Archive for June, 2015

Summer Vacations And Asthma

Summer is the time of year when most of us relax and take vacations.   My patients often ask me, other than taking their asthma medication with them when traveling, what other tips can I recommend to avoid asthma attacks.
If one is staying in the city or heading out to the country, I tell them to be cognizant of the weather reports each day.  The EPA recommends checking the Air Quality Index.  Most simply, this is done by checking televised weather reports or by logging on the EPA’s website,  The AQI measures the amount of air mixed with pollutants as well as pollens.
In an interesting article by the American Lung Association (ALA),  when flying, it  recommends taking a carry-on bag packed with the following: copies of your asthma action plan; extra written prescriptions; insurance cards; medicines such as  quick-relief and controller medications; a spacer; and a peak flow meter.
The ALA also has a free app, the State of the Air, for your smartphone which is free.  You punch in the zip code your are traveling to or use the geo-location  function.
Also when flying, the TSA allows you to bring a nebulizer on board or as checked baggage.
Before you arrive at your destination, you should have in mind the following to reduce the chances of an asthma attack:  request a hotel or  an inn with a smoke free room; wood floors instead of carpeting if available; ask for fragrance free toiletries; even bring your own bedding to reduce dust mite exposure.
Remember, each vacation environment poses its own challenges for asthmatics.  For beach-goers, bring fragrance-free sunscreen, pack plenty of water and pain relievers that won’t exacerbate your asthma–consult your physician.  When traveling to countryside, avoid animal hair and bird feathers which produce dander, and are asthma triggers.  When swimming in pools, make sure these areas do not have a strong smell of  chlorine and that the pools are well ventilated, to prevent an allergic reaction.
Following these tips should make your vacation more enjoyable.


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School Asthma Management Plan Act

School Asthma Management Plan Act

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.

Bill Summary
• 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.

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Is it a Food Allergy?

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!

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Skin Test

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.

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