Dear Dr. K: I keep an Epipen for “just in case,” but so far I have never had to use it. I keep replacing it when it expires, but it is expensive. Is it possible to use it past its expiration date? The answer is “yes, probably.” The “probably” is based on the clarity of the liquid. If, when you look through the syringe and the medicine is clear, then it’s both safe and effective. If the liquid is yellow…
Pityriasis rosea is not an allergic condition but is frequently seen by allergists as its main manifestation is a skin rash that looks “temptingly allergic” in nature. This rash is preceded by a single spot called the “herald patch.” This clue is sometimes missed because it appears in a hidden spot on the body such as the back or armpit. Within one to two weeks of the herald, a generalized rash appears. The spots are circular to oval in shape…
The results of a Harvard study done over the past 25 years on childhood asthma are somewhat distressing. The research was published in a recent edition of The New England Journal of Medicine. Known as CAMP – Childhood Asthma Management Program – the study allowed long-term outcomes to be determined. It compared the use of a daily inhaled steroid versus placebo for the first 4.5 years. Then the children were returned to the care of their pediatricians and followed for…
A recent double-blind study comparing phenylephrine to placebo showed no measurable difference in reducing nasal congestion. For people who need/use pseudoephedrine for their congestion, it is available “behind the counter” and must be signed for.
Since pseudoephedrine (found in drugs such as Sudafed Congestion, Claritin-D and Zyrtek-D) has become a “sign-for-it-at-the-pharmacy drug,” phenylephrine (brand name Sudafed 12/24 Hour® and others) has replaced it as the most common OTC decongestant.
Dear Dr. K: I’ve had a blood test for gluten sensitivity, allergy tests for wheat and even an intestinal biopsy for celiac. All the tests are negative, but I still feel better when I avoid wheat. What gives? What gives is that wheat is not good for you. No medical test is perfect. Even “gold standard” tests such as chest X-ray for pneumonia or cardiac catheterization for coronary blockage sometimes fail to demonstrate an existing abnormality. The bottom line is…
The most common cause for drug allergy is from IgE-mediated (allergic) reactions, such as having hives from penicillin. New research is discovering a second mechanism for drug reaction being called “drug hypersensitivity,” as it is mediated by T-lymphocytes. The reactions are different from the arch-typical “allergy” in that they tend to be somewhat delayed and different types of rashes. Examples are measles-type bumps, the life-threatening skin condition Steven-Johnson Syndrome or liver irritation. Of great interest is that there seems to…
In the early 1900s, German scientist and Nobel Laureate Paul Ehrlich pioneered an antiserum to help combat diphtheria. His anti-serum saved many lives in the pre-antibiotic era. He also popularized the concept in medicine of a “Magische Kugel” (Magic Bullet). His idea was to find treatments that were so specific that they only worked on their specific targets without any collateral effect or damage to the body. In 1975 Cesar Milstein and Georges Kohler (also Nobel Laureates) invented hybridoma technology…
Buteyko is a Russian breathing technique to improve control of asthma through respiratory exercises. Basically, it consists of daily sessions of progressively incremental breath holding. Research studies have shown improvement in asthma and even reduction in medication.
Vogt-Koyanagi-Harada syndrome is an autoimmune eye problem that starts with recurrent bouts of “pink” or “red eye”. Eventually it can cause the eyelashes to turn white and the retina to detach. Proper diagnosis by an ophthalmologist is key to anyone suffering repeated bouts of “red eye.”