Anaphylaxis is a life-threatening allergic reaction to specific triggers such as foods, medications, insect venom, or latex. Recognizing and treating anaphylaxis early is crucial since an allergic reaction can become an anaphylactic reaction in only a few minutes.
In a severe allergic reaction or anaphylaxis, the body is overwhelmed by its own immune response. Intravenous medications and chemicals are often the cause of severe anaphylaxis, as well as wasps, bees, and ants stings. This is because the allergen usually reaches the bloodstream very quickly, and circulates widely throughout the body.
If the reaction worsens, multiple body systems are affected, including the cardiovascular, respiratory, GI and skin. Patients can develop hives or urticaria, which can be very itchy as fluid shifts into the sublayers of the skin. As in other disease processes, the faster anaphylaxis sets in, the less likely the body can compensate and the more likely it will be fatal. Treatment must occur quickly in the form of a rapid, aggressive support of the airway, breathing and circulatory status of the patient, and administering epinephrine as early as possible.
It’s important to note that the beneficial effects of epinephrine, while quick, are short lived. Epinephrine is rapidly broken down by the body, therefore EMS providers may need to administer a second dose of epinephrine while waiting for the longer-lasting effects of diphenhydramine or corticosteroids to begin.
In very severe cases of anaphylaxis, massive swelling of the airway’s soft tissue may require immediate transport by EMS providers to the closest receiving facility for surgical intervention. Paramedics may perform a needle or surgical cricothyrotomy to preserve the airway if pharmacologic interventions are not successful.
If you have any questions regarding severe allergy symptoms and/or treatment, feel free to give my office a call, 866-632-5537.Tweet
Sinusitis and the common cold are often confused as they have similar symptoms including congestion, post-nasal drip, fever, and coughing. However, the common cold usually only lasts a couple of weeks, at most, and a serious case of sinusitis can last for months.
Sinusitis can also develop after a bout of the common cold and that may be a reason people confuse it. It may start as a cold but then the inflammation of the sinuses leads to an infection that will persist after the virus itself has been cleared from the patient’s system. With winter on the way, colds are soon to start interrupting our daily lives again with some regularity. If your cold seems to be persisting and is coupled with headaches that seem to be located behind the eyes and facial pain, you may be suffering from a sinus infection. If you are concerned you may have a sinus infection, particularly if symptoms have persisted for 8 weeks or more, see a doctor. Live in the NYC area? Feel free to contact my office for a consultation.Tweet
Itching without a rash may not be an allergy
Itching is a common symptom seen often in the allergist/immunologist’s office. However, if the patient is itching without a preceding rash, there are a list of numerous possible causes and include non-allergic conditions. We first need to determine whether the cause of itching is derived from the skin or another organ system. Itching that is not caused by a skin condition usually does not have a rash, although some patients can develop a secondary rash.
Several circumstances can cause itching without a rash and can be due to systemic, neurologic, or psychiatric conditions. A few examples of systemic conditions include kidney disease, liver disease, hyperthyroidism, lymphoma, polycythemia vera, and HIV infection. Narcotic medications can have itching as a side effect, as well as nerve injury from shingles or spine disease, as they can cause localized itching at the affected area. Lastly, psychiatric conditions such as substance abuse or obsessive-compulsive disorder can also lead to itching.
The management of itching without rash should start with evaluating for and treating the underlying cause. There are a variety of remedies available for symptomatic relief; moisturizing the skin, keeping nails short, wearing loose clothing and taking antihistamines. While antihistamines are often used for itching, studies suggest that first generation antihistamines only help itching by causing sedation.
There are more successful, prescribed oral medications available which can be slowly increased to minimize side effects.
If you have questions regarding an allergic condition, I invite you to come in for a consultation.
For more on allergy triggers, visit my website NYC Allergy Doctor.Tweet
Managing food allergies may seem overwhelming at first, but it does get easier over time.
Start with these basic measures to safeguard yourself from adverse reactions and prepare yourself for the challenges you will face.
- Emergency medication – Due to the nature of food allergies, it is important to be prepared against anaphylaxis, always carry your Epi-pen.
- Outline an emergency care plan and inform family and friends of the plan. This will alert those around you to recognize signs and symptoms of your allergies so that they know when and how to use your emergency medication.
- Wear medical identification at all times to make responders aware of your allergy.
- Plan in advance how to handle certain situations; prepare yourself for variety of environments you may find yourself in. Keep a food diary to assist in learning what foods to avoid and get tested if symptoms persist.
To successfully manage food allergies, you have to monitor your diet and lifestyle.
Accidents can happen and you should always be prepared. If you have any questions, you can read more about Food Allergies on my website at http://www.nycallergydoctor.com Or if you feel the need to be tested for allergies and live in the NYC area, please call our office to arrange for a consultation, 212-247-7447.Tweet
The most common chronic disorder in children, ASTHMA affects nearly seven million children. Over half of these children suffered with an asthma attack or episode in 2014 to their poorly controlled condition. As well as the health risk involved, these asthma attacks resulted in 10.5 million missed school days and U.S. $56 billion in healthcare expenditures. A good number of these costs are preventable when a prescribed Asthma Plan is implemented correctly.
On April 22, 2015 Senator Kirsten Gillibrand (D-NY) introduced the Asthma Management Plan Act with Senators Mazie Hirono (D-HI) and Bob Casey (D-PA).
The School Asthma Management Plan Act allows schools to apply for grants that help them: 1) develop asthma management plans, and 2) purchase medication and equipment necessary to treat students affected by asthma.
• Develop and implement school asthma management plan—Schools shall use grant money to develop asthma management plans based on national guidelines that include, among other provisions, methods for identifying all students with asthma diagnoses, implementing asthma education for all staff, providing access to medication and methods to administer medication for all affected students, and developing medication and emergency policies specific to each school.
• Purchase asthma medications and devices—Schools shall also use grant funds to purchase asthma inhalers, spacers, air purifiers, asthma education materials, and other supplies necessary for the relief and treatment of affected students.
• Improve communication and coordination—Schools receiving grants shall find ways to encourage bidirectional communication between schools and physicians, and improve adherence to asthma treatment my students. Schools shall also utilize existing systems and resources when possible.
The AAAAI is on the record as a supporter of the bill, having submitted an official letter of support to Senator Gillibrand. In it, AAAAI President Robert F. Lemanske, Jr., MD, FAAAAI, states: “As the current president of the AAAAI, this bill is of great interest to me personally since my major presidential initiative focuses on the creation of the Office of School-based Management of Asthma and Allergic/Immunologic Diseases within the AAAAI to serve as a resource for the creation of programs to establish optimal clinician-school nurse-family communications to better care for children with asthma in the school setting.”
If you have questions about Asthma or how to control asthma with an Asthma Treatment Plan, please contact an allergist. Live in NYC or tri-state area, please feel free to contact my office for a consultation. The first step to Asthma control, is adhering to your prescribed Asthma Treatment Plan.Tweet
Food allergy awareness has boomed over the past decades, and rightfully so. Many people suffer from some sort of food allergy, whether a minor irritation or life-threatening situation. Let’s talk about the symptoms, the causes, and what you can do if you suffer from food allergies.
Some common allergies include nuts, shellfish, gluten, egg and dairy. Allergic reactions to foods typically begin with minutes to a few hours after eating the food. How often and how severe one experiences symptoms varies widely from one person to another. Mildly allergic persons may only suffer from a runny nose or sneezing, while highly allergic persons may experience severe and potentially life-threatening rations.
The most common symptoms of a food allergy involve the intestines or the skin. Symptoms presenting on the skin can include rashes or hives. Intestinal symptoms often include nausea, vomiting, stomach cramps, indigestion, and diarrhea. Other symptoms can include swelling of the tongue, lips, or throat; asthma, with coughing or wheezing; itchy or runny nose and sneezing; loss of blood pressure; and, in rare cases, anaphylaxis, a very severe allergic reaction.
While it’s possible that a patient experiencing these symptoms is having an allergic reaction to food, there may be other causes in the works. We can run a skin test to be sure that these symptoms are caused by a food allergy before a treatment plan can be discussed. In the skin test, we look for particular allergies by scratching the patient’s skin with a toothpick like tool containing a tiny sample of the potential allergen. The skin’s reaction to the test will help us to determine if you are in fact allergic to the food in question or if their symptoms may be caused by something else.
If you do have a food allergy, it is the result of their body’s immune system over-reacting to food proteins. Normally the immune system protects the body against allergic reactions; however, in the individual with a food allergy, the immune system produces increased amounts of the allergic antibody called immunoglobulin E (IgE). When these antibodies combine with food proteins, histamine and other chemicals are released as part of the body’s immune reaction. The release of these chemicals can result in the symptoms mentioned earlier.
Avoidance is key in the treatment of food allergies. However, avoiding trigger foods isn’t always a guarantee. Accidents happen and it’s always smart to have a backup plan. For those with mild allergies, oral antihistamines can be quite helpful. For those with severe reactions, keep an EpiPen handy at all times. If you have any questions or want to be tested for allergies, please give our office a call!Tweet
Walking into our office for the first time, some people might not know what to expect.
One of the first things that needs to be done is to identify what allergies you suffer from. This is where the skin test comes in. A skin test is a simple procedure that allows us to assess what you may be allergic to and then create a treatment plan that is tailored specifically for you. Because everyone has specific allergy triggers, knowing what you are allergic to as early as possible is important to determine an effective treatment plan.
You may be asked to stop taking antihistamines or other decongestant drugs prior to your visit. Some drugs may interfere with the results of the skin test and prevent us from getting the most accurate (and helpful) assessment for you.
A skin test takes approximately two to three hours from start to finish. A series of tiny scratches are made on the surface of the back. The scratches are conducted with a small instrument similar to a plastic toothpick, which contains trace amounts of a single allergen, such pollen or mold. If you are indeed allergic to any of the allergens, a small mosquito bite-like bump will appear.
But are there any side effects? It is highly unlikely that you will experience any side effect beyond the small bump to the tests that you are allergic to. The size and redness of the bump will depend on the severity of your allergy. Some mild itching may occur, but a topical cream can be applied to reduce any discomfort. This type of reaction is normal and typically clears up in about 20 minutes.
Following the skin test, we will review the results with you and determine the treatment plan that is best for your profile. The skin test is just the first step in seeking relief from allergies. Further care includes trigger avoidance, medications and check-ups. Schedule an appointment with us today and take the first step towards diminished allergy symptoms.Tweet
It is estimated that 25 million people in the United States are currently living with asthma. That equals out to one in every 12 people or about 8% of the population. That’s a lot of people. But for a disease that is so common, symptoms and triggers can be confusing. Let’s shed some light on asthma.
The symptoms of asthma can be vast and varied but typically include shortness of breath, wheezing while breathing, tightness in the chest and excessive or painful coughing. If you experience any of these symptoms, be sure to visit your allergist to determine causes and triggers. Left untreated, allergies can also develop into asthma. Be safe and consult your allergist early on.
Symptoms of an asthma attack are caused by constriction (tightening of the muscles) and inflammation (swelling and irritation) of the airways. During an attack the muscles around the airways spasm, the mucosal membrane lining the airways gets inflamed, and excessive amounts of mucus flow in the airways all contributing to the narrowing of the airway. This increases constriction and makes breathing very difficult.
Types of Asthma and Causes
Depending on each person, asthma attacks can be caused by either internal and/or external triggers. Asthma is commonly categorized by symptom triggers. These categories include:
Allergic Asthma triggered by allergic reactions to allergens such as pet dander, dust or dust mites, mold or pollen.
Seasonal Asthma triggered by seasonal allergic reactions to allergens such as trees, grasses, or weeds.
Non-Allergic Asthma triggered by irritants in the air that you breathe such as tobacco smoke, wood smoke, room deodorizers, fresh paint, and perfume.
Exercise-Induced Asthma triggered by exercise or physical activity.
Nocturnal Asthma can occur in a patient with any of the aforementioned types of asthma, though the asthma symptoms will increase or worsen at night.
Asthma is the most common chronic illness among children. If a child’s asthma is left untreated, it can result in loss of sleep, exercise limitations, absenteeism, emergency room visits and, in a few cases, death. Asthma in both adults and children can be effectively managed with medications and “trigger” avoidance.
Receiving medical help for asthma is essential. If you’re concerned that you or a loved one is showing signs of asthma, please consult your allergist. Live in the NYC area, call my office to arrange a consultation, (212) 247-7447Tweet