Adventures of an Allergist Mommy

Last week, my 3 year old, whose asthma is generally very mild, needed a few treatments of his albuterol inhaler. Because he is unaccustomed to having the spacer device on his face, the process of administering the medication was a bit of an ordeal. When I say a bit of an ordeal, I mean kicking, screaming, tears flowing, hyperventilating -- you know, nothing I can't handle. I finally got the puffs in him, and swore to myself that we weren't going through that again. By that point, we were already late for daycare, so I left the inhaler and spacer on the coffee table and whisked the kids off to school. That evening, as I was preparing dinner, I heard a strange musical noise, and turned to find Son #2 using his spacer as a vuvuzela. Here was the same child who only that morning was so vehemently resisting his treatment, now dancing around the kitchen with his spacer and inhaler attached to his face. The sound might have been as annoying as anything coming out of the World Cu...

The past few years have seen increasing interest in potential strategies to reduce the risk of allergy and asthma in young children. One particularly popular topic has been that of early pet exposure potentially decreasing the risk of animal allergy. Indeed, I am often asked by parents of my young patients if I recommend adding a furry pet to the household. However, it has been unclear how early in life the pet exposure needs to occur in order to modify risk.  A recent analysis of data from the Detroit Childhood Allergy Study sheds some light on this important question. It was published in the July 2011 issue of the peer-reviewed medical journal Clinical & Experimental Allergy. (Clin Exp Allergy. 2011;41:920-922) Annual interviews from 1987 through 1989, and follow-up interviews at age 18 years, were used to assess study subjects' exposure to indoor dogs and cats. After analyzing pet exposure during the first year of life, specific age ranges, and cumulative lifet...

10 things I'm thankful for this Thanksgiving: 1. Increasing awareness of allergies and asthma among family and friends. 2. Schools that recognize the importance of not using food as a reward in the classroom. 3. The availability of novel, high-quality allergy and asthma-friendly products and foods. 4. Laws that protect the public from the dangers of environmental tobacco smoke. 5. The availability of life-saving epinephrine in Illinois schools (and hopefully soon, schools throughout the nation!) 6. A robust community of asthma and allergy parents and physicians sharing their experiences via the magic of social media. 7. Treasured patients who have put their trust in my expertise and care. 8. A steadily growing medical practice which is the beneficiary of kind word-of-mouth referrals (scheduled my 100th patient this month!) 9. The flexibility to set my own schedule, which allows me to a more involved mother. 10. My awesome family (and inspiration)... Wishing you and you...

One of the things that helps me be a better allergist is that I know, first hand, what it feels like to experience anaphylaxis.  I am severely allergic to blueberries. Here's what happened when I experienced my first episode of anaphylaxis: Red, itchy palms. They felt hot and uncomfortable (as though they were being cooked from the inside out), and I found myself rubbing them against my thighs because they were so itchy. Painful abdominal cramping.  This pain made me feel like my innards were being wrung out like a wet dishrag, and was followed by a sneaking suspicion that if I elected to go the bathroom at that very moment, I might just evacuate the entire contents of my body in a single second. Incessant throat-clearing.  I felt like something was caught in my throat, but I just couldn't clear it. I was trying to be quiet, because I didn't want to bother anyone, but I couldn't stop. When I finally spoke up for help, my voice was hoarse. Involuntary cough...

My 6 year son old just got over a rite of passage - strep throat and scarlet fever. Unfortunately, before we could even celebrate his recovery, I noticed a swelling on the left side of his neck. It was red and tender, and it was GROWING. The pediatrician in me worried, "Damn. Lymphadenitis (infected lymph node)". No sooner had we finished one course of antibiotics than we were onto another, and the side effects were bad enough to keep him out of school for another three days. Why did my munchkin suffer so? My answer: Drug allergy. Group A streptococcal bacteria (the cause of strep throat and scarlet fever) is remarkably sensitive to penicillin. Penicillin is the first choice treatment for strep throat, and has been proven to reduce the risk of developing rheumatic fever, a post-infectious complication which can result in chronic heart disease. Problem is, my son is allergic to antibiotics in the penicillin family. At 11 months of age (8 days into his second ever co...

Halloween is just around the corner! I went to the grocery store to pick up candy, and was pleased to find that there are plenty of allergy-friendly options available, both in terms of candy and non-edible treats. Here's what I picked up: 1. Smarties. Link to their Allergen info:  http://www.smarties.com/allergen/ 2. Sweet Tarts. (Wonka candies labels its products for inclusion or possible cross-contamination of the 8 major allergens- check your bag to make sure it's safe) 3. Nerds. (Wonka candies labels its products for inclusion or possible cross-contamination of the 8 major allergens- check your bag to make sure it's safe.) 4. Pencils. Yay for Target! 5. Stickers. Again, yay for Target! 6. Halloween-themed silly bands. Did I mention that I love Target? I keep the candy and the non-edibles in separate bins, and let the kids/parents choose. This year, my practice is having a Halloween candy "Buy-Back". So, I'll include the following note by the d...

You're Invited to an Open House! I am thrilled to celebrate the opening of Kaneland Allergy & Asthma Center with an Open House event for my colleagues, patients and community members. We'll be giving tours of our kid-friendly new office, talking about the latest developments in allergy and immunology, sampling yummy allergy-friendly treats, accepting donations for a local Food Pantry and giving away prizes! (iPad, anyone?) If you have a friend or family member who could use a good allergist, this is a great time to "Meet the Doc" and get a feel for the practice before scheduling an appointment, so bring a buddy! Where: 66 Miller Drive North Aurora, IL 60542 When: Wednesday, October 12, 2011 6:00pm-8:00pm I'm lucky to share my office building with great neighbors, who will also be opening their offices to the public during this time with similar events. Here's your opportunity to meet all of the professionals at 66 Miller Drive in one evening: Ligh...

In a rush to get the kids' clothes clean yesterday, I dumped the laundry basket contents into the washer without taking the time to sort... HUMONGOUS mistake. After returning home late from a business trip, DH walked into the bedroom asking me about the "crystals" in the laundry. "Crystals?!?! What the heck is my crazy husband talking about?" I wondered to myself upon being woken from my slumber... Well, this morning, it became "crystal" clear exactly what had transpired. Son #2, upon being instructed to "Throw all those dirty clothes down the laundry chute", decided to include his Pull-Up in the mix. My washer and all the clothing therein was covered in pieces of super-absorbent polyacrylate gel. Most excellent. Thankfully, it turns out the AllergistMommy is not the only ridiculous parent to have committed this laundry crime. Laura, the Mellodramamma, has walked this road before me:  http://www.melodramamma.com/?p=60 Read her pos...

 Ah, back to school... kids get back into a routine, and mom gets her life back, right?  WRONG! For most moms, back to school is anything but relaxing. However, for some of us "chosen ones", it's even more tiring: Is this the time of year when you struggle to drag yourself out of bed, despite hitting the sack as soon as you put the kids down for the night? Is your focus during the day so scattered that it takes you 3 times longer than usual to accomplish even relatively simple tasks? And when it's finally time for bed again, are you shocked to see a face 10 years your senior staring back at you in the mirror, with dark circles and puffiness? Many tired moms attribute these seasonal symptoms to the stresses associated with "Back to School".  However, if you're an allergy-mom like me, remember: your kids got those allergy genes somewhere, and you probably had a little something to do with it! As parents of kids with allergies and asthma, we are often...

As an immunologist, part of my job is to identify and treat immune deficiencies, which can predispose patients to recurrent infection. Primary immune deficiency is remarkably under-diagnosed, and it can often take years of chronic illness before a definitive diagnosis is obtained. This delay in diagnosis is frustrating for both patients and their physicians. However, a proper diagnosis and treatment for immune deficiency can be life-changing. With this in mind, I'd like to share the Warning Signs of Primary Immune Deficicency, courtesy of the Jeffrey Modell Foundation: 10 Warning Signs of Primary Immunodeficiency in Children 1. Four or more new ear infections within one year. 2. Two or more sinus infections within one year. 3. Two or more months on antibiotics with little effect. 4. Two or more pneumonias within one year. 5. Failure of an infant to gain weight or grow normally. 6. Recurrent, deep skin or organ abscesses. 7. Persistent thrush in mouth or fungal infection ...

My boys have recently gotten VERY into the Harry Potter series. Their new favorite game is to play wizard dueling with markers in their hands as wands. Here's a recent exchange: Son #1: (Pointing a green highlighter at his brother) I'm going to zap your wand! Experiamus! Son #2: You missed! (Pointing a blue highlighter right back at his big bro) SUPERFLY! With that slip of my 2 year old's tongue, I was treated to an image of Son #1 suddenly being transformed into Ron O'Neal. Superfly, indeed.

I am thrilled to announce that in July, 2011, Kaneland Allergy & Asthma Center will open its doors! The decision to open my own medical practice did not come easily. The combination of the changing healthcare environment and new economic realities in our nation has caused many to question the viability of private practice medicine altogether. So naturally, I am filled with butterflies at the prospect of starting from scratch.... However, my heart tells me that I am doing the right thing. I believe there is a great need for independent physicians in our nation- physicians who are not answerable to bureaucrats or administrators or insurance companies, but are answerable only to their patients and their own consciences. I believe that patients long for a return to the time when conversation and education created the cornerstone of medical care, rather than pills and procedures. I believe that medicine is still a noble profession- we only need to start believing in it again. W...

For families in the Illinois Kane-Kendall counties with school-aged children with potentially life-threatening allergies, the following FREE seminar will be of interest. Many children with severe allergies may benefit from having a 504 Plan in place- led by an attorney specializing in special education law, this seminar will aid parents in advocating for their child's right to a safe and healthy learning environment. Please note- as seating is limited, advance registration is required. See the flyer below for details (it will enlarge upon clicking):

Son #1 was in a funk this morning on the way to his last day of school. As Son #2 excitedly chattered on about an upcoming family "baycayshun", my eldest child's normally mild temper was flaring. Son #1:   "Stop talking about it! I don't ever want to go on vacation again! I just want to stay at Summer Camp!" Me: "Okay, if that's the way you feel, I guess you can stay home and we'll just take your little brother to Disney without you." Pensive Pause. (even Son #2 stopped jabbering to hear this response) Son #1: "Fine. This is the last vacation I'm going on. But then, I'm never going on vacation again!" Gotta love reverse psychology.

This morning, while getting dressed in his Pull-Ups (yay!) and jeans, the following conversation made it clear that my 2 year old is acutely aware of the power of suggestion: Son #2: "Mommy, we going to school?" Me: "Yes, honey, we're getting ready to go to school." Son #2: "How about Toys R Us?" Me: "Umm, no. Nice try, though." Son #2: "How about tomorrow?" He keeps this up, and we will eventually own a majority stake in the place. The kid has a bright future as a lobbyist.

Me: "Honey, we're overscheduling him." DH: "What are you talking about? He loves these classes, and gets to see his friends!" Me: "But he wakes up early to go to school, and by the time we get home from afterschool activities, we basically only have time for dinner and homework before it's time for bed." DH: "Great- that means he's not watching tv." Me: "So, when does he play outside?" DH: "Doesn't he have 2 recesses a day at school? And he plays outside all weekend whenever it's nice outside. Actually, I've been thinking that we should get him into a team sport on Sunday mornings." Me: "Are you kidding me?!!? If I have to drive this kid to any more activities, I'm going to lose it. Between getting the kids ready for school and barely getting to work on time myself, rushing to pick them up before the daycare closes and keeping track of karate, Saturday school, etc., I don't know if I ...

Dear Reader, With the recent media attention surrounding accommodations for food-allergic children in the school setting, and confusion about what reasonable and effective accommodations even are, it is important to gain a better understanding of parental attitudes about food allergies. I recently received this survey from the Kids With Food Allergies Foundation, and wanted to pass it on. Remember, there are no right or wrong answers- this survey is simply evaluating the opinions of parents of both food-allergic and non-allergic children. There is power in numbers, especially when it comes to compiling data. The more parents that complete this survey, the more compelling the results will be! Thanks in advance, the AllergistMommy The Kids With Food Allergies Foundation and some members of its medical advisory board are conducting a research study to examine parental opinions about food allergy management policies and accommodations in schools and child care centers. We are ...

Thanks to the Mothers of Children Having Allergies group for passing on the important information below! ----------------------------------------------------- With the generous support of the Food Allergy Initiative-Chicago there is now a food allergy-specific learning opportunity for school nurses on-line:   http://cmhdotnet.webitects. com/ce/online/article.aspx? articleID=238   When completed the participant will receive 0.5 INA contact hour for continuing education.     Please share this information with your favorite school nurse.  :-)   --------------------------------------------------------------------------- In this era of budget cuts and staffing shortages in our schools (especially when it comes to nurses), how wonderful to have easily accessible resources for our school nurses to educate themselves (and earn continuing education credit, to boot) on how to keep children safe! Bravo to the Food Allergy Initiative!...

I'm waiting for my flight home from the 2011 AAAAI Annual Meeting (delayed, naturally). It was a wonderful and educational conference, but I am ready to go home. I miss my boys. The time difference made it difficult to connect via phone- I was always calling during naptime, mealtime or mid-car ride to some really unhealthy restaurant meal with DH. During the one call where I was actually able to speak with them, all I could make out was "Mommy, guess what?" and the rest was garbled. Sigh. At the airport, there are adorable children everywhere. I know this is an impossibility, because children can only be annoying at airports (last trip, Son #2 actually ran OUT OF THE AIRPORT while we were checking our bags), but as I am not the mother, they are adorable to me. When I hear a toddler call out, "Mommy!", the reaction is visceral- my throat chokes and my eyes get watery. Similar to hearing a baby's cry when separated from your newborn. What is this connect...

I am in San Francisco, California for the 2011 Annual Meeting of the American Academy of Allergy, Asthma & Immunology. It promises to be a very educational and intellectually satisfying meeting. Last year, I tried my hand at live-tweeting from the conference. I'll be doing the same this year- hopefully, it will give folks at home an opportunity to take part in the knowledge sharing remotely. The exercise is mutually beneficial- in addition to sharing information with others, my tweets will obviate the need for any paper-based note-taking on my part! It really highlights the "green appeal" of social media- so many trees saved! I will not be alone in this endeavor- my expectation is that we'll see a substantial increase in the number of tweets coming out from the conference compared to 2010. If you'd like to partake in the knowledge-fest, please subscribe to hashtag #AAAAI on Twitter to get a live stream of tweets from the meeting!

Many thanks to Illinois House Representatives Chris Nybo (R) and John D'Amico (D)  for sponsoring HB3294, the School Access to Emergency Epinephrine Act, on 02/24/2011. Click here for details regarding this bill: http://www.ilga.gov/legislation/BillStatus.asp?DocNum=3294&GAID=11&DocTypeID=HB&LegId=60664&SessionID=84&GA=97 Synopsis: " Provides that the purpose of the Act is to allow schools to have access to life-saving emergency epinephrine auto-injectors if and when a student has an anaphylaxis reaction and to allow the school to have personnel trained to administer an emergency epinephrine auto-injector. Provides that a school district may provide emergency epinephrine auto-injectors to trained personnel, and trained personnel may utilize those epinephrine auto-injectors to provide emergency medical. Provides that each public and private elementary and secondary school in the State may make emergency epinephrine auto-injectors and trained p...

Clinician. Diagnostician. Prognostician. Healer. A physician has many jobs to perform, all critical to the appropriate management of what ails our patients. Without astute physical exam skills or a keen ability to sort through a medical history to uncover salient data, the physician is no better at diagnosing a patient than a Google search (and we're quite a lot better, in case anyone was wondering). Without a proper understanding of physiology and pharmacology, the physician is no better at healing than a placebo, and might actually do harm! As patients, we rightfully base our assessments of our physicians' competence on their ability to (as quickly and non-invasively as possible) determine what's wrong, and what to do about it. Unfortunately, we have also come to view physicians as the barrier to care, rather than the source of care. Who stands between the sick patient and the antibiotic? Whose signature is required before the blood test can be performed? The fundam...

Horrible, isn't it? I feel no guilt whatsoever about the following dishonest charade... Setting: Trusty Honda Civic, en route to a casual dinner out with the family. Son #1: I want to go to Red Lobster! Son #2: Red Lobster! Red Lobster! DH: (whispering to me) Not tonight. I'll spend the whole time shelling crab legs for him. I just want a relaxing meal. Allergist Mommy: Okay, kiddo. Let me call the restaurant... (fake dials phone, lifts to ear) "Hello, Red Lobster? Do you have a table for 4? Yes, for tonight. Oh, really? Well, how soon will a table be open? 11pm?!?! No no, that's too late. Maybe some other time. Thank you. bye." Honey, they are too full right now. How about Mexican? Son #1: Okay, Mommy. I like their chips! DH: Awesome. This trick will only work for another couple of years. Until then, I intend to milk it dry.

For nearly a century, doctors have known that the best way to control environmental allergy symptoms is by retraining your immune system to tolerate substances that you are currently over-reacting to. This is known as “immunotherapy”.   Until recently, immunotherapy required multiple small injections over a period of time (subcutaneous immunotherapy). Although allergy injection treatment is very safe and effective, weekly trips to the doctor for shots are not always convenient for today’s busy families. This means that many patients are not able to take advantage of allergen immunotherapy’s numerous health benefits, such as decreased need for medications, improved hay fever and asthma control, prevention of asthma in high-risk children, and a better night’s sleep. Sublingual immunotherapy, or allergy drops, can offer the benefits of immunotherapy to a wider array of patients. These drops are made from the same FDA-approved allergen extracts used in allergy injection treatme...

Setting: Son #2's Room, changing table (potty-training hasn't quite happened yet) Allergist Mommy: Whoa! You stink, kiddo! Son #2: I apologize. Dear Husband: What?!?! You're just copying your brother. Do you even know what that means? Son #2: I sorry. We stand corrected, smartypants.

Dear Members of the Illinois State Board of Education, As a parent of a child attending Illinois Public Schools, a taxpayer, and a Board-Certified Pediatric Allergist & Immunologist, I was distressed to hear of the irresponsible comments made by Illinois State Board of Education Members Catherine Campbell and Lawrence Gregorash regarding the requirement for Illinois schools to have a food allergy policy in place by 2011. When the parents of children with severe food allergies send their children to school, they place immense trust in our school system - not only to educate their children, but to keep them safe while in its care.  The safety of our children in the school setting is of tantamount importance, and the assertion by school board members that protecting children with life-threatening food allergies is "the most ridiculous thing" or “This isn’t the dumbest thing I’ve seen in my 64 years…but it sure ranks in the top 10” is worse than offensive - it is dangero...

I have been asked recently if there are plans for a Child #3. This video should help explain why any family expansion should be very thoughtfully considered in advance.

I am pleased to be a part of what I consider a very important educational initiative- the Anaphylaxis Community Experts (ACE) program.   Co-sponsored by the American College of Allergy, Asthma & Immunology (ACAAI) and the Allergy & Asthma Network - Mothers of Asthmatics (AANMA) , the ACE program's mission is to prevent anaphylaxis deaths and reduce anxieties through education, advocacy and outreach.   In light of the tragic death of a peanut-allergic girl at a Chicago school in December, our mission is even more timely. Who are the ACE team members? ACE Teams consist of one board-certified allergist and one community member who each share this mission. Goal : To understand and improve the care of people at risk for anaphylaxis by providing an evidence-based approach to the identification, diagnosis, assessment and management of anaphylaxis in order to prevent deaths from severe allergic reactions. Objectives: To help patients, families, and healthc...