Allergies

I came across this on the drive in to work yesterday morning, and it reminded me of just a few short years ago.  From time to time I would babysit my godson, and for quite a while, he used a pacifier (which I always call a "binky").  Like many babies and very young children, he took comfort in a pacifier.  It was often the "go-to" thing at bedtime or when he was fussy.  When babysitting, the pacifier would inevitably fall from his mouth and land on the floor.  More often than not, I would see it happen, pick it up, make sure there was no dog hair or big chunk of dirt on it then pop it back in.  I can hear a few people gasping, but generally speaking, "dirt don't hurt" was a saying that my brothers and I practiced on a daily basis as children. My one brother's nickname was literally "dirt" since he was generally filthy from playing outside so much.  This is all a bit circuitous, but it leads me to two things, the hygiene hypothesis and a recent study published in Pediatrics.

While my approach in cleaning the pacifier is probably not taken by many, this recently published study I mention focuses not only on how parents cleaned their children's pacifier but also how it may impact the development of eczema and allergies.  In examining 184 children, researchers studied what the children were sensitive to, how parents cleaned their pacifiers, and analyzed the bacteria in the children's mouths.  At 18 and even 36 months, children whose parents cleaned their pacifiers by sucking on them, showed remarkable protection against eczema and asthma.  Yes, you read that correctly.  Some parents clean their child's pacifier by sucking it clean then giving it back to the child.  Odd as it may sound, this is believed to be the key findings of the study.

Regardless of how "clean" we, as a species, think we are, there are literally billions of bacteria living on and even inside of us.  On our skin, in our digestive tracts and in our mouths, bacteria play a very important part in everything from our immune system to the way in which we break down our food.  The theory is that by sucking on the pacifier the parent not only cleans visible dirt or debris from it, but they actually place bacteria back onto it.  That bacteria is then introduced to the child, exposing the child's immune system to a broader array of bacteria.  This ties into the hygiene hypothesis in that many believe children in western societies are "too clean," and because of this, are at an increased risk of developing things like eczema, asthma or allergies.

When we are infants, our bodies' systems are developing.  Think of the immune system like a defense mechanism that is untrained.  By nature, this system is designed to find things harmful to us and fight them, so at a very early age, the immune system is trying to determine what is dangerous and what can be ignored.  The hygiene theory suggests that lack of exposure to a variety of bacteria and germs means the system doesn't get thorough training and often identifies innocuous substances as harmful.  "Well, we have to find the shady characters to defend you against, and I don't like the looks of these guys." So when they immune system cannot find real enemies, they start identifying harmless substances as dangerous.

The hygiene hypothesis is just that, a hypothesis, and there are some studies that run counter to this.  This piece of research, though, suggests that there is some validity to it.  While it is too early to suggest that parents start sucking on their kid's pacifier to clean it, it really can't hurt.  Oh, and just for the record, most parents simply rinse the pacifier.  I guess I all into that "other" category.

For an abstract of the pacifier study.

Author: KevvyG

May is Asthma Awareness Month, as designated by the Environmental Protection Agency (EPA) and with this comes a renewed focus on asthma and how it impacts not only individuals but the larger community as a whole. In addition to this, each year a few non-profit/advocacy organizations piggyback off this and have designated May Allergy & Asthma Awareness Month. During this month there are a variety of events scheduled to help promote awareness as well as action on these two respiratory problems.

The Asthma and Allergy Foundation of America (AAFA) is planning several events to help to raise awareness across multiple age groups. Some of these include kits to help people set up and organize their own events, free webinars, a poster contest for 3rd-8th graders, a sweepstakes and their Ditch the Drip event in Memphis, May 16-18th. For more information on these events, visit the AAFA.

Our the partner, AANMA, is spending the day at on Capitol Hill. There they will focus on a multiple of things including changes in healthcare law, meeting with lawmakers, and providing a variety of free booths that offer anaphylaxis preparedness demonstrations, asthma and allergy screenings as well as consultations with allergists. All of these events are geared towards raising awareness of allergies and asthma while interacting with legislators. To learn more about Capitol Hill Day or for more info on the AANMA.

Lastly, there is the EPA. While this large governmental agency doesn't do much in terms of directly sponsored or coordinated events, they do much in the way of providing educational materials and the tools needed for advocacy groups or just individuals to help spread awareness. This PDF is chock-full of ways that people can help to raise public awareness of asthma and its impact in the community. Some way wonder why the EPA would promote Asthma Awareness Month, but the reason is actually pretty simple. The link between the environment, particularly air quality, and asthma is clear. From ground level ozone, to studies that focus on asthma rates in urban areas (often choked with vehicle emissions), many of the things the EPA does on a day to day basis can have a direct impact on asthma in the United States.

For our part here at AchooAllergy, we know that allergy season is in full swing, so we are offering a 10% discount on asthma and allergy relief products. From window filters, allergy bedding and air purifiers to HEPA vacuum cleaners and nebulizers, save an extra 10% of your purchase of most products. Happy May!

Author: K. Gilmore

Pollen, pollen everywhere! It's like Christmas, except instead of snow, it's yellow pollen, and instead of receiving gifts, all you get is sneezing, congestion, a runny nose, allergic rhinitis or sinusitis. Though pollen levels are traditionally very high during the springtime, nature sometimes tries to do its part to help mitigate the mucousy misery that it spreads. Nature's idea of helping with pollen? Rain.

While wet, warm conditions are very conducive for the production of pollen, it tends to be drier days that see some of the highest pollen counts. This is because dry, low humidity days are better "pollen travel days". When not encumbered by moisture, pollens are freer to float about in the air and coat, well, everything. Ever notice the air feels "heavier" or "thicker" when it's humid out? There is some merit to this as humidity does make microparticles, like pollen, heavier and more likely to precipitate out of the air rather than continue floating along, tickling the noses of people across a very wide area.

Often rains spell relief for many folks since the humidity levels rises and grounds pollen faster than one of those new Boeing Dreamliners with a faulty battery (too soon?). Rain not only inhibits the spread of pollen, it also washes it away. Areas of the country, like Atlanta, that experience high levels of pine pollen often get that yellow, powdery coat over everything. While these larger, visible particles can sometimes be less responsible for allergic reactions than their smaller cousins, this pollen nonetheless is a good indicator to all that allergy season is in full swing.

So whether you're a farmer in many parts of our drought stricken country or just a seasonal allergy sufferer, spring rains bring welcome relief. Check out a few of the pictures I shot recently. No, it's not a chemical spill. That's pollen!

You can't always wait on the rains to give you a break during week long stretches of high pollen counts, but you can help to reduce the pollen you breathe by wearing an allergy mask, rinsing your sinuses and using OTC allergy medications when symptoms flare up. Or, there is always a rain dance.

Author: K. Gilmore

Well, it's time for Atlanta's annual rite of passage - spring pollen, and particularly pine pollen.  While there are certainly more tree pollens than just pine floating around in the air, pine pollen is what gives this city it's lovely yellow hue this time of year.  For those affected by allergies or have allergy-induced asthma, the next several weeks can be miserable without taking some steps to control exposure.

We generally recommend you first start at home.  What's floating around outside cannot be helped, but what's floating around inside your house can.  This time of year it's important to remember that a few simple steps can help keep many of those allergens outside, where they belong.

• Take your shoes off.  It seems pretty self-explanatory, but you can track a lot of pollen into the house.  This is also true for pets.  While your cat or dog probably doesn't wear shoes, using a pet wipe or simply damp rag to quickly wipe them down when they come in can help keep them from tracking throughout the house.
• Change the filter.  This can apply to a couple things.  Your HVAC filter is likely due for a change.  After spending much of the winter indoors, these filters can work overtime trying to keep your indoor air clean.  Start with a fresh filter every two to three months.  If you are using a HEPA air purifier, keep tabs on when your filter change is due.  Often they'll have timer based indicators, but keep this running properly can help reduce the pollen that you're bringing in the house.
• Don't skimp on the spring cleaning!  Regular vacuuming, washing, and dusting are more important during high pollen times than at any other point in the year.  By letting allergens build you can easily quickly increase your "allergen load" past the tipping point and be overwhelmed with symptoms.
• Keep the windows closed.  In places with high levels of pine pollen opening the windows can be about the equivalent of coating everything in your home with baby powder, except it will be yellow and likely cause a lot more sneezing.  If you do want to keep the windows open without the mess and allergens, try using a window filter.  They're not a efficient as a HEPA filter, but they do a good job in removing larger particles and much of the pollen in the air.  Besides, if they were HEPA rated, no air at all would pass through.

While these tips can help to keep pollen out of your home, we don't want people to be shut-ins.  So when you're out and about, plan certain tasks around specific times of the day.  Late morning and midday are often your worst times for peak pollen.  There are also a variety of resources that will give you a daily pollen count.  So if something could be pushed off from a particularly high pollen day, you can do a bit of short term planning.  If you are going to be out and about, whether for fun, work or exercise, OTC medication can help prevent and treat many of the symptoms, and a high quality allergy mask can block most of the allergens in the air.  Using a nasal irrigation device can help rinse away reaction causing pollen and other allergens that collect in the nose and sinuses.

None of these things cost much money.  More than anything, it is simply spending a little extra time or stepping up the frequency of things that you are already going.  Spring is here, so buckle up!  We have about three weeks of this lovely yellow powder ahead of us!

Author: Kevin G.

One aspect of my job here at Achoo puts me in touch with people with little to no knowledge of environmental control, allergy bedding or how specific things inside the house can be causing certain symptoms. One piece of information that I commonly pass along is based on previous studies of allergies and asthma that show links between allergic diseases like allergies, asthma and eczema. About 70% of the time, if a child has asthma, s/he also has at least one allergy. A study recently published in the Annals of Allergy, Asthma and Immunology clear up this picture for adults with asthma who likely also have allergies. The results were a bit surprising to most professionals in the field.

By studying and comparing data from over 2500 patients in two age groups, 20-40 and 55+, researchers found that for asthmatics, allergic sensitization was present far more often than not. For the first age group, 20-40, those with asthma were also allergic to at least one allergen 75.4% of the time. In the second group, 55 years and older, asthmatics were allergic to at least one allergen 65% of the time. While this type of overlap has been studied and identified in children, most believed that the link between allergies and asthma wasn't as strong with adults.

Within this data, there is some variation between the types of allergens that these age groups showed the most sensitivity to. For the older set of patients, the most common allergen was dust mite. Over one-third of those who were asthmatic and allergic were sensitive to dust mites. Rye grass, cats, dogs and cockroaches followed. For the younger set of patients the allergen sensitivities were similar with dog and the dust mite allergen leading the way.

Allergies and asthma are two very closely related animals. One is like a llama while the other is like an Alpaca. Both are different but fairly closely related, and like llamas/alpacas, sometimes people confuse the two.

In terms of helping people, this stronger correlation can help doctors and allergists better diagnose conditions in older adults. And while asthma and an allergy may be the cause of a particular set of symptoms, some of the same measures to help control your indoor environment will work for both.

To read the article's abstract or access the full article.

Three Ways to Reduce Allergens in Your Bedroom

Author: Kevin Gilmore

With Easter and Passover now behind us, the spring allergy season is set to begin making millions across the U.S. miserable. And while there is no shortage of weather forecasters and others singing "doom and gloom" for this allergy season, I am somewhat more optimistic about it. Why would I be optimistic about this spring allergy season you ask? There are a few reasons why I think the "doom and gloom" crowd are missing the mark.

Don't get me wrong here. Spring allergy season is going to really stink for tens of millions of people. It has, and likely always will, but think back to last year around this time. Do you remember the stories about the upper third of the country being buried under snow? Nope. Instead what we had was record setting high temperatures.

Remember this? A little digging around shows that temperatures in the upper Midwest ranged as widely as almost 70 degrees warmer on days last year versus the same days this year. Speaking strictly in terms of averages, much of the country is still above temperature averages for 2013 (1.9 degrees according to NOAA), but 2013 went even further (3.6 degrees). All that warmer weather last year meant spring, sprung early.

More than simply the temperature, the entire jet stream pattern is different. If you check out images from NOAA for March of this year and last year, you can see a big dip in the west that helped pull warmer air and temperatures up and disperse them throughout the country. This year the pattern more closely resembles the norm, and with it has come more normal winter temperatures and a more than healthy amount of snow to much of the country.

In February of 2012, people in different parts of the country began their annual trek to the allergist, and for most, this was a month sooner than they were used to. It was little wonder though. At the end of last March, we here in Atlanta saw the old pollen count record shattered by 55% (9369 vs. 6013). We didn't see anything even remotely close to that last week.

Again, I'm not saying spring allergy season took a vacation this year. Sneezing and coughing are likely to be the common sounds you hear for the next couple of months, and now is the time to start preparing for another round of springtime sniffles. However, I don't work for a company that has to make a news story out of everything as mundane as an inch of rain. So, time will tell but, I'm not buying that 2013 will be the worst allergy season ever. To quote Dana Carvey (impersonating G.H. Bush), "Wouldn't be prudent. Not gonna do it."

For good information on comparing historical trends, from year to year, visit The National Climatic Data Center, a division of NOAA (National Oceanic and Atmospheric Administration).

Author: Kevin Gilmore

With Good Friday and Easter just around the corner, most of us are finishing the final preparations for either dinner, Easter egg hunt or some type of family activity. In my household, my parents would put together Easter baskets then hide them at night so in the morning we would wake up early and begin the hunt!

Fortunately for us boys, the Easter Bunny knew just what we liked. So he would go easy on the jelly beans and heavy on the Cadbury eggs for me while doing the exact opposite for one of my younger siblings. Sweets and candy weren't the only things that came with our Easter baskets. In every basket was a stuffed animal. Mostly rabbits, but often ducks or turtles, from small to large, there was always one in each basket. Another favorite was a pail with a small plastic shovel and rake (which is great for filling with rocks, making sandcastles or mudpies with later). Other times there might be a pack of toy cars, plastic army men or even oversized chalk (that my dad LOVED to see us use on the sidewalk in front of the house!). There was also, always, an outfit - usually a pair of shorts and a shirt. These types of things can serve two purposes. First, they certainly last much longer than a chocolate bunny, but for children affected by food allergies, they can keep the baskets fun without the focus on candy.

As we grew up and began families of our own we also started having an annual Easter Egg hunt. While there always were at least a dozen or two colored eggs, most of what was hidden were plastic eggs, and though no one in the family has food allergies, some of the things my mother did were a bit forward thinking in that regard.

Starting from just a couple dozen and expanding to nearly three hundred, mom would purchase hollow plastic eggs in a variety of sizes and colors. Some would hold candy, like a small packet of jelly beans, individually wrapped chocolates or packets of sweet tarts (a favorite of mine). She would also fill many with a variety of other things, that while not the intention, were very food allergy friendly.

Running around a massive three acre yard we would find colorful plastic eggs with stickers, rubber bouncy balls, or money. The ones with money were what we called the "jackpot eggs". Filled with anywhere from fifty cents to a whopping two bucks, the older we got, the more these eggs became priceless to us. Another fun idea is to put tickets in the eggs. Number the tickets to match with a corresponding, larger, prize that will prolong the anticipation. They could be redeemable or things like a larger stuffed animal, an inexpensive pair of earrings, an iTunes gift card or even events like a couple hours of bowling or roller skating.

Though we didn't do this, before the event, you can have the children help you decorate the eggs. In reality you can get as extravagant as you want, from using simple stickers to going as far as hot gluing beads or other decorations on each egg. Ribbon or paints can also be used. For real eggs, you can fall back on the trusty Paas coloring kit or even use packets of Kool-Aid to dye the eggs. (Oh, and PLEASE make sure you boil them first! You or your child will only make this mistake, once.) Again though, for children with food allergies, the plastic, or even a purely decorative wooden egg, is likely your best bet to avoid and potential problems.

If you put on your own Easter egg hunt, here's a few tips, coming from years of experience. There are easy hiding spots as well as more difficult ones, so cater to your age ranges. By placing as much or more emphasis on things OTHER than food and candy, you can subtly make the event more inclusive for all kids. Lastly, don't let things get too big. Even with six to twelve kids searching, three hundred eggs is... a bit much. If you don't keep track of exactly how many you had to start with, you might have another annual experience that we had, finding them with the lawn mower a few weeks later.

There is nothing quite like hearing the audible change in the sound of the mower as you buzz through a plastic egg, or watch the contents spew out of the mower into a thousand little slivers (particularly when it is a George Washington that was obliterated). Nearly as bad, if not worse, when you hit one of the real, boiled eggs, after it had been sitting in the yard for three weeks.

For many people, Easter is much like other holidays in that a big part of it is gathering with family or friends. While things like food allergies shouldn't be completely ignored, they do not have to dampen the fun. There are a variety of easy ways to be more inclusive and to ensure all the children and adults involved have an enjoyable time!

Author: Kevin Gilmore

When it comes to allergies, rarely are they isolated or singular. Often there are groupings, like allergen punches in bunches, that can affect the body. Peanut allergy sufferers are often allergic to other types of tree nuts, or those allergic to ragweed pollen are also likely affected by dust mites. But more than being multi-allergenic, cross reactivity is also an issue for many allergy sufferers. Cross-reactivity is the body's immune system mistaking a similar protein or chemical as one it typically has a reaction to, and most people see this reaction with food.

So what are some common cross reactive allergens? Birch is one of the biggest culprits. A protein found in apple peels is very closely related to one found in birch, and this means the body can sometimes confuse the two. You may be diagnosed with an allergy to birch, but then, while eating a raw apple, you might experience tingling, swelling or itching around the mouth and lips. This type of symptom is most common for people with cross reactions to foods. Another example of this is with grass pollens and seemingly unrelated foods like kiwis, tomatoes, or peanuts. Sometimes referred to as "latex-fruit syndrome," a third common cross-reaction stems from a latex allergy and a sensitivity to certain fruits like bananas and kiwi.

Unfortunately, the problem with this can be felt year round. So while your spring allergy season may play hell on your birch pollen allergy, a reaction to eating fresh apples is likely to appear regardless of the season.

Challenges in identifying and categorizing these reactions can be difficult and cause false positive test results. Common allergen tests, like the skin prick test, can reveal a sensitivity to a particular allergen, potentially a cross reactive food, but then lead to a diagnosis of a full blown allergy to this food. Cross-reactivity does not mean that someone will have a reaction to ALL types of food that share a particular, similar protein. Because of this, eliminating an entire class of foods from the diet because of cross reactivity can sometimes be a bit unwarranted, though not uncommon.

One interesting away around this can be by cooking foods. While the cross reactions can be common when it comes to fresh food, cooked food often alters the proteins enough that the body no longer misidentifies them. This is not always the case (particularly with a cross-reaction to nuts), but this does explain why someone with a birch pollen allergy can feel a tingling in the lips and mouth when eating a fresh apple but experience no symptom at all when eating apple cobbler or drinking apple cider.

Without a doubt, cross reactivity complicates our understanding of allergies and the allergic response. Yet, solving the problem of allergies can't be solved until more is known, and cross reactivity is just another part of puzzle. If you think you may be cross-reactive, talk to your doctor or allergist. While the knowledge in this area is still rapidly expanding, he may be able to help further pinpoint the actual cause of the issue.

Author: K. Gilmore

We often get questions from allergy sufferers who are looking for allergists or immunologists in their specific city or state. While we do partner with many different allergists throughout the country (you may have come across our catalogs or single sheet flyers), we do not necessarily have a comprehensive listing of all the allergists or immunologists who are out there. If you are looking for someone local to help you with your allergies, we do recommend a place where you can quickly and simply search for one.

Our friends over at the AAAAI (American Academy of Allergy, Asthma & Immunology) have put together a database of board certified allergists and immunologists.

Simply enter your zip code or city/state and to search. What you will get is a list of local allergist and immunologist in within the range of the area you specified.

You can then click on each listing to see more information about the allergist you've selected such as what type of practice they offer, where they received their training, what types of patients they see, if they are conversant in Spanish, and location/contact information. If you have health insurance, you can cross reference these care providers with your approved list.

It is always helpful to ask friends and family, and social networks are an easy way to ask many of your friends and family quickly if they have any experience with the local allergist you are considering.

Author: Kevin Gilmore

As a long time early riser, I am typically up and reading the news before the sun ever begins to peek over the Atlanta skyline. There's the typical hubbub - Congress is lazy, politicians trading their usual election year barbs, tips on how to lose weight faster, etc. I caught an article about gearing up for fall allergies, and while fall is about a month away, 115 degree temps in OK possibly melting streetlights, a severe drought and warmer than average temperatures across the country tell me it's still a bit premature to start talking about fall allergy season. One story did catch my eye, and it came courtesy of the folks over at Ford.

Allergy and asthma sufferers will often check the air quality and pollen levels for the day, as these two things can significantly impact their health on any given day. Ford is taking this a step further and integrating current allergen data into their SYNC Voice Control feature via their Allergy Alert app. This means that while sitting in morning traffic or on vacation in a new locale, you can get a quick rundown of pollen levels and types (extra tissues anyone?), UV index (make sure you pick up some sunscreen), and other information that can be helpful for allergy and asthma sufferers.

This is likely just a first step in integrating health and wellness data and applications into vehicles. Ford has made no secret about creating "a car that cares." Currently, the SYNC AppLink is available in almost a dozen of the new Ford models. As another positive, because the app is integrated into the Synce Voice Control, it's hands-free and allows you to simply ask your car for the information you want. Wasn't there a show like this once? Ok, so the SYNC Voice Control isn't quite like Kit from Knight Rider. It's not as if your car can drive itself.... yet.

Author: Kevin Gilmore