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Coastal News (click here for archives)

Nov 6th2008

Did you Know?..Food Allergies:

Food allergies should be taken seriously; every year more people die of allergic reactions to food than allergic reactions caused by insect stings.  

The most common food allergens are cow’s milk, eggs, peanuts, wheat, soy, fish, shellfish and tree nuts.

  •  A recent study showed that up to 25% of adults believe they have a food allergy; but, scientific studies have shown that in reality only about 2% truly do.
  • Up to 5% of children have food allergies; most will outgrow their allergies, although allergy to peanuts, shellfish and tree nuts may be lifelong.
  • There is no proven relationship between ADD or ADHD and food allergies.
  • Allergic symptoms can begin within minutes to one hour after ingesting the food.
  • Symptoms of food allergy include: vomiting, diarrhea, cramps, hives, eczema, swelling, itching or swelling of the lips, itchiness or tightness in the throat, and difficulty breathing.
  • There is no cure for food allergies; strict avoidance of the food is the only way to prevent a reaction.
  • Epi-Pen can be given to control symptoms after a reaction occurs.   If your doctor prescribes an Epi-Pen for you, keep it with you at all times.
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Nov 6th2008

Did You Know?..Asthma

  • Asthma is an ongoing disease caused by inflammation of the airways, making it difficult to breathe. Symptoms include shortness of breath, chest tightening, coughing and wheezing.
  • In children or infants, other symptoms may indicate they have asthma, such as rapid or noisy breathing, chest congestion or grunting when nursing, complaints that their chest hurts or “feels funny”, or fatigue or irritability.
  • Approximately 20 million Americans suffer from asthma; 5 million of them are children.
  • Asthma is the #1 cause of school absenteeism, accounting for more than 14 million days of missed school. It is the most common chronic disease and the third ranking cause of hospitalization among kids.
  • 11 Americans die from asthma every day. There are more than 4,000 deaths per year from the disease, many of which are preventable with proper diagnosis and treatment. Asthma is cited as a “contributing factor” for nearly 7,000 other deaths each year.
  • African Americans are 3 times more likely to be hospitalized and 3 times more likely to die from asthma.
  • If you are overweight or obese, your odds of developing asthma are 50% greater than if you maintain a healthy body weight.
  • Over 50% of asthma cases are “allergic asthma.” Common allergens that can trigger asthma include animal fur, pollen, mold, cockroaches, cigarette smoke and household dust.
  • The annual cost of asthma is nearly 18 billion dollars.
  • Asthma runs in families: if only one parent has asthma, chances are 1 in 3 that each child will have asthma. If two parents have asthma, there is a 70% chance their children will have the disease too.
  • With proper disease diagnosis and management, people with asthma can live normal, active lives.
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Nov 6th2008

Did You Know?..Allergies

  •  Allergies affect more than 50 million people in the United States. Over half of all Americans test positive to at least one allergen.
  •  Over 35 million people suffer from allergic rhinitis or “hay fever”. Hay fever occurs when exposure to allergens like grass, pollen, mold, dust mites and animal dander cause symptoms such as sneezing, runny nose, teary eyes, congestion, dark circles under the eyes, and itching in the eyes, nose, or throat.
  • Allergic dermatitis (itchy rash) is the most common skin condition in children under age 11.
  • Dust Mites and their waste are the most common allergens to cause allergic reactions.
  • Symptoms of stinging insect allergy may include itching, redness and swelling at the sting site. More serious reactions, such as swelling outside the immediate sting area, shortness of breath or hives, may require immediate medical attention.
  • One in four people with seasonal allergies also have asthma.
  • Immunotherapy (allergy shots) is ultimately successful in over 90% of patients with conditions such as seasonal allergic rhinitis, insect allergy, and other allergic diseases.
  • Skin testing in a qualified allergist’s office can determine what substances you are allergic to.
  • Only a board certified allergist has the advanced training and specialized equipment necessary to offer you the best treatment options for your allergic conditions.
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Nov 6th2008

Mold

Molds are common causes of year round allergies, as well as being frequent contributors to seasonal allergic symptoms. Molds, also known as fungus, grow on old food, decaying vegetation, window basins, shower curtains, or other surfaces that stay moist. Molds produce spores that drift in the air. When these spores are inhaled, they may cause allergic symptoms such as sneezing, nasal congestion, and asthma exacerbation. Some types of spores are particularly abundant in humid environments.

Molds readily grow in the soil of potted houseplants. They are frequently found in other household areas such as around window basins, damp basements and cellars, and bathrooms. Outside mold is frequently found in decaying piles of leaves and cut grass.

 

Precautions

  •  Use air conditioning and try to keep the relative humidity in the house below 50%.
  •  Use fungicide cleaners or Clorox bleach and water around window basins, bath tubs, or any other areas that mold is noted. 
  •  Decrease the amount of live potted plants in the house.
  •  Frequently clean vaporizers and air conditioning and inspect for presence of molds.
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Oct 17th2008

Insect Allergy

Stings from insects such as bees, yellow jackets, hornets, wasps, and fire ants may cause severe allergic reactions that can be life threatening (anaphylaxis). However, not all reactions to insect stings or bites are allergic in nature and not all reactions are predictions of a future reaction.

Normal reactions to insect stings or bites include pain, local redness and swelling and local itching. This reaction may last several days and may respond to topical steroid creams (such as Cortaid), ice application, and oral antihistamines (such as Benadryl).

 Allergic reactions typically occur within seconds to minutes of a sting and are characterized by hives, generalized itching, throat closure, wheezing, dizziness, nausea, vomiting, and stomach cramping. If any of these symptoms occur, you should seek emergency medical assistance immediately and be evaluated by an allergist to identify possible insect allergy.

 Insect avoidance 

  • Do not walk outside barefooted; wear socks with covered shoes (no sandals or Tevas).
  • Avoid wearing brightly colored clothes or clothes with floral patterns, as these may attract flying stinging insects.
  • Do not swat at stinging insects.
  • Survey and exterminate yards for fire ant mounds and stinging insect mounds.
  • Do not wear perfume or cologne.
  • If you have been identified as having an insect allergy, wear a Medic Alert bracelet and carry a self injectable epinephrine at all times.
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Oct 17th2008

Gastroesophageal Reflux Precautions

Infants

  • Elevate head of crib to an angle of 30 ° (about 6 inches) by placing bricks under head of bed.
  • Reduce the quantity at feedings (volumes), but increase the frequency feedings.
  • Thicken formula with rice cereal.

Adults

  • Elevate head of bed to 30° by placing bricks under the head of the bed.
  • Eat dinner early in the evening and avoid eating 2-3 hours before sleep time.
  • Avoid spicy foods, alcohol, and fatty foods.
  • Avoid beverages and foods containing caffeine.
  • Eat smaller amounts of food at each meal. Eat several small meals rather than a few large ones.
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Oct 17th2008

Epi Pen

  • If you have been given a prescription for a self injectable adrenaline device (Epi pen), you should carry it with you at all times.
  •  Self injectable epinephrine kits are to be used for life threatening problems, such as throat swelling, tongue swelling, or difficulty breathing.
  •  You should inject your Epi pen into the upper, outer portion of the thigh. If necessary, it can be given through clothing.
  •  After injection, you may experience trembling, or a sensation that your heart is racing. These effects are expected and may last 30 minutes to one hour.
  •  After administration, you should call 911 or proceed to the nearest emergency center even if you are beginning to feel better.
  •  Notify your physician after you have received emergency medical assistance.
  •  Epi pens should be stored in the storage case provided to you, as epinephrine is light sensitive.
  •  Check expiration dates and replace before expiration date.
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Oct 17th2008

Coping with Indoor Allergies

Increased time spent indoors during the winter months also means increased exposure to dust, pet dander, mold and other allergens that can trigger an allergic reaction. Use the following checklist to guide your spring cleaning:

  •  Get rid of clutter that may be collecting dust
  •  Clean windows, book shelves and air conditioning vents thoroughly as they may have collected dust and mold throughout the winter
  • Put mattresses, box springs, and pillows in allergy-proof or “non-allergenic” cases
  • Vacuum carpeting, or replace it with washable throw rugs
  •  Wash blankets, sheets, and pillowcases in 130-degree water and dry in a hot dryer
  • Fix leaks – they leave surfaces wet and allow mold to grow
  •  Clean moldy surfaces, such as the corners of showers or under sinks.
  •  Clean under stoves, refrigerators, or toasters where loose crumbs can accumulate and attract cockroaches
  • Block cellar doors, outside drains, and wall, window or floor cracks where cockroaches could enter your home.

 Symptoms of Indoor Allergies

If you see an increase in sneezing, coughing, red eyes or other allergy symptoms, it is important to take steps to reduce allergens in your home.  Indoor allergy symptoms can occur quickly, or they may build and become most severe eight to twelve hours after contact with an allergen.

Causes of Indoor Allergies

  • Dust Mites thrive in house dust, which is composed of plant and animal material. Their droppings are the most common trigger of perennial allergy and asthma symptoms.
  •  Molds are microscopic fungi. Their spores float in the air like pollen, and are present throughout the year in many states. Molds can be found indoors in attics, basements, bathrooms, refrigerators and other food storage areas, garbage containers, carpets and upholstery.
  •  People are not allergic to their pets’ hair, but to a protein found in the saliva, dander (dead skin flakes) or urine of an animal with fur. These proteins are carried in the air on small, invisible particles and can trigger allergy symptoms.
  •  Cockroaches live in warm, tropical climates, but various species dwell in the offices and homes of humans living in various climates. A protein found in their droppings can trigger allergy and asthma symptoms.

 Please contact Coastal Allergy & Asthma, PC for information on treatment options and tips on reducing allergen exposure. It is important to learn what causes your indoor allergies so that you can take steps to make them easier to live with. An allergist/immunologist is the best qualified medical professional to manage the prevention, diagnosis and treatment of allergies and asthma.

Information from www.aaaai.org

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Oct 12th2008

Eczema and Atopic Dermatitis

Eczema or atopic dermatitis is a chronic skin problem characterized by xerosis (dry skin) and pruritis (marked itching). Eczema is often described as the “itch that rashes” Because eczema is chronic and difficult to control, it is a frustrating disease for both patients and their caretakers. The cause of eczema is not known, and hence there is no cure; however, eczema can be managed by following a daily skin care routine. Proper skin care helps control both the daily symptoms and prevention of complications. Additionally, many children’s eczema will improve with age.

Symptoms of eczema 

Sufferers of eczema generally have dry skin. Because dry skin itches, patients often scratch. Scratching, however, can cause the skin to crack and become infected. When patients with eczema have “flare-ups”, the skin may appear irritated and red.

On infants and young children, patches of eczema may ooze and appear red. The predominant sites of affected skin include the face, body and the outside of arms and legs. 

In older children the skin may appear thick and scaly (lichenified). The skin areas predominantly affected include skin folds – such as the neck, under the arms and the arm folds, and behind the knees. In adults, the appearance is similar to that of an older child but predominantly involves the hands and sometimes the feet.

Eczema and allergies 

Children with eczema frequently have allergies and/or asthma. Some children with eczema may have food allergies. Both respiratory allergens and food allergens may cause eczema flare-ups. Identification of these allergens may therefore be helpful in controlling flare ups. Not all patients have an identifiable allergy trigger, however. 

Managing eczema 

The most important management issue is providing adequate moisture to the patient’s skin. Remember, dry skin is itchy skin, so moisturizers must be used daily, 6 to 8 times per day.

Skin care routine

Bathing is ok, but should be limited to durations of less than 10 minutes.

  • Do not use very hot water; hot water decreases natural skin oils and moisturizers. Run baths at a lukewarm temperature.
  • Use as little soap as possible. Use mild soaps. Soaps may also remove the skin’s natural oils.
  • Add mineral oil. 1 to 2 tablespoons added to bath water will act as an added moisturizer.
  • BE CAREFUL – THE BATH TUB WILL BE SLIPPERY.
  • Pat your child dry after a bath. Rubbing irritates the skin and removes moisture.
  • Apply moisturizer immediately to the entire body, not just to the affected skin area.
  • Apply moisturizer a minimum of 3 additional times during the day; more if the patient’s skin appears dry, scaly, or flaky. Also, apply moisturizer any time the patient is itching.
  • Reserve the use of topical steroid creams only for acute eczema flare-ups (i.e. red, irritated skin).
  • Apply the steroid cream only to the red area and apply 2 to 3 times a day for only 3 to 5 days at a time unless directed by a physician.
  • Do not apply any steroid cream stronger than hydro-cortisone 1% to the patient’s face, groin or armpits.

Choosing a soap 

Recommended soaps that can be found at grocery/drug stores include:

  • Dove (unscented)
  • Purpose
  • Basis 

Avoid Ivory soap and anti-bacterial soaps Acceptable soap substitutes include: 

  • Cetaphi1
  • Aquanil
  • Moisturel Cleanser

Choosing a moisturizer

Moisturizers come in lotions, creams, or ointments. Ointments generally work the best because they stay on the skin longer. However, they tend to be thick and greasy. Ointments may be reserved for bedtime, with creams and lotions preferred for the daytime. Recommended moisturizers found in pharmacies and some grocery stores include: 

  • Eucerin (cream or lotion)
  • Cetaphil (cream or lotion)
  • NutraDerm (lotion)
  • Cure (lotion)
  • Moisture] (cream or lotion)
  • Dermovan (cream)
  • Vanicream (cream or lotion)
  • Aquaphor (ointment)
  • Vaseline petroleum jelly (ointment)

These moisturizers have no perfumes or fragrances and are less likely to irritate a child’s skin.

Itching 

The daily skin care regimen described above may control all of the patient’s itching; however, frequently, the use of oral antihistamines is additionally required to control pruritis. Some antihistamines will cause sedation, which can be a benefit at bedtime to control itching and scratching. Avoid the use of synthetic clothes fibers (polyester) and wool, and opt for loose fitting cotton clothing. 

Flare-ups

These are the times when the patient’s eczema worsens. Flare-ups may be characterized by:

  • skin becoming red or irritated
  • skin looks weepy or oozes
  • skin appears thick and scaly
  • increase in itching

Flare ups can happen at any time, and may occur for no reason at all. Some triggers may include:

  • weather changes
  • contact with or ingestion of an allergen

When flare-ups occur, use the topical steroid creams. Remember though: apply them sparingly and only to the red flared areas, and only continue using for 3 to 5 days.

Infections

  • Children with eczema are more likely to get skin infections. These can be caused by bacteria, virus or fungi. Signs of infection may include: fever, redness, swelling, draining skin, or blisters. Call your physician if these symptoms develop.
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Oct 9th2008

Dust Mite

     Dust Mites are microscopic living organisms that are found virtually everywhere dust collects. They live and feed on skin cells that are constantly shed by humans. People are allergic to the proteins found in dust mite excrement (feces). Mites are the most common cause of year round nasal allergies as well as being a common trigger for asthma. Dust mites are most commonly found on mattresses, pillows, blankets, carpets, upholstered furniture, stuffed animals, and draperies. They prefer warm and humid environment.

 Dust mite control

  •   Use allergy proof encasements (plastic or cloth covers) on box springs, mattresses and pillows.
  •   Use pillows made of synthetic fibers.
  •   Avoid clutter that is hard to dust, e.g., stuffed animals.
  •   Avoid upholstered furniture.
  •   If possible, replace carpets with wood, vinyl or tile floors. Wash throw rugs frequently.
  •   Vacuum frequently with a micro-filtered vacuum bag. If the allergic patient vacuums, he/she  should wear a mask. If not vacuuming, the allergic patient should leave the room.
  •  Wash bedding at least once a week in hot water (>135°). Also wash blankets, comforters, and pillows.
  •  Keep relative humidity lower than 50% by using air conditioning. AVOID USE OF HUMIDIFIERS.
  • Change the filters on central heating and air units a minimum of 4 times a year.
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