Monday, January 23, 2012

Forced Air Heaters and Stuffy Noses

We are seeing lots of stuffy noses and nighttime asthma problems lately with the colder weather and use of forced air heaters in the home.  Air ducts that have not been cleaned in the past few years may have dust or mold in them, and when you turn that heater on for the first time, expect a big puff of whatever is in the ducts to be in your bedroom.


Solution?  If you cannot clean the ducts immediately, close off the vent in your bedroom and use a radiant space heater instead.  Or, you could use a vent filter in the register itself to trap some of the particulates.   Taking an antihistamine at night or running your bedroom HEPA filter may also be helpful.

Friday, January 20, 2012

Childhood Asthma and Reflux

Esophageal acid reflux can trigger asthma at any age.  A study recently published in the in the Journal of Asthma suggested that children with higher intensity acid reflux (with abnormal results on esophageal pH monitoring) had more frequent or difficult-to-control nighttime asthma attacks.

It is important to consider GERD, or gastroesophageal reflux, in young children with asthma whose nighttime asthma control is difficult, especially if they are found to have no underlying allergies triggering their asthma.   The age of onset of nighttime uncontrollable asthma was younger for children with abnormal pH results:  3.63 vs. 5.77 years.

This study raises the possibility that some asthmatic children may have coexisting GERD in need of treatment.

Kwiecien J, Nachura E, Halkiewicz F, et al: Clinical features of asthma in children differ with regard to the intensity of distal gastroesophageal acid reflux.  J Asthma. 2011; 48: 366-373.

Tuesday, January 17, 2012

How Do Kids Describe Their Asthma Symptoms?

It is often difficult to tell what a child is feeling, and they may have a hard time describing symptoms to a parent or the doctor.  A recent study published in the medical journal, Chest, looked at the most common words used by children with moderate to severe asthma, ages 8-15 years, to describe their symptoms of moderate to severe asthma.

The most common descriptions were "My chest feels tight" and "I cannot get enough air in".  This is very similar to the way adults describe their breathlessness.  

But it is important to watch for nonverbal cues that asthma is causing trouble for your child.  Look out for night cough, or a cough triggered by cold drinks, laughter, or running.   Remember also that cough is a more common symptom of asthma than wheezing, which may or may not be heard without the aid of a stethoscope.

Harver A, Schwartzstein RM, Kotses H, et al: Descriptors of breathlessness in children with persistent asthma.  Chest. 2011; 139: 832-838.

Saturday, January 14, 2012

Sinus infection, a cold, or allergies?

The phrase "I have sinus problems" has become so common, it is hard to know what it means.  Here are some tips to tell the difference between sinus pressure due to true sinus infection, a cold, or allergies:

SINUS INFECTION (BACTERIAL SINUSITIS):  This is a bacterial infection in the sinuses (which are areas behind the facial bones that should be filled with air).  Signs can range from a wet cough, thick mucus in the throat, discolored (green, yellow, brown or grey) mucus that persists for more than a week or progresses over that time, pain in the upper teeth or cheeks, tenderness between the eyes or a chronic headache, and nasal congestion -- especially if symptoms are on one side only.   Kids tend to cough or vomit mucus as their only symptom.

A COLD (VIRAL RESPIRATORY INFECTION):  Sometimes difficult to distinguish early on from a sinus infection, the tip offs are that multiple people in the household start with similar symptoms within a week of each other (viral infections spread easily), there is a worsening within a few days then gradual improvement, and there may be fever or muscle aches associated for one or two days.

NASAL ALLERGIES:  The biggest clue here is itching of the nose, eyes, ears, or throat.  Repeated sneezing is also more likely to be due to allergies but can happen with colds as well.  Runny nose is usually clear and watery, not discolored.  But congestion and headaches can be just as bad as with sinusitis or viral respiratory infections.

Treatment is different for each of the above, so it is important to make the distinction.  If you have persistent symptoms and need some help with figuring out the reasons, make an appointment and we'll do our best to help you!  Send us a message from our "contact us" page at southbayallergy. com.



Ingredient alert - Burger King onion rings

Burger King resturants would like to inform you that the new onion rings that became available in November contain wheat and milk ingredients. All ingredient declarations are available online on www.bk.com in the nutrition and allergen download section. This nutrition page provides the most up-to-date listing of all ingredients, allergens, and general nutrition information. For more information, contact Burger King at (305)378-3535.

Friday, January 13, 2012

Fires in So Cal and Santa Ana winds make things tough for asthmatics

There are a few very predictable triggers of asthma, and smoke from wildfires is one of them.  With current wildfires popping up around the So Cal area this week, and Santa Ana winds whipping up pollens as well as the fires, this would be a good day to stay indoors if you have asthma.  Even if you are on good controller medications, these conditions can trigger an asthma flare.  So keep safe and enjoy the weekend with some nice indoor plans!

Wednesday, January 11, 2012

Sugar-Free, Dairy-Free Pumpkin Dip

1.8 oz. package of Tofutti Better Than Cream Chesse non-dairy cream cheese alternative
10 drops liquid stevia herbal sweetener (or substitute other sugar-free sweetener to taste)
1/3 cup pumpkin puree
1 tsp. cinnamon
1/4 tsp. cloves
1 tsp. vanilla extract
chopped pecans (optional, use only if not tree nut allergic)

Mix first six ingredients well. If used, top with chopped pecans. Serve with sliced apples.

Delicious and healthy!

Sunday, January 8, 2012

Southern California springtime trees already blooming!

Just got through the holidays, not really thinking about springtime yet -- but Southern California has had some beautiful weather lately, and along with the sunshine and breezes we are starting to see some early springtime blooming trees.

Pollen counts for ash and alder trees are on the rise, so by all means go out and enjoy the beautiful outdoors, but remember not to bring it back into your bedroom if you are pollen allergic.  Throw those outdoor clothes into your laundry and not onto your bed, to avoid nighttime exposure and a morning stuffy nose!

Friday, January 6, 2012

Tragedy at School Without Epi-Pen

It is important to have immediate access to an EpiPen, which can be life-saving in a situation like this one.  See article below about a little girl in Virginia who died at school earlier this week, after ingesting a peanut containing food and not having early treatment with epinephrine.  Very sad to see such a preventable situation happen.   Please be careful and make sure your food allergic child's EpiPen is current and available at all times!

http://bit.ly/wUxxCY

Thursday, January 5, 2012

Ingredient Notice - Mars

A new Snickers bar variety, called Snickers Slice n' Share, has a different allergen advisory statement than other SNICKERS bars. The Snickers Slice n' Share bar states "May Contain Tree Nuts and Wheat" because it is made on equipment that also uses these allergens. Other Snickers bars continue to state "May Contain Almonds" because they are made on different equipment. Snickers Slice n' Share, is a 1-lb bar, which is significantly larger than other Snickers bars.

Snickers Slice n' Share bars are available for the holiday season in CVS stores between November and February.

As always, Mars Chocolate North America urges you to read all labels for current allergen information. If you have any questions regarding these changes, please call (800) 551-0702.

Tuesday, January 3, 2012

Food allergy blood or skin tests are just a starting point

Allergy skin tests or blood tests (specific IgE to foods) are commonly used to diagnose food allergies in children, especially those with severe eczema.   However, these results are just a starting point -- oral food challenges in a systematic way are essential to developing a reasonable diet that will not trigger the eczema.  

While a large percentage of young children with moderate to severe atopic dermatitis (eczema) do have one or more food allergy triggers, and will improve with elimination of that food, often they will have several false positive results to other foods on skin testing or blood tests.

A 2011 study in the Journal of Pediatrics confirmed that 84% to 93% of implicated foods did not need to be avoided after oral challenges.  Of the 131 oral food challenges performed, only 11 were positive.

We feel that our job as allergists is not only to tell patients what they need to avoid, but also what is okay to keep in the diet.   It is often unnecessary to severely limit a child's diet, especially if based on the results of serum IgE testing alone!

Fleischer DM, Bock A, Spear GC, et al: Oral food challenges in children with a diagnosis of food allergy. J Pediatrics. 2011;158:578-583.

Monday, January 2, 2012

A New Year Full of Promise


Happy New Year!  



Whether the holidays brought busy, hectic times or a nice break from school/work – take a deep breath and think about the possibilities that await you this coming year.  Hope you have lots of great ideas for a wonderful 2012!




We at South Bay Allergy are looking forward to some exciting new changes this year, including:
  • a new Manhattan Beach/El Segundo second office location, to be launched later this year (will keep you posted!) 

  • new online asthma support group – a place for our patients to share tips and ideas that have worked for them, share stories and successes with others who might be just starting out with a new diagnosis, lend a listening ear to someone having challenges with asthma management,  or post stories of athletic accomplishments (did you know that many world-class athletes have asthma?)
  •  more community outreach programs through schools and workplaces – let us know if your company or school would like to have one of our doctors come out to speak to your group about discovering or managing allergies and asthma (just leave a comment here for us, or give us a call at 310-371-1388)


Let us know your thoughts – suggestions or ideas that would help you in your quest to conquer your allergies or asthma and reach your goals!

Sunday, January 1, 2012

Island-Style Hot Chocolate (Dairy Free)

3 cups coconut milk


1/3 cup semisweet chocolate chips (check label for dairy or substitute carob chips)


1 tablespoon sugar (or substitute 1 tsp. agave nectar)


1/2 medium-size banana (or substitute pinch of xanthan gum)


1 pinch ground cinnamon




Directions:


Microwave 2 cups coconut milk on high for 2 minutes (cooking time may vary based on microwave wattage); stir in chocolate, sugar and cinnamon. In blender, blend 1 cup coconut milk and banana until smooth.* Mix all ingredients together and heat in microwave on high for an additional 2-3 minutes.




*If using xanthan gum, heat all 3 cups milk in initial step, add pinch of xanthan gum to mixture and stir before heating the additional 2-3 minutes.




For range top, heat coconut milk initially in saucepan to moderate-warm before following same ingredient-mixing instructions above.