All posts by Charleston Allergy and Asthma

Do I Have Skin Allergies?

Skin allergies can range from inconvenient to painful, and are dealt with by many people who suffer from other allergy types as well. These allergies can vary widely and exhibit different types of symptoms, so it is important to know what to expect. Additionally, some non-allergic conditions may display similar symptoms.

We’ll go through a variety of information related to skin allergies, such as common symptoms and treatment options, so you can know what to expect during allergy season.

 

What Are Skin Allergies?

Skin allergies function in a way that is similar to any other allergy but simply affect the skin. There are several unique features that skin allergies have, which we will get into in detail later. However, the fundamental principle is the same.

When someone has skin allergies, their immune system is over-sensitive in a way that causes the skin to react with itchiness, swelling or pain. People can experience allergic reactions in their skin from many of the same irritants that affect their respiratory system or eyes. Skin rashes can exhibit a variety of symptoms, from hives to dry or puffy skin.

woman-scratching-neck-rashSymptoms of Skin Allergies

The main symptoms of skin allergies include red bumps, hives and scaly texture, and is often accompanied by itchiness. Some skin allergies may also involve angioedema. This refers to swelling in deeper layers of the skin, which may be less visible. Symptoms may arise along with other types of allergy symptoms like sinus congestion or on their own.

Symptoms will usually only appear when the skin comes into direct contact with an allergen. This could be from natural irritants like pollen, or synthetic ones such as chemicals found in cosmetics.

 

What Are the Causes of Skin Allergies?

Skin allergies can be caused by a variety of irritants. In many cases, skin responds to similar irritants that also cause respiratory allergies. This can include things like pollen, animal dander and chemicals found in cosmetics.

However, the most common skin allergies are things that usually won’t cause any other type of allergy. This includes materials such as latex and nickel, which is often found in jewelry.

 

Is Eczema a Skin Allergy?

Eczema, also known as atopic dermatitis, exhibits many of the same symptoms as skin allergies. It is also associated with the development of certain food allergies, so the conditions may seem linked.

There are different types of eczema, and it is sometimes difficult to ascertain whether it is itself an allergy or an allergy-related illness. Flare-ups of food allergies or contact with irritants can exacerbate eczema symptoms. However, eczema is primarily caused by a certain genetic variation, so it is a bit more complex than other allergies.

 

How Do You Treat Skin Allergies?

skin-rash-on-backSkin allergies can be treated in many ways depending on the symptoms. The first step to finding a recommended treatment plan is visiting a board-certified allergist to discuss allergy testing. There are a couple of test options available for those suffering with skin allergies. Your board-certified allergists will likely talk with you about skin tests and patch tests.

Skin tests are performed by inserting a small drop of the suspected allergen just under the surface of the skin. Many suspected allergens can be tested at the same time in this way and results become available within minutes. It’s fast and relatively pain-free.

Patch testing is available for patients experiencing contact dermatitis, or a reaction when the patient comes into contact with a material that irritates their skin. Hypoallergenic patches containing individual allergens are applied to the patient’s back for 48 hours. The patches are read and the patient will be scheduled to review results with their allergist afterward.

Once allergy testing is performed, your board-certified allergist will provide a treatment recommendation. This can include immunotherapy (also known as allergy shots), which aims to fully target the root of the skin allergy.

There are a variety of medications available for those suffering with skin allergies, ranging from ointments to oral antihistamines. Some non-medical approaches can help alleviate symptoms as well. Cold compresses and oatmeal baths can sometimes help with burning pain and swelling, although their efficacy will vary. Your board-certified allergist will be able to recommend a treatment option that works best for you.

 

Using Avoidance for Skin Allergies

If you have an allergy to something that you can avoid more easily, like nickel, then avoidance is your best option. In some cases, you may have to choose the lesser discomfort of long sleeves over the greater discomfort of exposing your skin to allergens.

A big nuisance associated with skin allergies is that in some cases, you won’t be able to tell what you are allergic to. In this case, your best bet is to visit a board-certified allergist. They will be able to help you find out exactly what you react to, as well as how to best treat it.

 

Key Things to Remember About Skin Allergies

If you have skin allergy symptoms, then finding out the triggers should be a top priority. This shouldn’t be done alone — an allergy test given by a board-certified allergist is the way to go. Different treatment options target different types of symptoms, so make sure you get some advice about how to approach your symptoms before you begin a treatment regimen.

Learn more about your symptoms and consult with one of our board-certified allergists by scheduling an appointment today.

 

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Allergy and Immunology: A Misunderstood Medical Field

Ever wonder why there is a specialized medical field just for allergy? How about those old tales you’ve heard of classic allergy symptoms only to realize they were caused by something else? Believe it or not, there are plenty of misconceptions about allergy and asthma, which is why our team is dedicated to educating our patients on their condition and treatment every step of the way. Dr. Lindsey S. Steadman took the time to share about her experience becoming a board-certified allergist and how our team’s training equips us to give our clients the very best allergy and asthma care.

 

How does an allergist become an allergist?

In order to become an allergist, we go through many years of medical school and clinical training:

  • 4-year undergraduate degree – Most healthcare providers choose a major that they feel best prepares them for medical school, such as biology, chemistry, biochemistry, etc.
  • 4-year medical school degree – Medical school provides the basis of education in becoming a doctor, covering a wide variety of medical care and topics to ensure a well-rounded education.
  • 3-year residency program – All physicians must enter a residency program of some kind to complete their specialty training. As allergists and immunologists, we all have to receive training in either pediatrics or internal medicine. These are both 3-year residency programs, and they are each followed by a board exam that must be passed in order to become a certified pediatrician or internist.
  • 2 to 3-year fellowship – Residents interested in specializing further can then apply to various fellowship programs. The majority of allergy and immunology fellowship programs are two years long (occasionally three years long). Once we graduate from fellowship, we must pass a board exam in order to be certified in allergy and immunology.

After passing our boards, we are able to treat patients of all ages with any sort of allergic or immunologic disease. This includes, but is not limited to, environmental/seasonal allergies, food allergies, stinging insect allergies, anaphylaxis, hives and swelling, eczema, asthma, chronic/recurrent infections and immunodeficiencies.

 

Why is allergy and immunology such a misunderstood field?

Allergy and immunology is a poorly understood field not only in the general population, but also within the medical community. There are many different myths and “old wives’ tales” out there about allergy signs, symptoms and treatments amongst the general population. When patients are not properly educated by allergy experts, these myths and misinformation continue to circulate and become accepted as fact. Even in the medical field, allergy is a misunderstood because there is very little, if any, dedicated teaching or training on allergy and immunology in medical school or residency programs. Fellowship is where the true allergy and immunology training occurs, so a board-certified allergist is always recommended for patients suffering from any sort of allergic disease or immune deficiency.

We are trained on how to obtain a detailed history to determine whether or not testing and further work-up is needed. We are taught how to interpret the results of both skin and blood tests for various types of allergies, lung function testing for asthma, and blood work for immune disorders, all of which are oftentimes not very straightforward. We are also taught how to appropriately manage these issues with medications, allergy shots, biologics, immunoglobulin replacement, oral food/drug challenges and oral immunotherapy for select food allergies. Therefore, it is always recommended to seek the help of a board-certified allergist because we are the experts in the disease process, pathophysiology, diagnosis, management and treatment of all allergic and immunologic diseases.

 

What are some common myths about allergy and immunology?

  • Every sniffle or sneeze is an allergy and every cough or episode of shortness of breath is asthma… FALSE. Fortunately, we are trained to determine whether or not patients have allergies and/or asthma. Not only can we diagnose and treat these issues, but if patients’ allergy- or asthma-like symptoms are caused by something else, we can often help with those problems as well.
  • Every hive or episode of swelling is due to an allergic reaction… FALSE. This can be true at times, but there are also instances when hives are caused by other things as well. We are trained on how to determine whether or not there is an allergy-causing patients’ hives and swelling and how to treat them no matter the cause.
  • All allergic reactions get worse with subsequent exposures… FALSE. There is no way to predict the severity of an allergic reaction based on previous reactions or testing methods. However, we can help diagnose the cause of the allergic reaction (foods, insect stings, medications, etc.) and educate patients on what exposures would be unsafe and how to handle reactions in the future.

 

If you believe you’ve been experiencing allergy or asthma symptoms but you’re unsure of what to do next, leave it to the experts! All of our allergists are board-certified and our team is dedicated to helping you breathe better, feel better and live better. Schedule your appointment with the experts today.

 

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Child blowing nose

Childhood Allergies: What You Need to Know

With childhood allergies afflicting around 30% of children, many parents are left wondering what to do. If your child is wheezing, sniffling and coughing often, you may be curious about the cause and what you can do to help. We’ll run through many of the common questions that parents have about childhood allergies, so you can put your mind at ease.

What are the most common symptoms of allergies?

There are many common symptoms that children deal with when suffering from allergies. These symptoms can vary greatly depending on whether the allergy is environmental, a food allergy, a drug allergy or an insect sting allergy.

Environmental allergies, also known as allergic rhinitis, are the most common form of allergic reaction. Most commonly, children will be sneezing or coughing and will experience a runny nose and itchiness in the nose and roof of the mouth. It is also common to experience red, watery eyes. Symptoms are similar to but not the same as the common cold.

Symptoms for allergic rhinitis will usually be seasonal, although this isn’t always the case. If your child is experiencing allergy symptoms only during the spring and summer, allergic rhinitis is likely. However, you should see a board-certified allergist to confirm the root cause.

The most common culprits for environmental allergies in the Lowcountry are dust mites, cockroaches and mold. These often have a year-round impact on an allergic individual’s health.

Food allergies can cause a variety of symptoms, such as tingling or swelling in the mouth, hives, or even anaphylaxis in more severe cases. When food allergies are less severe, they can often be hard to diagnose, especially when the allergen is less common.

If your child ever experiences these symptoms, you should investigate as early as possible. Knowing the cause of a food allergy provides invaluable information so that you know how to best care for your child and eliminate risks of allergic reactions.

How are allergies in children treated?

There are three main ways that allergies can be treated: avoidance, medication and immunotherapy.

Avoidance

Avoidance simply means not coming in contact with the relevant irritant. This will help greatly, but can sometimes be hard to keep up. If your child wants to play outdoors during summer, but comes home with a runny nose or worse, it can be hard to find a balanced solution.

When symptoms are more severe, this can require children to miss school or be unable to see their friends. Finding a way to deal with allergy symptoms can greatly impact a child’s life well into the future, so make sure to deal with the issues head-on.

There is usually a comfortable middle ground to find if the allergies aren’t too severe. For example, dust-proofing your child’s bedroom or making sure to shower after coming indoors to remove any pollen spores can aid in the quick cessation of allergy symptoms.

One question we often get asked is, “Do I need to get rid of my pet if my child is allergic?” While pet allergies can be a nuisance to say the least, your board-certified allergist can provide recommendations on how to best avoid allergens within the home. We certainly won’t ask you to get rid of your pet! Our top recommendation for individuals with pet allergies is to receive immunotherapy, which has shown to be extremely beneficial in treating the cause of pet allergies.

Medications

Allergy symptoms can be further aided by using certain medications. Do not give your child any medications without first consulting your doctor or board-certified allergist. If you are told that a given medication doesn’t come with any risk, it may be worth a try.

Medications don’t make allergies go away permanently, but they help deal with symptoms and inflammation. Especially when symptoms get severe, medications can be the difference between a normal day at school and a day spent wheezing and unable to focus. Once you know a given medication is safe and effective, it can be good to have on hand in case your child’s symptoms flare up unexpectedly.

One thing to consider when finding the best medication treatment for allergies are common symptoms, such as drowsiness. It’s important to find the right medicine if that’s the treatment route you wish to take, and your allergist will always be able to recommend the best medication treatment plan for you or your child. If medication isn’t doing the trick, immunotherapy is the closest thing to a cure.

Immunotherapy

Lastly, most patients benefit greatly from immunotherapy. This is a long-term treatment option that involves injecting small doses of an allergen into the patient so that they build up immunity. Each patient receives an individualized treatment plan that is custom-tailored for your child’s specific allergens.

This option can have some difficulties when it comes to kids — it can be hard to drag them to the allergist each week! But, it is the best long-term solution and the only way to get truly permanent relief from allergies without using medications. Immunotherapy is available for a variety of allergies. It is also helpful to see a board-certified allergist who specializes in care and treatment for pediatric patients. Our allergists are double-boarded to treat both adults and pediatric patients. Oftentimes, they know how to make children feel right at home during their doctor’s visits and can make shot appointments far less scary or intimidating.

Key Things to Remember

As always, the best option to pursue if you suspect your child is suffering from allergies is to see a board-certified allergist. Through allergy testing and detailed health evaluations, this can provide you with an understanding of the best treatment path that is specific to your child’s situation, rather than just a guess.

 

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Share Why You Love Charleston Allergy & Asthma!

There are thousands of reasons to love Charleston Allergy & Asthma! We’re celebrating topping 2,000 Facebook followers by hosting a contest for the ultimate #2000Reasons Beach Day Giveaway!

We feel so loved by our patients and community and we want to say THANK YOU for more than 30 years of choosing us to care for your families by giving away all that you need for a fun day at the beach with the entire family.

How to Enter:

Anyone can enter our #2000Reasons Beach Day Giveaway! Simply enter to win by liking our post on Facebook or Instagram and earn bonus entries by sharing why YOU love Charleston Allergy & Asthma! (If you need to find a few reasons, you can check out our website for some ideas. 😉)

  1. Like one of our contest posts on Facebook or Instagram and tag a friend to earn one entry. Earn an additional entry for each additional friend that you tag or comment sharing why you love CAA!
  2. You can also earn an extra 5 entries by publishing your own post and tagging us! Print and use our template or share in your own creative way why you love CAA. Post your picture or video to Facebook or Instagram by July 30 and tag us – don’t forget to use the hashtag #2000Reasons!
  3. We’ll randomly select a winner on August 3.

If you have an appointment with us soon, we’ll be sure to give you the opportunity to take part in the fun while you’re visiting as well!

Our Beach Day Giveaway includes:

  • Two Tommy Bahama beach chairs
  • Two XL beach towels
  • 55 quart Coho cooler
  • 2 CAA tumblers

Giveaway Guidelines:

  • Contestants do not need to be a Charleston Allergy & Asthma patient to enter
  • This giveaway is not sponsored or in partnership with Facebook or Instagram
  • The winner must respond to Charleston Allergy & Asthma outreach via social media no later than 5 days after the winner is announced. Should the initial winner not reply to Charleston Allergy & Asthma’s outreach, a secondary winner will be selected (and so forth).
  • The contest winner must pick up the prize at a Charleston Allergy & Asthma location (Mount Pleasant, West Ashley or Summerville).
  • Contestants will be considered for the opportunity to be selected to win at random once they share a public social media post including why they love Charleston Allergy & Asthma and tagging Charleston Allergy & Asthma in that post. Contestants must enter before (deadline).
  • For social media information, see Charleston Allergy & Asthma’s Facebook or Instagram

Thanks to our patients and to our community for your continued support throughout the years! It’s our team’s privilege to care for you and help you Breathe better. Feel Better. Live Better!

 

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Celebrating Dr. Harper's Retirement

Celebrating 40 Years of Patient Care with Dr. Thomas Harper

If you’ve been with Charleston Allergy & Asthma for quite some time, you’ve likely had the opportunity to share a smile with Dr. Harper! Whether it’s for his love for sharing a good laugh, his incredible necktie collection or his understanding and compassionate care, patients of all ages have grown to love Dr. Harper over his 40 years of owning an allergy practice.

While it’s bittersweet for our Charleston Allergy & Asthma team, we are excited to celebrate Dr. Harper’s retirement and honor the tremendous impact he has had on our staff, patients and community. After all, he’s been with Charleston Allergy & Asthma since day one, having founded the practice with Dr. Bruce Ball in 1992. Since then, we’ve had the opportunity to share many fond memories, walk through life’s highs and lows together, and become our own little “work family” here in the Lowcountry.

We took a moment to sit down with “Dr. H” and learn more about his story, his experience in caring for generations of families throughout his tenure, and to hear what he has planned next!

Where are you originally from and what brought you to Charleston?

My family is from Berkeley County, although my dad was an air force pilot and we moved 14 times in 10 years. We lived in Tokyo, Honolulu, Maine and New Hampshire. I come from a family of seven MDs over the course of three generations. My dad was from St. Stephens, SC and my mom from Moncks Corner. After going to medical school in New Orleans and fellowship in Denver, I wanted to be back with my folks here in the Lowcountry.

How long have you been practicing medicine and why did you decide to go into the allergy field?

I’ve been practicing medicine for 40 years. Initially, I wanted to be a pediatric cardiologist, then decided during my residency at Charity Hospital in New Orleans that I wanted to be in the busiest field; and at that hospital, it was allergy/immunology. I stayed in New Orleans for an additional two years at the National Institute of Health (NIH) for my immunology research fellowship and then my mentor helped me get into the National Jewish Hospital where I studied immune function of Cystic Fibrosis patients. I had the opportunity to study and treat children with various lung problems and received a lot of specialty training. When I came back to SC, there was no pediatric pulmonologist in the lower half of the state, so I became the de facto lung specialist.

How did you come to begin Charleston Allergy & Asthma?

I decided to join forces with Dr. Bruce Ball after working alongside each other. We quickly realized we would make a great team. Bruce is incredible at the “business side” and I don’t care for it, so we were a good fit! We eventually brought on Dr. Davidson four years later and have continued to grow over the years with an extraordinary team of board-certified allergists. There are seven of us now!

How has the field of allergy and asthma transformed over the years?

Forty years ago, the allergy field didn’t have the greatest reputation. A lot of people thought it was some sort of “hocus pocus.” There were also some major misconceptions about allergy injections and allergists putting everyone on allergy shots, like it was a shot factory. Our field has now developed tremendously and has a strong scientific footing with justification for what we do and the treatments we choose.

A huge positive change has been seen in severe asthma. Decades ago, individuals were considered invalids if they had asthma. There was little good medicine available in the 60s and 70s and the few medications that were prescribed had a lot of side effects. It’s been rewarding to treat people who weren’t aware of good asthma control medications and change their lives.

What is your favorite part about being a doctor?

The one-on-one interaction with patients, particularly the children. The opportunity to teach patients over the years, whether for their own care or their children’s care, has been rewarding. I’m the doctor but what I really want to be is your expert advisor. It is ultimately the patient’s role to choose their therapy. My job is to share what the problem is and then provide options for treatment. Working alongside patients on their health journey is what I enjoy.

How many patients do you believe you’ve had the honor of caring for over the years?

I’ve seen three generations of patients throughout my career. It’s been amazing for some of my patients who I took care of as children, to now take care of their children and their grandchildren!

What will you miss most after retirement?

Dr. Harper and his dog, GabeThe people! The patients, my staff, my colleagues. I’ll miss improving patients’ quality of life. Seeing the benefits of the therapies that people didn’t know were available. I’ll miss seeing them healthy, when they didn’t think they could feel any better!

It’s amazing to share a treatment plan with a patient, to tell them that it will change their life and then to see them become healthier, breathe better and start enjoying activities again.

What are you most excited about in this new chapter?

Time off doing other things that I love! I haven’t had more than three days off in five years. I haven’t taken a week off in 15 years. I know my dog Gabe will be really happy! I’m looking forward to spending time out on the water, hanging out with Gabe, white water paddling, kayaking and traveling around the U.S.

Can you share a bit about your family?

I’m excited that retirement will bring more time with my family as well! I have a wife, Joanna, a daughter, two step kids and a granddaughter. Here’s hoping they don’t get too sick of me now that I’ll be around more.

Are there words of encouragement that you would like to share with the Charleston Allergy & Asthma family?

I’ve enjoyed working with our team. It’s incredible to see that the average employee in doctors’ offices nationwide lasts around 18 months. Most of our staff has been with us for many years, and some even decades! It’s been wonderful to have a staff that works well together, that I work well with, and to see how we’ve come to know each other and anticipate what needs to be done.

 

We are thankful that while Dr. Harper is retiring, he will remain on our staff as a consultant for our allergy and asthma practice. We’re also thankful for the six talented board-certified allergists on our team that will continue to provide care for patients throughout the Lowcountry. Interested in requesting an appointment? Contact our team today.

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10 Things People With Food Allergies Want You to Know

More than 30 million people in the U.S. alone have one or more food allergies. In other words, their immune systems deem certain foods harmful and overreact by triggering symptoms such as hives.

Food allergies may not seem like a big deal, especially if you don’t have them or have only ever heard of or witnessed mild reactions. However, they are very serious. With that in mind, there are 10 things that people with food allergies want you to know.

1. Food Allergy & Food Intolerance Are Different

Intolerance to certain foods is a digestive reaction. Think lactose intolerance resulting in gas, diarrhea, nausea and similar symptoms.

Food allergies, on the other hand, are immune reactions and have the potential to be lethal. Therefore, it’s much appreciated when you take the food allergies of those around you seriously.

2. The Most Common Allergens

Eight foods are responsible for nearly 90% of all food-related allergic reactions. They are:

  1. Milk
  2. Egg
  3. Peanuts
  4. Tree nuts such as walnuts and pecans
  5. Wheat
  6. Soy
  7. Fish
  8. Shellfish such as shrimp and crab

Due to the prevalence of these allergies, all of these foods are required by federal law to be named when used in packaged food or when present in a facility where such food was prepared. So when shopping for someone with food allergies, read the labels carefully so you know what items to steer clear of!

3. Any Food Can Cause a Reaction

While the eight foods mentioned are responsible for the vast majority of allergic reactions, no food is off-limits. A person can develop an allergy to any food, which is a good reminder to take any and every mention of food allergies seriously. Just because one may not be common doesn’t mean it’s not real and potentially dangerous.

4. Reactions Are Unpredictable

Allergens can trigger either mild reactions such as hives and an itchy nose or severe ones such as repeated vomiting, difficulty breathing and worse. The trouble is that there’s no way to predict how severe a reaction will be. Even if previous reactions have been mild, there’s no guarantee that future ones won’t be life-threatening. Hence the importance of doing everything you can to help those with food allergies avoid foods that trigger their symptoms.

5. It Doesn’t Take Much to Trigger a Reaction

It doesn’t take a full serving of an allergen to cause a reaction. Depending on the severity of their allergy, a single bite, cross-contact or even being in a room with an allergen can be a trigger. Therefore, it’s critical to avoid the attitude that “just a little bit can’t hurt” and to be understanding when a person has to refuse an offer of food due to an allergy.

6. “Free-From” Labels Are Misleading

Claims like gluten-free and nut-free don’t always mean “100% free of.” Rather, they indicate that the amount of allergens contained in a food is under a certain threshold. So, technically, such foods may still have the potential to trigger allergic reactions.

The solution? Rather than relying on the labels on the front of packages, take a close look at the ingredients list when shopping for people with food allergies.

7. The Symptoms of Allergic Reactions

Allergic reactions can take their toll quickly and unexpectedly so you need to know the signs. Symptoms include:

  • Hives
  • Flushed skin or rash
  • A tingling or itchy sensation in the mouth
  • Face, tongue, or lip swelling
  • Vomiting and/or diarrhea
  • Abdominal cramps
  • Coughing or wheezing
  • Dizziness and/or lightheadedness

By far, the most serious reaction is anaphylaxis, which can cause breathing difficulties, sudden drops in blood pressure, swelling of the throat and loss of consciousness. Anaphylaxis is life-threatening and can set in minutes or even seconds after exposure to an allergen. Swift action is essential to reverse its effects, which brings us to our next point.

8. How to Help in Emergencies

Many people with food allergies have a treatment plan in place for emergencies. Such a plan often includes an epinephrine auto-injector, which should always be nearby in the event of a severe reaction. If a family member or friend of yours has food allergies, get informed beforehand about what to do if they ever have a reaction in your presence.

9. The Time Window For Reactions

As mentioned, many reactions happen within minutes of exposure. However, remain alert beyond that time as some reactions can be delayed by as much as four to six hours.

10. Stay Alert

Food allergies should be taken seriously by both the person who is allergic and individuals who spend time with them. If someone makes you aware of their food allergy, consider how you might help keep them safe and avoid any foods that may contain that allergen. If it is questionable as to whether a food contains a certain allergen, it’s best to keep things safe and avoid that food altogether. Your food-allergic friends will appreciate your support.

 

If you believe you may be experiencing symptoms to food allergies, our team of board-certified allergists offers allergy testing and can advise on the best form of treatment or symptom management. You may even be a candidate for oral immunotherapy! Learn more by requesting an appointment today.

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Charleston Allergy & Asthma is offering allergy testing for the COVID-19 vaccine

If you’ve had a history of allergic reactions to vaccines or tend to be skeptical of vaccination side effects, you may have quite a few questions regarding the newly available COVID-19 vaccinations. 

While our team of board-certified allergists advises the majority of our patients to move forward with scheduling their vaccination appointments as they are able, there are some who have experienced allergic reactions to vaccines in the past and will need to proceed with caution. In order to best serve these patients along with other Lowcountry residents concerned about vaccine reactions, our team is excited to announce we are offering allergy testing specifically for the COVID-19 vaccine!

We took a moment to get all of the details from Dr. Meredith Moore, a board-certified allergist at Charleston Allergy & Asthma, to learn more about the vaccine and to find out who might want to consider an allergy test before moving forward with their vaccination appointment: 

Why would someone want to get tested to see if they might have an allergic reaction to the COVID-19 vaccine? 

Individuals should be evaluated by a board-certified allergist/immunologist if they have a history of severe allergic reaction to any vaccine in the past, any reaction within 4 hours of receiving the first COVID shot, or an allergic reaction to any of the components of the COVID-19 vaccine. At this time, it is not known which COVID-19 vaccine component(s) is/are causing allergic reactions. Polyethylene glycol is an ingredient in the mRNA vaccines and has been associated with anaphylaxis. Polysorbate 80 is used in the Johnson & Johnson vaccine and can cross-react with polyethylene glycol.

 

How will Charleston Allergy & Asthma test for COVID-19 vaccine allergic reactions?

We use a protocol that was developed by a team of allergists/immunologists specifically for COVID-19 vaccination. The protocol tests for immediate skin test reactivity to the vaccine components polyethylene glycol, polysorbate 20 and polysorbate 80. We use both skin prick testing and intradermal testing. With skin prick testing, we introduce the testing material to the immune system just under the skin. There is no bleeding and only minimal discomfort from the testing device that lasts for a few seconds. Intradermal testing uses a very small needle to inject the antigen under the skin. 

The tests can be administered at any Charleston Allergy & Asthma location. The test results are available immediately when the test is completed. The test can take up to three hours to complete. 

 

If someone tests positive for an allergic reaction to the COVID-19 vaccine, what should their next steps be? Will they be allergic to all three that are currently available (Pfizer, Modern, J&J)?

Patients will be tested for different ingredients of the vaccines. If you test positive for one component, but negative for a different component then that may suggest that one of the vaccines may be better tolerated than the others. In that case, you and your board-certified allergist may decide to proceed with vaccination to a certain brand of COVID-19 vaccine.

To note, there have been fewer reports of severe allergic reactions to the Moderna and Johnson & Johnson vaccines. However, most of this data is provided through reporting which may not be fully accurate. Additionally, only a fraction of the final doses have been administered so these numbers may change over time. It is recommended that individuals receive whichever vaccine is available unless they are at risk for a severe allergic reaction in which case it is recommended they seek evaluation by a board-certified allergist. 

 

Are there any risks associated with getting tested to see if an individual is allergic to the COVID-19 vaccine?

As with any allergy testing, there is a rare risk of an allergic reaction. Our experienced staff monitor patients for any sign of allergic reaction throughout the procedure.

 

If someone does not test positive for allergies to the COVID-19 vaccine, should they move forward with receiving the vaccine?

This will be a decision made between the patient and their board-certified allergist. It involves weighing multiple factors such as the severity of any prior allergic reactions, any medical condition that may increase the risk of an allergic reaction, their exposure risk to COVID-19 infection, availability of the vaccine in locations experienced in treating allergic reactions and the patient’s personal preferences.

 

How effective are the COVID-19 vaccines that are currently available (Pfizer, Moderna and Johnson & Johnson)?

The vaccines currently available in the U.S. have been shown to reduce COVID-19 infection by 72 – 95% and prevent 86 – 100% of severe infections.

 

What are some of the most common side effects experienced after receiving the COVID-19 vaccine? 

Most people experience mild side effects from the COVID-19 vaccine that are similar to common side effects from other vaccines. Most people, if they have an allergic reaction, will experience the following: 

  • Headache (22% of recipients)
  • Tiredness (17% of recipients)
  • Dizziness (17% of recipients)
  • Chills
  • Fever
  • Nausea
  • Muscle aches

These side effects are a sign that your immune system is recognizing the vaccine and developing protective antibodies. These symptoms generally go away on their own in 1-2 days. For some people, these common side effects are more intense after the second dose of a 2-shot series.

 

What are the most common allergic reactions that individuals are having to the COVID-19 vaccine? 

According to a paper published in the Journal of American Medical Association which tracked reactions in Mass General Brigham employees, the most common allergic reactions were rash, itching, hives, swelling that was not at the injection site and respiratory symptoms (Blumenthal). This occurred in a total of 2% of vaccinated individuals. Anaphylaxis, a more severe allergic reaction, occurred in 0.025% of vaccine recipients (16 people out of 64,900).

 

How serious is anaphylactic shock?

When someone experiences anaphylaxis they have allergic symptoms in multiple organs. These patients have difficulty breathing, low blood pressure or severe gastrointestinal symptoms in addition to hives or itchy rashes. Anaphylaxis can be life-threatening if the heart or lungs are severely involved. Fortunately, for those who experience anaphylaxis, injectable epinephrine is very effective at reversing anaphylaxis if used early. Among the Mass General Brigham employees, 16 developed anaphylaxis but only 1 required hospitalization. The Vaccine Adverse Event Reporting System has received reports of 3.8 anaphylaxis reactions per 1,000,000 doses of mRNA vaccines.

 

How are reactions treated at COVID-19 vaccination sites? Is every site equipped to handle reactions?

The CDC has created a Checklist of Best Practices for Vaccination Clinics Held at Satellite, Temporary or Off-Site Locations. This checklist includes expectations that vaccine providers are CPR certified and that an emergency medical kit is on-site. Most vaccine sites are advising patients to wait 15 minutes after receiving the vaccine to ensure they are in a location where medical assistance can be provided.

 

What signs should an individual look for or consider as they gauge their risk of an allergic reaction to the COVID-19 vaccine?

Most severe allergic reactions start within 15 minutes of the vaccine being administered. Common symptoms are hives, cough, shortness of breath, fast heart rate or nausea. Let a vaccine provider know if you experience these symptoms.  

 

Are there any additional details to note on allergy testing for the COVID-19 vaccine?

The COVID-19 skin testing protocol was developed by experts in the allergy and immunology field using our current understanding of the ingredients of the COVID-19 vaccines. The protocol has not been extensively evaluated so we do not know how reliable the test protocol is. The testing results will provide you and your allergist information that can be incorporated in decision-making regarding COVID-19 vaccine administration.

 

If you have a history of allergic reactions to vaccines or components of the COVID-19 vaccine, our team of board-certified allergists recommends you consult with your healthcare provider before receiving the COVID-19 vaccine. To find out if it’s recommended that you receive allergy testing for the COVID-19 vaccine, request an appointment with one of our board-certified allergists today.

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Lowcountry nurse shares what it’s like to be a COVID long-hauler

Throughout 2020 and now into our second year of the COVID-19 pandemic, many people might be able to relate when saying the coronavirus “felt close to home.” Whether you have received a positive diagnosis personally or a loved one has been affected by COVID-19, when someone you know has a difficult experience with the virus, it can truly shape perspectives.

Our team is thankful to report that Sarah, a nurse here at Charleston Allergy & Asthma, is now farther along on her road to recovery than she was just a few months ago, but her experience with COVID-19 as a 37-year-old, healthy and active woman is not as uncommon as you would think.

We sat down with Sarah to learn more about her experience as a “long hauler” (the nickname given to those with prolonged cases of COVID-19), and how she fought along the road to recovery from the coronavirus.

When were you first diagnosed with COVID-19 and do you know how you may have contracted it?

I tested positive for COVID-19 on June 28, 2020. I’d recently gone in for a surgical procedure and had to be tested prior to that on June 23. I didn’t go anywhere prior to the surgery or after, so I assume that I contracted COVID during my hospital visit for the procedure. I began having symptoms on June 25.

What initial symptoms did you experience with COVID-19 and how did they progress over time?

  • Day 1: extreme lower back pain, terrible headache.
  • Day 2: sore throat, mild sinus congestion.
  • Day 3: raw and sore throat, severe sinus congestion, loss of taste and smell.
  • Day 7: intense sinus congestion, headaches and fatigue. Still no signs of fever, body aches or chills.
  • Day 10: chest tightness, breathing issues, starting to really decline.
  • 4 weeks: breathing under control, but now experiencing heart issues including heart palpitations and chest pain. Received EKG that came back abnormal and was referred to a cardiologist.
  • Continued experiencing heart-related symptoms including an inconsistent heart rate. (i.e. Heart rate in the 140s while sitting and resting, 180s while standing, feeling short of breath, nearly passing out.)
  • 5 weeks: diagnosed with tachycardia and began treatment for myocarditis (inflammation of the heart muscles).
  • Also experienced a range of different symptoms in this time period, including hurting calf muscles, bloating, gas, heartburn, diarrhea, constipation and vomiting. Began to lose my hair in clumps, had extreme fatigue and felt “brain fog” (couldn’t remember words, had forgetful days, etc.) Felt like every nerve in my body was firing off at the same time, causing tremors. Taste and smell had only partially returned, certain foods tasted strange. Gained 30 pounds. Felt like every system in my body was failing.
  • Eventually diagnosed with Dysautonomia; autonomic nervous system was damaged by COVID-19, which controls heart rate, blood pressure, breathing and digestion. Severely deconditioned by the time physical therapy was started and had no muscles in hips or legs.

What specific treatment did you seek in hopes of recovering from COVID-19?

I have seen our wonderful Dr. Moore at Charleston Allergy & Asthma since my initial diagnosis. I also consulted with a pulmonologist, cardiologist, gastroenterologist, neurologist and I have now been in physical therapy twice a week since the end of October. I received a wide variety of tests including chest x-rays,  CT of the chest, EKG, ECHO, Holter monitor, cardiac MRI, endoscopy and colonoscopy. I’ve also been prescribed several medications including antibiotics, daily inhaled steroid, rescue inhaler, oral steroids, beta-blocker, colcrys, countless vitamins, turmeric, probiotics, peppermint oil pills and Pepcid.

Are you still receiving treatment for your COVID-19 symptoms?

I am still in physical therapy and follow up with my cardiologist and primary care provider every other month.

Are you still experiencing any lasting symptoms of COVID-19?

 I still have heart rate issues, extreme fatigue, shortness of breath with exertion, headaches, brain fog and occasional GI issues.

How has COVID-19 affected your everyday life? 

COVID-19 continues to have an extreme affect on my everyday life, even now as I’m many months post-diagnosis. I haven’t been able to work full-time in the office for over seven months. I’m fortunate my work has been so patient, as I have just started to return to the office occasionally, for a few hours at a time so I’m not pushing myself too hard. My work has made it possible for me to do some things from home so I can continue to have income.  I haven’t been able to venture out anywhere, although we all should be staying home as much as possible to help reduce the spread of COVID-19 anyway. But I miss small, simple things, like going to the grocery store, picking up a coffee.

As I’ve started to feel better over time, I have experienced some exciting milestones. One big milestone was finally being able to clean my home on New Year’s Eve, it felt like such a big step after being bed ridden for so long. Who knew you could be so excited to clean your house?!

I’m incredibly grateful that Charleston Allergy & Asthma’s team has supported me throughout this journey. They have been super understanding if I’ve been unable to work or if I have a bad day. The people in my life, friends, family, co-workers, have had the greatest impact on my comfort and healing. There’s a big mental aspect to this disease and my support system has been incredible.

How are you currently seeking encouragement and support throughout your COVID-19 journey?

Early on into my diagnosis, I joined several Facebook support groups. After five weeks of being sick, I shared my story on Facebook and it went viral (pun intended) and was shared over 1,200 times all over the world. People were contacting me from New Zealand, Australia, Africa, Germany and throughout the U.S. I have honestly met people that I now consider friends or my “COVID sisters” as we joke, who are going through the same thing as me. My boyfriend, family and friends have been amazing and have helped me with so much. Plus, I am lucky to work from home right now and have also been able to do some self-care by reading books, binging shows, and even took up paint-by-numbers!

What encouragement do you have for those who have similar cases of COVID-19?

I think the biggest thing for people going through this is being your own biggest advocate. Doctors don’t know what causes these symptoms and you really have to fight for treatment and make sure your providers are listening to you. Most testing comes back normal which is frustrating, yet you have all these things going on in your system that can’t be explained. Also, be patient with the healing process. Early on, I knew that I was going to be in this for the long haul and tried my best to stay positive and not get discouraged when I had setbacks. Your mental attitude and fight toward this is everything.

Don’t underestimate COVID-19. Yes, a lot of people get through this illness, but sadly a lot of people have lost their lives. You truly do not know how your body will react. I was a healthy, active 37-year-old with no health issues and I had my life as I knew it stripped away from me. And, unfortunately, my case is not uncommon. There are thousands of people going through what I am going through and it just really is not talked about widely. We need our story to be heard so that more take notice and help figure out what is going on.

Sarah is still on the road of recovery from COVID-19 and continues to serve as an incredible member of the Charleston Allergy & Asthma team. She recently received her COVID-19 vaccinations along with the rest of the Charleston Allergy & Asthma staff and shares her story to help raise awareness of the potential affects the coronavirus can have on those diagnosed with the virus.

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New Asthma Guidelines Just Announced

The field of science is ever-changing with new discoveries and ideas about life and diseases. Scientific textbooks have become obsolete over past millennia and recently, as frequently as a decade or two! Our ideas about what causes various diseases and appropriate management have changed drastically over the last 500 years. Our team receives official updated recommendations for the treatment of our patients and we are pleased to share that the accredited organizations we look to for guidance have shared the latest recommendations on treatment for patients with asthma. In the last 30 years, we have learned much more about asthma pathophysiology and management as new medications have become available for treatment of asthma. If you’re wondering why these might change overtime, Dr. Harper has shared a bit of perspective…

In the 1970s and 80s, I had the opportunity to train at National Jewish Hospital in Denver, Colorado where the sickest asthmatics in the United States are referred. We managed children and adults from every state in the US. What we observed at that time was the marked disparity in asthma understanding and management by referring physicians and hospitals. For example, some of these patients referred to our hospital for severe asthma didn’t even have asthma! The National Institute of Health (NIH) was also concerned about this disparity in the understanding of asthma diagnosis and management. In 1991, an expert panel was convened by the NIH which included physicians, respiratory therapists, and nurses and they assembled uniform guidelines for assessment and management of asthma.

This organization was designated the National Association for Asthma Education and Prevention Program (NAEPP). The document generated by this group was extensive and covered recommendations for asthma evaluation and diagnosis, identification of asthma triggers, assessment of asthma severity, and a stepwise approach to medications for asthma management in children and adults. Simultaneously, the international community also developed guidelines for asthma management (Global Initiative for Asthma or GINA) which are updated yearly. The guidelines from this international group generally parallel American guidelines although there have been some recent differences.

Since 1991, this expert panel has reconvened periodically to update guidelines in an effort to share new ideas about asthma pathophysiology, triggers and new medications available for management with practicing physicians. These updates were published in 1997, 2002 and 2007. Since the last guidelines were released in 2007, our understanding of asthma pathophysiology has greatly changed and a wide variety of new asthma medications have become available. One of the most important new concepts is that asthma appears to be more than one disease with major differences in inflammatory pathways leading to the characteristic twitchy airways and airway obstruction seen in asthma. Depending upon which type of asthma inflammatory pathway is present in an asthmatic, certain therapies may be more or less effective. Monoclonal antibody therapies (medicine that targets the chemicals involved in the inflammatory reactions resulting in airway narrowing) to block these various inflammatory pathways are rapidly evolving and becoming available. In 2021, we have finally obtained a new NAEPP update for asthma management which was just published this past week.

New NAEPP asthma guidelines are similar to previous guidelines, identifying individual asthma triggers, determining the severity of asthma and suggesting a stepwise approach to the management of increasing asthma severity. Here are the new major changes outlined for you:

  1. A major change in the new guidelines is the concept of using a single inhaler containing an inhaled corticosteroid and fast onset but long acting bronchodilator (currently only Symbicort or Dulera) as both controller therapy and rescue therapy. This has not been recommended in previous NAEPP guidelines but has been present in GINA guidelines. This new strategy has been suggested for children over 4 years old, adolescents, and adults. It’s a safer way to use short term higher dose steroids to control an acute flair up for asthma than oral steroids.
  2. It is recommended that measurement of exhaled nitric oxide, which is a marker of eosinophilic driven airway inflammation, can be used to accurately direct specific therapy. Eosinophils are white blood cells that all people have but those with allergies and asthma tend to have higher numbers.
  3. The new guidelines also confirm the benefits of reducing indoor allergens in individuals with allergen sensitivity, particularly to dust mite.
  4. Lastly, allergy extract immunotherapy (allergy shots) has also been confirmed to be of benefit in select individuals with allergy triggers for their asthma.

These new guidelines have just been published and it is not certain when insurance companies will alter their coverage for asthma medications based on these new guidelines. These guidelines will help the board-certified allergists at Charleston Allergy & Asthma determine the most appropriate management strategy and medications for their many asthma patients.

If you’re seeking treatment for your asthma symptoms, request an appointment with one of our board-certified allergists today.

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Is it allergies or a cold?

Are you sniffling, sneezing, wheezing and coughing? You may be wondering if you have a common cold or suffering from allergies. The problem is, it’s not always easy to tell the two apart. The symptoms can be the same, but the treatments, not so much. So let’s take a look at each, see how they differ, and how to treat them.

The Common Cold

A cold is an infection caused by a virus, usually in the upper respiratory tract affecting the nose, throat and/or sinuses. Symptoms may appear less than two days after exposure and include coughing, sore throat, runny nose, sneezing, headache, and possible fever. A cold will usually develop over several days and takes a couple days to clear up.

While there is no vaccine or cure for the cold, there are ways to help prevent it, the most common being hand washing. While antibiotics will not help with a cold, nonsteroidal anti-inflammatory drugs such as ibuprofen can help with discomfort. You also need to stay hydrated and rested. 

Allergies

Allergies are your immune system’s reaction to things like pollen, grass, pet dander and foods like peanuts. An allergic reaction usually triggers symptoms in the nose, lungs, throat, sinuses, ears, and on the skin. In the most serious cases, a life-threatening reaction called anaphylaxis can occur.

Because allergies and colds have similar symptoms, like sniffles and stuffiness, many people get them confused. But, there are additional symptoms with allergies like red eyes, an itchy rash, shortness of breath, or swelling. But unlike a cold, which develops over time, allergies begin shortly after you’re exposed to what you’re allergic to. When it comes to the duration, allergies will last as long as you’re exposed. More than likely, if you’ve been experiencing symptoms for more than two weeks, it’s allergies.

So, what if you don’t know what you’re allergic to, but you have symptoms? How can you tell a common cold from allergies? Take a look at the list below and decide how many of the symptoms you have. 

    • Clear or watery mucus
    • Itchy skin or watery eyes
    • Unchanging symptoms 
    • Sniffles for more than a week
    • Symptoms only during certain situations

If you’ve been experiencing symptoms like these, all hope is not lost. There are multiple kinds of allergies, and treatments vary for each. Treatments include avoidance, medications and allergy injections. 

If you want relief from your allergies, or to find out what you’re allergic to, schedule an appointment with a board-certified allergist.

Sources:

https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Libraries/EL-allergies-colds-allergies-sinusitis-patient.pdf

https://www.aaaai.org/conditions-and-treatments/allergies

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