Allergy Shots: Worth the Wait

Q. Why do I have to wait 15 minutes after allergy shots at the doctor's office? I've never had an allergic reaction.

A. Waiting for 15 minutes after receiving an allergy shot is inconvenient, I know. But allergy shots contain what the individual is allergic to, so the major risk from an allergy shot is an allergic reaction.

Intuitively, you might think such reactions would be most likely to occur during the build-up phase of allergy shots - the initial period of about three to six months where the dose of allergen you receive is gradually increased - but it turns out that's not the case. Reactions can happen at any time, even long after a maintance dose has been achieved (that's when the shots get less frequent and keep up your immunity to the allergen).

While most reactions to allergy shots are mild, there is a small risk of a serious reaction. And rapid treatment is key in preventing mild reactions from progressing into more serious ones. The vast majority of allergy shot reactions occur within 15 minutes of the injection, but occasionally they happen later.

The professional allergy associations' joint recommendation is that to ensure safety, individuals should stay in the doctor's office for at least 15 minutes after receiving an allergy shot. Patients who have experienced reactions more than 15 minutes after an allergy shot should be observed for a longer period of time.

Source: White MD, Martha. Allergy & Asthma Today, Volume 9, Issue 4. Winter 2011.

Treating peanut allergy through a patch

Can your peanut-allergic child be treated by simply wearing a patch? That is what researchers at National Jewish Health are researching. National Jewish Health, along with four other institutions in the Consortium of Food Allergy Research (CoFAR), are currently testing the safety of a peanut patch.

The peanut patch would work to desensitize allergic patiens by exposing them to increasing amounts of peanut protein, similar to the way allergy shots can desensitize people to pollen. The patch will release minute doses of peanut oil under the skin, like nicotine patches used by people trying to quit tobacco. The aim is to educate the body so it does not over-react to peanut exposure.

Human safety trials have started in Europe and the United States and it is hoped the patch could become available within three to four years.

One of its inventors, Dr Pierre-Henri Benhamou, said, "We envisage that the patch would be worn daily for several years and would slowly reduce the severity of accidental exposure to peanuts. The beauty of the patch is that it is absorbed just under the skin and is taken up by the immune system. But because it doesn't go directly into the bloodstream there is no risk of a severe reaction. We have carried out a number of small safety trials and now moving to trials that will establish the size of the dose needed and for how long the patch would need to be worn."

They believe that after about a year of wearing the patch, patients may be cured of a severe reaction to peanut. But it would need to be worn for several more years before a nut allergy sufferer could safely be exposed to peanut.

Dr Benhamou said, "At best we are talking about a sufferer eventually being able to eat modest amounts of peanut without a reaction. But what we want to do most is eliminate the severe reaction that occurs when people are exposed to the tiniest speck of peanut."

Read the whole article from physorg.com at http://bit.ly/dGGkAD

Red-and-White Milk and Egg free Holiday Cookies

2/3 cup dairy-free shortening

1/2 cup brown sugar

1/2 cup white sugar

1/4 cup apple sauce

1 tsp. vanilla extract

1-3/4 cups all-purpose flour (contains wheat/gluten)

1/2 tsp. baking soda

1/2 tsp. salt

3/4 cup dairy free white chocolate chips (can substitute carob chips)

1/2 cup currants or sundried cranberries

Directions:

Preheat oven 375 degrees. Mix together shortening, sugars, apple sauce and vanilla. In separate bowl, combine flour, baking soda and salt; combine wet and dry ingredients until smooth. Add in fruit and white chocolate chips. Roll dough into balls and place on baking sheet lined with parchment paper. Bake 12 minutes or until lightly browned. Cool and serve!

Puppy Love Tied Up in a Bow

Nothing is sweeter than a puppy, except perhaps one with a Christmas bow on her head. But is it a present that will make somebody at home sick?  Things to think about:

Family member with furry pet allergies? Not a great idea to have an indoor dog, even if it is supposed to be "hypoallergenic".  All dogs share certain proteins in their dander that can trigger allergies.

Family member with pollen or mold allergy?   An indoor dog that doesn't roll around on the grass or chase squirrels through the leaves might be better.   But it's still best to keep the dog out of the bedrooms, to minimize the likelihood of developing a new allergy to dog dander.

Allergic to dust mites? All dogs shed dander. One flake feeds an entire dust mite family. 

But then, plenty of allergists and veterinarians have asthma and furry pet allergies. How do they do it? They use immunotherapy (allergy shots) to improve their tolerance, and a host of environmental management techniques.

Here's a few to consider before you buy a puppy this Christmas:

• Frequent grooming - a clean coat harbors fewer pollen and mold spores. 


• Flea and tick prevention - Use products recommended by your veterinarian.  Avoid powders or sprays or chemical bombs that can irritate the airways.


• Out of the bedroom -  Unless you are disciplined enough to train the new puppy to stay outside the bedroom and provide positive reinforcement for good behavior, you are inviting trouble.

• Clean the house daily - Dogs increase the cleaning work load. Use a HEPA vacuum daily, dust with microfiber cloth (but don't use dust sprays) and make sure puppy accidents are cleaned and neutralized immediately. 

• Diet - Read the label. You don't want your dog eating any food that contains an ingredient your child may be allergic to. Otherwise, the first kiss after dinner might lead to a hospital visit.

Want to know more about building a tolerance to your pets with allergy shots?  See if you might be a candidate, by coming in for an allergy evaluation.  

Source:  Allergy & Asthma Today. Volume 9, Issue 4. Winter 2011

Handling the Holidays

Do asthma and allergies threaten to be the Grinch in your holidays? The American Academy of Allergy, Asthma & Immunology (AAAAI) offers these tips to help keep your season merry:

• 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.

• 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.


• Prepare for visits to homes with pets by taking your allergy and asthma medication before the visit. The medication may help reduce your reaction. You can also ask party hosts to keep Fido in a separate room.


• Food is 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.

Ingredient Notice - PowerBar/Nestle Nutrition

PowerBar/Nestle Nutrition would like you to know that the allergen declaration format on PowerBar ProteinPlus Reduced Sugar Bar (chocolate peanut butter variety) labels have changed.  There is no longer a "Contains:" allergen statement on the product label.   All allergen declarations currently exist on the label ingredient statement and will remain as such.   No changes have occurred in the product allergen content; this is a change to label format only.   This change took effect in October.

Additionally, the allergen declaration format on PowerBar Fruit Smoothie Energy Bar (creamy citrus variety) labels have changed. There will no longer be a "Contains:" allergen statment on the product label.   All allergen declarations currently exist on the label ingredient statement and will remain as such.   No changes have occurred in the product allergen content; this is a change to label format only. This change took effect in October.

Nestle Nutrition encourages its consumers to read the product label for all allergen information. For more information, contact PowerBar Service Center at (800) 587-6937.

Exercise Improves Asthma Control

Among patients with asthma, those who are physically active use less health care.  A recent study in Europe showed that a 12-week supervised aerobic and strength training exercise program led to improved asthma control, quality of life, and aerobic fitness in 21 adults with partially controlled asthma.  The benefits were maintained with another 12 weeks of self-administered exercise.

The improvements were not supported by measurements of airflow obstruction, however there was clearly a benefit suggesting that this "natural" adjunct to asthma treatment may be helpful -- and there is no copay or authorization needed for this prescription!

Dogra S, Kuk JL, Baker J, Jamnik V:  Exercise is associated with improved asthma control in adults.  Eur Respir J. 2011; 37: 318-323.

Oatmeal Snowball Cookies

Oatmeal Snowball Cookies

Milk, Egg, Peanut and Nut free.

2 cups light brown sugar, firmly packed
1 cup milk-free margarine, softened
3 T. water, 3 T. oil, 2 tsp. baking powder, mixed together
1 1/2 cups flour
2 tsp. ground ginger
1 tsp. baking powder
1 tsp. baking soda
1/2 tsp. vanilla extract
4 cups quick oats
confectioners sugar

In a large bowl, with an electric mixer on medium speed, beat brown sugar and margarine until creamy. Beat in water, oil, and baking powder, baking soda, and salt. Beat in vanilla extract. Stir in oats. Shape dough into 1-inch balls and roll in fectioners sugar. Chill 1 hour. Preheat oven to 375 degrees. Bake 10 minutes.

How Can You Tell if It's a Cold or Allergies?

With more than 200 types of viruses circulating in the community, and lots of sharing going on (the kind you don't really want), we are seeing more stuffy noses, sneezing, and cough these days. But if you also have allergies, how can you be sure whether it is a cold or your allergies flaring? And when does it matter?

1. Does it itch?

If there is itching of the nose, throat, or eyes involved, you are more likely dealing with allergy symptoms. Remember the seasonal allergies that go with the holidays -- old decorations coming out of storage (along with dust and maybe a little mold), stagnant water at the base of a Christmas tree, dust blowing out of air ducts the first time the heater is turned on -- more exposure means more allergy symptoms.

2. Is there fever or muscle ache?

Respiratory infections can come with fever and other symptoms such as fatigue, muscle aches, or nonrespiratory symptoms such as stomachaches, nausea, or diarrhea. This is often the tip-off that the stuffy nose is not due to allergy this time.

3. Why does it matter?

If your symptoms are due to allergy, a few changes in the environment might be very helpful, like using a HEPA air filter, cleaning ducts, wearing a mask while moving old boxes out of storage; and your allergy medications are more likely to work for this type of problem.

If it is a respiratory infection, especially with thick or discolored mucus, it may be better to clear out secretions with a decongestant and expectorant, or salt water rinse of the nasal passages, rather than drying up secretions with an antihistamine.

Ingredient Notice - General Mills

General Mills Dark Chocolate Chex Mix labels have changed. No changes have occurred in the product allergen content (it contains milk, wheat, and soy); this is a change only to the advisory/cautionary "May Contain" statement on the label due to a change in the manufacturing location. The product may contain peanuts. Product packaging with the new "May Contain" statement took effect in October.

Fiber One Mocha chewy bars label has changed. No changes have occurred in the product allergen content; this is a change only to the advisory/cautionary "May Contain" statement on the label due to a change in the manufacturing location. The previous allergen statement was: Contains soy and milk, may contain wheat ingredients; the new allergen statement will be: Contains soy and milk, may contain wheat, peanut, almond, and sunflower ingredients. Product packaging with the new "May Contain" statement came on the market in October.

General Mills urges you to read all labels for current allergen information. For more information, contact General Mills Consumer Services at (800) 231-0308.

Ingredient Notice - Wendy's

Wendy's Premium Buns are not buttered and toasted. The buns are brushed with a clarified butter prior to toasting. Clarified butter is butter that has undergone purification to separate the solid particles and butter oil.

The purification process may not remove 100% of the solids; therefore clarified butter may contain trace amounts of milk protein. Individuals with a milk allergy should request the bun to be untoasted (without butter).

Anaphylaxis: Better Safe than Sorry

Q. How can I tell when to use auto-injectable epinephrine? I don't want to use it or go to the hospital if it's not necessary.

A. There's no way to predict how severe an anaphylaxis episode might become, so the time to begin treatment is when symptoms first develop.

Only epinephrine stops anaphylaxis. Injected into the thigh, it begins to take effect within 5-8 minutes. It often takes more than one dose - and if something were to go wrong with the first dose, you'll need a back-up. By comparison, antihistamines don't start working for an hour and won't touch the respiratory or cardiovascular effects of anaphylaxis.

After you administer epinephrine, call 911. Don't drive yourself to the hospital! Adults should lie down with feet elevated to help protect the heart and brain while they wait for help. If possible, be ready to explain what you were doing before symptoms appeared and what's happened since you used epinephrine. Children tend to have breathing compromised more so than cardiovascular function and it's important they be kept comfortable, so they can remain or be held by a parent sitting upright.

Epinephrine is not a dangerous drug; adverse effects typically are mild and affect only elderly and frail patients. Anaphylaxis, however, can be fatal - it's safer to treat!

source: Wallace, Dana MD, Allergy & Asthma Today, Volume 9, Issue 4. Winter 2011.