Refinery29: 5 things to know before your first skin allergy test

SARAH JACOBY

JUNE 1, 2017, 2:20 PM

Maybe it's the phrase "skin prick" or the pictures of huge, angry red weltscovering people's backs. Whatever it is, something gets us really worked up about skin allergy tests. But experts want us to know: It's time to take down our skin test anxiety a few notches.

"Most people are way more worried about this than they need to be — it's just not that big a deal," says J. Allen Meadows, MD, chair of the advocacy council of the American College of Allergy, Asthma, and Immunology. In reality, the testing itself takes up a fraction of your appointment time and, in most cases, you don't need to worry about a scary allergic reaction.

Before you even get to the test, Dr. Meadows says your allergist will go through an extensive consultation to figure out the best plan of attack (allergy tests aren't one-size-fits-all). That initial chat will probably cover what you think you might be allergic to, how likely it is for you to come into contact with those allergens, where on your body the testing should take place, and whether or not you're already on an allergy treatment plan.

If you're really nervous about the test, your allergist can also use this time to show you what it looks like. "I demonstrate it on my arm," Dr. Meadows says. "And when people see what it actually looks like, it's a relief. They're pleased to see there's no needle involved."

So what does happen? Essentially, your allergist will decide on a bunch of allergens (up to 40) to test out. Then you'll be turned over to a technician who will actually administer the test. That person will put marks on your skin (usually your forearm or back) to keep track of what's being tested. Then she'll use a plastic scratcher to apply just a little bit of each allergen to that area. It may feel weird, but it won't be painful — it's more like scratching an itch than getting a shot.

After letting the allergens sit on your skin for about 15 minutes so your body has time to react, your allergist will interpret your results and help you figure out what needs to happen next.

If you're getting tested for a potential drug or insect allergy or your initial skin test was unclear, that might include further testing that actually goes under your skin (in other words: an injection), explains Dr. Meadows. Those who have skin conditions or take medications that interfere with skin testing may instead get a blood allergy test, meaning you'll have your blood drawn and it'll be tested in a lab. But for most patients, skin prick testing is all it takes to figure out the next course of action.

Ahead, learn more from Dr. Meadows about how to prepare for your test and what you can really expect to happen.

 

Bustle: 7 hygiene habits that are actually dangerous that everyone should stop doing

ByCARINA WOLFF

Some habits like showering or washing your bedsheets have obvious health benefits when it comes to good hygiene. We tend to assume that all hygiene habits help make us cleaner and healthier, but there are a number of hygiene habits that are actually pretty dangerous. Sometimes when trying to stay clean, we actually end up harming our bodies or exposing ourselves to more germs. These habits might come as a surprise, but with so much misinformation on the internet, there are a number of practices that become increasingly popular but that aren't actually good for you.

"There is an overwhelmingly continuous outpouring of hygiene info that we may receive from family, friends, colleagues, and other sources," says Nesochi Okeke-Igbokwe, M.D., M.S. over email. "Sometimes it can be truly confusing to determine what is accurate and inaccurate health information. Nonetheless, it is so important to be aware of the hygiene habits that are indeed healthy and the others that are potentially dangerous in order to avoid health problems."

Even though it might feel weird to ditch these habits, it's for the best, especially if you're trying to protect your health in the first place. Here are seven hygiene habits that are actually quite dangerous,

1 Long Hot Showers

Many people mistakenly believe that taking a very long and hot shower is good for the skin. "When you shower with extremely hot water, this can actually have a serious drying effect on the skin," says Okeke-Igbokwe. "There are natural oils the skin produces to help it retain moisture, and repeatedly using very hot water or showering for extended periods of time may actually be a detriment to the skin. It can essentially remove many of those oils naturally produced and contribute to rough, dry, and sometimes even irritated skin."

 

2 Using Fragrance Sprays After Going To The Bathroom

Spraying a room with a nice scent can seem more hygienic than letting an unpleasant smell linger in the air, but these sprays can actually be quite dangerous for our health. "The American College of Allergy, Asthma, and Immunology warns that many common home fragrance products contain pollutants, which can increase the risk of asthma, trigger eye and respiratory tract irritation, headaches, dizziness, and even memory impairment," says Rachel Delia, co-founder of Flask Natural Products, over email. "Making a switch to an all-natural fragrance spray is a quick and effective healthy swap."

 

 

3 Cleaning Your Ears

Most of us were taught growing up to clean our ears with q-tips, but it turns out, it's totally unnecessary — and can actually be very dangerous. "It’s unfortunate that ear wax is brown because people assume it’s dirty," says HealthPartners otolaryngology physician Christopher Hilton, MD over email. "But it’s actually healthy and good for us. It kills bacteria and lubricates our ear canals. Ear wax prevents bacteria from causing ear infections." Although you might get some ear wax out with a q-tip, the majority of the wax is actually pushed deeper into your ear canal. This can lead to a vicious cycle of feeling like your ears are dirty, using q-tips, and pushing more wax deeper in your ears.

 

4 Aggressive Tooth Brushing

"Aggressive tooth brushing, especially coupled with an abrasive toothpaste, like most whitening toothpastes, can wear away gum and tooth structure, leading to various dental problems," says dentist Dr. Steven D. Cook over email. "Many people don’t know that they are brushing too hard, potentially causing irreversible damage to their teeth by brushing away the enamel. It can also cause the gums to recede.

 

5 Douching

Douching not only ups your risk of infections like bacterial vaginosis and yeast infections, but it can also complicate pregnancies and increase your risk of pelvic inflammatory disease, according to WomensHealth.gov. It also increases your exposure to chemicals called phthalates, which can be absorbed through the vaginal walls and lead to reproductive problems down the line, according to research published in the journal Environmental Health.

 

 

6 Using An Air Dryer

Most of us use air dryers after we've washed our hands instead of using paper towels, if the option is available to us. However, paper towels are actually much more sanitary. Multiple studies have found that paper towels remove more bacteria than air dryers, so you might want to choose to wipe your hands rather than dry them.

 

6 Plucking Nose Hairs

No one likes stragglers, but you should proceed with caution before plucking out any nose hairs. Getting rid of unwanted hairs can expose hair follicles to bacteria, which could make you sick, according to Dr. Mehmet Oz in a video on Sharecare. Not only that, but nose hairs help prevent you from inhaling dust and particles.

 

7 Leaving Your Dishes To Soak

Leaving your dishes to soak in the sink might seem like it would make them cleaner, but it could actually be a breeding ground for bacteria. Research from the University of Arizona has found that the kitchen sink contains more E. coli than a toilet after flushing it.  Soaking pots and pans can also act as a breeding ground for for E. coli or salmonella, according to  research from Long Island College Hospital of Brooklyn, New York.

Cincinnati Enquirer: 4 ways to manage your springtime asthma

Sandy Weiskittel

9:26 p.m. ET May 28, 2017

If you’re one of the 25 million Americans who suffer from asthma, the allergens of spring can make it difficult to breathe.

Asthma is a chronic condition in which the airways of the lungs become inflamed and narrow, often due to one or more triggers in the environment. Up to 80 percent of children and half of adults with asthma experience attacks when they come in contact with specific allergens.

During the spring, tree pollens, mold spores and grass all have the power to inflame and narrow the air passages of people who are sensitive to these natural triggers. Wheezing, shortness of breath, chest tightness and coughing are some of the common symptoms that occur during an asthma attack.

Among the most common triggers for asthma are:

• Outdoor allergens

• Indoor allergens, including pets, dust mites and smoke

• Cold air

• Exercise

• Reflux disease (heartburn or acid indigestion)

Make a Plan to Manage Your Asthma

“It’s important to recognize what your triggers are,” says Jeff Raub, MD, allergist and immunologist with TriHealth. “Then you can create a plan of action with your health provider. I’ve lived with asthma for 36 years, so I know how important it is to develop habits that will help you breathe better and make physical activities more enjoyable.”

Here are some tips he offers for managing asthma in the spring or anytime:

1. Take a preventative stance.

If you’re especially sensitive to springtime allergens, use air conditioning in the house and car to limit your exposure. If you’ve been outdoors, wash your hair and clothes when you get home to get rid of those allergens. Clear your nasal passages with a neti pot or other nasal irrigation method. Indoors, try to clear your house of allergens that trigger you.

2. Ask your doctor about effective medicines.

If you know you have allergies, over-the-counter antihistamines and nasal sprays will help minimize your allergic reaction. “Start your allergy medicines a week or two before allergens are due to come out,” counsels Dr. Raub. He also recommends prescription medicines like Singulair — with your doctor’s consent — to prevent both asthma and allergy attacks.

3. Be familiar with your inhaler.

For those times when you can’t breathe, knowing where your inhaler is, how much medicine it contains and how to use it properly can greatly relieve your breathing distress. “Using your inhaler properly is really important for getting the medicine into your lungs,” Dr. Raub says. “If you’re not sure how to use it, ask your doctor or pharmacist.”

Common sense guidelines for optimal inhaler use include:

• Shake the canister for 10 seconds and take off the cap.

• Attach a spacer device to the inhaler to get more medicine into your lungs.

• Take a slow, deep breath just after you press down on the canister and inhale through your mouth, not your nose. Hold your breath for 10 seconds. After 30 seconds, repeat with a second puff and a third, if needed.

Know when to seek medical attention.

If you’re using two to three puffs of inhaler medicine every 10 to 15 minutes and are still struggling to breathe, seek immediate medical attention. “Despite all of the medicines we have available, 3,000 people die each year from asthma,” Dr. Raub says. “Don’t wait to get help.”

For additional information on asthma and its treatment, Dr. Raub recommends the American College of Allergy, Asthma and Immunology, acaai.org, and the American Academy of Allergy, Asthma and Immunology, aaaai.org. Or visit TriHealth Allergy and Immunology for further information.

If you want more health stories like this, subscribe to DailyHealthWire or connect with TriHealth: Twitter / Facebook

Martha Stewart: Allergic to animals? 3 easy steps to combat it once and for all

May 23, 2017

By Evelyn Battaglia

Here's a plan to help you sneeze less and enjoy them more.

 

Many of us grow up knowing that dogs or cats make our eyes watery, our throats scratchy, our noses runny. But the telltale signs of a pet allergy can show up later in life, too. Or we may not connect the dots until we adopt one of our own. According to Janna Tuck, an allergist in Cape Girar­deau, Missouri, and a spokesper­son for the American College of Allergy, Asthma & Immunology, about 10 percent of people have a reaction to dogs or cats (and it’s the dander, saliva, or urine in their hair that we react to, not the hair itself). If you suspect you're among them, don't worry — unless your case is extremely severe, there are ways you can coexist with a furry friend. Tackle your symptoms one step at a time to find a strategy that works.

1. First, see an allergist

You may think it's not such a big deal if you wheeze whenever you give your pup a good brushing, or if you break out in a rash after a kitty curls up in your lap. But it's a good idea to see an expert, who can do some tests (either pricking your skin with about 40 immune­ response­triggering substances or drawing blood to look for antibodies) to pinpoint exactly what's causing your reaction. It might be something other than an animal. "About 30 percent of patients tested end up with pet allergies," says Tuck. "The rest are allergic to dust mites, pollen, mold, or other allergens." Even if the tests show your suspicions were correct, that doesn't mean you should never get near another little creature: "It just points to a bigger risk of being sensitive or allergic," says New York City immunologist Dean Mitchell. For instance, a person with a high score might react more strongly to one breed than to others, or even to one specific dog.

2. Next, clear the air at home

Tuck estimates that 80 percent of her patients figure out how to live with their allergy­causing animals. "It entails reducing the allergen load as much as you can," she says. Some pointers: Make your bedroom off ­limits, and keep the door shut. (Sorry, no fuzzy foot warmers on the bed.) Frequently change your HVAC air filters, and use a HEPA­-equipped vacuum and air purifier, especially in rooms where your dog or cat spends a lot of time. At least once a week, dust furniture and hard surfaces (including walls and ceilings) and launder your bedding; tackle curtains, rugs, slipcovers, and pet beds and toys as often as you can. Brush your four­legged companion outside with a deshed­ ding tool weekly, wearing a mask or enlisting help if you need to, and then give her a bath.

3. Last, manage your symptoms

Over­ the ­counter medications can take care of mild itchiness and congestion, and help you visit other homes with animals. (Tuck says nasal sprays, like Flonase and Afrin, work especially well, though some shouldn't be used daily.) If that doesn't cut it, your doctor may prescribe immuno­therapy, which builds up your tolerance to an allergen by expos­ing you to it in tiny, controlled increments over time, via doctor­ administered shots or at­home drops. "We aim to get your body to do the right thing instead of having an allergic response," ex­plains Tuck. Both methods have pros and cons. There's a very small chance you could have a severe reaction to the weekly shots — thus the required office vis­its — but they're effective, Tuck says, and they're covered by insurance. The daily drops or tab­ lets aren't; they can cost up to $1.50 per dose. But they're conve­nient, since all you have to do is let them dissolve under your tongue, and they work well, says Mitchell, who's used them to treat patients successfully for the past 16 years.

Whichever treat­ment you choose, know that it won't go on forever — and will most likely have a happy ending. Your allergist will monitor and adjust your dosage until you're ready to stop, usually after three to five years, though Mitchell has seen results in as few as two. That's a mere blip compared with a lifetime of puppy or kitty love.

Fact or Fiction: Hypoallergenic Pets

The truth about cats and dogs: "No pet is 100 percent hypoallergenic, but there are breeds that allergy sufferers tend to do well with," says Brandi Hunter, vice president of PR for the American Kennel Club. Good canine options include bichons frisés, Brussels griffons, Malteses, poodles, Portuguese water dogs, schnauzers, and soft-coated wheaten terriers. Consider cats with a short, tight coat, like Bengals (above), Cornish and Devon rexes, Oriental shorthairs, and sphynxes. To be safe, visit an animal for several hours to test for potential sensitivities before you bring her home.

 

Miami Herald: Your kids could have an allergy you don’t know about

BY TERESA WELSH

twelsh@mcclatchy.com

It’s that time of year where seasonal allergies strike with runny noses, itchy eyes and scratchy throats. But those who suffer from pollen allergies can also have other hidden allergies to fruits and vegetables they may never have known about.

Seasonal allergy sufferers, like those with asthma and hay fever, can also have oral allergy syndrome, known as OAS. People with the condition experience tingling or itching when they eat certain raw foods, indicating an allergic reaction to some fruits and vegetables. Symptoms include itching or swelling in the mouth and throat and on the tongue and lips.

“Oral allergy syndrome is due to a cross-reactivity between plant proteins from pollen and fruits or vegetables,” the Children’s Hospital of Philadelphia reports. “When a child or adult with pollen allergy eats a raw fruit or vegetable, the immune system sees the similarity and causes an allergic reaction.”

Foods in the same botanical family can cause reactions. The following pollen allergies can trigger certain cross-reactions:

Ragweed: Bananas, melons (watermelon, cantaloupe, honeydew) zucchini, cucumber, dandelions, chamomile tea

Birch: Apples, pears, peaches, apricots, cherries, plums, nectarines, prunes, kiwi, carrots, celery, potatoes, peppers, fennel, parsley, coriander, parsnips, hazelnuts, almonds, walnuts

Grass: Peaches, celery, melons, tomatoes, oranges

Mugwort: Celery, apple, kiwi, peanut, fennel, carrots, parsley, coriander, sunflower, peppers

Alder: Celery, pears, apples, almonds, cherries, hazelnuts, peaches, parsley

Latex: Bananas, avocado, kiwi, chestnut, papaya

Both children and adults are susceptible to the condition, although the Children’s Hospital of Philadelphia says adults can be more affected.

Symptoms can be eliminated by cooking or baking foods that cause a reaction, or eating canned fruits or vegetables. Oral antihistamines like those taken to relieve seasonal allergy symptoms can also ease reactions.

Symptoms don’t usually spread beyond the mouth, according to the American College of Allergy, Asthma and Immunology, but the condition could become systemic. In one study, 9 perecent of those with OAS experienced more drastic allergy symptoms, and 1.7 percent ha anaphylactic shock.

MSN.com: This tick will make you a vegetarian

The Daily Meal

Michael Serrur

5/19/2017

Have you always desired to become a vegetarian, but haven’t been able to resist a perfectly seared cut of steak or a crispy strip of bacon? Maybe you should take a walk through the wilderness, because a bite from the inconspicuous lone star tick is able to accomplish what hundreds of graphic PETA commercials have failed to do — it can turn you into a vegetarian.

For the most part.

Although you may still be able to eat poultry and fish, a bite from the lone star trick can trigger a delayed allergic response to the alpha-gal sugar, a molecule found in the flesh of all mammals besides monkeys, apes, and humans. The alpha-gal sugar naturally exists in red meat and pork products, but it doesn’t produce an adverse reaction in humans unless it is injected directly into the blood stream, as it can be during a bite from the lone star tick. After the initial bite from the tick, the next time the alpha-gal sugar is consumed, whether it be from a hamburger or a lamb chop, the body will have an allergic reaction and break out in hives, body itching, stomach pains, and in severe cases, anaphylaxis.

Hives, itchy rashes, and potentially life-threatening swelling of the throat are strong deterrents that will have diners reconsidering whether they really need red meat in their lives. The American College of Allergy, Asthma, and Immunology says not to worry though; this form of meat allergy is uncommon. However, if you’re still concerned, be especially alert when walking through the eastern United States.

EverydayHealth: Dust mites may be causing your winter allergies

Dust Mites May Be Causing Your Winter Allergies

By Michael Steven Blaiss, MD, Special to Everyday Health

Why am I sneezing so much this winter – and why does my nose run all the time? Why do I wake up every morning with nasal congestion? Is it a cold that’s lasting for weeks? If you’ve been asking yourself these questions, it’s likely you have winter allergies.

We usually think of allergies in the spring when the trees and grasses produce pollen, or in the fall with ragweed pollen in the air. But allergies can occur year round. House dust mites are a common trigger of winter allergies. The good news is there are many ways to help reduce the effect of dust mites and feel better.

What Are Dust Mites?

Dust mites are 8-legged bugs related to the spider family, and they’re too small to be seen by the naked eye. They are sightless and live off discarded dead skin cells. In fact, the two major dust mite species found in the United States get their name, Dermatophagoides, from the Latin meaning “skin eating.” Luckily, they are not parasites, and they don’t bite or sting. It is the proteins in the bodies of the mites and their droppings that cause allergy in people.

Dust mites have specific environmental requirements for growth. Ideally, they need temperatures above 70 degrees F, and relative humidity above 70 percent. Adult mites have a life expectancy of between 4 and 6 weeks, during which time females can lay between 40 and 80 eggs. With this rapid reproductive turnover, mites can colonize a new home within a year.

Most homes in this country have dust mites no matter how much they are cleaned. The highest levels of mites in homes are found in pillows, mattresses, sofas, carpet and other soft furnishings. These objects can trap and accumulate skin dander and moisture, leading to optimal growth of the mites. Studies have shown that a typical mattress may have 100,000 to 10 million mites inside. Ten percent of the weight of a two-year-old pillow can be composed of dead mites and their droppings.

How do you know if you have a dust mite allergy? If you have sneezing, nasal congestion, watery eyes, and wheezing on a year-round basis, especially outside the pollen seasons, dust mites may be the culprit. It is estimated that 20 million Americans suffer from a dust mite allergy. Your allergist can do either an allergy skin test or a blood test to confirm if dust mites are causing your symptoms.

Fighting Dust Mite Allergies

What can you do? First, there are ways to reduce your exposure. Concentrating on the bedroom is most important, as people spend more time in their bedrooms over a 24-hour period than any other room in the house. If possible, all carpeting and drapes should be removed. Levels of mites in the bedroom can be reduced by using small area rugs, blinds or window shades, all of which can be easily cleaned.

Enclose the mattress and pillow in mite-proof casing. These covers are made of a material with openings too small to let dust mites and their droppings get through. All bedding should be washed weekly with hot water. Unfortunately, cold-water washing will not kill dust mites.

In some cases, the use of a dehumidifier in the bedroom can help, as dust mites can’t grow with humidity below 50 percent. If your child has a dust mite allergy, try to limit the number of stuffed animals in their bed. Freezing stuffed animals for 24 hours weekly will also kill dust mites. Vacuum at least weekly using a double-layer bag or HEPA filter on the vacuum to prevent dust mites from circulating back into the air. 

Medications can help control symptoms. There are several over-the-counter treatments such as non-sedating antihistamines and intranasal corticosteroidswhich may give some relief to your nose and eyes. If these treatments are not effective, or if every time you stop using them your symptoms return, you may want to see a board-certified allergist for further management.

There are excellent prescription treatments, and you may be a candidate for immunotherapy for allergies. Allergy shots are the only way to reduce sensitivity over time to dust mites, and can lead to lasting relief of symptoms after the treatment is stopped. Remember: You don’t have to be miserable all winter with dust mite allergies. Relief is available. 

Michael Steven Blaiss, MD, is clinical professor of pediatrics at the Medical College of Georgia in Augusta and executive medical director of the American College of Allergy, Asthma, and Immunology.

 

The Nest: Cat allergies in babies

CAT HEALTH

Cat Allergies in Babies

By Melissa McNamara 

Infants can develop cat allergies.

The American Academy of Pediatrics recommends not adding a cat to your family until you're sure your baby doesn't have allergies. However, what if you already have a loving cat? Before placing a “free to good home” ad for Whiskers in your local newspaper, make your baby an appointment with an allergist.

Identification

The symptoms your baby experiences depends on the severity of the cat allergy. The most common symptoms are sneezing and a runny nose, according to MayoClinic.com. Nasal congestion, postnasal drip, coughing, dark circles under the eyes, wheezing and difficulties sleeping are additional symptoms. Nasal congestion can block both nasal passages, causing your baby to breathe from the mouth. Contact dermatitis from a cat allergy includes redness, hives and itchy skin.

Cause

Allergies appear first during infancy or childhood and are more common in families with a history of allergies, according to the American College of Allergy, Asthma & Immunology. Your baby's immune system is equipped to attack foreign substances, but if he has allergies, certain triggers cause the immune system to overreact. Cat allergies are caused by proteins that usually are harmless in the cat's dander, saliva or urine. As your baby inhales the cat dander, the immune system attacks and causes an inflammatory response of the lungs and nasal passages, according to MayoClinic.com. Even if you remove the cat from your home, dander and fluid can stick to walls, clothing and other surfaces in your home for several months, according to the Asthma and Allergy Foundation of America.

Diagnosis

A skin test and blood test can confirm or deny a cat allergy. In some cases, pollen or mold gets trapped in your cat's fur and is released into the air during petting or brushing sessions, according to the American Academy of Pediatrics. The allergist may suggest removing the baby from your home for a few days to see if allergy symptoms subside. This may seem obvious, but be sure to stay somewhere that doesn't have a cat. Temporarily removing the cat from the home is ineffective, since the dander remains.

Treatment

The United States Food and Drug Administration advises parents never to give children under the age of two any cough and cold products containing decongestants or antihistamines without consulting with a pediatrician. Infants can use a cool mist humidifier to reduce congestion by reducing swelling of the nasal passages. Saline nasal drops and suctioning your baby's nostrils with a bulb syringe also provide comfort to a congested baby. Discuss with your baby's pediatrician the use of allergy shots, which are small injections of the cat allergen that help your baby develop a tolerance to the proteins in cat dander. Do not allow the cat in rooms where you're baby sleeps, and clean the bedroom thoroughly and often. Its best to remove carpeting in the home, but if this is not an option, vacuum with a high efficiency particulate air filter and steam clean the carpet often. The Asthma and Allergy Foundation of America suggests covering bedroom vents with cheesecloth. If your baby's allergies are severe, a new home for your cat is the best option.

References

About the Author

Melissa McNamara is a certified personal trainer who holds a Bachelor of Arts in journalism and communication studies from the University of Iowa. She writes for various health and fitness publications while working toward a Bachelor of Science in nursing. 

 

Health.com: Six surprising new places nuts are hiding

Chili, cocktails, and other surprising foods to watch out for if you are allergic to peanuts or tree nuts

By Lisa Lombardi

LAST UPDATED: JAN 20, 2017

My younger son has food allergies and I'm absolutely obsessive about helping him steer clear of peanuts and tree nuts. Yet somehow, last month, I brought him home a pistachio sandwich.

Let me explain: I ran to the deli to buy chicken salad, but it was next to a salad with nuts. Trying to avoid that cross-contamination risk, I pivoted and grabbed Gus, who is 10, a slice of an Italian Combo hero, stupidly without asking what was in it. One bite in he said, "My mouth feels itchy and numb." I ripped apart his sandwich and found a meat dotted with green flecks...oh nopistachio? A quick call to the deli revealed he had eaten mortadella—an Italian pork studded with one of his worst allergens.

Thankfully, after an injection of epinephrine and a few hours in the ER, Gus was fine. But my husband and I were traumatized. Where else were there nuts lurking? Raising a child with a food allergy sometimes feels like being a hockey goalie, to use an analogy from Gus's favorite sport: You're always guarding against not only the obvious threats (that Thai takeout) but also the surprise wraparound ones you never see coming (nut meat, I'm talking to you).

And, in a way, having a food allergy is a paradoxical health problem: You are perfectly healthy. And yet the wrong food, in the wrong amount, without prompt administration of the right amount of epinephrine, can kill you. To make sure that we know all the wild cards out there, I consulted Sujan Patel, MD, an allergist/immunologist at New York University Langone Medical Center in New York, and David Stukus, MD, a Columbus-based spokesperson for the American College of Allergy, Asthma, and Immunology.

Chili

In 1986, a freshman at Brown University tragically died after she ate restaurant chili thickened with peanut butter. More recently, a 28-year-old dad in England reportedly died from anaphylaxsis after having a chili burger that likely contained peanuts. PB may not be a classic ingredient in this comfort food, says Dr. Patel, "but with chili cook offs and all kinds of ways to prepare things, you shouldn't assume it is safe."

Still, the even more common danger in Mexican joints is the mole sauce. While mole's most famous ingredient is chocolate (itself a potential disaster for the nut-allergic), peanuts or peanut butter may also be in the mix. "Sauces in general are dicey," warns Dr. Patel, adding that Indian and Thai cuisines are particularly tricky. "Indian cooking uses cashews and almonds made into a paste and then used as a thickener."

French fries

Most frites are a-ok, but when grabbing them out, do ask about the oil. Peanut oil is the go-to at some chains such as Five Guys, as well as smaller restaurants. "The interesting thing about peanut oil," says Dr. Patel, "is that when it's made in the U.S. it is so refined that almost nobody with a peanut allergy would react to it. But the problem is we don't know if it is one from China, which are much less refined. We don't tell people this because we don't want them to take a chance."

My family got stumped by cottonseed oil on a trip to Florida. ("Siri, is cottonseed a nut? Help!") Nope, cottonseed oil, I've since learned, is not a nut, though it's pretty terrible for your health.

Deli meat

My son's kryptonite—mortadella—is a fancy Italian bologna that was banned from import to America for years due to an Italian outbreak of African swine fever, according to The New York Times. More expensive than bologna and speckled with fat and pistachios, it isn't a big seller in the U.S (which almost explains how I could be half Italian-American, raised on antipasto spreads, and never heard of it). "A real fluke," is how Dr. Patel described my son's close call. And yet in 2016, BJ's Wholesale Club issued a recall of deli meats for undeclared pistachios; they had been sent Citterio's Mortadella by mistake and sold it—along with other meats sliced on the same equipment—without listing pistachio on the labels.

So how do you make sure your cold cuts don't come with an unwanted side of nut residue? "Ask the person at the counter about any potential source of cross contact," advises Dr. Stukus, who is also an associate professor of pediatric allergy and immunology at the Ohio State College of Medicine.  And if they're unsure, steer clear and opt for a prepackaged lunch meat with a nut-safe label.

Cocktails

Better ask what's in that signature cocktail before you knock it back. Major vodka makers now sell bottles infused with hazelnut, almond, and other tree nuts. Frangelico gets its flavor from hazelnuts and Nocello from walnuts. And here's a who knew: Many gins, including Bombay Sapphire, are flavored with almonds. Not even beer is completely safe. Brown ales may contain peanuts and/or macadamia, walnut, or other tree nuts.

Pet food

Is your toddler at the stage where she puts everything in her mouth? If she's allergic to peanuts or tree nuts, watch out for your dog food, warns Dr. Patel. Pet foods are not subject to The Food Allergen Labeling and Consumer Protection Act—a law mandating that food labels clearly list out in plain English if they contain any of the top eight most common allergens (peanuts, tree nuts, milk, eggs, wheat, soy, shellfish, fish). But a scan of that puppy chow label should alert you to peanuts, he adds. (When in doubt, call the manufacturer.) Bird food almost always contains nuts, or has a nut warning. Our family's solution is to buy food-grade sunflower seeds (labeled as nut-safe) for our outdoor feeders.

Gluten-free treats

A gluten-free cupcake or bread may seem harmless for all, but don't be fooled: It can pack lupin, "a legume frequently used as flour in gluten-free products that can cross react with a peanut," says Dr. Stukus. He notes that there have been many reports of people with peanut allergies having reactions from lupin. Also watch out for almond flour, sometimes used to hold things together in G-free sweets.

Another 2017 concern? Nut butters popping up in unexpected places. "I had a mom whose child had a reaction to kale chips," shares Dr. Patel. "Randomly, they were made with cashew butter."

To stay one step ahead, read labels every time (ingredients on familiar products can change). And, as I learned the hard way, always ask, even when it seems unlikely that a dish would contain nuts. When it comes to managing food allergies, you can never be too careful. My son knows this well: Hand him a banana and he'll ask you, "Are there nuts in it?"

 

 

 

Health IT Pulse: Telemedicine can minimize disruption in patients’ lives

Health IT Pulse

JAN 19 2017   11:09AM GMT

Kristen Lee

Telemedicine

Telemedicine has the potential to helpdiverse patient groups – from nursing homes to rural communities – get better healthcare; One place where telemedicine  can minimize the disruption to a patient’s life is in schools, according to a Huffington Post story.

The article gives an example of a girl who had trouble breathing at recess at a school in Maryland. The school was outfitted with telemedicine equipmentabout a year ago. The girl went to the nurse, who determined that the girl was having an asthma attack. The girl’s father was an hour away and there was no time to wait for him to come get his daughter. The nurse could have also called an ambulance but that would have meant the girl would miss the rest of the school day.

Luckily, the girl’s parents had has agreed to enroll their daughter in the school’s telemedicine program, allowing the nurse to set up an online video and audio link with an emergency room pediatrician at a nearby county general hospital.

The doctor confirmed the school nurse’s diagnosis, the nurse administered the necessary medicine, and the girl was breathing normally again within 10 minutes and was able to go on with her day.

According to a study in the Annals of Allergy, Asthma and Immunology, children with asthma who were given treatment via telemedicine were able to gain control over their asthma just as well as when children saw a doctor in person to address their asthma.