Allergies & Asthma FAQs
What are allergies?
What we commonly call allergies are actually groups of common symptoms affecting the upper respiratory tract such as runny nose, nasal congestion, sniffles, postnasal drip, itchy nose, sneezing, etc. and other symptoms affecting the lower respiratory tract such as cough, throat clearing, shortness of breath, chest tightness, frequent bronchitis, wheezing and more. These symptoms may manifest themselves in any combination and have various triggers. Sometimes they are present all year round and sometimes only in certain seasons and are respectively referred to as either “perennial” or “seasonal.” They affect about 15-20% of the population and cause more time lost from work and school than any other reason. Billions of dollars are spent yearly on over-the-counter remedies and prescription drugs that infrequently work as advertised. Despite research and increased awareness of these conditions, little more is known now about their cause or treatment than 30 years ago. In fact, the incidence of nasal allergies and allergic asthma has been rising for the past 15-20 years and, in some circumstances, so has the death rate from allergic asthma!
The “cause” of all this trouble is a tiny little protein made by our lymphatic system and bound to our respiratory tissues called “allergic antibodies.” Those very same people who have the most allergy symptoms have been confirmed to be the most prolific producers of allergic antibodies.
Now, allergy symptoms have been shown to be the result of the action of the allergic antibodies on inhaled antigens toward which they are aimed at, and the subsequent chronic and acute inflammation in the respiratory epithelium or mucous membranes is the result. The allergic inflammation causes the mucous membranes to be “hyper-reactive” to stimuli that rarely cause problems for non-allergic individuals. Many non-allergenic stimuli such as temperature swings, air pressure changes, chemicals, strong odors, emotions, infections, and so on adversely affect allergic individuals.
Some conditions other than nasal and sinus problems, bronchitis, and asthma that affect allergic people are related to food, chemical, and medication allergies with a wide variety of symptoms that are sometimes difficult to diagnose. Often in these cases, the causative agent(s) are difficult or impossible to identify, particularly in those patients with symptoms of hives and allergic edema.
It is important to note, however, that most patients with such symptoms can be successfully treated, despite any problems identifying specific offending agents. All adults and children with chronic debilitating symptoms affecting their upper and/or lower respiratory systems, eyes, skin, sinuses, throat, nose, or ears or having reactions to foods, medications, or workplace chemicals should seek o ut a Board Certified Allergy Asthma and Immunology specialist for professional allergy testing and subsequent appropriate diagnosis and treatment. Almost all allergy problems will yield to some sort of diagnosis and treatment that your Board Certified Allergy Specialist is best prepared to furnish to you.
Allergies seem simple to the uninitiated, but those who try to take care of allergy patients without the proper specialized Board Certified training are most likely to fail. Seeking out a properly trained Board Certified Allergy Asthma and Immunology physician is probably the one best first step one can take on the road to medical treatment and possible cure of allergy and asthma problems.
What is a pollen count?
A pollen count is the measure of the amount of pollen in the air. Pollen counts are commonly included in local weather reports and are usually reported for mold spores and three types of pollen: grasses, trees, and weeds. The count is reported as grains of pollen per square meter of air collected over 24 hours. This number represents the concentration of all the pollen in the air in a certain area at a specific time. The pollen count is translated into a corresponding level: absent, low, medium, or high.
In general, a "low" pollen count means that only people extremely sensitive to pollen will experience allergy symptoms. A "medium" count means many people who are relatively sensitive to pollen will experience allergy symptoms and a "high" count means most people with any sensitivity to pollen will experience allergy symptoms.
Although the pollen count is an approximate value and fluctuates, it is useful as a general guide when you are trying to determine whether you should stay indoors to avoid pollen contact.
What types of plants produce the most pollen?
The type of pollen that most commonly causes allergy symptoms comes from plants (trees, grasses, and weeds) that typically do not bear fruit or flowers. These plants produce small, light, dry pollen granules in large quantities that can be carried through the air for miles.
Common plant allergens include the following:
- Weeds, such as ragweed, sagebrush, redroot pigweed, lamb's quarters, goosefoot, tumbleweed (Russian thistle), and English plantain
- Grasses, such as timothy grass, Kentucky blue grass, Johnson grass, Bermuda grass, redtop grass, orchard grass, sweet vernal grass, perennial rye, salt grass, velvet grass, and fescue
- Hardwood deciduous trees, such as oak, ash, elm, birch, maple, alder, and hazel, as well as hickory, pecan, and box and mountain cedar. Juniper, cedar, cypress, and sequoia trees are also likely to cause allergy symptoms.
How can I tell if my child has allergies or a cold?
Symptoms of allergies and colds can be similar, but here's how to tell the difference:
Occurrence of symptoms: Both allergies and colds cause symptoms of sneezing, congestion, runny nose, watery eyes, fatigue, and headaches. However, colds often cause symptoms one at a time: first sneezing, then a runny nose, and then congestion. Allergies cause symptoms that occur all at once.
Duration of symptoms: Cold symptoms generally last from seven to 10 days, whereas allergy symptoms continue as long as a person is exposed to the allergy-causing agent, usually months. Allergy symptoms may subside soon after elimination of allergen exposure.
Mucus discharge: Colds may cause yellowish to dark brown nasal discharge, suggesting an infectious cause. Allergies generally cause clear, thin, watery mucus discharge.
Sneezing: Sneezing is a more common allergy symptom, especially when sneezing occurs three or more times in a row.
Time of year: Colds are more common during the winter months, whereas allergies are more common in the spring through the fall, when plants are pollinating.
Presence of a fever: Colds may be accompanied by a fever, but allergies are not usually associated with a fever.
What does it means when a product is labeled “hypoallergenic”?
"Hypo" means "under" or "less than," so "hypoallergenic" means a product is less likely to trigger an allergic reaction.
Many products that we use every day, such as cleansers and soaps, deodorants, makeup, and even mouthwash, have ingredients that can irritate the skin or act as antigens (substances that act as an allergy trigger). Exposure of the skin to these ingredients—most often fragrances and chemicals used as preservatives—can lead to a condition called contact dermatitis. Contact dermatitis appears as areas of redness, itching, and swelling on the skin, and sometimes as a rash or blisters.
Many manufacturers of cosmetics and cleaning supplies now market their products as "hypoallergenic," meaning the products do not contain ingredients that are known to cause irritation or allergic reactions. However, manufacturers are not required to prove the claim that their products are hypoallergenic, and there are currently no regulations or standards for manufacturers to follow.
Although choosing hypoallergenic products may help reduce the risk of contact dermatitis, no product can guarantee never to irritate the skin or produce an allergic reaction. It's always a good idea to test any new product before you use it, especially if you have had skin reactions in the past. To test it, simply put a sample of the product on your inner wrist or elbow and wait 24 hours to see if a reaction occurs.
How does stress affect allergies?
Stress is the body's response to conflict or situations, both internal and external, which interfere with the normal balance in life. Virtually all of the body's systems, including the digestive system, cardiovascular system, nervous system, and immune system, make adjustments in response to stress. When you are feeling anxious or stressed, your body releases numerous hormones and other chemicals, including histamine. Histamine is a powerful chemical that can lead to allergy-like symptoms.
Stress does not cause allergies, but it can make an existing reaction worse by increasing the level of histamine in the bloodstream.
Can allergies be cured?
While allergies are genetically determined, allergy shots can allow the appearance of a cure possibly for life. That is to say, many patients eventually stop shots, have no symptoms, and stop all medications.
What are allergy shots?
Allergy shots are the current treatment of choice for those allergic patients who are not controlled by simple medications and avoidance: children for whom medications are not desired, all those with asthma or chronic unresponsive sinusitis or bronchitis, and all those with seasonal and year-round allergy symptoms. Allergy shots are often referred to as immunotherapy treatment and actually contain extracts of the very same substances that the patient is allergic to. The shots are virtually painless, quick, are considered comparatively safe even for pregnant women, and have virtually no side effects except for rare mostly minor allergic reactions.
Convenience is assured by the fact that we do not make appointments for shots, making it easy to just come in and get treated quickly at any time we are open. Safety is our highest priority and is assured by our extensive use of higher tech methods to assure the right patient gets the right shot. First, shot patients are signed in, and their records called up by the use of fingerprints. The patient's photo shows up on the screen and guarantees the authenticity of that patient's record. Finally, the patient is shown his or her vial containing the shot serum and is asked to confirm his or her identity. None of these measures is standard in the general protocols of allergy clinics, and we know of nowhere else these measures are routinely used.
Fortunately, the result of allergy immunotherapy is usually the disappearance of the allergy symptoms, the cessation of need for medications, and, surprisingly, the end of the immunotherapy itself. In fact, the treatment is overwhelmingly successful and most patients can look forward to a lifetime of freedom from symptoms and depressing medications.
The shots can be taken once or twice a week for the initial period of eight to fourteen months, depending on the patient’s schedule, at which time the maximum dose and relief is reached. After that, the shots are rapidly tapered to once a month for a couple years and then realistically discontinued for life. These results have been common for many years, and relapses after cessation of shots are extremely rare and easy to treat.
Interestingly, immunotherapy not only seems to “cure” a patient’s current allergy symptoms but also prevents any worsening of the patient’s symptoms and, importantly, the appearance of new and possibly worse symptoms. When it comes to “asthma,” this feature is highly desirable!
How do allergy shots work?
Allergy shots work because they expose the patient to the substances they are allergic to in a way that doesn’t sensitize them or cause worsening of allergy symptoms. Allergenic substances are most sensitizing when they are presented to us as airborne particles that we inhale while breathing in the respiratory manner. Allergy injections are not respiratory, but merely subcutaneous and thus seem to immunize allergic individuals and suppress allergic reactions. It appears that the route of exposure to the allergenic substance is the key factor in the body’s choice between sensitization and desensitization!
To sum up, there are a few choices for the treatment of allergies, but the only FDA approved treatment that leads to a “cure” are allergy shots. This immunotherapy is safe, relatively painless, effective, curative, spares medication, and is self-limiting. It is relatively indicated in all patients with allergies and particularly in patients with chronic, seasonal, nasal, sinus, bronchitic, and asthmatic symptoms on medications and in virtually all children with any allergic problems both for the treatment of current problems and the prevention of future possibly worse problems.
Cosmetic Procedures FAQs
What is Botox?
Botox is a brand name of Botulinum toxin, which is a protein produced by the bacterium Clostridia Botulinum and is the most powerful neurotoxin by weight ever discovered. It is used primarily to minimize wrinkles and lines in the face due to the effects of aging and gravity over time. There are several products available distinguished only by their trade names. Botox Cosmetic and Xeomin are prepared and sold by pharmaceutical companies and are used for various cosmetic and medical procedures. Used by trained physicians, they will erase the engrained facial lines and folds that are the result of voluntary movement of the facial muscles combined with the force of the gravity over many years.
Is Botox safe?
Yes. For cosmetic application, tiny amounts are used safely to treat many neurological and muscular diseases and particularly in cosmetics.
These toxins must be administered under the supervisions of a trained physician.
What is the process for Botox injections?
The doctor typically injects the Botox Cosmetic serum into the skin with tiny needles and syringes, causing little or no pain. Within 24–72 hours, the fine muscles that lead to unwanted signs of aging are so weakened that they disappear usually for 4-6 months. At this point, the procedure may be repeated indefinitely without any risk of side effects. In fact, there have never been any reports of any serious side effects from the use of Botox Cosmetic or Xeomin by a licensed physician.
The procedure normally takes less than 10 minutes after applying a simple vanishing cream containing a numbing agent that prepares the skin. There are a very few simple precautions to follow for a few hours, but normal activity can be resumed almost immediately after treatment. Age, muscle size, skin thickness, sex, and other patient characteristics influence how much serum is needed to achieve the goals of treatment. Other parameters help determine how long the effects will last. However, generally each area of the face will require 12 to 20+ units of toxin, and the effect will last 4-6 months.
How are Botox and Xeomin different?
Unlike Botox, Xeomin does not need to be refrigerated before its reconstituted, which is an advantage during distribution. What's more, Xeomin has no additives that may lessen a patient's likelihood of developing a resistance.
What are dermal fillers?
Dermal (injectable) fillers are substances designed to enhance volume, erase wrinkles, augment lips, and overall restore the youthful 3-dimensional contour of the face. They are used to fill in lines, creases, folds, and gaps in the skin, particularly on the face. If some folds are old and deep, then plastic surgery might be considered. The face may be reevaluated for injectable filler therapy after a surgical procedure.
How do dermal fillers work?
Dermal fillers are made of Hyaluronic acid, which is produced by modified bacteria in a laboratory. This acid is a highly "conserved" protein, meaning that its genetic composition is the same in 97% of all animal species. This results in an extremely low incidence of allergic reactions; hence, there is no need for pre-treatment skin testing. if you think of the skin as a 3-dimensional lattice with the structure mostly composed of collagen (which are like large ropes intertwined with each other) and elastin (which gives it its bounce and keeps it from getting stiff), the hyaluronic acid is the gel that is found between these structural proteins in the skin to cushion them. Thus, it has a very natural feel and cannot be seen under the skin since it is clear.
What are the benefits of dermal fillers?
Other than the low percentage of allergic reactions, dermal fillers have a natural feel and can be molded after being injected by the physician or the patient up to 2 or 3 days later. They also draw water into the area, increasing a volume effect over time.
What are the different types of fillers?
Restylane is manufactured by Q-Med, a Swedish company, and distributed in the U.S. by Medicis, while JUVEDERM 24HV Injectable Gel, JUVEDERM Ultra Injectable Gel, and JUVEDERM Ultra Plus Injectable Gel are manufactured by and distributed by Inamed, a division of Allergan Inc. These are just a few of many available products.