If you have a child with allergies or asthma – this is a very good time to review your “allergy action plan” for the upcoming school year.  First, if your child has asthma - learn about asthma triggers, including exercise associated asthma.

Second, more than 2 million children have allergies to one or more foods, making it imperative to incorporate a savvy avoidance and elimination diet 24/7 both at home and at school.  If you need help, enroll in the Food Allergy and Anaphylaxis Network at www.foodallergy.org.

Third, seasonal allergies and indoor allergies can cause a decrease in learning in the classroom. As a result, your child may require proper attention and pre-treatment before they head to the classroom.

Here are some more tips to get you started:

– All children with a history of severe allergy or allergic emergencies should have an auto-injector with epinephrine immediately available to them and appropriate school personnel. A written plan of action should be in place.

– If your child has asthma – work with your child’s physical education staff to allow for safe and enjoyable athletic activities during the school year. It is very important to provide time for a warm up and adequate cool down as well as have available drinking water during exercise.

– Wear protective eyewear on windy days to reduce pollens and molds entering the eyes.

– Work with your family doctor and/or allergist to get proper allergy treatment for environmental allergies that may be aggravated by exposure to indoor allergies such as pet dander (cat hair is often present in high levels in schools, and is usually from exposure to clothing).

– For kids allergic to food, always plan ahead with safe snacks for school and reinforce “reading food labels.” 

Let’s make the school year a safe, successful and fun-filled experience, especially if your child has allergies or asthma. Learn more at www.acaai.org and www.aaaai.org.

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

Summer allergies and oral allergy syndrome

If you are one of the thirty million people suffering from summertime seasonal allergies, it is important to know about pollen-food syndrome, also known as oral allergy syndrome (OAS), caused by allergens such as ragweed pollen. 

Each year, grass pollens and weeds cause seasonal suffering and ragweed begins to bloom around early August in many areas of the U.S.  In the warmer climates weed pollens may be seen during much of the year.

Itchiness of the mouth and throat immediately after eating fresh fruits or vegetables are common symptoms of OAS. Oral allergy syndrome results from a cross-reaction between allergy antibodies directed towards pollens with similar proteins that are found in foods in about one-third of seasonal allergy sufferers.  Individuals with ragweed allergies might experience these symptoms when consuming foods such as:

• Banana
• Cucumber
• Melon
• Zucchini
• Sunflower seeds
• Chamomile tea
• Echinacea

Grass pollen allergic individuals might experience symptoms when ingesting

• fig
• melons
• tomatoes
• oranges
• Mugwort (weed pollen) allergic sufferers may suffer after eating:
• carrots
• celery
• coriander
• fennel
• parsley
• peppers

Generally, cooking or microwaving the food will eliminate a reaction, but not always.  Less commonly it is possible for the OAS to induce mouth and throat swelling if you are allergic to various foods. 

For additional information from the American Academy of Allergy, Asthma and Immunology at http://www.aaaai.org/media/news_releases/2006/08/080206.stm

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

Stress may actually play a role in whether or not your allergies will be tolerable or very bad! Researchers from Ohio State University Medical Center reported “stress and anxiety make a big difference” in terms of how we respond when allergies attack. 

The study evaluated the link between the severity of allergy symptoms and how much stress a person has.  Those allergy sufferers, who were much stressed, were four times more likely to test positive for allergies!
Remember, greater amounts of anxiety are physically linked to an increased production of “stress hormones.”

 Dr. Ronald Glaser, a researcher from Ohio State University, thought these chemicals released when stressed may be to blame for delayed allergic reactions.

As we approach the height of the summer and early fall allergy season, the message is to try and reduce excess stress. You can also learn anti-anxiety and coping strategies to improve your emotional well-being - and your allergies!

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

Alert: FDA Advises Patients to Switch to HFA-Propelled Albuterol Inhalers Now

The U.S. Food and Drug Administration is encouraging asthma patients to speak with their physicians and health care providers about the “switch” to HFA-propelled rescue inhalers (albuterol).  These environmentally friendly inhalers will replace the old CFC propelled inhalers that are harmful to the ozone layer. 

The FDA is encouraging patients to talk to their health care providers now about switching to HFA-propelled inhalers.  The new inhaler may give some patients a perception of a softer mist as compared to the old CFC inhalers.  The medication (albuterol) is exactly the same, and has not changed. 

The phase-out of CFC-propelled inhalers is the result of an international environmental treaty: the Montreal Protocol on Substances that Deplete the Ozone Layer and the U.S. FDA mandated these inhalers been phased out by the end of 2008.

Again, many patients have already been transitioned to the new propellant in their rescue inhalers and may not have even noticed the change. Talk with your provider or asthma specialist to learn more about asthma triggers and optimal control.

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

If you believe your summer and fall allergies are actually getting worse, you are probably correct.  For a quick explanation, good old global warming and overproduction of greenhouse gases may be the cause. More than 40 million allergy sufferers in the U.S. have seasonal and year-round allergies. Studies show that plant pollen production such as ragweed (season starts mid-August) and spring tree pollens go way up as a result of exposure to carbon dioxide, a major contributor in greenhouse gases.

Plant ecologist Lewis Ziska with the U.S. Dept. of Agriculture is a pioneer in studying allergies and climate change.  The warmer temperatures are also having an effect even in Alaska, leading to a possible increase in pollen and mold allergies as well as stinging insects.  An Intergovernmental Panel on Climate Change (a leading authority on effects of global warming) as well as the U.S. EPA cites an increase in allergic reactions.

Data from the American Academy of Allergy, Asthma and Immunology show that one ragweed plant can produce 1 billion pesky pollen grains that wreak misery to those sufferers.  So if you magnify this number by two to four times you have a “mega-pollen burst”!  Pollens grains may also travel up to 400 miles leaving almost no location untouched. 

Be prepared and develop a sound survival plan:

• Pre-treat with your prescribed allergy medications before exposure
• Keep windows closed – this will reduce indoor pollen levels
• Use the air conditioner unit – place on “do not recirculate”
• Avoid certain foods that may aggravate those (about one-third of sufferers) with ragweed allergy such as bananas, melons, cucumbers, zucchini, chamomile tea, sunflower seeds and even echinacea
• Shower nightly to remove excess pollen that accumulates in your hair, skin and eyelids
• Take your summer vacation to an area where pollen levels are typically lower, such as a beach or lake
• Consider moving outdoor activities or exercise indoors during high pollen times of the day, generally between 10 a.m. to 4 p.m. (even more so on “windy” days)
• Check out your local pollen count at www.aaaai.org/nab

Global warming and greenhouse gases are here to stay, so sufferers let’s make ourselves better prepared in living successfully with our less allergy friendly environment. 

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

As we approach the Olympic Games in Beijing, China this week is time to take note if you find yourself “breathing heavy” during or after exercise.  This may a sign of more than just good aerobic activity.  Exercise-associated asthma can be the culprit; in many cases you may not realize you have this form of intermittent asthma.  Symptoms such as coughing or difficulty breathing during or shortly after exercise are commonly seen. 

In the past several Olympic Games up to one-fifth of athletes have a history of EIA (exercise induced asthma).  It certainly does not keep these elite athletes sidelined.  EIA may be triggered by “oversensitivity” to changing conditions including temperature, humidity as well as air quality, during the workout.  

Strategies in dealing with EIA

·         Hydrate with water before, during and after exercise

·         Warm up with a decent stretch and light exercise

·         Give yourself an adequate period for a “cool down” when done

·         Control your allergies and asthma triggers (especially on high pollen count days)

·         Check out the air quality index (pollution and ozone levels) before you exercise outdoors

·         Pre-treat with inhaled medication as advised by your doctor (after your diagnosis is confirmed) to prevent symptoms

Additional info and tips on “exercise induced asthma” can be found at www.aaaai.org/patients/publicedmat/tips/exerciseinducedasthma.stm.

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

Dr. Bassett

Seasonal allergies may cause a variety of symptoms for sufferers such as nasal stuffiness, sneezing, itchy and watery eyes in addition to an increase in mucus causing the familiar “clearing” of the throat in some.  There are also a variety of associated things that I hear from my allergy patients in the office, such as “fatigue” and lack of energy.  In many cases congested nasal and sinus passages may cause poor quality, interrupted sleep as a result of sleep disordered breathing.  So what to do?

Having an examination of your nose and sinuses which reveal the extent of the level of severity is the first step.  In some cases clogged breathing passages may be a result of a deviated septum or chronic infection.  The work up by a specialist for these conditions may include a sinus X-ray (CT scan) to completely visualize the sinuses and identify the problem.  In many cases, saline (salt water) irrigation of the sinuses and nasal steroid sprays can provide a great deal of relief, safely. 

Another tip you have allergy is the timing of your symptoms along with the season and weather. For example, pollen levels are typically higher on dry, sunny and windy days and lower on windless, cloudy and wet days. 

Survival tips

• WASH WISESLY: Shampoo your hair at end of day to remove excess allergy containing pollens that accumulate during the day
• BEAT THE CLOCK: Check local pollen counts at www.aaaai.org/nab to plan outdoor activities and/or “move inside” on high pollen days
• DO NOT RE-CIRCULATE: Keep the A/C on the “do not re-circulate mode” and change filters in the air conditioner frequently during the allergy season
• Changing your clothing outside of the bedroom, washing your glasses and brushing off your shoes, to help to reduce the pollen load in your bedroom
• Vacation by a body of water, such as a lake, river or at the beach, where pollen levels are typically lower

These survival tips actually work!

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

Dr. Bassett

 

As we are going through our summer rainy season in many areas of the country I thought it would be an appropriate time to discuss a little know asthma phenomenon.  After a rainstorm pollen grains can be washed away lowering pollen counts and giving some allergy sufferers temporary relief.  However, a number of pollen grains, in particular grass pollen levels, may actually increase as much as 50 fold! It is thought that in some cases, these higher amounts of allergy causing particles, when inhaled, may bring on an asthma attack.  This has been categorized as “thunderstorm associated asthma” and it is indeed a paradox. 

A recent study published in the journal Thorax looked at millions of ER visits during a decade in Atlanta.  The study found that following a thunderstorm there were many more individuals seeking ER care for worsening asthma.

Other theories have looked at air quality and pollution that may be affected by rain and thunderstorms.  The relationship between thunderstorms and an increase in the number of emergency room visits for asthma has been identified in many studies throughout the world; however most doctors and patients may not be aware of this phenomenon. 

So for the 20 million Americans with asthma according to the American Academy of Allergy, Asthma and Immunology, the next time there is a thunderstorm, make it an opportunity to pay close attention to your symptoms and stay one step ahead for proper and timely asthma treatment.   This underscores the importance of having an “asthma action plan” for optimal asthma prevention and management.

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

Dr. Bassett

Do fish oils protect against asthma?

One of the major components of asthma is airway inflammation (swelling of the lung passages).  It appears that supplementation with fish oils may provide a natural “anti-inflammatory” benefit in asthma.  EPA and DHA are some of the more important components of fish oils and they block some of chemicals responsible for chronic asthma. 

Studies out of Japan indicated fish oil supplements reduced asthma symptoms and severity in children.  Researchers from Australia also reported eating oily fish (i.e. Atlantic salmon, trout) was associated with lowering the risk of a child from developing asthma as well as a reduction in asthma severity. 

And now prenatal exposure to various fish oils may have a protective effect against asthma.   My colleague Dr. Roberta Lee, Medical Director of the Center for Health and Healing Director in New York City, stated “I have observed great clinical improvement using fish oil supplements as an adjunctive  therapy to standard allergy and asthma care.”  There is a huge need to further study this in preventing asthma and to complement standard treatment in larger controlled trials.  

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended to diagnose or treat any condition.

Dr. Bassett

Allergy season in many areas of the US has had a big impact on all of allergy sufferers, particularly on children.  As children often spend a larger amount of time outdoors during the summertime they may be more so affected by the onslaught of daytime seasonal pollens and mold spores.  

 If one parent has allergies there is at least a 25 to 33 percent chance of the child developing allergies and the risk goes up over 50 to 75 percent if both parents are allergic sufferers.  So family history is a key factor in whether or not your children will develop seasonal allergies, indoor allergies and/or asthma.

 Recent studies have looked at impaired sleep as a result of poor breathing due to congested nasal and sinus passages during the night.  This may have a direct impact on daytime behavior and performance in the classroom.  Fatigue and daytime drowsiness may also be a sign of sleep disturbances that occur due to poorly controlled allergies.

Some suggestions I typically discuss with the parents of children suffering from seasonal allergies are:

  * Change clothes after spending time in the park where pollens are plentiful

  * Washing hair and taking a bath later in the day after being outside on a “high pollen day

  * Pre-treat to prevent daily symptoms during peak seasonal pollen periods

  * Vacation at peak allergy times by a body of water such as a lake, river or by the beach, where pollen levels are typically lower

* Ask your pediatrician or allergist if your child should be on “anti-inflammatory” nasal sprays to reduce congestion from seasonal allergies that may assist in better quality sleep at night

Be proactive and develop a sensible allergy management program for your child to successfully combat seasonal allergy triggers!  Learn more at www.acaai.org and www.aaaai.org.

 Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended to diagnose or treat any condition.