In The News: Allergies

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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When are allergy tests needed?

If you have allergies, you likely know it. Sneezing, sniffling, itchy and watery eyes, the symptoms are sometimes overwhelming. Your immune system controls how your body defends itself and it overreacts to allergens you’ve inhaled, touched or ate. For example, if you’re allergic to dogs, your immune system identifies dog hair or dander as an invader. Your immune system produces antibodies called Immunoglobulin E (or IgE). These antibodies travel to cells that release chemicals, causing an allergic reaction. These reactions can range from annoying sniffles to a life-threatening response called anaphylaxis.  

If you’re experiencing symptoms, but aren’t sure why or what’s causing them, allergy testing may be needed. Symptoms that usually prompt testing include:

  • Respiratory – itchy eyes, nose or throat; nasal congestion, runny nose, watery eyes, chest congestion, cough or wheezing
  • Skin – itchiness or eczema  
  • Abdominal – vomiting or cramping and diarrhea consistently after eating certain foods
  • Severe reactions to stinging insect stings (other than swelling at the site of the sting)
  • Anaphylaxis (pronounced an-a-fi-LAK-sis): a serious allergic reaction that affects many parts of the body at the same time

Allergy tests are the best and safest way to tell exactly what triggers your symptoms. The most common triggers include dust mites, animal dander, mold, pollen, insects, foods, latex and drugs. An allergist/immunologist can perform multiple types of allergy tests.

 

  • Skin tests: This is the most common kind of testing done in the allergist’s office. In this test, a small amount of allergenic liquid is placed on your skin and this area is pricked or scratched. Redness and swelling at a testing site tells us you are allergic to the tested allergen. It is generally not much more bothersome than a bug bite. The results of this test are ready in minutes, so you leave the office knowing what you are allergic to.
  • Intradermal tests: Intradermal tests are more sensitive than prick tests and may be used when prick test results are inconclusive. In this test, a very small amount of the sterile testing liquid will be injected just under the surface of your skin, similar to a TB test. The results are available in minutes.
  • Challenge tests: Challenge tests are sometimes used when a doctor suspects you have a food or drug allergy. In this test, a patient will eat or inhale a very small amount of the possible allergen under the close supervision of a board-certified allergist. The amount is gradually increased over several hours to ensure a full serving or dose can be tolerated. This type of test should only be done by a board-certified allergist with experience treating anaphylaxis. For your safety, do not try this test at home!
  • Blood tests: For this test, blood is drawn and then tested for allergies. This test is more expensive than skin testing and it takes longer to receive your results. Interpretation of this test should be done by a board-certified allergist as a positive result does not necessarily mean the patient is allergic. It is best understood in conjunction with an extensive allergy history and skin test. Unlike skin testing, blood allergy testing can be done when patients are still on oral antihistamines.

 

Many people with untreated symptoms aren’t aware of how much better they will feel once they are properly diagnosed and their symptoms are managed. We are here to help you breathe better, feel better and live better!

Give us a call or request an appointment online to begin your allergy treatment plan with one of our amazing board-certified doctors!

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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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Allergy Shots vs. Over-the-Counter Meds: Which Do You Need?

Finding relief from persistent symptoms is a top priority for many allergy sufferers. If this is true for you, you may wonder whether over-the-counter (OTC) medications could do the trick or if you need a more heavy-duty treatment such as allergy shots. 

 

Advantages of Allergy Shots Over OTC Meds

Over-the-counter medications can be effective in reducing allergy symptoms such as runny nose, sneezing, itchy eyes and congestion. However, the relief they offer is generally short-lived with many medications lasting just 24 hours, meaning that you have to take them daily. How do allergy shots differ?

They can provide long-term relief from symptoms triggered by seasonal allergies, indoor allergens and even insect bites. Therefore, allergy shots can be a good option if you’d like to cut down on your long-term use of allergy meds. 

They may also be necessary if you’ve been unable to find OTC medicines that successfully keep your symptoms under wraps or you can’t avoid the allergens that trigger your symptoms.

In fact, allergy shots are the closest thing we have to a cure for allergies. They are also more cost effective than a lifetime of OTC medication. To put it plainly, medicines are simply a band-aid for your symptoms, while allergy shots can make a positive impact on your immune system for the long haul.

 

How Do Allergy Shots Work? 

Allergy shots are a form of immunotherapy. Within each allergy shot is a small amount of the allergen that triggers your symptoms. While not enough to lead to a full-blown allergic reaction, it is enough to stimulate your immune system and is tailored specifically for you. 

Over time, as your board-certified allergist increases the dose of allergens in each shot, your body builds up a tolerance for them, which results in a reduction of symptoms or even complete desensitization. 

 

Allergy Shots: What to Expect

Generally, allergy shots are injected into the upper arm and are administered in two phases. The first usually takes three to six months. During this period, shots with higher allergen doses each time are administered one to three times a week. Then, during the maintenance phase, which lasts three to five years, you’ll receive a shot monthly. 

What results can you expect from this form of treatment? While your symptoms will not go away overnight, most patients see significant improvement within the first year of treatment and even more progress thereafter. By year three, most people are desensitized to the allergens contained in the shots and no longer have significant allergic reactions to those substances. 

While some need ongoing immunotherapy treatment to keep allergy issues under control, some can discontinue treatment after the three to five-year period without the return of allergy attacks. In either case, it’s always a welcome relief for our patients not to have their lives constantly interrupted by runny nose, sneezing, skin rashes, congestion and the laundry list of other unpleasant symptoms caused by allergens. 

Would you like to discuss whether allergy shots would be an appropriate treatment for you? Contact us today to schedule an appointment with one of our board-certified allergists. 

Sources: 

https://www.mayoclinic.org/tests-procedures/allergy-shots/about/pac-20392876

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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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What are inhalers & how do they work?

Bronchodilators, or most commonly called inhalers, are medications that are breathed through the mouth and into the lungs to help relax muscles that tighten around your airways. The medicine helps open the airway and lets more air move in and out of your lungs and helps you breathe more easily. 

People with asthma use inhalers during an attack when their airways swell and become narrower. These attacks cause the person to cough, wheeze and have trouble breathing. Almost everyone with asthma will use a bronchodilator to help open their airways. Others may use one at some point in their life if diagnosed with a persistent cough, COPD, bronchitis, etc. Different inhalers have different medications, or a combination of drugs, to address different illnesses. 

Different Kinds of Inhalers

There are three basic types of inhalers that deliver medications. The most common is the metered-dose inhaler (or MDI) which uses pressure to push the medication out of the inhaler. Nebulizers use air or oxygen and deliver a mist of the medication through a tube or mask that fits over your nose and mouth. Dry powder inhalers (or DPIs) deliver medication, but they require a strong and fast inhalation.

Short-acting bronchodilators are used as “quick-relief”, “reliever”, or “rescue” inhalers. These bronchodilators open the airways and help stop or relieve acute asthma attacks very quickly. While they’re best known for working on sudden attacks, they’re also great to use before exercise to help stop asthma during your workout. 

While many people use short-acting bronchodilators, the overuse of an inhaler, tablet, or liquid/nebulizer, is a sign of uncontrolled asthma that needs better treatment. If you are using short-acting bronchodilators more than twice a week, call Charleston Allergy & Asthma about improving your asthma control therapy.

Long-acting bronchodilators provide control, not quick relief, of asthma. Your board-certified allergist will prescribe the medication, which is usually taken twice a day along with inhaled steroids for long-term monitoring of symptoms. 

Unlike short-acting inhalers, long-acting inhalers do not work on muscle inflammation directly. Instead, they help the airways relax, allowing more air to pass through.

If you’re struggling with your asthma or think you may be in need of a prescribed inhaler, request an appointment online today.

 

Sources:

https://www.aaaai.org/conditions-and-treatments/conditions-dictionary/asthma-inhalers

https://www.aaaai.org/conditions-and-treatments/conditions-dictionary/bronchodialator

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Vocal Cord Dysfunction (VCD) – A Very Misunderstood Illness

Have you noticed an increased shortness of breath or tightness in your chest when exercising? Do you feel like you’re choking or do you experience wheezing when you take part in strenuous activities? Does your voice feel hoarse after working out? Many of these symptoms are common in patients who are diagnosed with vocal cord dysfunction.

Commonly misdiagnosed as asthma, vocal cord dysfunction (VCD) is a function disorder of the vocal folds, which are located in the “voice box.” VCD is characterized by abnormal movement of the cords resulting in respiratory symptoms. Patients with VCD typically experience symptoms during inspiration or when they take a breath in. This is because the vocal cords close at a time when they usually would not. VCD can occasionally cause symptoms during exhalation, but this is less common. VCD poses challenges for both patients and providers as it can mimic and co-exist with asthma. However, an asthma attack is treated very differently than a VCD attack, and misdiagnoses can lead to inappropriate and unnecessary treatments.

The most common symptoms seen in VCD include difficulty with shortness of breath, throat tightness, difficulty swallowing, feeling like something is “stuck” in your throat, choking, gagging, voice changes (hoarseness, raspiness, loss of voice) and wheezing. The “wheezing” that occurs with VCD is a high-pitched wheeze-like sound that comes from the throat, not the lungs, as seen in asthma.

There are several possible causes of VCD, some of which result in irritation of the vocal cords, leading to the abnormal movements. Underlying issues or coexisting conditions are also common with VCD and can sometimes even lead to misdiagnosis. These include heartburn (GERD or reflux), post-nasal drainage from poorly controlled allergies, viral upper respiratory illnesses or colds, depression, anxiety, irritable bowel syndrome (IBS) and chronic pain syndromes. Exercise and inhaled irritants (strong scents/smells like colognes, perfumes, cleaning agents and fumes) are also very commonly identified triggers.

Direct visualization of the abnormal vocal cord movements via rhinolaryngoscopy (camera scope through the nose and down the back of the throat) is the gold standard for diagnosing VCD. However, if the patient is not actively having a VCD attack with the symptoms listed above, then this scope will be normal at the time, Therefore, normal rhinolaryngoscopy cannot definitely rule out a diagnosis of VCD. A pulmonary function test can help to diagnose VCD as well, but this can also be normal in VCD patients. More likely, your board-certified allergist can diagnose VCD based on symptoms and history. 

The mainstay of VCD treatment involves recognizing triggers, appropriately managing co-existent diseases, and utilizing breathing exercises. If patients have difficulty with these exercises, their allergist may refer them to a speech therapist to help as well. Education for patients on the signs and symptoms of VCD and how they differ from asthma can help to reduce unnecessary emergency department visits, hospitalizations, procedures, breathing treatments and steroids.

Statistics on VCD are really hard to find because of how often it is missed. It is almost always diagnosed as something else at first. Our practice has seen many patients who have been treated for “asthma” for years with inhalers and steroids, but all they really needed was vocal cord exercises and maybe some help from speech therapy. 

Treatment by a board-certified allergist for VCD is critical because of how much time, money, energy and unnecessary medications, procedures and emergency department visits/hospitalizations are present on misdiagnosed VCD patients. The treatments for these other issues are not only unnecessary and unhelpful for VCD patients, but they can have side effects of their own. Incorrect treatments for VCD often include inhalers, prednisone or the unnecessary use of EpiPens. Additionally, VCD is seen in a significant amount of the asthma population. VCD attacks and asthma attacks have subtle differences that can be picked up on once patients are better educated. The typical treatments for asthma don’t help with VCD and vice versa.

If you believe you might be experiencing VCD symptoms, scheduling an appointment with a board-certified allergist can lead to a diagnosis and proper treatment so that you can find relief. Request an appointment with our team today.

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The Flu Vaccine: More Important Than Ever

Like clockwork, we hear the warnings every year. When flu season rolls around, everyone is encouraged to get the vaccine to prevent the spread of influenza. There are many reasons why getting the flu vaccine is beneficial and highly recommended. What are some of those reasons and, more importantly, why is it more vital than ever that you get your flu shot during the COVID-19 pandemic?

The Usual Benefits of the Flu Vaccine  

The most obvious benefit of flu vaccination is that it can keep you from coming down with the flu. While 100% protection is not guaranteed, getting vaccinated does make a difference

In fact, during 2018-2019, it was estimated to have prevented more than 4 million flu illnesses, more than 2 million flu-related medical visits, tens of thousands of hospital visits and 40,000-60,000 deaths. It may have even been you who was spared from the flu and its potential complications as a result of vaccination (on your part or that of others)! 

What other compelling reasons are there to get your flu shot yearly? Besides reducing your risk of getting sick and reducing hospitalizations, the vaccine has been shown to:

  • Prevent and limit the severity of influenza illnesses in people with chronic health conditions that put them at higher risk for complications
  • Protect women during and after pregnancy, as well as protecting their newborn child(ren)
  • Reduce the severity of illness in people who get vaccinated but still get the flu anyway. Since every flu season and every individual’s response to influenza are different, you’ll want to have the most protection possible against things going south

Don’t forget that, even if you’re not pregnant or dealing with chronic illness, your flu shot can protect others around you who are. This is especially true during the COVID-19 pandemic.

How Flu Shots Can Save Lives During COVID-19 

Experts have predicted that the viruses responsible for the flu and COVID-19 will be co-circulating this fall and winter. This has the potential to cause several problems. 

  1. It could perpetuate the spread of COVID through individuals who mistake symptoms as mild flu and do not adhere to the recommended guidelines for the sick
  2. Contracting the flu and coronavirus at the same time comes with an increased risk of serious and even life-threatening illness
  3. Severe but preventable cases of the flu requiring hospitalization take away the staff and resources needed to treat COVID-19 patients

Protect Yourself, Protect Others 

As you can see, the flu vaccination is more important than ever before. While in 2018-2019, less than half of all Americans got the flu shot, we hope that many more will do their part to protect themselves and others this year, especially since the stakes have been raised by the pandemic. 

With fall already upon us and flu season looming, now is the time to get your flu shot. Since the vaccine takes about two weeks to trigger the creation of antibodies, the sooner, the better! 

 

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