The Allergist
A newsletter from the Oklahoma Allergy & Asthma Clinic Winter 2013-14
Winter Allergies or a Cold?
If you think allergies should go away in
the winter, think again. The temperature drops, the wind picks up and you
are sniffling and sneezing again. So it is
a cold or winter allergy instead?
Here’s how you can tell the difference?
Winter Allergies
• Nasal secretions are watery,
clear
• Itchy eyes and throat
• Symptoms persist for weeks
Colds
• Nasal secretions are discolored
• Chills and body aches
• Symptoms are usually gone in a
week
Top Winter Allergy Triggers
Pet dander – because your pets are
probably indoors more, your exposure
heightens in the winter months leading
to a surge in symptoms.
Mold and mildew – decaying leaves
and other yard waste brings on mold
and mildew. Shoes and clothes provide
the ideal conductor of bringing these allergens inside.
Pollen – Cedar is a very relevant allergen during this time of the year.
Tame Winter Allergies
Take these eight tips to
manage and or prevent
winter allergy symptoms:
Avoid Allergens. Stay
indoors when the wind
is blowing around
moldy leaves in the
yard. Keep dust bunnies at bay by dusting,
sweeping and mopping often. Wear a
mask if you have to do these tasks yourself.
Wash Away Allergens. Washing your
hands and face reduces allergens you
carry and spread. If your symptoms are
intense, take a shower to remove allergens from your hair and put on fresh
clothes that allergens may have clung
onto from outside. A hot bath or shower may relieve allergy symptoms such as
sinus congestion.
Temperate climates – milder climates
where there are few or no frosts or hard
freezes – means year-round presence of
allergens like pollen.
Damp wood – cut wood stored outside becomes a moist haven for mold
spores. Bringing wood inside can be a
classic allergy trigger. If you have a fireplace in your home, a roaring fire may
aggravate existing symptoms.
Brought to you by
Wash Bedding Often. Most bedrooms
are havens for pet dander and dust
mites. Wash your sheets, pillowcases
and blankets in hot water at least twice
each month, if not weekly.
Allergy Resistant Bedding. Look for
bedding that is specially designed to
be less permeable to allergens like dust
mites.
@okallergyasthma
(continued on page 2)
CDC Releases New
School Food Allergy
Guidelines
With apVoluntary Guidelines for Managing
proximate- Food Allergies In Schools and
ly four to Early Care and Education Programs
six percent
of all U.S.
children
now estimated to
have food
allergies,
the
U.S.
Centers for
Disease
Control
and Prevention has released a new set
of voluntary guidelines to help prevent
allergic reactions. The most common
food allergens are peanuts, tree nuts,
milk, egg, wheat, soy, fish and shellfish.
Even though it is a small percentage of
students actually affected by these allergies, the reaction can be very deadly.
The Voluntary Guidelines for Managing
Food Allergies are intended to support
implementation of food allergy management, implement prevention plans
and practices in schools, and early care
and education (ECE) programs. They
provide practical information, planning steps, and strategies for reducing
allergic reactions and responding to
life-threatening reactions for parents,
district administrators, school administrators, staff and ECE program administrators and staff. They can guide
improvements in existing food allergy
management plans and practices. They
can help schools and ECE programs develop a plan where none currently exists.
Priority areas in the Voluntary Guidelines for Managing Food Allergies are:
1. Ensure the daily management of
food allergies in individual children.
(continued on page 3)
New Test for Peanut Allergy
A new test is available that can help
find which patients are at risk for severe
peanut allergy. The current methods of
peanut allergy testing (both skin and
blood tests) detect allergic antibodies
to whole peanuts. The reality is that
peanuts contain 10 more allergenic proteins. A number of people are allergic to
some peanut proteins but not to other
peanut proteins. Certain peanut proteins causes more severe allergic reactions (such as component #2) while others (component #8) are associated with
mild reactions or no reactions at all.
The new peanut “component test” can
measure individual peanut proteins.
If the test shows a high total peanut
level and most of it is component #2,
the patient is more likely to have a serious peanut allergy. If the patient has a
high total peanut level, but most of it
is component #8, there is a much lower
chance of having a serious reaction to
peanut. There is a good chance the patient may not be allergic to peanuts at
all.
Some previously diagnosed peanut allergy patients may not actually be allergic. Many children have been diagnosed
with a peanut allergy based on a positive test, but have never eaten peanuts
or had a reaction. Peanut component
testing can help sort out the children
who are at higher risk for serious allergic reactions and those who may not be
allergic at all.
If a patient has peanut component testing and is at low risk for peanut allergy,
an oral food challenge (OFC) could be
the next step. An OFC is where the patient eats a tiny bit of peanut in a controlled environment. Then the patient
is monitored closely in the allergist’s office for a reaction. If no reaction, then
the patient gradually eats larger and
larger amounts of peanut. The largest
amount is usually a small handful of
peanuts or a couple of tablespoons of
peanut butter.
Experts consider OFC to be the gold
standard for diagnosing a food allergy.
If a patient doesn’t have a reaction, he
or she is deemed not allergic. If there is
a reaction, including a serious reaction
like anaphylaxis, the patient is given the
appropriate medicines, the challenge is
stopped and then the patient is found
to be truly allergic.
How does this happen? Component
#8 resembles the proteins in birch tree
pollen. If you have birch pollen allergies
in the spring, you may test positive for
peanut due to cross reactivity between
peanut and birch protein.
An oral food challenge involves giving a
patient incremental amounts of a food
in a controlled environment.
If you have birch pollen allergies, you
may test positive to a component of
peanut protein.
2
Only one company Phadia immunology Reference Laboratory offers peanut component testing. The test called
uKnow Peanut Test costs $300. Still
considered experimental by most insurance companies, most families will have
to pay the costs themselves. Hopefully,
peanut component testing will be covered by insurance in the near future.
Winter Allergies?
(continued from page 1)
Nasal Irrigation? A great home remedy
to relieve nasal congestion is to consider using nasal irrigation. You can also
purchase a kit or make your own using a squirt bottle. In a clean container,
mix 3 heaping teaspoons of iodide-free
salt with 1 rounded teaspoon of baking
soda and store in a small airtight container. Add 1 teaspoon of the mixture to
8 ounces (1 cup) of lukewarm distilled
or boiled water. Use less dry ingredients
to make a weaker solution if burning or
stinging is experienced. For children,
use a half-teaspoon with 4 ounces of
water.
Hydrate! When you are constantly
blowing your nose and the thermostat
is turned up for heat, it is easy to become dehydrated. Drink more water.
Eat more water-rich fruits and veggies
or enjoy hot tea. Hot drinks’ steam may
reduce nasal congestion.
Air Moisture. A balancing act when you
are indoors a lot is keeping the right humidity. Too little may irritate your nose
and throat, too much encourages mold
and mildew growth. Track your moisture with a hygrometer (available for as
little as $5) and adjust accordingly. Aim
for humidity no lower than 30 percent
and no higher than 50 percent.
Take
Your
Medicine!
A l l e r g y
medicines
can relieve
symptoms
like
itchy
eyes and nasal congestion.
However,
over
the counter or prescription drugs won’t
help if you don’t use them correctly.
Take the medicine BEFORE symptoms
appear. Follow directions carefully and
you should get the relief you desire.
More than 40 million Americans are
allergy prone year round. If you aren’t
getting the relief you want, it may be
time to talk to an allergist.
Meet the Staff...Jeanice Shopshire
Name: Mary Jeanice Shropshire. Job Title: Clinical Laboratory and Radiology Supervisor, and is responsible for
supervising the lab and x-ray personnel in their performance of laboratory
tests, CT scans and x-rays.
What’s A Typical Day Like? The laboratory staff collects and performs nasal smears for eosinophils – this test
is where you are asked to blow your
nose into wax paper. She also assists
the nurses and physicians in the consideration and ordering of necessary lab
procedures. In radiology, chest x-rays
and CT scans are performed. She also
serves as the OSHA Safety Officer, and
is responsible for seeing to the safety of
the employees and patients.
One of her main tasks is the daily performance of the Pollen and Mold Spore
Report. Pollen and mold is collected by
an instrument called the Burkard Spore
Trap located on the roof of the main
clinic.
She is a certified Pollen and Mold Spore
Counter through the American Academy of Allergy, Asthma, and Immunology (AAAAI) and the National Bureau of
Allergists (NAB).
Her educational/medical background:
She attended Moore Public Schools
from kindergarten until graduation
from Moore High School in 1974. After
high school, she attended East Central
University in Ada, Okla., and holds a
Bachelors of Science Degree in Medical
Technology. After college, she attended
Mercy Health Center School of Medical Technology in Oklahoma City for a
year. In 1978, she passed her certification boards and received the American
Society of Clinical Pathologists (ASCP)
Certification. She practiced at several
hospitals and physician offices before
coming to the Oklahoma Allergy and
Asthma Clinic.
Where is she from? Even though she
was born in Dallas, Texas, she has lived
her whole life in Moore. Until recently
she lived only 15 blocks south of the
home she grew up in. She met her husband, Kendell, while in college and they
just celebrated their 35th wedding anniversary. Their daughter, Jessica, is a
OAAC Staff Gets in the
Holiday Spirit of Giving
Oklahoma Allergy & Asthma Clinic
Editorial Advisory Board
Dean A. Atkinson, M.D.
Laura K. Chong, M.D.
James R. Claflin, M.D.
Warren V. Filley, M.D.
Garyl Geist, Chief Operating Officer
Richard T. Hatch, M.D.
Gregory M. Metz, M.D.
Patricia I. Overhulser, M.D.
Shahan A. Stutes, M.D.
Karen Gregory, DNP
Stefanie Rollins, APRN-CNP
“I started working at the Oklahoma Allergy and Asthma Clinic in 1983,” said
Jeanice. “In fact, I just received my pin
for 30 years of service to the clinic. I
have really enjoyed my time here at the
clinic. It is like having a large extended
family. This summer, my husband and
I lost our home to the May 20th tornado. Everyone was so supportive and
showed such concern for our situation. The hardest part about the disaster was
not the loss of items but the sense of
not having a place you could call home. Several weeks later when I returned to
work, I realized I did have a home and
that ‘home’ was with my Oklahoma Allergy and Asthma Clinic Family.”
New CDC Food
Allergy Guidelines
(continued from page 1)
2. Prepare
for
emergencies.
“The Allergist” is published quarterly by the
Oklahoma Allergy & Asthma Clinic. Contents
are not intended to provide personal medical
advice, which should be obtained directly from
a physician.
“The Allergist” welcomes your letters,
comments or suggestions for future issues.
Send to:
The Allergist
750 NE 13th Street
Oklahoma City, OK 73104-5051
Phone: 405-235-0040
www.oklahomaallergy.com
Jeanice Shopshire
Pre-K Special Needs educator with the
Edmond Public School System.
food
allergy
3. Provide professional development
on food allergies for staff members.
4. Educate children and family
members about food allergies.
In December, OAAC staff members donated more than 10,000 items for the
food pantry at Ronald McDonald House
Charities of Oklahoma City on the Oklahoma Health Center campus. RMHC
benefits children by providing a ‘home
away from home’ for families with seriously ill or injured children receiving
medical treatment in the Oklahoma
City area. By providing lodging, meals
and laundry facilities, the House helps
relieve some of the financial burdens
and stress for families during difficult
times. OAAC staff also gathered clothing for Positive Tomorrows, a school for
homeless children.
5. Create and maintain a healthy and
safe educational environment.
Implementation of the guidelines is voluntary. However, staff in schools and
ECE programs can take concrete actions
to protect children with food allergies
when they are not in the direct care of
their parents or family members. When
schools and ECE programs develop and
implement plans to effectively manage
the risk of food allergies, they help keep
children safe and remove one more
health barrier that keeps some children
from reaching their full potential.
To read the entire guidelines, www.cdc.
gov/healthyyouth/foodallergies/pdf/
Food_Allergy_Guidelines_FAQs.pdf
3
Infants Exposure to Smoking
Puts Allergies at Higher Risk
A recent study in the Annals of
Allergy, Asthma & Immunology, the scientific journal of the
American College of Allergy,
Asthma & Immunology, revealed
more evidence about smokers
who have infants in their home.
Infants with a family history of
allergic disease with lower respiratory tract infections who are
exposed to secondhand smoke
are 23 percent more at risk for
longer hospital stays.
An estimated 20 to 30 percent
of otherwise healthy infants annually develop lower respiratory
infections and three percent end
up being hospitalized.
According to the Centers for Disease
Control and Prevention (CDC), secondhand smoke contains more than 7,000
chemicals, hundreds which are toxic
and 70 that cause cancer. Secondhand
smoke can trigger life-threatening asthma attacks in small children.
Infants hospitalized with bronchiolitis
have a 30 percent chance of developing persistent wheezing or asthma
within the first ten years. Bronchiolitis
is inflammation of the bronchioles, the
smallest air passages of the lungs. It
usually occurs in children less than two
years of age with the majority being
aged between three and six months.
Parents and family members should
never smoke around children particularly inside the house and the car where
smoke can linger. However, tobacco can
even be on clothing and other surfaces
so quitting would be the best option,
according to OAAC Board Certified Al-
Asthma is one of the leading causes of
missed school.
lergist Dr. Laura Chong. Asthma is one
of the leading causes of missed school
for seven million American children and
annually causes 456,000 hospitalizations. Asthmatics under the care of a
board-certified allergist have a 60 to 89
percent reduction in hospitalizations.
Need help?
Oklahoma Tobacco Helpline
1-800-QUIT-NOW
The Oklahoma Tobacco Helpline is a
FREE service for all Oklahomans with a
desire to stop smoking or using other tobacco products. Through the Helpline,
callers receive one-on-one quit coaching, specialized materials, and referrals
to community resources. Callers interested in receiving follow-up can enroll
in the Helpline’s multiple call program
in which they will receive a series of
telephone based coaching sessions
with the same Quit Coach throughout
their quitting process. Participants in
the multiple call program may also receive free nicotine patches, or gum, or
they may be referred to their health insurance plan or health care professional
for additional treatment.
Winter &
Cedar Fever
If you are sneezing, have a runny nose
and a throbbing headache in the winter, you may be suffering from Cedar
fever, resulting from the high pollen
counts from the Cedar tree. Where Cedar growth runs rampant, Cedar fever is
the result and affects those who live in
Oklahoma, Texas and parts of the Midwest. The winter months are the worst
for Cedar fever and many think it is a
cold that just won’t go away.
Symptoms are: runny nose, nose drainage is clear, stuffy nose, itchy eyes,
sneezing, and sinus pressure and often
lasts for up to six weeks or longer. The
key difference between a cold and cedar fever is that the mucus from allergens is clear. If you have an infection,
your mucus may be thick, greenish or
discolored.
However, the name Cedar fever is a
misleading because it has nothing to do
with having a fever. A fever may come
from a cold or sinus infection but not
from allergies.
Cedar Fever can be treated the same
way as any other seasonal pollen allergy. If symptoms are left untreated, your
sinuses may become inflamed and can
turn into a sinus infection.
For more information, consult your
OAAC allergist.
Cedar fever plaques many people during the winter months