login
FAS has upgraded our forum security. Some members may need to log in again. If you are unable to remember your login information, please email food.allergy.supt@flash.net and we will help you get back in. Thanks for your patience!

Author Topic: Environmental Allergies  (Read 3291 times)

Description:

Offline hezzier

  • Global Moderator
  • Member
  • ****
  • Posts: 4,560
Environmental Allergies
« on: August 08, 2012, 12:36:54 PM »
Starting this here and then we can always move to "health" later.


We saw a new allergist today.  Nothing has changed in how we are to manage DS's food allergies.  The allergist wanted to redo the skin testing for environmentals since it had been 4 years and he was now old enough for the adult panel.  So he was allergic to trees, grass, weeds, dust, cockroach and dust mites.  He is negative for dog, cat and molds.

The allergist wants us to try zyrtec (adult dose) at night for a month to see if it improves DS quality of life.  The other thing he wants us to think about is starting allergy shots in theory to prevent developing asthma in the future.

I guess I was shocked at how many things came up positive since DS just doesn't seem that bad on a daily basis.  He some congestion that tends to come and go.  I know the fact that he's in the chlorinated pool a couple times a week makes a big difference.

So anyone want to give me any advice? 

Offline GingerPye

  • Moderator
  • Member
  • ****
  • Posts: 15,460
Re: Environmental Allergies
« Reply #1 on: August 08, 2012, 01:20:10 PM »
I would take those test results with a grain of salt.  My kids test positive to a bunch of stuff also.  The big one is grass.  I would believe the grass one because the wheal was HUGE, but the others I am not so worried about.  However, I've really got no way of knowing whether the other positive environmentals are true allergies.

As for the antihistamine, if it is not presenting a huge problem I wouldn't mess with one.  I haven't heard of using an antihistamine or allergy shots to prevent asthma.  My kids both have asthma so I guess I don't know how accurate that statement is.
DD, 25 - MA/EA/PA/env./eczema/asthma
DS, 22 - MA/EA/PA/env.
DH - adult-onset asthma
me - env. allergies, exhaustion, & mental collapse ...

Offline GoingNuts

  • Moderator
  • Member
  • ****
  • Posts: 9,715
Re: Environmental Allergies
« Reply #2 on: August 08, 2012, 04:08:04 PM »
What GP said. 
"Speak out against the madness" - David Crosby
N.E. US

Offline CMdeux

  • Global Moderator
  • Member
  • ****
  • Posts: 31,861
  • -- but sometimes the voices have good ideas!
Re: Environmental Allergies
« Reply #3 on: August 08, 2012, 04:48:11 PM »
Quote
I haven't heard of using an antihistamine or allergy shots to prevent asthma.

I have.  Our research-hound allergist first suggested this to us when DD was about three, so almost a decade ago now. 

This has been an area of clinical research in hyper-atopic kids for some time, actually...  it seems to prevent subclinical airway impairment from resulting in airway remodelling that leads to frank asthma over time, or at the very least, in reduction in the severity of symptoms.

It takes pretty high doses of antihistamine to act preventativelty this way, but in most kids those second gen antihistamines (like zyrtec) are REALLY well-tolerated and they are also (pharmacologically) very very clean in terms of action and specificity.  They hit histamine receptors and pretty much nothing else.

They're also old at this point, and seem to have no long-term side effects when given in children, even for decades.

That certainly CANNOT be said for asthma drugs.


I view daily antihistamines and allergy immunotherapy as two of the only real things that we CAN do to help our kids-- other than avoidance, I mean. 

Allergy shots really changed DD's life completely, even though it was a long and grueling process (6 years).  She uses her rescue inhaler a couple of time a YEAR now, and when she started shots, she literally couldn't play outside for about four months of the year.  She was on a trajectory to have pretty severe asthma by this point in her life, and, well-- asthma DOES still kill people.
Resistance isn't futile.  It's voltage divided by current. 

Western U.S.

Offline YouKnowWho

  • Member
  • ***
  • Posts: 12,200
Re: Environmental Allergies
« Reply #4 on: August 08, 2012, 04:58:29 PM »
I might say okay to the long term antihistamines over allergy shots.

I had actually brought up enviro testing/allergy shots with our allergist for DS2 because of his non-stop coughing over the winter.  Our allergist was against it for two reasons.  One being that enviro allergy testing can be very unreliable in young kids and two that allergic profiles change often at young ages (which is why some outgrow food allergies).  Now in our case, DS's coughing was asthma related but brought on by illness.

Honestly I would consider shots IF my child's life was being impacted by allergies.  Consistently miserable, hives, illness, etc but I would rather try antihistamines first.  Shots did help my husband tremendously the second time around, not the first.  But it was also the move to GA as opposed to living in FL that made them conquerable.  I don't care how long, aggressive, etc we were with shots in FL, it wasn't going to work for him.
DS1 - Wheat, rye, barley and egg
DS2 - peanuts
DD -  tree nuts, soy and sunflower
Me - bananas, eggplant, many drugs
Southeast USA

Offline CMdeux

  • Global Moderator
  • Member
  • ****
  • Posts: 31,861
  • -- but sometimes the voices have good ideas!
Re: Environmental Allergies
« Reply #5 on: August 08, 2012, 05:14:30 PM »
Let me see what I can dig up via Google Scholar really quickly:

http://www.nejm.org/doi/full/10.1056/NEJM199701303360502

http://www.ncbi.nlm.nih.gov/pubmed/15643339


http://onlinelibrary.wiley.com/doi/10.1034/j.1399-3038.2001.121422.x/abstract

http://onlinelibrary.wiley.com/doi/10.1111/j.1399-3038.1995.tb00272.x/abstract


http://cel.webofknowledge.com/InboundService.do?SID=3Dem2L6Ef36IanNLHl9&product=CEL&UT=000172938400008&SrcApp=Highwire&Init=Yes&action=retrieve&Func=Frame&customersID=Highwire&SrcAuth=Highwire&IsProductCode=Yes&mode=FullRecord

http://onlinelibrary.wiley.com/doi/10.1111/j.1399-3038.1998.tb00356.x/abstract


The last one is the study that my allergist knew about prior to publication.





The point here is that it is super-important (especially in FA kiddos whose food allergies are likely to persist and result in anaphylaxis) to prevent the changes which lead to asthma and airway remodelling.  If you can, of course.  Once you have a kid who has some of those 'warning signs,' though, many modern allergist like to DO SOMETHING about it in a preventative sense.

Once they already have asthma, of course, you treat it.  But the idea is to prevent the allergic march from getting there in the first place-- or even just to delay it some, since larger airways mean less remodelling in response to asthma episodes over time, if nothing else.

HTH.


Having asthma puts you in an infortunate catch-22 with allergy shots, too, btw-- you are a poor risk because of yout asthma... but... um... yeah, that's why you NEED the things to begin with, yk?  We're really fortunate that DD's asthma episodes were almost limited to illness when we started.

What YKW says is true, though-- because we started shots so early with DD, we were in the unpleasant position of deciding what to do about an emergent aeroallergen (mold, and pretty severe) after two years.  We opted NOT to start over again with it included, but there are times when I regret that now.

Shots don't help everyone, either.
« Last Edit: August 08, 2012, 05:18:36 PM by CMdeux »
Resistance isn't futile.  It's voltage divided by current. 

Western U.S.

Offline hezzier

  • Global Moderator
  • Member
  • ****
  • Posts: 4,560
Re: Environmental Allergies
« Reply #6 on: August 08, 2012, 05:18:36 PM »
Thanks CM, looks like I have some reading to do!

Offline CMdeux

  • Global Moderator
  • Member
  • ****
  • Posts: 31,861
  • -- but sometimes the voices have good ideas!
Re: Environmental Allergies
« Reply #7 on: August 08, 2012, 05:20:42 PM »
I know that Mfamom's DS also had allergy shots and they started when he was quite young, too. 

It sounds like you aren't motivated by the same things that we both were, though-- her DS and my DD were both complete messes from those allergies for a portion of each year, so we were pretty motivated since we were running out of pharmacology to combat the problem from that side of things.

One more-- a nice review from 2004:

http://www.jacionline.org/article/S0091-6749(03)02476-X/fulltext 

and one regarding the efficacy of allergy shots for this purpose:

http://onlinelibrary.wiley.com/doi/10.1111/j.1398-9995.2007.01451.x/full

The bottom line is that it seems to work... some of the time, and only for some kids.  <shrug>  We decided that in light of her quality of life issues anyway, it was worth a shot.  Obviously that decision may differ for other kids. 
« Last Edit: August 08, 2012, 05:45:59 PM by CMdeux »
Resistance isn't futile.  It's voltage divided by current. 

Western U.S.

Offline hezzier

  • Global Moderator
  • Member
  • ****
  • Posts: 4,560
Re: Environmental Allergies
« Reply #8 on: August 08, 2012, 05:42:50 PM »
Ds is a mucus producer.  I am always amazed at how much comes out if he has to blow his nose far more than I can produce during a cold.  So far we have managed it with humidifiers, flonase, swimming, and saline.  He used to snore, but that's when the flonase came into play.  His adenoids were/are enlarged.

It's my assessment that it doesn't bother him that much, but then again I'm not living in his body.


Offline eragon

  • Member
  • ***
  • Posts: 2,550
Re: Environmental Allergies
« Reply #9 on: August 08, 2012, 05:59:27 PM »
my son is allergic to  dustmite, cat, dog, mold , tree pollen , hay fever.

is on daily antihistamines.

due to nhs banning  allergy shots, due as one doctor told us to the few deaths linked to the treatment.
only treatment is oral for severe hay fever.
sadly of all enviro allergies the hay fever is the most mild....

I think some other eu countries ban the shot treatment as well, americans wanting this treatment in england go to harley street were one american doc carries out the treatment. of course this is not strictly legal.

Its OK to have dreams:one day my kids will be legal adults & have the skills to pick up a bath towel.

Offline hezzier

  • Global Moderator
  • Member
  • ****
  • Posts: 4,560
Re: Environmental Allergies
« Reply #10 on: August 08, 2012, 09:22:32 PM »

and one regarding the efficacy of allergy shots for this purpose:

http://onlinelibrary.wiley.com/doi/10.1111/j.1398-9995.2007.01451.x/full




Now that I read this, yes, the allergist mentioned PAT (preventive allergy treatment) studies.

Offline GingerPye

  • Moderator
  • Member
  • ****
  • Posts: 15,460
Re: Environmental Allergies
« Reply #11 on: August 08, 2012, 10:43:22 PM »
I really didn't have a chance with my two kiddos --- they both had asthma early on.  DS was diagnosed at 2 y.o.  He'd already been on allergy and asthma meds before that --- it just took several instances of reactive airway disease before diagnosis.

Wish we'd had a chance to avoid the asthma.   :-/
DD, 25 - MA/EA/PA/env./eczema/asthma
DS, 22 - MA/EA/PA/env.
DH - adult-onset asthma
me - env. allergies, exhaustion, & mental collapse ...

Offline hezzier

  • Global Moderator
  • Member
  • ****
  • Posts: 4,560
Re: Environmental Allergies
« Reply #12 on: August 09, 2012, 12:04:11 AM »
That's why we are seriously considering it.  I'd like a crystal ball so I can make a decision...we could do nothing and maybe he won't develop asthma.

Offline CMdeux

  • Global Moderator
  • Member
  • ****
  • Posts: 31,861
  • -- but sometimes the voices have good ideas!
Re: Environmental Allergies
« Reply #13 on: August 09, 2012, 10:15:14 AM »
Well, I don't know if this helps you, Hezz-- but the combination of strong family history of asthma with... (in this order, roughly):  early eczema, then food allergy, then sensitization to grass pollen and dustmite/mold....


 seems to be highly predictive.  Once they wheeze during every illness, your fate is nearly sealed.  Our allergist still feels that we probably managed to avoid highly brittle asthma, though, so that is definitely something.  It's amazing how much less medication DD has needed in the last four years compared with the four that preceeded those.  She's older, of course, but the real difference was immunotherapy.
Resistance isn't futile.  It's voltage divided by current. 

Western U.S.

Offline candyguru

  • Member
  • ***
  • Posts: 3,254
Re: Environmental Allergies
« Reply #14 on: August 09, 2012, 08:36:25 PM »

During grass pollen, tree pollen, and leaf mould season, our 4 yr old daughter takes cetirizine (Reactine / Zyrtec) on a daily basis.  It works quite well.  We go through numerousl bottles a year of it.

As for me, I had terrible environmental allergies as a teenager.. nocetirizine back then, so I took Hismanol.   I had allergy shots for 2 years (13 week cycle each season prior to tree pollen arriving).. it helped dramatically.  Major change as allergies were much less severe.  However, I do know of others who had no success with allergy shots.
-----------------------------------------------------------
CANADA, land of maple syrup and poutine
Me:  peanuts, ragweed
DD1:  PRACTICALLY EVERYTHING NOW! peanuts, tree nuts, sesame, eggs, wheat, lentils/peas/beans, leaf mould
DD2:  milk (and avoiding peanuts)