• Based on a study published in Lancet, it is best not to give children prophylactic doses of acetaminophen (Tylenol) when they get immunized. Some parents do this to lessen the chance of fever or soreness from the shot. As it turns out, acetaminophen lessens the immune response to the vaccine by a significant amount.
– Call the airline in advance to learn its policy on food allergy and what snacks are served, and about special seating arrangements.
– Confirm your food allergy status with the gate agents and flight crew.
– Pack safe snacks; most airlines allow fluid exceptions for formula and breast milk.
– To head off hassles, bring a doctor’s letter regarding these fluids and also about carrying an epi-pen.
– Label your carry-on bag clearly so in the event of emergent need for your epi-pen or medicine, you can locate it quickly.
For years allergists and ear, nose and throat docs have preached Afrin avoidance due to its addictive nature. In some people use of Afrin for as little as four or five days can lead to severe addiction with rebound congestion. Such patients often are trapped into escalating use of Afrin with poor outcomes.
That said, Afrin is very seductive as it is an extremely effective way to reduce nasal congestion. Hence, the University of South Carolina School of Medicine did a study to see if nasal steroids could prevent Afrin addiction.
In this study patients used both Afrin and a nasal steroid once nightly for six weeks.
The results were amazing.
The patients had excellent improvement in nasal congestion and no rebound effect. The researchers cautioned that this was a short-term study and plan to study such an approach over a longer time frame.
Dear Dr. K: I read that since I’m 68 years old I won’t get as good immunity from the flu shot as a 30-year-old. Am I wasting time by getting vaccinated?
The complete and total answer to your question is “No.” However, let me elaborate.
The issue at hand is immunosenescence, or aging of the immune system. Just like other parts of our body, our immune systems age. It is for that reason that persons over age 50 are more likely to get shingles and to die from influenza. We (I can say that since I’m over 50) also are more likely to get bacterial pneumonia, urinary tract infections, meningitis, gastroenteritis and tuberculosis.
Because of these risks, it makes it all the more important to take preventive steps to bolster our immunity.
People over 65 get only 56 percent of the protective effect of flu vaccine and only 65 percent of the protective effect of the pneumonia vaccine, as compared to young people. Still, that 56 and 65 percent improvement is better than 0 percent.
There has been intense research on the aging immune system, especially with the wave of baby boomers enlarging the elderly population. One unexpected finding was that in addition to increased risk of infection in people over 50, there is a specific infection that by itself can actually speed the senescence of the immune system. The culprit is a virus called CMV – Cytomegalovirus.
As it turns out, this dastardly virus reduces the helper T-cell lymphocytes which are so important in building good immune function. CMV is in the family of herpes viruses and once you’re infected, it stays with you life long.
Since CMV is fairly common, there is intense research into finding a way to prevent its immunologic mischief.
Dermatographism is a term that comes from Greek and Latin words dermos (skin) and graphia (to write). It literally means to write in the skin and thus, describes an exaggerated cutaneous response to physical stimuli in the form of hives.
The physiologic mechanism is histamine degranula-tion from mast cells in the skin by mechano-immuno-logic triggers. Thus, systems of burning, itching, redness and welting occur from pressure such as tight clothing, belts and bra straps.
Stroking the skin or scratching can also lead to symptoms, as can continuous pressure such as sitting (on your buttocks) or standing (on your feet).
There are some subtypes of dermatographism such as the cholinergic form. This form is worse when the body is heated as from exercise, a hot shower or a fever. Follicular dermatographism tends to center around hair follicles and manifests as several papules rather than larger welts.
White dermatographism is, as the name implies, blanching of the itchy skin rather than redness, and is due to vasoconstriction (blood vessel narrowing). Cold-dependent dermatographism requires cold exposure.
Dermatographism can be primary (inherited) or secondary. Secondary can be systemic disease-induced such as hyperthyroidism, diabetes and mastocytosis; drug-induced as in allergic reactions (especially to amoxicillin, cephalosporins, atorvastatin and famotidine); from infectious triggers (this is especially common in children with strep infections and viruses), and from psychological factors such as stress and anxiety.
The mainstay of treatment is antihistamine drugs. Usually a combination of a histamine one (H1) receptor blocker and a histamine 2 (H2) receptor blocker is required. A combo that often works well is Zyrtec (H1) and Zantac (H2).
In more severe cases a third drug can be added – a leukotriene modifier (Singulair or Accolate). Also, phototherapy using narrow-band UVB has been shown to be helpful.
Fire ants are wingless bees and they sting with an abdominal stinger while holding on with their jaws. (Eeeww! and Ouch!) The allergic reaction is to the sting, not the bite. When gardening or picnicking, be sure to wear shoes and socks to make fire ant contact less likely.
When barbecuing, keep in mind the issue of second-hand smoke. Be sure to position the grill in such a way that the smoke blows away from adults and children. Some people with oak or hickory allergy are more sensitive to these flavoring wood chips.
Insect bites and stings can hamper an active outdoor lifestyle. For people sensitive to bug repellants there is a new line of clothing, hats and scarves that are impregnated with a safe, effective repellant. This clothing is widely marketed in catalogs and on websites.
Sunscreens are important commodities in the Florida summer. The ones most likely to cause skin allergy contain PABA (para-amino-benzoic-acid). If you have problems with sunscreen try one that is PABA-free.
If you or your child’s skin is aggravated by pool chlorine, try applying a small amount of olive oil to the skin before swimming.