Today’s Family Wellness Advisory Group Sounds Off:
Q: How do Allergies Affect Your Family?
MARTIN
Food allergies affect how I cook and where we can go for special treats (for instance, both children are dairy-allergic so the only ice cream shop we can visit is Graeter’s, which offers sorbet). – STACIE L. MARTIN
BREISCHAFT
We moved here from Southern Arizona (where most people go to escape allergies) about a year and a half ago. Everyone warned us that if we’d never suffered from allergies before, we surely would in the Ohio Valley. My husband and oldest son have started to have allergy symptoms. – RHONDA BREISCHAFT Advisory group members are: Klaus Boel, MD, FAAP; Rhonda Breischaft; Erin Brown; Becky Carothers, MD; Amanda Castle, RN; Carrie Crigger, DO; Dr. Bradley Goldberg; Ann Greenwell, DMD, MSD; Korie Acord, DMD; Stacie L. Martin; Lisa Mascio-Thompson; Veda Pendleton McClain, Ph.D.; Lorie Minnich, RN; Abigail Mueller; Dr. Mark Perelmuter; Ursula Robertson-Moore; Yelena Sapin; Jeb Teichman, MD, FAAP; Jeanine Triplett
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April/May 2012
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When to see an Allergist If your child has a severe reaction to a food or to stinging insect venom — hives, swelling, wheezing, nausea, vomiting, loss of consciousness — you need to take him to a doctor and learn how to keep him safe. But when your child has milder indoor or outdoor allergy symptoms like itchy eyes, coughing, congestion, or a runny nose that are more of a nuisance rather than a life-threatening event, it can be difficult to know whether to see a specialist. Asking your pediatrician to recommend a medication to alleviate some of the symptoms is a good start, according to Derek Damin, M.D., of Kentuckiana Allergy, Asthma and Immunology. There are a lot of generic and over-the-counter antihistamines on the market now, and for the most part you can’t go wrong with trying different things to see what works for your child, says Damin. But read the labels and be aware of which medicines have a sedating effect so they don’t interfere with school performance. If your child is having to take medication all the time, however, if what you’re doing on your own doesn’t seem to work and your child is miserable or having to miss school, or if there are respiratory symptoms involved like wheezing, chest tightening or chronic cough, then it’s time to see an allergist who is trained to focus on the entire immune system to get to the root of the problem.
Getting an Accurate Diagnosis Identifying the sources of your child’s symptoms is the first step in deciding what course of treatment to follow. Doctors agree that the most accurate way to find out what you’re allergic to is through skin testing, where a small amount of an allergen is pricked into the skin to check for a reaction. Most kids tolerate the testing well, says Damin, and because it can be customized to check for any number and any variety of suspected allergens, the temporary discomfort of the test is well worth the result. There are several benefits to getting your child tested. You may discover that the allergy is seasonal and that your child only needs medications a few months of the year. Or that the problem is not the cat, as you had suspected, but rather mold and dust mites, so you can keep your pet. Or that your child is only allergic to tree nuts and doesn’t have to give up PB&J for lunch. More and more allergists are also starting to use carefully controlled
A Note about Indoor Air Quality Allergies cause inflammation in the respiratory tract, making people more sensitive to irritants and pollutants in the air. Keeping indoor air as irritant-free as possible helps alleviate the symptoms. Here are some recommendations from James Sublett, M.D., of Family Allergy & Asthma: • Don’t smoke in the house. Be aware of lingering smoke odors and particles on clothes and hair. • Avoid strong perfumes and heavily-scented products. • Don’t use incense or scented candles. Anything you burn releases airway-irritating odors and combustibles. • Don’t use plug-in air fresheners. They produce small particles and ozone, both of which are irritants. • To clean the air, use devices with HEPA air filters. Do not use ozone-producing air ionizers. oral challenges, giving small amounts of suspected foods under medical supervision, in tandem with other tests and a detailed history, to confirm an allergic reaction. “We don’t want to put kids on very restrictive diets when they don’t need to be,” says Sublett, “and testing is really the most accurate way of getting a diagnosis.”
Treatment Options Once you isolate the allergic triggers, treatment depends on the nature and the severity of the allergy. Usually it will be a combination of three options: If there’s a risk of a life-threatening reaction your doctor may also recommend getting an EpiPen, an autoinjection device that administers an emergency dose of medication. While not exactly a cure, allergy shots work by gradually desensitizing the immune system to a particular substance and are effective for all except food allergies. Children can start allergy shots as young as ages three or four, says Damin, and over a period of several years can build up a tolerance to an allergen to a point where they can get rid of most of their medications and not worry so much about their exposure. But whether your child’s allergies are severe enough to warrant aggressive treatment or mild enough to just sniffle through, they’re usually a lifelong condition that should be kept in check, not only to prevent potentially serious complications, but to improve your child’s overall quality of life.
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