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Ask An Allergist: Dr. Mardiney

Ask An Allergist - Frequently Asked Questions, Answered by a Board Certified Allergist - Dr. Mardiney

As our most recent contribution to our expanding Ask An Allergist segment, we would like to welcome Dr. Matthew Mardiney! In our continuing efforts to provide you with expert advice, we invite you to send us your allergy, asthma and related questions. You can find the most recent set of questions and answers posted here as well as on our blog. Submitting questions is easy! Send them to us via any of the FAQ sections on our product pages, call them in, send them via our live chat, email blog@achooallergy.com, use carrier pigeon or float them down the Chattahoochee on an inner tube! We'll select some of the most relevant and intriguing to pass along to our experts and post the answers.

Ask An Allergist - Your Questions for Dr. Mardiney


Dr. Mardiney's Bio

Matthew Mardiney M.D. is a native of Baltimore, Maryland . He attended college at the University of Virginia and obtained his Masters of Cellular Physiology at Georgetown University, where he received Superior Scholar Distinction. Dr. Mardiney attended the Georgetown University School of Medicine and completed his Internal Medicine Residency at Cedars-Sinai Medical Center/ UCLA in Los Angeles California. He then completed his Fellowship In Allergy and Clinical Immunology at The National Jewish Center for Immunology and Respiratory Medicine in Denver, Colorado. {currently ranked the #1 Respiratory Hospital in the world}.

Dr. Mardiney is board certified in Internal Medicine and Allergy & Immunology. He has been in practice in the Baltimore Metropolitan area for 15 years and has recently started his own practice, the Advanced Allergy and Asthma Centers. Dr. Mardiney specializes in both pediatric and adult allergy, asthma and Clinical Immunology. He is currently a member of the Academy and Allergy, Asthma, and Immunology.


Allergy Tips for TravelHow can I keep my allergies in check when traveling to countries where I might be exposed to trees/plants that I've never encountered before?

Traveling out of the country or even other parts of our country can be challenging for people who suffer from environmental allergies. There is no easy way to predict how a foreign allergen will impact the allergic individual. Factors that can impact include previous exposure, the amount, and duration of exposure. Often allergy sufferers who have not have had previous exposure will be less affected by a new environment.

The keys to travel success is to ensure that your baseline allergic condition is being maximally treated and controlled prior to your travels and having a treatment plan going forward. Being prepared to travel means knowing the predominant allergen that you will be exposed to {endemic pollens, animal dander, mold, etc.} and having backup measures to initiate if symptoms escalate. This includes avoidance measures (as best as possible) and additional medications such as antihistamines and/or decongestants for symptomatic control if needed. In extreme cases traveling with a low dose oral steroid and/or a rescue inhaler may be warranted based on the person's allergic history.

Finally, Individualizing a treatment plan with your Allergist or PCP is always a good idea before traveling. Remember the phrase "Fail to prepare...prepare to fail".
- Dr. Mardiney

Keeping Your Child Active with AsthmaAny advice on how to keep my asthmatic son active but safe during the spring and summer?

Every asthmatic is different but typically the summer and particularly the spring can be challenging. Our goal is always shooting for maximum control where the asthmatic patient essentially normalizes and can do anything a non-asthmatic can do. Typically this can be obtained to some degree with preventative allergy and asthma treatment.

If your child does have pollen sensitivity in the spring and summer its best to do most activity outside in the early morning or late afternoon when pollen counts are down and temperatures are cooler. Be aware of the air quality and limit outside activities during poor air quality days. If your child struggles with allergy and asthma despite these measures, a reassessment of their maintenance allergy and asthma treatment is indicated and consideration for allergen desensitization "shots" should be discussed with your local allergist.
- Dr. Mardiney

Developing an Allergy to a New Pet?Can someone develop and allergy to something they're close to? Specifically, MY pet. Can allergies be that specific?

Allergy is a genetic disorder that involves reactivity to specific allergens such as dust mite, pollens, and animals to name a few. Unfortunately, allergies can turn on at any time for unknown reasons. It is very common to see a pet owner develop allergy to their pet over time. Relocation of their animal or treatment with medication and possible allergy shots is often necessary.
- Dr. Mardiney

Am I Allergic to Dust or Dust Mites?Is it possible to be allergic to dust but not dust mites? I am on immunotherapy for several different allergens, one was dust. Recently, the FDA has taken away the dust serum and is saying that dust mite serum is the same thing? I was retested for dust mites and didn't have an immediate reaction, but did within 24 hours, a red itchy bump the size of a dime that lasted for several days. The allergy nurse said it was irrelevant because I didn't react right away within 20 minutes. My problem is being symptomatic to dust again since it has been eliminated from my weekly shots. I've been on shots going on two years.

Yes!!! You can be allergic to house dust and not dust mite. House dust is a mixture of many substances including shed human skin, mold, animal hair and dander, fibers, and dust mite and its excrement. The amount of each can vary from home to home. The significance of Late Phase skin test responses to an airborne allergen such as dust mite has long been controversial. Despite the lack of conclusive data, many allergists consider a delayed response to be significant. This is based on the known fact that the allergic response is made up of an early phase [immediate up to 30 minutes] followed by a more prolonged late phase reaction. The late phase typically occurs 4-8 hours after exposure but can occur even later in some circumstances. Based on this data it can be extrapolated that a delayed response up to 24 hours could be relevant.

Every allergist has their own style and protocol as to what they may remove from serum after a retest. Typically I do not remove an allergen that has shown significant reactivity on previous testing.

Finally, If you seem to be more clinically sensitive to dust.... it may be necessary for your allergist to review your allergy serum makeup and increase the individual components (such as dust mite, mold etc.) that you may have lost with the removal of house dust from your serum.
- Dr. Mardiney

Ask an Allergist - Dr. Mardiney - What Are Hidden Allergens In The Home?What are some hidden sources of allergens that I may be overlooking in my home?

Potted Plants can be a nice touch to the home. Unfortunately, they have the potential to become a breeding ground for mold. Standing water and decaying leaves are the primary sources. Frequent pruning as well as plastic pot liners (kept dry and clean) will help decrease the likelihood of mold growth. Finally, an artificial plant may be a wise alternative.

Cleaning and Hidden Allergens in Your HomeRugs and Drapes can be a haven for animal dander and dust mites. The dust mite thrives in dark, warm and humid areas and feast on the shed scales of human skin. The optimum solution is for the removal of the carpet and replacing drapes with mini-blinds. This allows for fewer hidden allergens and an easier surfaces to clean. In situations where this is not feasible, frequent vacuuming (2-3x/wk) with a HEPA filtered vacuum and controlling humidity (35-40%) will decrease both dust mite and indoor mold.

Bedding and stuffed animals are also significant reservoirs for dust mites and animal dander. Encasing the mattress and pillow has proven to be one of the most important maneuvers in reducing indoor allergen exposure.

Washing your bedding in hot water and minimizing the number of stuffed animals is also a must. Washing stuffed animals in hot water or freezing them has proven effective as well.

Air conditioner/central air ducts are also a source of hidden allergens. Having your ducts cleaned every 3-4 years is the current recommendation. Placing air vent filters has shown to be very effective in minimizing the circulation of indoor allergens throughout the home.
- Dr. Mardiney

Ask an Allergist - How to Clean Without Allergies?What are some tips about how to clean properly/more thoroughly?

Feather Dusters - Colorful But Not Effective for Dust RemovalCleaning without providing proper allergen barriers for yourself is a common mistake. Often allergy symptoms can be delayed to the cleaner and you do not realize the impact until its too late.

Wearing a dust mask, gloves, and goggles particularly with the heavier cleaning, is a good idea. Showering immediately after cleaning is also helpful.

The old-time feather duster should not be used in cleaning as this simply relocates and stirs up dust. Obviously this can be provoking to the allergy sufferer.

Cleaning/dusting should be done with a damp cloth or rag or electrostatic/microfiber cleaning cloth to better capture allergens.

Use of an older "low efficiency" vacuum can be a provoker of indoor allergies and asthma attacks. While these vacuums are adequate in picking up dust bunnies and visible debris, it does little to remove the common allergenic particles which are too small for this vacuum to capture. What happens? The vacuum essentially shoots allergens into the air.

Fortunately, most newer vacuums have HEPA (high efficiency particulate air) filters which capture allergens such as dust mite, mold, and pet dander.

At this point, I think it's important to bring up a broader issue when it comes to cleaning inside your home. Most of us have traditionally taken the approach that if it looks clean then it is clean. For many people that approach is fine, but anyone dealing with allergies, asthma, COPD, or a compromised immune system, appearances can be deceiving. Instead, it is far better to clean for your health not for appearances. This means keeping in mind some of the tips Dr. Mardiney outlined above as well as taking note of what you are actually use to clean (types of cleaners, cleaning devices, etc.). It also means adjusting your mindset to consider that even though a floor or kitchen countertop may look clean, it could be chalked full of microscopic allergens or bacteria/viruses.
- Dr. Mardiney

To view Ask an Allergist - Dr. Frank