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Fall Allergy Season is here

Fall Allergy Season is here

As most allergy sufferers will tell you, allergy symptoms can always be bothersome, turning any time of year into sneezing season. A runny nose, itchy eyes and scratchy throat can arise as the days get shorter and the leaves begin to change.

The fall can be especially difficult for people who are sensitive to mold and ragweed pollen. But these seasonal elements are not the only triggers that can make symptoms worse this time of year. There are also a few lesser-known triggers. Here are four things you might not know about fall allergies, courtesy of the American College of Allergy, Asthma and Immunology:

 Hay Fever

Hay fever, a term from a bygone era, actually has nothing to do with hay; Instead, it s a general term used to describe the symptoms of late summer allergies. Ragweed is a common cause of hay fever, which is also known as allergic rhinitis. The plant usually begins to pollinate in mid-August and may continue to be a problem until a hard freeze, depending on where you live. See an allergist for prescription medications to control symptoms or to see if allergy shots may be your best option.

 Lingering Warm Weather 

While most people enjoy Indian summer, unseasonably warm temperatures can make rhinitis symptoms last longer. Mold spores can also be released when humidity is high, or the weather is dry and windy. Be sure to begin taking medications before your symptoms start. Track your allergy symptoms and bring ot your visit with you primary care clinican and/or allergist to find relief.

 Pesky Leaves

Some folks might find it difficult to keep up with raking leaves throughout the autumn. But for allergy sufferers, raking presents its own problem. It can stir agitating pollen and mold into the air, causing allergy and asthma symptoms. Those with allergies should wear an NIOSH rated N95mask when raking leaves, mowing the lawn and gardening.

School Allergens 

It s not only seasonal pollen and mold that triggers allergies this time of year. Kids are often exposed to classroom irritants and allergy triggers. These can include chalk dust and classroom pets. Students with food allergies may also be exposed to allergens in the lunch room. Kids with exercise-induced bronchoconstriction (EIB) may experience attacks during recess or gym class. Help your child understand what can trigger their allergies and asthma, and how they can avoid symptoms. Be sure to notify teachers and the school nurse of any emergency medications, such as quick relief inhalers and epinephrine.

No matter the season, it s important for those who think they may be suffering from allergies or asthma to see a board-certified allergist. A primary care clinician or allergist can help you develop a treatment plan, which can include both medication and avoidance techniques.

Having your allergies properly identified and treated will help you and your family enjoy the season. To schedule an appointment with a Pentucket Medical primary care clinician/ pediatrician and/or allergist call 888-227-3762 or visit www.pmaonline.com for a complete listing of clinicians. 

Is there a cure for food allergies?

By: John Hein, MD

Allergy and Immunology

Is there a cure for food allergies?

Well, it depends on the type of food someone is allergic to.

Peanut Allergy Treatment

Recently there has been information in the press about advances in peanut allergy treatment.  Researchers are currently studying the effects of giving multiple small doses of peanut in attempt to cure the allergy.  Although this therapy may work in some patients, the rate of treatment-related side effects is quite high.  Even in patients who respond positively to this treatment, it is unclear if their desensitized state will be maintained for long periods of time.  Due to the high rate of side effects and unclear duration of improvement, desensitization therapy for peanut allergy is not currently the standard of care.  Allergists continue to recommend avoidance of peanut consumption if a patient has a peanut allergy.

On the other hand, allergies to fruits and vegetables have a more promising prognosis.  Oral itching after eating foods such as raw apples, cherries, and carrots is a common complaint in New England.  Cooked forms of these foods are often tolerated.  These symptoms are termed the “Oral Allergy Syndrome”.  Patients who have a severe allergy to pollen often complain of itching or swelling of the mouth after eating raw fruits and vegetables.  This is caused be structural similarities between pollen and raw fruits and vegetables.  Cooking these foods changes their structure, making them less allergic.  Because pollen allergy is the cause of this syndrome, reducing pollen sensitivity often improves food-related symptoms.  Many patients who undergo 2 or more years of pollen desensitization or “allergy shots” report an improvement in their fruit and vegetable allergy.  

Food Allergy Treatment at Pentucket Medical

Although a definitive cure for all food allergies is not yet available, there is hope for people who suffer from raw fruit and vegetable allergy.  Please contact my office for more information: 

John Hein, MD

Haverhill:  978-469-5445

Newburyport: 978-499-7200

How I became an allergist – By John Hein, MD

Hein | allergist |Newburyport

When I was in the first grade, I was having difficulty in school. I told my mother that I could not hear the teacher. A test indicated that my hearing was significantly impaired. 

Further investigation revealed that my adenoids were enlarged and were affecting my hearing. As a result, my adenoids were surgically removed.  During the operation it was discovered that the allergic cells in my body were extremely elevated. 

My surgeon recommended that I be evaluated by an allergist. 

Allergy testing showed that I was allergic to many molds and other environmental allergens. 

After frequent doctor visits and treatments in childhood, my health and school performance greatly improved. And this experience opened my eyes to the career I have chosen for my life:  I was inspired to pursue a career as an allergist. 

I am extremely happy to be in the profession that I am today, a field of medicine in which a physician can make life-changing differences in lives of our patients.  My life goal is to help others like myself, because I know from my own experience how allergies can miserably impair someone’s life. 

Working as an allergist puts you in a field of work where you can actually cure people. You can really watch them go from being very sick to becoming very healthy, and it’s really gratifying as a physician to see this. 

I would like to do everything possible to improve the health and quality of life of my patients.

John Hein, MD,  AAAAI, is a member of Pentucket Medical’s Allergy Department. Dr. Hein practices in Newburyport and Haverhill. For an appointment, please call 888-227 3762.

Spring Cleaning and Seasonal Allergies

springcleaning-01

Do you suffer from seasonal allergies?

Did you know that Spring cleaning could be just what the allergist ordered? 

More than 40 million Americans suffer from allergy problems. After a long winter of being stuck inside, it’s important to clear your house of lingering dirt, dust and mold. Spring cleaning can reduce, and even remove some allergens. Here are a few tips to clean effectively:

  • When dusting, use moist cloths or special dry dusters designed to trap and lock dust from hard and soft surfaces.
  • Certain cleaning products can also contribute to airborne irritants, especially if they contain harsh chemicals, strong odors or volatile organic compounds (VOCs). Choose products that contain none of these irritants, but also beware of “green” labels, as some of these solutions may be made with natural allergenic ingredients, such as lemon, coconut or tea-tree oils.
  • Use a Certified vacuum that has a high efficiency filter with tight seams and seals to prevent particles from leaking out while you vacuum. Also, choose a style that requires minimal exposure during canister emptying or bag changes.
  • Whether you have a cat or dog, pet dander is present in most U.S. homes. If it is possible, keeps pets out of the bedroom. If not, your cleaning routine should include frequently washing linens in your bedroom, where cat or dog dander can settle.
  • Place Certified allergen-barrier bedding on your mattresses and pillows. Wash your bedding at least once a week in 130+ degree hot water to kill mites and their eggs.
  • Mold, a common allergy trigger, can grow anywhere in your home where moisture is present. Look for cleaning products that help kill and prevent mold from returning. Also, keep household humidity below 50 percent and fix leaky pipes and cracks to reduce standing puddles of moisture where mold can prosper.
  • If children live in your home, look for Certified plush toys. Dust mites, mold and pet dander can accumulate on plush toys over time. Certified toys can be placed in the freezer for 24 hours, then rinse in cold water to remove dead mites, and dry completely. Do this monthly.

In addition to reducing allergens in your home, Spring cleaning can also:

  • Provide your family with a healthier living environment.
  • Reduce stress and renew your calm by removing clutter.
  • Be a form of cardio exercise

Spring-cleaning is a great way to improve your living environment while boosting your mental moral and physical health. It’s the time of the season!

Homemade cleaning products:

White Vinegar

Did you know that white vinegar is a natural deodorizer? It absorbs odors instead of just covering them up. It can be used in the kitchen, bathroom, or on hardwood flooring. 

Just mix these two ingredients in a spray bottle:

1 cup white vinegar
1 cup water

Rubbing Alcohol

Did you know that rubbing alcohol could replace windex?

Just mix these 3 ingredients in a spray bottle:

1 cup (isopropyl) alcohol
1 cup water
1 tbsp. white vinegar

What’s the difference between food allergy and food intolerance?

 whats the difference between food allergy and intolerance

Food Allergy

Food allergy is caused by the body’s immune system reacting adversely to the consumption of a specific food.  Symptoms occur shortly after a food is placed in a person’s mouth.  Initial symptoms include oral itching, tingling, and swelling.  Symptoms typically occur within seconds to minutes after the food is placed in the mouth.  Symptoms may progress into facial swelling and hives.  If the food is swallowed, nausea and vomiting may occur.  Symptoms may worsen, resulting in faintness and a drop in blood pressure.

Food Intolerance

Food intolerance encompasses a wide variety of adverse reactions following food consumption.  These reactions are often not caused by the body’s immune system.  Intolerances may be classified as gastrointestinal, metabolic, chemical, or toxic.  Gastrointestinal disorders include gluten intolerance (celiac disease) and colitis.  Metabolic disorders include lactose intolerance and carbohydrate malabsorption.  Chemical disorders include reactions from MSG and food dyes.  Toxic reactions occur from eating spoiled foods.

Identifying Food Allergens

People often have a strong suspicion of their specific food allergy.  Patients explain that every time they consume a certain food, the same symptoms occur.  Symptoms occur quickly after exposure, and they resolve by the next day.  Common food allergens in adults include:

  • peanuts
  • tree nuts
  • shellfish
  • finned fish
  • raw fruits

Children may additionally be allergic to:

  • cow’s milk
  • hen’s eggs

These allergies can be quickly identified by allergy testing.

Diagnosing Food Intolerance

Food intolerance can be difficult to diagnose.  Allergy testing does not identify food intolerance.  Because of the wide spectrum of food intolerances, a careful history must be taken in order to identify a specific diagnosis.  Elimination diets are sometimes needed to identify the specific food trigger.  Consultation with a gastrointestinal specialist can help aid in the diagnosis of gluten intolerance and colitis.  The patient’s story often guides the clinician’s path in establishing the diagnosis.

What is Hay Fever?

hayfeverinformation

What is Hay Fever?

Hay fever is an allergic reaction that occurs in the late summer and early fall.  Symptoms include itchy eyes, runny nose, sneezing, and fatigue.  These symptoms can be accompanied by cough and wheezing.

The name “Hay fever” originates from symptoms that occur during the time of year when farmers harvest and bale hay.  This is typically in the late summer and early fall.  The name “Hay fever” is a misnomer in that baled hay is usually not the cause of symptoms.  Instead, plants that pollinate during the hay baling season are the culprits.  These plants are weeds including Ragweed and Mugwort.  These weeds use the wind for pollination.  Their pollen grains become airborne and can travel for many miles.  These pollen grains induce allergic symptoms when they come in contact with a person’s eyes, nose, or lungs.

 How do I know if I have Hay fever?

You may have Hay fever if your allergic symptoms worsen during the months of August, September, and October.  Symptoms improve after the first hard frost of the year.  The diagnosis can be confirmed by an allergist by performing allergy tests that identify sensitivity to weed pollens.

 What can I do about my Hay fever?

Symptoms are reduced by minimizing time outdoors.  Windows in your house should be closed.  Air conditioning is helpful and can remove pollen particles from indoor air.  Over the counter antihistamines can treat the majority of symptoms.  Symptoms of cough and wheezing are more concerning and should be addressed by a doctor.  Patients whose symptoms are not relieved by medications may benefit from allergen immunotherapy or “allergy shots”.  Immunotherapy reduces the body’s allergic response to allergens and can be a cure for many patients.

More than Scratching the Surface – Unusual Allergy Diagnoses

Everyone has heard the term “textbook cases”.  In recent weeks, RiverWalk allergist Bryan Stone, MD has had three such cases jump right off the page and into his office.

Last year, preparing for his allergist board recertification, Dr. Stone decided to study unusual syndromes that he’d heard and read about.

“I had a feeling these might come up on the test,” he says.

Sure enough, he encountered these topics when he took – and passed – the exam.

Flash forward a year later: his study has paid off in real terms. Within a two-week span,  Dr. Stone has seen and resolved cases of some of the same rare conditions he boned up on for the exam.

The first case was referred by a non-Pentucket primary care practice. The patient was having what seemed to be anaphylactic reactions with no obvious cause.  She’d seen multiple physicians who hadn’t been able to diagnose her problem. Meanwhile, she was suffering.

“She’d been using her EpiPen about five times a week,” says Dr. Stone, “each time going to the emergency room thinking she was having a severe allergic reaction.”

“I had a hunch,” he says, “and sent blood samples to our lab for a baseline tryptase test. The first result was mildly positive, but a second test turned out to be strongly positive.”

The patient, diagnosed by Dr. Stone as having  mast cell activation syndrome, is now back in the care of her PCP, who is referring her to a hematologist. Things are looking up for her.

“[Mast cell activation syndrome is] not an allergy, but it masquerades as one. It’s really a cellular disorder at the genetic level,” Dr. Stone states.

While this was going on, another patient presented with ailments  that mimicked allergic reaction. Again, there seemed no obvious cause.  But it rang a bell that hearkened back to last year’s board exam.

Cases of hereditary angioedemas are  rare – about one in 50,000 individuals.  They are also dangerous:  swelling around the eyes, lips, hands and feet that can be life-threatening, when restricted  airways cause the patient to choke.  The disease is known to be difficult to diagnose, but by process of elimination, indicators were pointing in that direction.

“All the lab tests for the better researched hereditary angiodemas came back negative, so I suspected it was Type 3,” says Dr. Stone. “There is no FDA-approved test for this problem. Diagnosis has to be made clinically. I consulted with a friend at Harvard Medical School who had seen a couple of dozen of these cases. He agreed and felt this was the only thing it could be.”

The patient was prescribed a new type of medication and after two weeks was clear of symptoms.

“So far it  (the prescription) is working like a charm,” Dr. Stone says. “Which is also proof that we made the right diagnosis.”

Just a few weeks ago, yet another  unusual case came in,  a patient that Dr. Stone diagnosed as having urticarial vasculitis.

“It looks like hives,” he says, “but it’s not due to allergy, but to an inflammation of the blood vessels. The hives last longer and they leave dark patches. It’s an important diagnosis to make because it only responds to specific medications that are never prescribed for garden-variety hives.”

Three diagnoses of unusual cases in as many weeks has left Dr. Stone a bit bemused.

“You never know what’s going to come in on a given day,” he says. “And that’s what makes practicing medicine fun. For these cases that had shown up on my board exam to actually walk through the door at RiverWalk, that is pretty remarkable.”

 

Allergies & Eczema

what is eczema

What is eczema?

Eczema is a complex disorder of the skin that causes inflammation and itchy rashes. Eczema symptoms include a dry, itchy, red rash on the face, arms, or legs, especially in the folds of the knees and elbows. Patients with eczema exacerbate the disorder by itching and scratching at their skin. Eczema triggers include food, airborne pathogens and bacterial products.

Food allergy and eczema

Incidence of eczema have increased significantly in the past thirty years. In the U.S. today, about 1 in every 10 infants has eczema. Studies of eczema in infants are varied, but suggest that in approximately 40% of infants with eczema, food allergies are also prevalent. In children with severe eczema, food allergy is even more prevalent. Therefore, all infants with persistent eczema should be seen by an allergist and evaluated for food allergies.

Most common food allergies in people with eczema

Of young children with food allergies and eczema, 90% have an allergy to one of the following foods:

  • cow’s milk
  • hen’s eggs
  • soy
  • wheat

For adults and older children, allergy-related eczema flares are more often caused by inhaled allergens like pollen and dust mites. (NOTE: Air purifiers don’t work as well to eliminate dust mite allergens because the particles are so large.)

Eczema treatment plan

  1. Make an appointment with an allergist for yourself or your child with eczema. 
  2. Antihistamines may provide some itch relief.
  3. Topical cortisone creams help to control skin inflammation.
  4. Antibiotics may be prescribed if there is a secondary infection.
  5. Avoid proven food allergens in your diet.
  6. Hydrate skin with moisturizer.

Call 888-227-3762 to make an appointment with a Pentucket Medical Allergist today!

Is there a cure for food allergy?

Well, it depends on the type of food someone is allergic to.

Recently there has been information in the press about advances in peanut allergy treatment.  Researchers are currently studying the effects of giving multiple small doses of peanut in attempt to cure the allergy.  Although this therapy may work in some patients, the rate of treatment-related side effects is quite high.  Even in patients who respond positively to this treatment, it is unclear if their desensitized state will be maintained for long periods of time.  Due to the high rate of side effects and unclear duration of improvement, desensitization therapy for peanut allergy is not currently standard of care.  Allergists continue to recommend avoidance of peanut consumption if a patient has peanut allergy.

On the other hand, allergies to fruits and vegetables have a more promising prognosis.  Oral itching after eating foods such as raw apples, cherries, and carrots is a common complaint in New England.  Cooked forms of these foods are often tolerated.  These symptoms are termed the “Oral Allergy Syndrome”.  Patients who have a severe allergy to pollen often complain of itching or swelling of the mouth after eating raw fruits and vegetables.  This is caused by structural similarities between pollen and raw fruits and vegetables.  Cooking these foods changes their structure, making them less allergic.  Because pollen allergy is the cause of this syndrome, reducing pollen sensitivity often improves food-related symptoms.  Many patients who undergo 2 or more years of pollen desensitization, or “allergy shots,” report an improvement in their fruit and vegetable allergy.

Although a definitive cure for all food allergies is not yet available, there is hope for people who suffer from raw fruit and vegetable allergy.  Please contact your local allergist for more information.

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Public health guidance for masking related to vaccination status has NOT changed in healthcare settings.

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