FCAAIA Notes: Restaurant employees are far more aware of food allergies now than they were 20-25 years ago, undoubtedly because of training by managers and owners. Nonetheless (as with most things) there is always room for improvement.
The burden remains on the patient to address his food allergies with wait staff and if unsure, ask to speak to the chef. When in doubt, don’t eat it.
Communication is a major problem. Continue reading
FCAAIA Notes: As I’ve written before, “The nose bone’s connected to the lung bone.” Asthma is part of “allergic airway disease” and control of the lower airway (lungs) always requires that we consider the upper air way (nose) as well. So, we treat nasal allergies even if the symptoms are relatively mild and not bothersome.
Here it also becomes clear that patients with asthma who also have sleep apnea (do you snore loudly, a lot, and sometimes startle awake gasping for a breath?) should address the apnea Continue reading
FCAAIA Notes: Latex allergy is usually diagnosed purely by clinical history. Unfortunately, there is no other good test for latex allergy. This article gives a nice review of latex allergy with some good points for allergic patient.
People with latex allergy should wear or carry a medic-alert identifier that specifies what type of reaction they had. Continue reading
FCAAIA Notes: Ah….the Goldilocks paradigm! Too little or too much? Of course, the answer is “just the right amount.”
Oral corticosteroids (e.g., prednisone) are the treatment of choice for bad asthma exacerbations. Continue reading
FCAAIA Notes: Up to 95% of people who are labelled allergic to penicillin (amoxicillin, etc.) are not allergic. Some never were; either they had something happen that was while taking the antibiotic but was unrelated to it, others avoid it because a family member had a reaction, whether it was allergic or not), and other don’t even know why they carry the diagnosis.
Of course, there are clearly people who had true allergic reactions to penicillin, but even they lose their sensitivity over time so that after 10 years only about 10% are still allergic. Continue reading
FCAAIA Notes: I guess one of the best ways to avoid having asthma is to choose the right parents, as asthma and other allergic disease are more common in children whose parents have allergies.
Of course, as shown in this study air pollution is a big risk factor for the onset and for exacerbations of asthma. Outdoor air pollution is something over which individuals have little control (think globally; act locally!). Indoor air pollution is easier to control. Active and passive smoking are major triggers to allergic airway disease. Wood stoves, fireplaces, and wood burning stoves are also a big source of indoor air pollution.
Vitamin D is a hot topic in asthma control. Continue reading
FCAAIA Notes: Many people blame many of their symptoms on gluten. While it is hard to put a number on it, many of those people do not actually have a gluten-related condition. No one has to eat gluten containing grains, but those with Celiac Disease need to avoid them.
Testing for Celiac Disease should be reserved for patients who are suspected of having it. Continue reading
FCAAIA Notes: What do you do if you are allergic to one tree nut but are not sure about others? First of all, cashew and pistachio allergies tend to go together as do pecan and walnut. So if you are allergic to one of the pair, it is often prudent to avoid both.
But what about unrelated nuts? Some people choose to avoid all tree nuts to decrease risk of accidental ingestion of the ones to which they are allergic. Some people choose to eat only those nuts to which they had negative tests. The purpose of this study was to address what to do with nuts that never caused a clinical reaction with ingestion but to which there are positive tests.
The point here is that some patients with positive tests might not be allergic. Continue reading
FCAAIA Notes: Lots of things are connected on the inside, so we should not be surprised when one condition (in this case reflux) is associated with another (in this case nasal congestion). I can speculate a couple of possible mechanisms: Maybe reflux triggers a neurological reflex that leads to nasal congestion. Maybe reflux into the back of the nose and upper throat have a direct effect causing some inflammation, irritation, swelling, and obstruction. Maybe it’s a combination or Continue reading
FCAAIA Notes: The “peanut patch” is not FDA approved and is not commercially available. Let’s assume it is someday. Then, what might we expect from it? Use of the patch will not “cure” peanut allergy, nor will it be a free license to eat peanut products. Users will still need to avoid peanut in their diets at least as things stand now. At this point it seems that the patch merely increases the amount of peanut that must be ingested before there is a clinical reaction and the increase in the amount tolerated will vary from patient to patient. There also no data as to what happens if someone stops using the patch. Continue reading