Our offices will have new hours starting February 2, 2015. For your convenience, we now have expanded early and late hours in our Stamford and Greenwich offices. Please note the new schedule below. All offices will be closed from 12-1 for lunch. Allergy shot appointments available whenever the office is open except 30-45 minutes prior to lunch and closing.
Monday: 8:00 am-7:00 pm
Wednesday: 8:00 am-7:00 pm
Thursday: 7:00 am-5:00 pm
Friday: 7:00 am-4:00 pm
Monday: 7:30 am-5:30 pm
Tuesday: 8:00 am-6:00 pm
Thursday: 8:00 am-7:00 pm
Friday: 7:00 am-4:00 pm
Monday: 8:00 am-7:00 pm
Tuesday: 7:00 am-5:00 pm
Wednesday: 8:00 am-6:00 pm
Friday: 7:00 am-4:00 pm
Thursday: 2:00 pm-6:00 pm only
FCAAIA Notes: As the Boy Scouts motto warns us, “Be prepared.” Epinephrine auto-injectors are potentially life-saving devises. Albuterol inhalers are “rescue medicines” that everyone with asthma should have available. One of the biggest reasons rescue medications don’t work is that they are not used correctly. It is easy to forget some steps even after having received instructions in proper use. Have we reviewed inhaler or epinephrine technique with you recently? Don’t hesitate to ask us if you want a refresher. Or, if you prefer, there are numerous on-line handouts, videos, etc. Continue reading
FCAAIA Notes: There have been numerous studies trying to identify early life risk factors for developing asthma and allergies. The problem with all these studies is that they are retrospective; that is, they look at people with and without the disease and identify how the groups were different as infants and toddlers. Perhaps it is the tendency to develop allergic airway disease early in life that puts them at risk (in this case) of needing antibiotics. The same thing could be the case with acetaminophen (Tylenol) and risk for asthma (see article below), although there are biochemical hypotheses that at least could explain a causal association.
The ultimate prospective study will never be done for obvious ethical reasons: Continue reading
FCAAIA Notes: The “hygiene hypothesis” about which I have written, does not apply to childhood vaccines. Rather, it addresses the effects of mild infections and exposure to a diffuse variety of germs on the developing immune system.
It is unfortunate that there is such skepticism over one of the greatest advances in public health in the history of the world: Immunization for childhood diseases. Ask your parents or grandparents what it was like to grow up in an era of rampant polio. Any of us to have seen a bad case of pertussis (whooping cough) or rubeola (measles) knows what I mean. Any of us who ever cared for a child with varicella encephalitis (chicken pox affecting the brain) would not question the value of global immunization and herd immunity. If your child’s immunizations are not up to date, please pick up the phone and call your pediatrician now. Continue reading
FCAAIA Notes: “Hypoallergenic.” What does it mean? As shown in this article, not much. The Food and Drug Administration has never defined it, so any company may use it in any manner it chooses. Therefore, it appears the label often applied to products primarily in order to sell them. Many such products contain ingredients that cause contact dermatitis or other contact rashes. If you react to any topical products, it is important to consider all of its components. Sometimes, patch testing by a dermatologist is necessary to identify the specific culprit.
(Source: http://www.medscape.com/viewarticle/835355?nlid=71467_281&src=wnl_edit_medp_aimm&uac=112079PK&spon=38 November 24, 2014. For Medscape articles: User name: FCAAIA, Password: Allergies)
Products for kids with itchy skin that are labeled hypoallergenic often contain ingredients that can cause allergic reactions Continue reading
FCAAIA Notes: As noted in the article above about antibiotic use in early childhood, there are numerous studies trying to identify early life risk factors for developing asthma and allergies. The problem with all these studies is that they are retrospective; that is, they look at people with and without the disease and identify how the groups were different as infants and toddlers. Perhaps it is the tendency to develop allergic airway disease early in life that puts them at risk (in this case) of needing acetaminophen (Tylenol). Acetaminophen’s biochemical actions have been hypothesized as a potential risk for later asthma.
The ultimate prospective study will never be done for obvious ethical reasons: Take children with similar genetic risks for allergy and asthma, give half of them numerous courses of acetaminophen when they are not sick, and then see how many in each group have allergies and asthma 5 years later. Continue reading
FCAAIA Notes: This is an excellent review of ocular allergy. Feel free to skip over the “science-y” parts if you wish. Allergic conjunctivitis has a major impact on quality of life for patients with allergies. Overall, the spring tends to be the worst season for our patients with allergic conjunctivitis. There are numerous classes of medication available as eye drops, some of which re available over the counter. Unfortunately, many that are only available by prescription are prohibitively expensive under insurance prescription plans. Speak with your allergist to find the best combination of medications to control your ocular allergies. Continue reading
FCAAIA Notes: This study was presented at the American College of Allergy, Asthma, and Immunology meeting in November. Those of us in the audience smiled and nodded our heads during the research presentation. There are numerous urban myths about allergies. Who knows where, when, or how they got started, but I suspect most of them were propagated long before the research disproving them was done. Old habits die hard, however. I often stop to remind myself that things I used to think were true have been disproven. Science evolves and what we tell our patients needs to change accordingly.
(Source: https://www.doximity.com/doc_news#entries/1543918 November 7, 2014)
Many primary care doctors may not be up to speed on the causes and best treatments for allergies, a new study suggests. Continue reading
FCAAIA Notes: Nobody but the patient can really know how the patient feels. An old paradigm is that children 12 and older are better at identifying the impact their allergies and asthma have on their quality of life and that under 12 years old, the parents are better at rating their children’s quality of life. This study indicates that maybe we should give 4-11 year old children more credit for recognizing their symptoms. For instance, a child will know if he wakes up in the middle of the night but if he doesn’t tell his mother, she will never know. How can a parent know that his daughter’s asthma worsens with exercise if she doesn’t tell him or he doesn’t ask. I ask my patients these questions and a parent often exclaims, “You didn’t tell me that!” Of course, the parent didn’t ask the question. The point here is that our patients have something to tell us and we need to listen.
(Source: http://www.medscape.com/viewarticle/834837?nlid=70059_281&src=wnl_edit_medp_aimm&uac=112079PK&spon=38 November 12, 2014For Medscape articles: User name: FCAAIA, Password: Allergies)
Parental assessment of a child’s asthma severity can sometimes underestimate the child’s level of discomfort and control Continue reading
FCAAIA Notes: Children with a sibling with peanut allergy are more likely to be allergic than the general population, but it is still the minority. Even identical twins do not have 100% concordance. We understand the trepidation in offering peanut to a child if an older sibling is known to be allergic. But, there are right ways to find out before offering the food blindly. Skin and/or blood test give valuable direction. The tests tell us different things and often both are needed before a decision is made to do (or not do) a peanut challenge. It is important to remember that a positive test does not necessarily mean allergy. Many people have a lot of positive tests but fully tolerate the foods. Test results should be interpreted and recommendations made by an allergist familiar in the statistical value of the tests.
(Source: http://www.medscape.com/viewarticle/834519?nlid=70059_281&src=wnl_edit_medp_aimm&uac=112079PK&spon=38 November 7, 2014 For Medscape articles: User name: FCAAIA, Password: Allergies)
Parents who have one child with peanut allergy may be shielding their other kids from peanuts when it’s not necessary, and might actually increase the child’s allergy risk Continue reading