Learn more about the strategy of Allergy Avoidance to manage your allergies on my website, NYCAllergyDoctor.com. If you suffer from indoor/outdoor allergies, and live in the NYC area, please feel free to contact me for a consultation 866-632-5537.  I have successfully treated NYC allergy sufferers for over 25 years.  Together we can address and resolve your allergy condition.

This question from the Seattle Times is very relevant to the time of year and for those that experience symptoms other than pain and itching at the site of the sting.

Q: Last summer, I walked on the deck where a yellow jacket was lying upside down. I stepped on it and immediately went down. My foot and calf swelled up within seconds, and I found it hard to breathe.

Should I ask my doctor for an EpiPen? I’m afraid this will happen again this spring or summer.

A: Tell your doctor about your reaction. We believe this could be a strong indication of a serious allergic reaction, and next time might be worse. Your doctor can prescribe an EpiPen and explain how and when to use it to avoid anaphylactic shock, which can be life-threatening. Even with a shot of epinephrine, you would need to go immediately to an emergency department.

The normal reaction to the “sting” of an insect such as a bee, wasp, hornet, yellow jacket or fire ants may result in pain at the sting site, reddening, swelling and itching that may last just a few hours. Enlarged local reactions may have painful swelling several inches around the area of the sting lasting for days.

If you have a history of reaction other than that spelled out above – you may be allergic to the insects’ venom.

The symptoms of severe allergic reaction include;

• Dizziness
• Nausea
• Weakness
• Stomach cramps
• Diarrhea
• Hives and itching
• Wheezing and difficulty breathing
• Anaphylactic reaction (shock)
• sudden drop in blood pressure
• loss of consciousness

Anaphylactic reaction may lead to death and can occur if no immediate medical care is provided.

In a majority of patients, venom immunotherapy will protect against any future life-threatening reactions. In the case of severe or generalized reactions, patients with known allergic sensitivities to insect venom should be evaluated by an allergist and placed on protective desensitization therapy.

If you experience abnormal reactions to the “sting” of an insect. Consult your allergist.  Live in the NYC area, I welcome you to call my office at 866-632-5537.  Together we can manage your allergies.

Learn more about Common NYC Allergies here

A May 1^st article appearing on the Mother Nature Network asks the question, “Why are pollen allergies so common?”  According to Susan Waserman, Professor of Medicine in Clinical Immunology and Allergy at McMaster University in Canada, the question should be “Why allergies at all?”

Many of us have become allergic to normal things we’ve been frequently exposed – even allergic to substances since we’ve been around since we were children.  Pollen is one of those things.  And we are routinely exposed to food and pets as children; some of us develop allergies to those substances as well, “if you’ve got that genetic tendency to become sensitized.”

Allergies set in when your immune system misjudges a protein and interprets it as a threat.  Unfortunately, once your immune system sets the “trigger” it operates on this wrong assumption that certain substances such as pets or pollen grain must be defended against, you are stuck with an allergy. And most likely, you will have to cope with the symptoms of this allergy for the rest of your life.

Recent research has shown that inadequate exposure to bacteria and viruses during early childhood may increase the likelihood that you’ll develop allergies.  In this modern time of antibacterial soap, clean water, pasteurized milk and more – children aren’t exposed to nearly as many microbes as they used to be.  As a result, immune systems get fewer opportunities to learn how to discriminate between dangerous pathogens and harmless substances like pollen.  According to Waserman, it’s an now an accepted theory that “people whose immune systems are no longer busy fighting infection become disregulated and allergic.”

So, what is the perfect balance of filthiness and cleanliness during childhood?

For more information on allergies, their diagnosis and treatment, check out my website . If you suffer with allergies and live in the NYC area, please feel free to contact me for a consultation 866-632-5537.  For over 25 years I have successfully treated NYC allergy.  Together we can find a solution that can relieve your symptoms. Book an appointment online.

“Sometimes you may think you’ve got the common cold.  Your throat is really itchy and you’ve got a runny nose.  Your skin you need to scratch and your eyes may start to swell… ”  Show your child this video, it discusses allergies quite well.

When it comes to treating your child for allergies, remember that children are not just small adults. Pediatric allergists have the skills and experience to examine children in a way that helps them relax and cooperate while providing the most up-to-date treatment and therapy options to improve your child’s quality of life.

Going to the doctor is stressful for children. Initially, they might take their allergic reactions personally, and think that there is “something wrong” with them.  We assure them that many people suffer from allergies. There is nothing out of the ordinary about allergies. Once children are comfortable and understand that their allergies are treatable, going to the doctor becomes entertaining, even interesting.  Our comprehensive allergy testing process fascinates many kids, and it empowers children to learn how each individual body functions and how each person responds to their surroundings.

If you believe your child may be suffering from allergies, give us a call at 866-632-5537 for a consultation.

As springtime yard work commences, I see a number of cases of contact dermatitis.  Some cases are just a skin irritability, others can stem from the handling of last year’s crop of poison plants like, ivy and sumac.  There is a difference between an irritation and full blown chronic hives.

A chronic outbreak of Hives is defined by symptoms lasting longer than 6 weeks. When hives become chronic they can become severely itchy. The pruritus (or itch) keep people awake for long periods destroying their sleep requirements and as well as their  waking hours. Total or widespread hives on the body can make the sufferer unable to participate in the daily activities of life.

Chronic hives are most likely caused by autoimmune or infectious causes. Such markers like antithyroid peroxidase or thyroglogulin can indicate an autoimmune disease. Positive double stranded DNA Rheumatoid factor or sjogrens antibody can indicate a tendency towards rheumatoid disease. Some other blood measures can indicate incipient diabetes. Elevated immunoglobulin indicate a tendency towards autoimmune disease and positive viral titers to hepatitis c can  indicate an present infection causing the hive.

At times patients who have hives over 3 months are unable to find the root problem. We usually check a CU index or antibodies against their own mast cells with ige receptors. Usual treatments involve using H1 receptor antagonist such as fexofenadine or levocetirizine.  Singulair can be added as a secondary agent. Rentless itching and painful rashes candictate a skin biopsy to see if there is a neutrophilic infiltrate. If so a patient may have to consider immune modulators such as cyclosporin ,dapsone or plaquinil.

If you suffer from hives and rashes – please come by my office for a consultation.  We have the tools at our disposal to isolate your allergy trigger and ease your symptoms so you can get a good night’s sleep and have an improved quality of life.

A German study of Allergic Rhinitis (AR) in adolescence reveals that AR can be predicted with a degree of certainty.

The study of 2810 prepubescent children followed into adolescence  compiled by Jessica Kellberger, Dipl-Stat, from the University Hospital of Munich, Germany, and colleagues shows the strongest predictors of AR is positive skin-prick tests for outdoor allergens.

“Our prediction models indicate a substantial increase in the likelihood of new onset of AR in girls with high socioeconomic status and parental history of asthma who have not been exclusively breast-fed for 2 or more months and who presented with a positive [skin-prick test] response to both outdoor and indoor allergens at age 9 to 11 years,” they write.

“The risk factors indicated in our study are in accordance with those of other studies. However, thus far, none of these studies have used the information for individual prediction of disease course.”

Reaction to the findings suggest the positive allergy test may help in answering is it a cold or allergies question when dealing with a specific patient’s health.

“I think this paper is probably more useful to general pediatric practitioners, because they are the ones who eventually tell the difference between colds and allergic rhinitis when deciding to make the referral and when to look further to see what the patient’s allergic to,” said Weihong Zheng, MD, an allergist at Tufts Medical Center and assistant professor of Medicine at Tufts University School of Medicine in Boston, Massachusetts. Dr. Zheng was not involved in the study.

The study’s abstract is available here: http://www.jacionline.org/article/S0091-6749%2811%2901317-0/abstract

If you have questions about Allergic Rhinitis in adults or children- contact my office for a consultation 866-632-5537.

I am frequently asked to recommend a “allergy free, hypoallergenic pet.”   Now as Valentine’s Day is right around the corner, the question has come up again.

THERE IS NO ALLERGY FREE DOG OR CAT.

Pets with little or no hair are often advertised as such.  However, the  fact remains that protein in the pet’s saliva is the allergy trigger.  As the animal grooms or offers an affectionate lick, the trigger is released. Additionally, as the saliva dries the allergen can become airborne.

If the pet discussion continues, see an allergist. Depending on the severity of  the allergy, a pet may not make any sense. If the sensitivity is mild, spend time around a potential pet to see how the allergy sufferer reacts.

For more on pet allergies visit : Common Allergies

Call my office at 866-632-5537 for a consultation.  Together we can test, diagnose and treat pet allergies.

Studying piglets, which are often used as models for humans since they share many aspects of physiology, metabolism, genetics and immunity, Dr. Marie Lewis’ research out of the University of Bristol’s school of veterinary sciences resulted in findings that showed early life in a complex farm environment increased the number of regulatory T-lymphocytes, the cells that damp down the immune system and limit immune responses.

In the study, piglets were nursed by mothers on a farm while siblings spent day one and onwards under very hygienic conditions and were fed formula milk, depicting the environment in which human babies are raised.

Compared to isolator piglets, the farm-reared piglets have a reduced numbers of immune cells which drive immune responses (T-lymphocytes) in intestinal tissues. Importantly, the farm-raised piglets also had significantly increased numbers of a subset of these cells, the regulatory T-lymphocytes, which reduce allergic responses and limit inflammation, reported Dr. Lewis.

This shift in the ratio of stimulatory and regulatory cells appeared to have functional effects since the farm-reared piglets also exhibited decreased antibody responses to novel food proteins when they were weaned.

Regulatory T-cells have been identified in many mammalian species, including humans, and appear to be universal regulators of immune systems and a reduction in their numbers is often associated with the development of allergies as well as autoimmune and inflammatory diseases.

“At this point it is not clear exactly what caused the increased capacity for immune regulation in our farm-reared piglets. Our previous work suggests that intestinal bacteria play a pivotal role in the development of a competent immune system and these bacteria are obtained from the environment during early life,” said Lewis.

Lewis and her team suggested additional work is required to determine the extent to which other farm-associated factors, such as social and maternal interactions, aerial contaminants, antigens from bedding and early nutrition, contributed to the impact of the environment on increased local and systemic immune regulation.

Interesting findings.  What’s your take? You can read more about the study here

New Hampshire House Bill 1444, state workers who interact with the public as a part of their job would be prohibited from wearing fragrances or scented products during business hours. If approved the law will go into effect in 60 days.

As we have previously discussed, perfumes by their design are an indoor pollutant and can irritate inflamed airways of those who already suffer from asthma or allergies. Those affected by breathing difficulties, inflamed airways due to nasal allergies or asthma should avoid perfumes when possible.

If you experience breathing difficulties from a sensitivity to perfumes, air fresheners, or scented products give me a call 866-635-5532 for a consultation. We can assist you by treating the cause resulting in symptom relief.  You can breathe easier.

If you or your spouse have a history of allergies, the child should be tested.

In cases of symptoms of exposure – for example to an animal – itching, red eyes, sneezing and certainly if there is a serious underlying allergy to eggs or peanuts or if there was an episode of anaphylaxis it is critical to see an allergist. Anaphylaxis, in extreme cases can be fatal. Symptom onset can be quite sudden, varying from an itchy rash, throat swelling, and low blood pressure.

Also, if a child has asthma, allergy testing is required sooner than later. An allergy may aggravate asthma symptoms and make it harder to breathe. When asthma is well controlled, a child will sleep better at night, can be physically active, does not miss school and require fewer trips to the doctor.

Trained in the diagnosis, testing and treatment of Pediatric Allergies, we offer the convenience of same day appointments from 5 convenient locations throughout  Manhattan.  Call 866-635-5537 for more information.