Eczema/Atopic Dermatitis (skin allergies)
Nasal Allergies (Allergic Rhinitis)
Eye Allergies (Allergic Conjunctivitis)
Anaphylaxis
What is anaphylaxis?
Anaphylaxis is a serious allergic reaction that happens to some people who have allergies to food, insect stings, drugs or latex.
Symptoms can occur very quickly and affect your entire body. Signs usually start within 5 to 30 minutes of coming into contact with the allergic trigger. Warning signs may include: red rash, with welts, that is usually itchy, itching and swelling in the throat or swollen areas of the body, wheezing, passing out, chest tightness, trouble breathing, hoarseness, difficulty swallowing, vomiting/diarrhea, stomach cramping, lightheadedness, loss of color to skin.
Anaphylaxis requires immediate medical treatment. If you think you are having this type of reaction, use your autoinjectable epinephrine and call 911 immediately. Then call for evaluation.
Asthma
What is Asthma?
Asthma is a chronic disease that affects 300 million people worldwide, and 20.3 million people in the United States. It accounts for approximately 14.5 million missed work days for adults and 14 million missed school days for children annually. Its primary cause is inflamed airways in the lungs. This inflammation makes the airways smaller, which makes it more difficult for air to move in and out of the lungs. For people who have asthma, the air flowing in and out of their lungs may be blocked by muscle swelling and squeezing. Symptoms of asthma include cough, chest tightness, shortness of breath and wheezing. Asthma is the most common serious disease among children. Nine million children in the United States are affected by asthma.
Many people have "allergic asthma," which means that allergens - like dust mites, mold, animal dander, pollen and cockroaches - make their symptoms worse. Approximately 70% of asthmatics have allergies.
Could You Have Asthma?
The ongoing cough you can’t get rid of could be a signal that you have asthma. Signs that you might have asthma include: coughing, wheezing, shortness of breath, or chest tightness
Ask yourself these questions:
For you:
- Is there a family history of asthma or allergies?
- Are you constantly short of breath and wheezing?
- When do you notice your symptoms – when you have a cold, when you are exercising or around allergens, such as pollen, mold and animal dander?
- Are you missing work because of symptoms?
- Is coughing and wheezing keeping you up at night?
For your child:
- Does your child cough, wheeze (a rattling sound when they breathe), have chest tightness or shortness of breath?
- Does your child cough or wheeze with play, exercise, laughter or during temper tantrums?
- Is your child missing school because of symptoms?
- Is coughing and wheezing keeping your child up at night?
- Is there a family history of asthma or allergies?
Asthma Statistics:
About 70% of asthmatics also have allergies.
The prevalence of asthma increased 75% from 1980-1994.
Approximately 40% of children who have asthmatic parents will develop asthma.
A study done in 2007 showed that 29% of children who had food allergy also had asthma.
Common triggers of adult asthma include:
Pregnancy: Uncontrolled asthma can harm the health of a mother and her baby.
Work situations: Fumes, gases or dust that are inhaled at work can trigger asthma.
Age: Older people with asthma face unique health challenges.
Exercise: Some people may have asthma symptoms when they exercise.
Medications: Medications like aspirin and ibuprofen, or beta-blockers (used to treat heart disease, high blood pressure, migraine headaches or glaucoma), may cause an asthma attack in some adults.
Uncontrolled EIA limits physical activity
People with exercise-induced asthma (EIA)/exercise-induced bronchospasm (EIB) may not be able to participate in physical activities if it is not properly controlled.
About 20 million Americans suffer from asthma. In addition, many non-asthmatic patients, up to 13% of the population, experience asthma symptoms with exercise.
If someone is experiencing symptoms of EIA, it is important for them to be properly diagnosed by an allergist/immunologist to make sure it is not something more serious. Dr. Gomez Dinger will be able to treat the patient’s EIA with proper medications and will also address other issues to ensure the person can participate in sports and exercise to their fullest capacity.
EIA is caused by airways that are overly sensitive to sudden changes in temperature and humidity, especially when breathing colder, drier air. During physical activity, people tend to breathe through their mouths, allowing the cold, dry air to reach the lower airways without passing through the warming, humidifying effect of the nose.
Symptoms of EIA include wheezing, chest tightness, coughing, chest pain, shortness of breath and fatigue. These symptoms can be controlled with proper medication and guidance.
Inhaled medications taken prior to exercise are helpful in controlling and preventing exercise-induced bronchospasm. The medication of choice in preventing EIA symptoms is a short-acting beta 2 agonist bronchodilator spray used 15 minutes before exercise. These medications are effective in 80 to 90 percent of patients, have a rapid onset of action, and last for up to four to six hours. These drugs can also be used to relieve symptoms associated with EIA after they occur.
In addition to medications, a warm-up period of activity before exercise may lessen the chest tightness that occurs after exertion. A warm-down period, including stretching and jogging after strenuous activity, may prevent air in the lungs from changing rapidly from cold to warm, and may prevent EIA symptoms that occur after exercise.
Every person has their own asthma triggers. If you have asthma, you can minimize your symptoms by avoiding the factors that trigger your symptoms. If you are experiencing symptoms and they are keeping you from work, school or normal activities, you should schedule an appointment with Dr Gomez Dinger.
Chronic Cough
Do you have a lingering cough that won't go away? Cough is a common symptom of allergies such as allergic rhinitis (hayfever). Allergic triggers are often common, usually harmless substances such as pollen, mold spores, animal dander, dust, foods, and medications.
Cough is a way that the body protects itself from these allergens. It helps by removing mucus, fluids, and infections from the airways.
Coughing does not always mean there is a problem, however coughing at night after going to sleep is almost always abnormal and needs medical attention.
Causes of cough:
- In children, cough is divided into acute cough (usually lasting one to two weeks) and chronic cough (lasting greater than four weeks).
- Acute cough - Most children with brief periods of coughing are coughing because of viral upper respiratory tract infections. Many different viruses cause these infections in children. Healthy preschool children in day care can have up to six to eight viral respiratory infections with cough every year. This acute cough is usually due to postnasal drip and direct airway irritation by the virus. Postnasal drip is a condition in which mucus drips slowly from the nose and sinuses to the back of the throat. Medications may or may not be necessary or helpful. It is best to check with your doctor.
- Nasal and sinus disease causing cough - Postnasal drip due to rhinitis (inflammation in the nasal passages) or sinusitis (inflammation in the sinus cavities) is another common cause of cough that can become chronic. Usually, other symptoms such as nasal congestion and runny nose are present, but sometimes the only symptom noticed is the cough. Allergic rhinitis, either seasonal or year-round, is often the cause, and tests for allergies may be necessary. Sinus infections can persist for weeks to months causing cough, sometimes with minimal nasal symptoms. Occasionally, your doctor may advice you to do a sinus X-ray or limited CT scan of the sinuses.
- Stomach and esophageal causes of cough - In some children, the cause of chronic cough is due to problems with the stomach and esophagus (food tube). Most commonly, this is due to gastroesophageal reflux disease (GERD). This is often associated with a feeling of heartburn. But young children often don't complain of heartburn because they may not know it is abnormal or may not be able to describe the feeling. In some children, heartburn does not seem to occur even with GERD. Other children may develop a hoarse voice and/or choking as a symptom of GERD. This may need to be investigated by your doctor which includes a trial of medicines for GERD. In young infants, reflux and swallowing problems are a common cause of persistent cough, particularly when it occurs after eating.
Other causes of cough include:
- Post-viral cough - Children without asthma, allergies or sinusitis can have a cough after viral respiratory infections lasting for weeks. There is no specific therapy for this cough and it does eventually resolve. It is often due to increased sensitivity at the cough trigger points and is suspected when the cough does not respond well to asthma medications. Cough suppressant medications can be tried but they are not always helpful.
- Inhaled foreign body - Although small foreign bodies, such as a piece of a plastic toy or part of a peanut, hot dog or a hard candy can be accidentally inhaled at any age, it most commonly occurs in boys, ages two to four years. The foreign body may or may not appear on an x-ray. It can cause a cough to persist for many weeks to months until it is discovered.
- "Habit" cough - This is a persistent cough that has no physical cause. It occurs most commonly in children, adolescents and young adults. It occasionally persists after a simple viral respiratory infection. The cough typically is dry and repetitive or is a "honking" cough that usually worries parents and teachers much more than the child. Habit cough is absent at night after the child goes to sleep.
- Irritant cough - Exposure to environmental tobacco smoke and other pollutants (smoke and exhaust from wood burning, air pollution and exhaust from vehicles) is associated with increased cough in healthy children and may worsen the cough associated with asthma or rhinitis. These substances should be avoided, particularly in children with asthma or rhinitis.
Treatment
Often, simple daytime cough after viral respiratory infections requires no specific treatment, particularly if it resolves in one or two weeks.
The primary treatment for chronic cough should be aimed at the underlying cause-asthma, GERD, rhinitis or sinusitis. Treating cough symptoms with mucus thinning agents such as guaiafenesin has limited benefit in most patients. Cough suppressing medications such as over-the-counter medications that contain dextromethorphan are also of limited value, but can be tried. Stronger cough suppressing agents such as codeine-containing medications are more effective, but have more side effects and should only be used for short periods of time.
If you have been experiencing a cough, make an appointment with Dr Gomez Dinger for an evaluation today.
Contact Dermatitis
Contact dermatitis is a condition resulting from the direct contact of an allergen or irritant with the surface of the skin. A reaction will typically appear 48-96 hours after contact. This type of reaction can develop at any time in life.
The skin becomes red, itchy and inflamed, and will frequently blister. Poison ivy is the most common cause, but other plants, metals (such as nickel), cosmetics and medications can also cause a reaction.
Allergic contact dermatitis can be treated by scrubbing the skin with soap and water after exposure to the allergen and using prescribed antihistamine and cortisone medications, depending on severity. Avoidance of the irritant is the key to prevention.
Drug Allergies
All medications have the potential to cause side effects, but only about 5% to 10% of adverse reactions to drugs are allergic.
Allergy symptoms are the result of a chain reaction that starts in the immune system. Your immune system controls how your body defends itself. For instance, if you have an allergy to a particular medication, your immune system identifies that drug as an invader or allergen. Your immune system reacts by producing antibodies called Immunoglobulin E (IgE) to the drug. These antibodies travel to cells that release chemicals, triggering an allergic reaction. This reaction causes symptoms in the nose, lungs, throat, sinuses, ears, lining of the stomach or on the skin.
Most allergic reactions occur within hours to two weeks after taking the medication and most people react to medications to which they have been exposed in the past. This process is called "sensitization." However, rashes may develop up to six weeks after starting certain types of medications.
One of the most severe allergic reactions is anaphylaxis (pronounced an-a-fi-LAK-sis). Symptoms of anaphylaxis include hives, facial or throat swelling, wheezing, light-headedness, vomiting and shock.
Most anaphylactic reactions occur within one hour of taking a medication or receiving an injection of the medication, but sometimes the reaction may start several hours later. Anaphylaxis can result in death, so it is important to seek immediate medical attention if you experience these symptoms.
Antibiotics are the most common culprit of anaphylaxis, but more recently, chemotherapy drugs and monoclonal antibodies have also been shown to induce anaphylaxis.
Rarely, blisters develop as a result of a drug rash. Blisters may be a sign of a serious complication called Steven-Johnson Syndrome where the surfaces of your eye, lips, mouth and genital region may be eroded.
Toxic epidermal necrolysis (TEN), where the upper surface of your skin detaches like in a patient who has suffered burns, is another type of severe cutaneous adverse reaction. You should seek medical help immediately if you experience any of these. Certain medications for epilepsy (seizures) and gout are often associated with these severe skin reactions.
A number of factors influence your chances of having an adverse reaction to a medication. These include: body size, genetics, body chemistry or the presence of an underlying disease. Also, having an allergy to one drug predisposes one to have an allergy to another unrelated drug. Contrary to popular myth, a family history of a reaction to a specific drug does not increase your chance of reacting to the same drug.
Non-Allergic Reactions
Symptoms of non-allergic drug reactions vary depending on the type of medication. Certain antibiotics irritate the intestines, which can cause stomach cramps and diarrhea. If you take ACE (angiotension converting enzyme) inhibitors for high blood pressure, you may develop a cough or facial and tongue swelling.
Some people are sensitive to aspirin, ibuprofen, or other non-steroidal anti-inflammatory drugs (NSAIDs). If you have aspirin or NSAID sensitivity, certain medications may cause a stuffy nose, itchy or swollen eyes, cough, wheezing or hives. In rare instances, severe reactions can result in shock. This is more common in adults with asthma and in people with nasal polyps (benign growths).
Taking Precautions
It is important to tell your physician about any adverse reaction you experience while taking a medication. Be sure to keep a list of any drugs you are currently taking and make special note if you have had past reactions to specific medications.
If you have experienced an allergy to a medication, call to schedule an appointment with Dr. Gomez Dinger to discuss whether you should be avoiding any particular drugs or if you should be wearing a special bracelet that alerts people to your allergy.
Eczema/Atopic Dermatitis (Skin Allergies)
Are you experiencing a rash that is red, scaly and itchy? These three words best describes the rash that is known as eczema, also known as atopic dermatitis. But where does this mysterious rash come from? Identifying triggers and learning management techniques may be the key to curing the itch.
For the most part, eczema is found in younger children. Approximately 50% of all eczema patients are diagnosed with symptoms within the first year of life, while another 30% develop symptoms between the years of one and five, according to the American Academy of Allergy, Asthma and Immunology. However, this allergic disease is not limited to children, sometimes occurring later in life in individuals with family histories of atopy, meaning asthma or allergic rhinitis. Identifying the cause of the rash is essential in managing symptoms. Dr Gomez Dinger can help you recognize your triggers and assist in minimizing the outbreaks.
Eczema may at times ooze, or it may also appear to be very dry. On babies, the rash usually occurs on the cheeks or the torso. As they grow to be toddlers, the rash’s location changes to the arms and the legs. The rash often improves with age, but other symptoms, such as allergic rhinitis or asthma, can occur.
To prevent the outbreak of a rash, avoid known triggers. These triggers can vary among individuals. Common triggers can include:
• Overheating or sweating
• Irritants: wool, pets or soaps
• Emotional stress (usually in older individuals)
• Foods
Patients must refrain from scratching or rubbing the rash, to avoid further irritation. To relieve the itch, apply cold compresses and gently lubricate the skin with a fragrant-free cream or ointment. This is especially important when the season is extra dry. Patients should also be aware of all triggers and be sure to remove those irritants from their environment.
To determine the cause of the eczema, a small number of tests are performed for common irritants/allergens. This is tolerated quite well with babies and young children.
If you believe you have eczema and are unsure what your specific irritants are you should call and schedule an appointment. After taking a detailed history and examining you, Dr. Gomez Dinger will assess your triggers as well as help you learn how to minimize exposure to them.
Eosinophilic Esophagitis
EE is an allergic condition characterized by inflammation of the esophagus. People with this disease have a large number of white blood cells called eosinophils in their esophagus.
The majority of individuals with eosinophilic esophagitis have family histories of allergies and symptoms of one or more allergic disorders such as asthma, nasal allergies, atopic dermatitis or food allergy.
Acid reflux can cause eosinophils in the esophagus; therefore, it is useful to exclude acid reflux as the cause with a trial of acid suppressive medications.
Currently, the only way to diagnose eosinophilic esophagitis is with an endoscopy and biopsy of the esophagus. This is typically coordinated between Dr. Gomez Dinger and gastroenterologist.
Food allergy is a major, yet complex, cause of eosinophilic esophagitis in children, and a probable factor in adult eosinophilic esophagitis. Environmental allergies such as dust mites, animals, pollens and molds may also play a role.
Allergy skin tests are useful in determining which allergens are triggering your symptoms. Another method for testing for food allergies is a challenge. This is done by feeding the food to find if it causes a reaction. Food patch testing is in another type of allergy test that may be used in the evaluation of EE. This test is used to determine whether an individual has delayed reactions to a food. The patch test is done by placing a small amount of fresh food in an aluminum chamber. The food stays in contact with the skin for 48 hours, is removed and the allergist reads the results at 72 hours. Areas of the skin in contact with the food that have become inflamed indicate a delayed reaction to the food.
Exercise Induced Bronchospasm
Symptoms of EIA include wheezing, chest tightness, coughing, chest pain, shortness of breath and fatigue.
People with exercise-induced asthma (EIA) may not be able to participate in physical activities if it is not properly controlled.
About 20 million Americans suffer from asthma. In addition, many non-asthmatic patients, up to 13% of the population, experience asthma symptoms with exercise.
If you or someone you know is experiencing symptoms of EIA, it is important for them to be properly diagnosed to make sure it is not something more serious. Dr. Gomez Dinger will be able to treat the patient’s EIA with proper medications and will also address other issues to ensure the person can participate in sports and exercise to their fullest capacity.
EIA is caused by airways that are overly sensitive to sudden changes in temperature and humidity, especially when breathing colder, drier air. During physical activity, people tend to breathe through their mouths, allowing the cold, dry air to reach the lower airways without passing through the warming, humidifying effect of the nose.
Inhaled medications taken prior to exercise are helpful in controlling and preventing exercise-induced bronchospasm. The medication of choice in preventing EIA symptoms is a short-acting beta 2 agonist bronchodilator spray used 15 minutes before exercise. These medications are effective in 80 to 90 percent of patients, have a rapid onset of action, and last for up to four to six hours. These drugs can also be used to relieve symptoms associated with EIA after they occur.
In addition to medications, a warm-up period of activity before exercise may lessen the chest tightness that occurs after exertion. A warm-down period, including stretching and jogging after strenuous activity, may prevent air in the lungs from changing rapidly from cold to warm, and may prevent EIA symptoms that occur after exercise.
Eye Allergies (Allergic Conjunctivitis)
Eye allergies can cause inflammation of the conjunctiva - the mucous membrane covering the white of the eyes and the inner side of the eyelids. If something irritates this clear membrane, your eyes may water, itch, hurt, or become red or swollen. In these instances, the condition is called either allergic conjunctivitis or ocular allergy. It can occur alone, or it may be associated with nasal allergy symptoms. Unlike pink eye, this condition is not contagious.
If you have an allergy, your immune system identifies something as an invader or allergen. This reaction usually causes symptoms in the nose, lungs, throat, sinuses, intestinal tract or the eyes. The most common allergen is pollen, which is seasonal. Some people are susceptible to allergies at any time of year, usually triggered by dust mites, animal dander and feathers. Most people suffering from eye allergies have problems in both eyes. Symptoms may appear quickly, soon after the eyes have come into contact with the allergen. The most common symptom occurs when the eyes become irritated, the small blood vessels widen and the eyes become pink or red. Some people experience pain in one or both eyes. Other symptoms include swollen eyelids, a burning sensation, and sore or tender eyes.
There are many different treatment options, depending on the severity of the symptoms. As with any allergy, the first approach to managing eye allergies should be avoiding the allergens that trigger your symptoms. However, avoiding airborne allergens isn’t always possible. That is when medications may be helpful.
Over-the-counter eye drops and oral medications are commonly used for short-term relief of some eye allergy symptoms. However, they may not relieve all symptoms, and prolonged use of some eye drops may actually make your symptoms worse.
Prescription eye drops and oral medications can also treat eye allergies. Prescription eye drops provide both short- and long-term targeted relief and can be used with an oral antihistamine for nasal allergy symptoms.
If you are suffering from eye allergy symptoms, call Dr Gomez Dinger for an appointment to identify your allergic triggers today.
Peanuts, eggs, milk, wheat, tree nuts and soy account for 90 percent of allergic reactions in children.
Reactions to food allergies include hives, swelling, upset stomach or a severe, life-threatening reaction called anaphylaxis.
Approximately 3 million school-age children suffer from food allergies, yet each individual school district sets its own policies for dealing with food allergies.
Hives (Urticaria)
Urticaria or hives, are red, itchy, swollen areas of the skin that can range in size and appear anywhere on the body. The blotches can migrate on body, appearing in different areas throughout the course of the reaction.
The causes of acute urticaria (< 6weeks duration) is readily identifiable—often a viral infection, or allergic reaction to drugs, food or latex. These hives usually go away spontaneously or by avoiding the allergic trigger. However, in some cases, medical intervention is needed to increase comfort or prevent recurrence. Treatment with oral antihistamines is frequently successful, but in severe cases, steroids may be needed.
Chronic urticaria (>6 weeks duration) can occur almost daily for months or, in some cases, years. For these individuals, scratching, pressure or stress may aggravate the condition. The majority of these case are autoimmune in origin. Autoantibodies form that bind to a mast cell and trick the mast cell into believing it has encountered an allergen releasing it’s inflammatory contents in the skin causing hives or tissue swelling.
Hives can be flared by stress, hormone changes, medications (NSAIDS). The treatment goal is avoidance of possible triggers and selecting the best combination of medications to control the frequency of outbreaks. Annual thyroid testing is recommended. This diagnosis is benign and will wax and wane over time.
Insect Sting Allergy
For most people, an insect sting means a little pain and discomfort. But some people may have trouble breathing or itch and have hives all over their body after being stung. These people are allergic to insect stings. This means that their immune system overreacts to the insect's venom.
Most allergic insect sting reactions are caused by five kinds of insects: yellow jackets, honeybees, paper wasps, hornets, and fire ants For people who are very allergic to an insect's venom, a sting may cause a severe allergic reaction called anaphylaxis.
Signs of anaphylaxis include:
- Itching and hives over a large part of the body
- Swollen throat or tongue
- Trouble breathing
- Dizziness
- Stomach cramps
- Nausea or upset stomach
- Diarrhea
If you are stung by an insect and experience any of these symptoms, call 911 immediately. You should also seek follow-up care from an allergist/immunologist.
Latex Allergy
Natural rubber latex is a processed plant product used in the production of sterile gloves, balloons and condoms. It is derived almost exclusively from the sap of the tree Hevea brasiliensis found in Africa and Southeast Asia.
Latex allergy occurs when the body's immune system reacts to proteins found in natural rubber latex. Exposure to latex may result in contact dermatitis. However, in some individuals, latex allergy can trigger a life-threatening reaction called anaphylaxis.
Certain fruits and vegetables (such as bananas, chestnuts, kiwi, avocado and tomato) can cause allergic symptoms in some latex-sensitive individuals. Synthetic products, including latex house paints, have not been shown to pose any hazard to latex-sensitive individuals.
Nasal Allergies (Allergic Rhinitis)
Allergic Rhinitis is an inflammation of the mucous membranes of the nose, commonly known as a stuffy nose. Symptoms of allergic rhinitis include: sneezing, itching of the nose, itching roof of the mouth, itchy throat, itchy eyes and/or ears, runny nose, congestion, and/or watery eyes. Seasonal allergic rhinitis (or hay fever) is cause by allergens like molds and pollens. Some people have symptoms of rhinitis no matter what season of the year - perennial rhinitis. It can be caused by allergens such as animal dander, indoor mold, dust mites, and other inhaled allergens.
Sinusitis is a painful, long-lasting inflammation of the sinuses. Sinuses are hollow cavities around the cheek bones found around the eyes and behind the nose. Symptoms of sinusitis include: congestion, green or grey nasal discharge, postnasal drip, pressure in the face, headache, fever, and possibly a chronic cough. Sinusitis is more common in the winter. It may last for months or years if not properly treated. Colds are the most commong cause of acute sinusitis, but people with allergies are much more likely to develop sinusitis than people who don't have allergies.
Every person has their own triggers for rhinitis or sinusitis. If you are experiencing symptoms of allergic rhinitis or sinusitis, you should schedule an appointment with Dr Gomez Dinger to diagnose and treat your allergies.
Pet Allergy
Many Americans suffer allergic reactions when exposed to dogs, cats, rabbits, guinea pigs, and horses. It is a common misconception that people are allergic to a dog or cat's hair, and it is falsely believed that an animal that sheds less will not cause a reaction. However, allergies to pets are caused by protein found in the animal's dander (dead skin cells), saliva or urine. These proteins are carried on microscopic particles through the air. When inhaled, they trigger reactions in allergic people. As all dogs and cats posses these proteins, none of them are allergy-free. Though some breeds are considered more allergy friendly, it is likely because they are groomed more frequently – a process that removes much of the dander. While the most effective treatment for animal allergies is avoidance, this is not always possible. Below are some tips for minimizing allergy symptoms:
- See an allergist/immunologist to diagnose the allergy and discuss treatment, which may include maintenance medications or immunotherapy (allergy shots).
- Keep the pet out of the allergic person's bedroom. Animal dander will collect on pillows, leading to worsened symptoms at night and morning.
- Bathe the animal weekly to reduce the amount of dander shed at home, apply a product such as AllerPet after the bathe to keep dander down.
- Replace carpeting with hardwood or other solid-surface flooring for easy clean-up.
- Vacuuming may not be effective in decreasing allergen levels, but using a HEPA filter and double bags may help as well as using a HEPA air purifier in the patients bedroom and throughout the home.
- Wash bedding and clothing in hot water. While animal allergens are not easily removed by high temperatures, these measures may help.
If you are stung by an insect and experience any of these symptoms, call 911 immediately. You should also seek follow-up care from an allergist/immunologist.
Pollen
Pollen is the male fertilizing agent of flowering plants, trees, grasses and weeds. Pollen is a central cause of many allergic reactions. Weather conditions affect pollen levels. The most variant factors influencing different pollen counts from approximately the same region are wind, humidity, and the proximity of the sampling equipment to pollen producing vegetation. Because pollens are small, light and dry, they can be easily spread by wind, which keeps pollen airborne and carries it over long distances. When the air is humid, such as during or after it rains, pollen becomes damp and heavy with moisture, keeping it still and on the ground.
Mountain Cedar Pollen: Cedar trees, also known as juniper trees (officially called Juniperus ashei), are evergreens that are predominant in Texas, especially in the city of San Antonio. Peak pollen production is from December through February and release of pollen occurs between 5 a.m. and 10 a.m. Pollen counts are highest on warm, sunny days. The pollen is very buoyant and may be carried by the air for miles. Among all the junipers, the mountain cedar has received the greatest attention as an allergen source largely because of the high carbohydrate content of the major protein causing a high degree of toxicity. The term cedar fever describes the dreaded allergy symptoms brought on by the pollinating cedar tree each winter. In contrary to the name, you don't actually get a fever. Instead you get itchy, watery eyes; runny nose; and sneezing.
Recurrent Infections
Frequent infections may be a sign of immune deficiency.
Children who get frequent infections, such as ear infections, sinusitis or pneumonia, may have a more severe condition called immunodeficiency.
Patients who have immunodeficiency have infections that usually do not go away without using antibiotics and often recur within one or two weeks after antibiotic treatment is completed. These patients frequently need many courses of antibiotics each year to stay healthy. There are several forms of immunodeficiency and while some are very severe and life-threatening, many are milder but still important enough to cause recurrent or severe infections.
People with immunodeficiency get the same kinds of infections that other people get—ear infections, sinusitis and pneumonia. The difference is that their infections occur more frequently, and are often more severe, and have a greater risk of complications.
Allergist/immunologists often use the frequency of the use of antibiotics to mark the frequency of significant infections.
Here are some guidelines to determine if you or someone you know may be experiencing too many infections:
- The need for more than four courses of antibiotic treatment per year in children or more that two times per year in adults.
- The occurrence of more than four new ear infections in one year after four years of age.
- The development of pneumonia twice over any time. (Some experts say even one pneumonia warrants an immune work up)
- The occurrence of more than three episodes of bacterial sinusitis in one year or the occurrence of chronic sinusitis.
- The need for preventive antibiotics to decrease the number of infections.
- Any unusually severe infection or infections caused by bacteria that do not usually cause problems in most people at the patient's age.
If your child has any of these conditions schedule an appointment with Dr. Gomez Dinger for an evaluation.
Patients should see an allergist/immunologist if they:
- Have chronic or recurrent infectious rhinosinusitis.
Have any of the following warning signs:
- Eight or more new infections within one year.
- Two or more serious sinus infections within one year.
- Two or more months on antibiotic with little or no effect.
- Two or more pneumonias within 1 year.
- Failure of an infant to gain weight or grow normally.
- Recurrent deep skin or organ abscesses.
- Persistent thrush in mouth or elsewhere on skin after age 1 year.
- Need for intravenous antibiotics to clear infections.
- Two or more deep seated infections.
- A family history of immune deficiency.