FCAAIA Notes: Allergen immunotherapy (IT) is the only disease-modifying treatment and thus the only potential cure for allergies. People respond at different rates to different extents, but it is a highly effective treatment.
For IT to be helpful, you need to come regularly to build up to the top dose. High doses are more effective than lower doses. Continue reading
FCAAIA Notes: Weight loss and good physical conditioning are so important in virtually every aspect of health that we should not just concentrate on asthma. It is pretty clear that obesity contributes to diminished respiratory status with more shortness of breath and so on. My interpretation of the data are that at least some of that is because of other factors such as increased incidence of GE reflux, increased “work of breathing” because of the very thick and stiff chest wall, and overall de-conditioning resulting in worse exercise tolerance.
If you are overweight or obese, work hard to lose weight. Your ideal body mass index (BMI) should be 18.5-24.9. Curious? Continue reading
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