Monday, August 26, 2013

Food additives and Allergies

More and more foods we eat have additives.  These are chemicals that the food industry adds to food to color, flavor, preserve, and keep them emulsified. 

Just like anything else, you can be allergic to these additives.  In the allergy world we refer to them as hidden food ingredients.

What are some symptoms you might be reacting to food additives?
  • Hives,
  • Nasuea,
  • Diarrhea
  • Abdominal pain/cramping
  • Rashes
What are common food additives that cause allergic reaction?
  • Food dyes
  • Cinnaminic aldehyde (a common flavor enhancer)
  • Propolyene glycol
  • Benzoic acid
  • alpha tocopherol
What should you do if you suspect a hidden food ingredient is causing your symptoms?
  • Speak with an allergist about being tested to see if this is triggering your symptoms.
  • Be prepared to provide a detailed diet history along with when your syptoms are happening.

Want to talk to me about your symptoms?  Please call the office at 212-679-3574 or email me at jcollins@grammercy.com.  As always you are welcome to visit our website to learn more.

Wednesday, August 21, 2013

Back to School with Food Allergies

I love the end of summer- the mixed weather of warm and cool.  It reminds me that soon the beauty of fall will arrive.  The end of summer also brings the excitement of going back to school- seeing old friends, meeting your new teacher, and the anticipation of a new year.

For parents and children with food allergies, going back to school may bring on feelings worry about an accidental food allergy exposure.  Did you know about 3 million children suffer from food allergies!  The most common ones are peanut, eggs, milk, wheat, tree nuts and soy. 

Here are some simple tips that hopefully help alleviate any anxiety or fear you might have about an accidental food exposure.

  • Meet with your child's teacher, principle, and/or school nurse prior to starting school to make them aware of the allergy
  • Fill out any school forms that the school requires to have epinephrine & any other medications on site.
  • If your child has a severe allergy, you might consider a bracelet  Allermates has some fun ones for children.   Putting allergy stickers on their cups/lunch bags/clothes is a great option for young children You can customize them at Allergy Stickers.
  • Make sure that they know how to administer the medication.  Did you know that NYS training on delivery of epinephrine is not mandatory for school nurses/teachers.
  • Talk about common signs of an allergic reaction:  hives, swelling, cough, shortness of breath, vomiting, and even anaphylaxis.
  • Good news! A generic epinephrine auto-injector recently came to market.  This will help reduce your costs.  The training for the device is a little different from Epi-Pen so make sure that everyone at school/home knows how to use the device that's available in your school.
  • Teach your child how to ask about the ingredients in snacks and to talk about their food allergies with their friends.
  • Pack allergy free snacks.  You might include enough to share with other kids.
  • Think about areas outside of the cafeteria where there might be an exposure- field trips, art class and school parties.
Hopefully, these simple tips will help you prevent any accidental exposures this upcoming school year!

Need more specific advice or training on how to use an epinephrine pen?  Please email jcollins@gramercyallergy.com or call the office for an appointment 212-679-3574.  We are located at 205 East 22nd Street @ 3rd Ave, NY NY 10010.

Monday, August 19, 2013

Allergy and Nutrition- Expanding our Practice

Over the past year I've written several posts on the role of nutrition and allergy.  It's an important topic to me and I often spend time with my patients learning about what they are eating to see if it might be affecting their health.

I'm so excited to announce that starting in September, we'll have a nutritionist in the office!  Her name is Stefanie Casillas, RD and she'll be starting with us every Thursday.  When I asked Stefanie about what she hoped to add to the practice she said, "My passion lies in helping clients learn to nourish their bodies and optimize their health. Whether your goal is to lose weight, manage blood sugar, live healthfully with food intolerance, or improve your overall nutrition, I would love to help your patients on their journey!"  I knew then she'd be the perfect addition.

A bit about Stefanie- her original background is in education in NYC where she worked as a teacher.  She decided to change career paths and became a dietitian at Beth Israel Medical Center.  Afterwards, she joined the staff at Beth Israel Medical Center as an inpatient nutritionist.  She's had extensive experience in teaching cooking classes and even working on a roof-top farm!

Whether you have questions for her like, how do I deal with food intolerance, food allergy or lose weight?  I know you'll love working with her and know a consultation with her will change your life in a positive way.

Want to schedule an appointment with Stefanie?  Call the office at 212-679-3574, www.gramercyallergy.com, or email me at jcollins@gramercyallergy.com

Thursday, August 15, 2013

Hypoallergenic Dog- Truth or Fiction?

I love dogs and so do many New Yorkers.  About 72.2 million households have dogs in the USA.  And in NYC,  there are about 600,00 dogs according to a survey by the American Veterinary Association & American Community Association. The medical benefit of animals in the home is strong. Dogs provide companionship, stress reduction and bring a lot of love into the home. 

Sadly, about 20% of the population are allergic to dogs.  These symptoms can lead to allergies, asthma and disputes within the family.  Most animals have the same "rights" as others in the home and being allergic to a pet can be the source of family stress. Uncontrolled allergies and asthma can lead to poor school/work performance, overall reduction in quality of life and even emergency department visits.
Common dogs marketed as hypoallergenic are  poodle, labradoodle, Spanish waterdog, and the Airedale terrier. Recently I've had several patients develop allergies after getting a "hypoallergenic" dog.  They are a bit dumbfounded  as they were told that these dogs couldn't cause allergies.  After welcoming their dog into their family, at a loss for what to do next.  Symptoms are severe and they question even giving up their pet.
I thought it would be worth looking at the data to see if this is truth or fiction.  Luckily, there was a study in Journal of Allergy and Clinical Immunology in 10-2012 that asked the same question.
The protein that causes dog allergy is called Can f1 and it's found in the hair and coat of all dogs. 
The researchers measured the levels of Can f1 in dust samples from the hypoallergenic dogs versus allergic dogs and found the levels to be slightly higher in the hypoallergenic dog dust sample!  Unfortunately, there is no thing as a hypoallergenic dog.  Want to read the study yourself?  http://www.jacionline.org/article/S0091-6749(12)00793-2/fulltext
Don't despair though! If you are having allergies to your dog or other pet, seek out an allergist and they will help develop a plan so you will feel better.  The answer isn't always giving up your pet.  Symptoms can be controlled often with some simple environmental control measures, medications, and allergy shots if needed. 
Want to talk to me about it?  Please feel free to email jcollins@gramercyallergy.com or call the office for an appointment 212-228-2312.  We are located at 205 East 22nd Street, NY NY 10010

It's no wonder that truth is stranger than fiction.  Fiction has to make sense.
- Mark Twain.


Monday, August 12, 2013

August in New York...

... is one of exodus.  The city empties as residents seek to be calmed by the sea, cooled by the green shade from a mountain top, or inspired by the intoxicating glow of the moon from the other side of the world.  

As exotic and relaxing as all this sounds, traveling with allergies and asthma at times can be dangerous. Being in unfamiliar territory can pose some unexpected challenges.  

Recently my patients have told me stories about their difficulty with allergies- like a moldy apartment in Buenos Aires, Brazil that triggered an asthma attack, cedar storm in TX during a music festival causing severe sinusitis and loss of voice, and sunscreen allergy during a surfing expedition in Costa Rica causing a very bad rash.

Here are some easy tips to keep you healthy, safe and focused on your priority as Robert Louis Stevenson says, "For my part, I travel not to go anywhere, but to go. I travel for travel’s sake. The great affair is to move.” 

Have food allergies?

  • Do a quick search to see what restaurants in the area are friendly for those with allergies.
  • Have a travel anaphylaxis kit to carry in you carry on or purse

Have asthma?
  • Bring an extra inhaler along with you in your bag.  You never know what kind of environmental triggers you'll be exposed to in your vacation home.
  • Check out common triggers/environmental exposures you might face 
  • Ask your doctor to put together an emergency supply of medicine that you can bring with you in case you get sick- this will help keep you out of an unfamiliar emergency room,
Have skin allergies?
  • Bring travel size versions of your favorite sunscreens, moisturizers, shampoos/conditioners
  • Ask your doctor for a small tube of a corticosteriod to carry with you just in case; no one wants to be be itchy and scratchy while on vacation
Going somewhere where they speak another language?
  • If you have food allergies  translate your food allergy before you go.  It might help to put this on a card and carry it with you to make sure there's no confusion
  • In many countries asthma and allergy medications are over the counter.  Translate your problem so you'll be able to effectively communicate with the pharmacist there.
With these simple effective tips, your vacation will be filled with laughter, love, and beautiful memories rather than a trip the doctor

Want more directed tips on allergies and travel?  Feel free to email me at jcollins@gramercyallergy.com, click here to schedule an appointment, call the office 212-679-3574 or check out our new website- www.gramercyallergy.com

"Bizarre travel plans are dancing lessons from God"– Kurt Vonnegut

Friday, August 9, 2013

Exercise Induced Asthma

The weather in NYC these past few days has been beautiful! It's such a treat to go outside in August and not melt.  I'm seeing more and more New Yorkers outside running, rollerblading and biking and just enjoying the sunshine and late days.

Every now and then, I'll see someone start coughing while they are exercising or reach for their inhaler.  I wonder, do they have exercise induced asthma?

What Causes Exercise Induced Asthma?
  • As we breathe air through our noses, water is added so when it enters our lungs it humidified.
  • When we exercise, we use our mouth to breath and water isn't added to the breathe.
  • Some people (those with exercise induced asthma) are more sensitive to this "dry " air
  • The dry air causes the muscles in the lungs to contract making the air ways smaller.
  • This contraction and narrowing causes exercise induced asthma

What are signs of Exercise Induced Asthma?
  • Cough
  • Increased fatigue
  • Chest Tightness
  • Shortness of breath
  • Wheezing
All of these symptoms would occur with exercise

Should I Avoid Exercise if I have Exercise Induced Asthma?
  • No!
  • Speak with your doctor or asthma specialist if you suspect you have exercise induced asthma
  • They'll put together a specific plan to help keep you moving and enjoying the summer days.
Want to Learn more about Exercise Induced Asthma?

Feel free to email me jcollins@gramercyallergy.com , book an appointment on line or give the office a ring at 212-679-3574.  We can put together a specific plan tailored your needs.


Thursday, August 8, 2013

Summer Cold or Summer Allergies?

Summer Cold or Summer Allergies?
Lately many people have been coming into my office complaining of a summer cold.
They have a stuffy nose, are sneezing sore throat, and have sinus pressure.
Is it a cold or could it be summer alleriges? 
What causes summer allergies?
  • Pollinating summer plants often bloom during or after thunderstorms.
  • Grass Pollen counts typically spike in mid June through early August
  •  Goosefoot plants and Nettle, and Plantain are active July through August

    Grass Plant Flower
File:Zoysia grass flower.jpg

Goosefoot Plant    
Platain Plant
How can you tell if you have a cold or summer allergies?
  • It can be difficult and you may need to see a doctor to differentiate
  • Allergies often cause itchy watery eyes, runny nose, sneezing, and nasal congestion
  • Symptoms can be intermittent and associated with pollen counts
  • Summer colds last only a few days (5-7); They are often accompanied by feelings of fatigue, low grade fever and often others around you will be sick.
Need more information? Or want to speak with me directly?  Call the office at 212-679-3574 for an appointment or visit the www.gramercyallergy.com for more information about the office.