 A
full 10 percent of the United States population has an allergic
disease like hay fever and 15 million Americans have asthma, says Dr.
Mary Jo Rolfes-Lo, an allergist with ProHealth Care Medical Center in
Waukesha.
Hay fever and asthma are among the most prevalent allergies, too,
says Dr. James Pugely, an allergist at Columbia St. Mary’s in
Milwaukee. "The most common ones are airborne allergies —
pollen, dust mites, pets and mold. That’s followed by foods and
medication. In this area, everyone would talk about hay fever in late
summer and early fall. Also in the fall of the year, the dust mites
and molds do very well and tend to cause a lot of asthma
problems."
Rolfes-Lo groups the allergies in two categories: seasonal, such as
reactions to pollen in spring, and year-round, such as reactions to
mold, pet dander and dust mites.
Meanwhile, Dr. Tad Johnson, an allergist with Allergy and Asthma
Clinic of Wisconsin, categorizes them as indoor (pet dander, dust
mites and mold) and outdoor (outdoor molds and allergens such as
pollen in spring and ragweed in fall) allergies.
Then there are less frequent contact allergies, such as reactions
to foods — with an adverse reaction to peanuts being the most common
— and medication, with penicillin leading the list of drugs causing
a negative reaction.
But whichever way allergies are categorized, they are treated in
remarkably similar ways. "The oldest treatment is
avoidance," says Johnson. "If you have a cat and you’re
allergic to cats, get a new home for the cat."
Other medical options include the use of antihistamines, nasal
cortisone and allergy eye drops. "These treatments have been
stable over the years," he says.
While traditional, Pugely says today’s antihistamines are less
sedating and longer lasting. Some newer medications, like XOLAIR to
treat allergic asthma, work to block immunoglobulin E production, an
underlying cause of a reaction. "Injection therapy is probably
more common," he says. "It points the way in the future to
treating the immune system."
According to Rolfes-Lo, a new antihistamine that’s not yet
FDA-approved is coming out this summer and promises better control of
allergy symptoms. In addition, there are new asthma inhalers with
fewer side effects on the horizon, as well as sublingual immunotherapy
that’s similar to an allergy shot except it’s placed under the
tongue and is in higher doses.
But before treatment, a correct diagnosis needs to be made. That
can be done through skin tests — pricking the skin with a comb-like
tool that contains the allergen; intradermal tests, in which the
allergen is placed under the skin with a needle if the skin test is
negative; and what’s called a CAP test that measures an allergen’s
antibodies in the blood.
Additionally, and before any testing is done, a thorough medical
history of the patient is needed, says Dr. Kristen Volkman, an
allergist with Wheaton Franciscan Medical Group. "There probably
is some genetic predisposition to allergies," she adds.
For example, she says if both parents are allergic, there’s a 60
percent chance that their child will be too. If only one parent is,
there’s a 30 percent chance. And if neither parent has allergies,
the chances that their child will drops to 15 percent. However, she
notes there’s a theory that says the cleaner that environment, the
more prone one would be to allergies. It’s called the hygiene
hypothesis, and it states that a lack of early exposure to infectious
agents increases susceptibility to allergies. "They do run in
families," Volkman says. "But it’s also a product of your
environment."
 Peanut
woes
Ninety-percent of all food
allergies are caused by a handful of allergens, with peanuts the
most prevalent, says Dr. Mary Jo Rolfs-Lo, an allergist with
ProHealth Care Medical Center in Waukesha. "Food allergies
are rare, but peanuts make up two-thirds of them," says Dr.
Tad Johnson, an allergist with Allergy and Asthma Clinic of
Wisconsin. And the number of people allergic to peanuts is on
the rise. While there’s no known reason, he says "Part of
it may be that the peanut is introduced early in the diet of the
child. The digestive system is still immature and hasn’t
developed a resistance to peanuts." For that reason, he
suggests not introducing peanuts — including peanut butter —
to children until they are 3 or 4 years old. |
 Deadly
reactions
Being stung by a bee can be
deadly for the person allergic to its venom, says Dr. James
Pugely, an allergist who practices at Columbia St. Mary’s in
Milwaukee. "But the one that seems to be the most dangerous
is the peanut." Life-threatening symptoms include a
swelling in the throat, a severe drop in blood pressure and the
lungs filling with liquid. Reducing exposure is the ideal way to
avoid a reaction. But in the event of contact, Pugely says
treatment to block a reaction is needed. "The emergent
treatment is to have access to epinephrine. Obviously, schools
keep it, day cares keep it now. That should be administered as
quickly as possible." Then, see a doctor. "If you’ve
had a reaction, you have to get medical care." |
 Pet
lover
Shelby Therkelsen, 11, loves
horses — so much so that she saved up her hard-earned dollars
to help buy one.
Unfortunately, that’s when
Therkelsen’s allergic reaction accelerated.
Sandy Nelsen, her mother, says
Therkelsen would be sneezy if she spent a lot of time around
horses and hay. In fact, when Misty joined their family,
Therkelsen would go through a box of tissue if she spent the
afternoon with her horse.
"I would sneeze a lot, I’d
get a runny nose, and my eyes would get red and itchy,"
Therkelsen says.
A skin test on her back revealed
that Therkelsen was, indeed, allergic to horses. And today she’s
taking Zyrtec, an antihistamine. "It keeps her from having
such a severe reaction," Nelsen says.
She also takes Patanol —
prescription eyedrops. "The drops help with the redness,
the itching and the swelling," says Nelsen, adding that the
treatments have relieved 80 to 90 percent of the symptoms.
And for Therkelsen, medication
was the only option, as she told her mother, "I’m not
getting rid of the horse." |
 Foodie
Casey Zwettler, 27, has loved
peanut butter since he was a kid.
So when he recently starting
having a reaction to it, he was more than concerned.
"I had a swollen lip and
some itchy hands, and a little bit of hives," he says.
"I thought it was the peanut butter. That was something
that stuck out in my head."
He knew that peanuts were a
fairly common food allergen, and he tried over-the-counter
medications to alleviate the symptoms. That worked somewhat, but
still the symptoms persisted. "After it happened a few
times, I wanted to be sure what it was," he says.
At his first trip to an
allergist, Zwettler’s medical history was
documented. With it, he was asked
to recount what he had eaten prior to his reactions.
That was followed by a skin prick
test on his back, which came back positive to peanuts — but
not overwhelmingly so. And a subsequent blood test came back
negative. "Then we weren’t sure," he says.
Confusing matters more was when
he had a similar reaction but had not consumed any peanut
butter.
Now, he’s undergoing a food
challenge, in which he’ll eat peanut butter in increasing
amounts every day for two weeks to see if that is definitely the
cause. "We’re definitely going to talk and see what else
we can do," Zwettler says. |
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