminary finding could help people with asthma manage their condition more effectively and reduce the need for drugs.

Exercise has a reputation for making asthma worse, but this study shows that as long as the levels are moderate, exercise is beneficial. Professor Stefano Del Giacco of the University of Cagliari, Italy, studied an Italian professional football team as an example of training on a regular basis. They tested the team for allergies at three different times during the playing season, analyzing their blood for signs of an immune reaction. The results showed that the team had a lower than average allergic response, indicating that the regular exercise undertaken by the team reduced their chance of allergy.

But how can mild exercise reduce the risk of an asthma attack? The answer seems to lie in the effect of regular, moderate physical activity on the immune system, whereby levels of certain immune molecules that are responsible for bronchial inflammation, and consequently for an asthma attack, are reduced, and those that protect against this are raised. Furthermore, being overweight can increase the chances of an asthma attack, and mild exercise has the added advantage of helping to prevent obesity.

How Do You Feel? The Psychological Impact of Food Allergy
Perceived quality of life is worse for those with food allergy than it is for those with diabetes because they live in a state of uncertainty, new research shows. Dr. Anthony Dubois of the Beatrix Children’s Hospital, The Netherlands, used a new psychological test to measure “health-related quality of life” of food allergic people, and compared their results with those from people with type I diabetes.

This new test aims to assess quality of life in food-allergic individuals, but also to look at the impact of accurate diagnosis using food challenge tests and subsequent management of their condition. “The studies show that uncertainty is a source of diminished quality of life in food allergic patients, and accurate diagnosis with challenge testing improves health-related quality of life,” said Dr. Dubois. In addition, carrying an adrenaline auto injector might help because it has the potential to reduce perceived uncertainty in people with food allergy and improve their health-related quality of life.

 

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2011.

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Study Examines the Placebo Response in Patients With Asthma

A recent study sheds light on the placebo's effect on subjective and objective outcome measures in clinical trials. The study, published in The New England Journal of Medicine, was conducted by researchers at Harvard Medical School in Boston; Endicott College in Beverly, Massachusetts; and the University of Hull in the United Kingdom.

The placebo response can be defined as the benefit patients receive from a treatment that has no active components. Clinical trials often include comparison of a treatment to a placebo, so that the true and specific value of the treatment can be accurately measured compared to the placebo effect. This is particularly important in clinical trials measuring subjective patient-reported outcomes, which, in general, are more strongly affected by the placebo response.

There are many questions about the mechanisms by which placebos operate, their role in clinical practice, whether they can—or can ethically—be employed intentionally to improve patient outcomes, and their effects on subjective and objective outcome measures in clinical trials.

At the conclusion of the study, data showed that only treatment with the albuterol inhaler improved lung function.

This double-blind, crossover, pilot study examined 39 patients with chronic asthma who were assigned to receive each of four treatments: an albuterol inhaler (the active treatment), a placebo inhaler, sham acupuncture (another placebo), and no intervention. (Sham acupuncture is like actual acupuncture, but without skin penetration.) All patients received each of the three interventions plus a no intervention session, in random order, 3 to 7 days apart. This pattern was repeated 2 more times for a total of 12 visits by each patient. At each visit, lung function tests were administered and patients’ self-reported symptom ratings were recorded. Lung function was assessed by measuring lung capacity as maximum forced expiratory volume in 1 second.

At the conclusion of the study, data showed that only treatment with the albuterol inhaler improved lung function. Lung function did not improve with either of the placebo treatments or after the no intervention visit. However, patients’ self-reports on their symptoms showed significant and approximately equal improvement with albuterol, the placebo inhaler, or the sham acupuncture.

While this study documents beneficial effects of placebo on asthma patients’ symptoms (e.g., chest tightness and a perception of difficulty breathing), it also documents the lack of effect of placebo on the restricted movement of air out of the lungs, which is responsible for many potentially serious or life-threatening consequences of untreated asthma. The goals of treatment of asthma are both to improve lung function and to relieve the symptomatic distress caused by the restricted movement of air. As the investigators note, self-reports of improvement as a measure of successful treatment can be unreliable in assessing treatment success. The study also illustrates how inclusion of a no intervention control can be helpful in discerning the contributions of different components of an intervention.

 

Source: National Center for Complementary and Alternative Medicine, nccam.nih.gov

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IgE’s Role in Allergic Asthma

Immunoglobulin E (IgE) is a type of antibody that is present in minute amounts in the body but plays a major role in allergic diseases. IgE binds to allergens and triggers the release of substances from mast cells that can cause inflammation. When IgE binds to mast cells, a cascade of allergic reaction can begin:

• Allergen exposure
Repeated exposure to a particular allergen can be the first step in developing a reaction to it. Some allergens trigger strong allergic reactions, while others trigger

• T cell action
Allergens induce T cells to activate B cells, which develop into plasma cells that produce and release more antibodies.

Binding of IgE to Mast Cells
The surfaces of mast cells contain special receptors for binding IgE. The IgE antibody fits to this receptor like a module docking with the mother ship. This arrangement is such that when two adjacent mast-cell-linked IgE antibodies are in place, the allergen is drawn to both and attaches itself to both, crosslinking the two IgEs. When a critical mass of IgEs become cross-linked, the mast cell releases histamine and other inflammatory substances, and the allergic cascade begins.

Your mast cells are like little bombs that are armed and ready for detonation.

The Allergic Cascade
Following exposure to an allergen, a series of initial reactions in the immune system occurs. This early-phase response is followed by a second, more severe reaction known as a late-phase response. Typically, the allergic cascade follows this pattern:

1. Sensitization to an allergen – being exposed for the first time
You might be initially exposed to an allergen by inhalation (of pollen, mold, dust mites, etc.), ingestion (swallowing a type of food or medication), touch (coming into contact with poison ivy, latex, or certain metals, such as nickel), or injection (receiving a medication or being stung by an insect).

Your body produces IgE designed specifically for that particular allergen, but you won’t experience a reaction yet. If you are atopic (meaning, you’ve inherited a predisposition toward allergic disease), your T cells are quick to stimulate B cells. When stimulated, B cells develop into plasma cells. Plasma cells produce IgE antibodies, which are targeted to that specific allergen, and the IgE binds to special receptors on mast cells. Your system is now sensitized. Your mast cells are like little bombs that are armed and ready for detonation.

2. Early-phase response upon reexposure to an allergen
When you are re-exposed to an allergen, the IgE of mast cells binds to the allergen, cross-linking the IgE. When enough cross-linking occurs, the mast cells explode with histamine and other inflammatory substances, called mediators. The mediators speed through your system.

Then it happens. You wheeze, sneeze, cough, get itchy eyes, have a runny nose, become short of breath – in other words, you experience the whole unpleasant range of symptoms known as the allergic response. And all of this occurs within an hour after initial exposure.

3. Late-phase response to an allergen
The late-phase response actually begins at the same time as the early-phase response, but it takes longer to see. In some individuals, the body rallies its immune system for this second phase, which can happen relatively soon after the initial reaction – anywhere from about three to ten hours later. Often, this late-phase response involves immune cells known as eosinophils, and it can last for 24 hours or so before subsiding. During the late-phase response, congestion and certain other symptoms can be more severe than those seen during the initial response.

Consequences of Chronic Allergic Reaction in Asthma
With repeated allergen exposure and allergic response, some damage can be done to the tissues involved. Long-term controller medications that aggressively attack inflammation and maintain maximum lung function may reduce the risk of permanent damage.

Although allergic disease is not curable, it is treatable enough to live with. Healthcare providers can be significant allies in this effort – particularly allergists, pulmonologists, and certain other specialists. In addition, many research organizations make studying allergic disease their top priority and can be excellent sources of information on the immune system. The more you know about how an allergic response occurs, the better armed you’ll be to meet its challenges.

 

Source: Asthma and Allergy Foundation of America, www.aafa.org

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2011.

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Packing a Food Allergy-Safe Picnic Basket

Whether it’s a romantic outing or family trip to the beach, the summer months are the perfect time for dining outdoors. Like all food-focused events, picnics pose special challenges for people with food allergies. But with careful planning, it’s easy to put together an allergy-friendly picnic basket that everyone can enjoy.

Ask first.
If picnic attendees include people outside of your immediate family, ask ahead of time if anyone has specific food allergies. If someone has an allergic condition, inquire about any precautions you can take in food preparation to make the picnic allergy-safe.

Keep it simple.
Picnics are casual affairs, so make your menu uncomplicated. Fresh fruits and vegetables and basic sandwiches and salads are easy to make and to transport. And fewer ingredients means less potential for an unexpected allergic reaction.

Fewer ingredients means less potential for an unexpected allergic reaction.

Make it yourself.
Prepackaged picnic foods from the deli or grocery store may save time, but they can also contain hidden allergy triggers. Many pre-made marinades or salad dressings contain allergens like wheat and soy, and hummus, a popular dip and spread, includes sesame. Creating your own salads, dips, dressings, and marinades is easy, and it ensures that the food you’re eating is allergy-safe.

Pack food separately.
If your picnic basket contains a mix of foods for both allergic and non-allergic picnickers, be sure to pack foods in separate sealed containers. Or bring two baskets and designate one allergy-friendly. Bring hand wipes and use condiment packets rather than shared jars to avoid cross-contamination.

Practice food safety.
Remember to follow basic food safety tips when picnicking to keep everyone safe and healthy. Keep cold foods cold and hot foods hot to prevent bacteria growth. If you’re planning to grill, pack raw meat separately and handle carefully.

More Picnic Tips
Bring a clean tablecloth to cover the picnic table. This will prevent contact with germs and any allergens left over from previous picnics. Potluck-style picnics and barbecues can be a minefield for those with food allergies. Always bring allergy-safe options for yourself or your child, and have whoever is doing the grilling cook your food first to avoid cross-contamination. Bring hand wipes or sanitizer in case there is no water at the picnic site. If you’re camping, remember that cleaning pots, pans, and plates may be more difficult than at home, increasing risks for cross-contamination.

Check cellphone coverage at your picnic or campsite, especially if you’re headed to a more remote area. Have a plan if you or someone you’re with does have a severe allergic reaction.

Clean up when you’re done eating. Leaving food out in the open can attract bugs, such as wasps and honeybees, to which many people are allergic.

 

Source: American Academy of Allergy, Asthma & Immunology, www.aaaai.org

This article was originally published in Coping® with Allergies & Asthma magazine, May/June 2011.

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Are Your Furry Friends Causing Your Allergy & Asthma Symptoms?

Allergies to pets with fur or feathers are common, especially among people who have other allergies or asthma. People with dog allergies may be allergic to all dogs or to only some breeds. Cat allergies are about twice as common as dog allergies.

Causes
People with pet allergies have supersensitive immune systems that react to harmless proteins, called allergens, in the pet’s dander (dead skin that is shed), saliva, or urine. Dogs and cats secrete fluids and shed dander that contain the allergens. They collect on fur and other surfaces. The allergens will not lose their strength for a long time, sometimes for several months. They appear to be sticky and adhere to walls, clothing, and other surfaces.

Pet hair is not an allergen. It can collect dander, though. It also harbors other allergens like dust and pollen.

Cat and dog allergens are everywhere. Pet dander is even in homes never occupied by these animals because it is carried on people’s clothing. The allergens get in the air with petting, grooming, or stirring the air where the allergens have settled. Once airborne, the particles can stay suspended in the air for long periods of time.

Symptoms
Reactions to cat and dog allergens that land on the membranes that line eyes and nose include swelling and itching of the membranes, stuffy nose, and inflamed eyes. A pet scratch or lick can cause the skin area to become red. If allergen levels are low or sensitivity is minor, symptoms may not appear until after several days of contact with the pet.

Cat and dog allergens are everywhere, even in homes never occupied by these animals.

Many airborne particles are small enough to get into the lungs. When inhaled, the allergens combine with antibodies. This can cause severe breathing problems – coughing, wheezing, and shortness of breath – in highly sensitive people within 15 to 30 minutes. Sometimes, highly sensitive people also get an intense rash on the face, neck, and upper chest.

For about 20 percent to 30 percent of people with asthma, cat contact can trigger a severe asthma attack. Cat allergies also can lead to chronic asthma.

Diagnosis
If a pet allergy is suspected, your doctor may diagnose it by taking a medical history and testing your blood. Some people are so attached to their pets that they will deny the pets could cause their symptoms. In these cases, the person is removed from the animal’s environment to see if symptoms go away. It does not help to remove the dog or cat. Allergens still in the area can cause symptoms months after the animal is gone.

To diagnose cat-induced asthma, a person must have asthma symptoms when exposed to a cat or cat allergen, as well as an allergic reaction to a skin test or to a blood test. To make sure the diagnosis is correct, your doctor will watch what happens when a cat is added then removed from your environment several times.

Treatment
The best treatment is to avoid contact with cats or dogs and their dander. Keep the pets out of the house, and avoid visiting people with pets. Avoiding cats and dogs may give you enough relief that you will not need medication.

Keeping the pet outdoors will help but will not rid the house of pet allergens. Another option is to have pets that do not have fur or feathers. Fish, snakes, and turtles are some choices.

What if I Want to Keep My Pet?
To test the effect of household pets on your quality of life, remove them from your home for at least two months and clean thoroughly every week. After two months, if you still want pets, bring a pet into the house. Measure the change in your symptoms; then decide if the change in your symptoms is worth keeping the pet.

If you decide to keep a pet, bar it from the bedroom. Keep the bedroom door closed, and clean the bedroom aggressively. Washing the pet every week may reduce airborne allergens but is of questionable value in reducing a person’s symptoms.

Because animal allergens are sticky, you must remove the animal’s favorite furniture, remove wall-to-wall carpet, and scrub the walls and woodwork. Keep surfaces throughout the home clean and uncluttered. Bare floors and walls are best.

Wear a dust mask to vacuum. Vacuum cleaners stir up allergens that have settled on carpet, making allergies worse. Use a vacuum with a HEPA filter if possible.

Forced-air heating and air conditioning can spread allergens through the house. Cover bedroom vents with dense filtering material like cheesecloth. Adding an air cleaner with a HEPA filter to central heating and air conditioning can help remove pet allergens from the air.

 

Source: Asthma and Allergy Foundation of America, www.aafa.org

This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2011.

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Avoiding Poison Plant Allergy

First comes the itching, then a red rash, and then blisters. These symptoms of poison ivy, poison oak, and poison sumac can start from a few hours to several days after exposure to the plant oil found in the sap of these poisonous plants.

Poison Ivy
Found throughout the United States except Alaska, Hawaii, and parts of the West Coast, poison ivy can grow as a vine or shrub. Each leaf has three glossy leaflets, with smooth or toothed edges. Leaves are reddish in spring, green in summer, and yellow, orange, or red in fall, and the plants may have white berries.

Poison Oak
It grows as a low shrub in the eastern United States, and in tall clumps or long vines on the Pacific Coast. Poison oak has fuzzy green leaves in clusters of three that are lobed or deeply toothed with rounded tips and may have yellow-white berries.

Poison Sumac
It grows as a tall shrub or small tree in bogs or swamps in the Northeast, Midwest, and parts of the Southeast. Each leaf has clusters of 7 to 13 smooth-edged leaflets. The leaves are orange in spring, green in summer, and yellow, orange, or red in fall, and the plant may have yellow-white berries.

Not Contagious
Poison ivy and other poison plant rashes can’t be spread from person to person. But it is possible to pick up the rash from plant oil that may have stuck to clothing, pets, garden tools, and other items that have come in contact with these plants. The plant oil lingers (sometimes for years) on virtually any surface until it’s washed off with water or rubbing alcohol.

The plant oil lingers (sometimes for years) on virtually any surface until it’s washed off with water or rubbing alcohol.

The rash will only occur where the plant oil has touched the skin, so a person with poison ivy can’t spread it on the body by scratching. It may seem like the rash is spreading if it appears over time instead of all at once. But this is either because the plant oil is absorbed at different rates in different parts of the body or because of repeated exposure to contaminated objects or plant oil trapped under the fingernails. Even if blisters break, the fluid in the blisters is not plant oil and cannot further spread the rash.

Tips for Prevention
Learn what poison ivy, oak, and sumac plants look like so you can avoid them. Wash your garden tools and gloves regularly. If you think you may be working around poison ivy, wear long sleeves, long pants tucked into boots, and gloves. Wash your pet if it may have brushed up against poison ivy, oak, or sumac. Use pet shampoo and water while wearing rubber gloves, such as dishwashing gloves. Most pets are not sensitive to poison ivy, but the oil can stick to their fur and cause a reaction in someone who pets them.

Wash your skin in cool water as soon as possible if you come in contact with a poisonous plant. The sooner you cleanse the skin, the greater the chance that you can remove the plant oil or help prevent further spread. Use the topical product “Ivy Block” if you know you will come into contact with the poisonous plants. This FDA-approved product is available over the counter.

Tips for Treatment
Don’t scratch the blisters. Bacteria from under your fingernails can get into the blisters and cause an infection. The rash, blisters, and itch normally disappear in several weeks without any treatment. But you can relieve the itch by using wet compresses or soaking in cool water, applying over-the-counter topical corticosteroid preparations or taking prescription oral corticosteroids, and applying topical over-the-counter skin protectants, such as calamine, labeled to dry oozing and weeping or to relieve itching and irritation caused by poison ivy, poison oak, and poison sumac.

See a doctor if you have a temperature over 100° F, if there is pus, soft yellow scabs, or tenderness on the rash, if the itching gets worse or keeps you awake at night, if the rash spreads to your eyes, mouth, genital area, or covers more than one-fourth of your skin area, or if the rash is not improving within a few days.

 

Source: U.S. Food and Drug Administration, www.fda.gov

This article was originally published in Coping® with Allergies & Asthma magazine, May/June 2011.