FAQ

Q. When I eat fresh strawberries my mouth and throat itch, but when they are baked in a pie I can have them without problem.  Why is this?
A. Heat with baking tends to destroy proteins in the strawberries that you may be sensitive to.  The proteins in fresh fruit can often cross react with pollens found in the air.  So, many patients with this sort of history also have pollen allergy.

Q.  What is a food allergy?
A.  A true food allergy occurs typically within minutes to several hours of ingesting a food. This reaction should occur every time the food is ingested, not just sometimes.  Only about 6 to 7% of children less than age 5 have true food allergy and only about 2% of adults have food allergy. Lactose intolerance and intolerance to other foods is much more common than true food allergy.  True food allergy can be a life threatening emergency and these patients should be evaluated by an allergist and avoid the food at all costs. They should also be able to use an epipen  (adrenaline) if they accidentally get exposed.

Q. When my allergies are bad my ears pop when I swallow, and I feel like I am in a tunnel. I’ve tried decongestants but they don’t seem to help. What do you suggest?
A. The Eustachian tube joins the middle ear and the back of the nasal cavity, and allows air in and out of the middle ear so that the pressure is the same on both sides of the eardrum. In allergic rhinitis (hay fever), the nasal end of this tube may become swollen and obstructed with secretions, preventing the passage of air. The muscle action of swallowing temporarily opens the tube and allows air into the middle ear. The popping you hear is your eardrum adjusting its position. The hearing loss, especially if temporary, is probably due to the unequal pressure which interferes with the eardrum’s ability to vibrate. While decongestants were recommended in the past, nasal corticosteroids have now been found to be more effective for this condition.

Q. The fall is the worst time for my allergies. What can I do?
A. In Oklahoma, the major type of pollen in the air in late September and early October is ragweed and marsh elder. Taking prescription antihistamines and nose sprays regularly starting a few weeks before the pollen season begins and continuing several weeks past the first freeze is often effective. Moderate to severe cases can be helped by starting allergy injections, preferably at least six months before the pollen season.

Q. I have frequent bouts of bronchitis. A friend asked if I had asthma. Could I?
A. Possibly. People who have recurrent bronchitis or pneumonia often have undiagnosed  asthma. If this is the case, you should seek diagnosis and treatment by an allergist as soon as possible.

Q. What is postnasal drip? Is it allergic? What can I do to stop it?
A. Postnasal drip is mucus draining down the back of the throat from the nasal mucous membranes or sinuses. It can be caused by allergy, viral or bacterial infections, and gastroesophageal reflux. Control of postnasal drip depends on the cause. For allergy, antihistamines, decongestants, drying agents, and saline nasal sprays are helpful. For viral infections, nasal saline and acœtime” can be helpful.  Lastly, for bacterial infections, antibiotics should cure the drip.

Q. I have asthma.  Should I get a flu shot?
A. Yes, you should. You are in one of the “high risk” groups. Individuals with any chronic respiratory disease, including those with asthma, have a higher than normal risk of coming down with the flu, and are more likely to experience serious complications. Other individuals, at particularly high risk include persons over 65 years of age, residents of chronic care facilities, persons with chronic heart disease or a chronic metabolic disorder such as diabetes, and children receiving long-term aspirin therapy. Persons who might transmit the flu to high-risk individuals should also be vaccinated. It takes approximately two weeks to one month for immunity, which is usually effective for about six months. For those individuals who come down with the flu, or who know they have been exposed and have not been vaccinated, ostelmavir (an antiviral medication) may be helpful. It prevents the flu in many individuals if taken after exposure, and generally reduces the severity and duration of flu symptoms once one is infected.

Q. How early do children with allergic symptoms need to be referred to an allergist?  Is the testing painful?
A. Children as young as 1 year of age can develop allergies to perennial allergens such as molds, pet danders, and Dustmites.  If allergy testing is indicated, then prick skin tests are applied on the back with minimal discomfort. (Far less than a small kitty scratch) This is a screening test.

Q. I have had a cough for years. Antibiotics and cough medications don’t seem to help. What is causing my cough?
A. There are multiple potential causes of a chronic cough.  These include post nasal drainage, asthma, gastroesophageal reflux, and habit.  The most concerning and potentially serious one is Asthma. Asthma can be diagnosed using a focused clinical history, physical exam, pulmonary function tests, methacholine challenge, and, if needed, a therapeutic trial of bronchodilators like albuterol.

Q. Is RAST or Immunocap testing more or less accurate than skin testing for diagnosing allergy?
Most allergists do not use the RAST or Immunocap as a primary diagnostic test for allergy because it is less sensitive than conventional skin tests, and is more expensive.

Q. Do children “outgrow” their allergies?
A. No, if children have positive skin tests then they will suffer life long with their allergies unless they are treated appropriately.  Allergies tend to be less troublesome once patients reach their 50?s or 60?s.  It is true that some allergies may be less severe at certain times in life. However, many children are denied important medical care when they are young in the hope that their allergies will improve or go away spontaneously. Choosing not to treat your child’s allergies may make them more susceptible to asthma, recurrent sinus infections and middle ear infections, and eczema.

Q. I suffer from severe hay fever. Will my children also have this?
A. 50% of children that have one parent with hay fever will also suffer.  75% of children with two parents with hay fever will also suffer.  The tendency to be allergic is inherited, but what you are allergic to is not.