There’s never been a better time to be a CSU patient, with cutting-edge therapies and revolutionary treatments just around the corner. As research accelerates, new and promising options that could significantly improve the quality of life for those living with Chronic Spontaneous Urticaria are coming to market.

In this episode, Dr. Matthew Zirwas joins us to discuss the latest advancements in treating CSU, offering invaluable insights into both current and emerging treatment options. With his extensive experience and patient-centred approach, Dr. Zirwas breaks down the complexities of CSU and highlights how these new therapies can make a real difference.

This podcast was made in partnership with Allergy & Asthma Network. We thank Novartis for sponsoring this podcast.

What We Cover in Our Episode About Emerging Chronic Spontaneous Urticaria Treatments:

• How Dr. Zirwas explains CSU to his patients: Discover the patient-friendly explanations that help demystify CSU and empower patients to learn more about their disease.
• When to start with a biologic: Learn about the decision-making process for initiating biologic therapies like Xolair (omalizumab) and when they are most appropriate.
• The new medications coming to market: Get an overview of the latest advancements, including:
  • Dupixent (dupilumab): A biologic administered via injection that targets key pathways in the inflammatory response.
  • Remibrutinib: A BTK (Bruton tyrosine kinase) inhibitor available as a pill that blocks a crucial enzyme in mast cell activation.
  • Barzolvolimab: A promising biologic that targets the C KIT receptor on mast cells to reduce their number.
• Shared decision-making with these medications: Explore strategies for choosing the most appropriate treatment in a rapidly evolving therapeutic landscape.
• Research into the underlying cause of CSU: What’s happening on the research front to uncover the root causes of CSU.

About Our Guest

Dr. Matthew Zirwas, MD, is a board-certified dermatologist and a nationally recognized expert in allergy patch testing, psoriasis, and eczema. He founded the Bexley Dermatology Research Clinic, offering patients access to the latest treatment options before they are widely available. Dr. Zirwas also serves as a dermatologic advisor for several companies, including ALL Laundry Detergent and Cerave, and contributes to Women’s Health Magazine. Learn more about Dr. Zirwas.

More resources about chronic spontaneous urticaria: 

• Chronic Urticaria Management, Resources & Glossary of Terms: https://allergyasthmanetwork.org/health-a-z/chronic-urticaria/management-and-resources/
• What is Chronic Urticaria: https://allergyasthmanetwork.org/health-a-z/chronic-urticaria/ 
• More information about Omalizumab (Xolair): https://www.xolair.com/chronic-spontaneous-urticaria.html

Disclaimer: This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

Did you know that the month of September sees a drastic rise in asthma attacks and hospitalizations?

Dr. G and Kortney delve into the challenges that asthmatics face during the fall season, also known as "peak week." Despite what the name suggests, asthma cases start to rise in the second week of September and continue into early October before returning to normal levels.

We begin by defining asthma and then explore why asthma attacks are more prevalent in September. We discuss the role of germs and viruses, indoor and outdoor allergens, and cold weather in exacerbating asthma symptoms. Dr. G also shares tips on how to lessen your exposure to these triggers. Additionally, we cover the importance of having an asthma action plan and the significance of well-controlled asthma.

Dr. G also discusses the financial aspects of asthma management and offers advice on how to discuss this with your doctor.

>>>> Listener survey: https://forms.gle/6Pb2PGq6nuVReasZ6

What we cover in our episode about the rise in September asthma attacks

• Why September is Peak Asthma Season: Explore why asthma attacks increase in the fall and what you can do to prepare.
• The Role of Germs and Viruses in Asthma: Understand how illnesses can trigger asthma and learn tips for staying healthy.
• Indoor and Outdoor Allergens: Discover how common allergens like dust mites, pet dander, ragweed, and mold can affect asthma, and what you can do to limit exposure.
• Preparing for Peak Week: Essential steps to take before asthma season hits, including scheduling doctor visits and creating an action plan.
• Asthma Management Tips for Different Age Groups: Advice for school-aged children and elderly patients to ensure they receive the best care.

More resources about asthma peak week: 

• Asthma and Allergy Forecast: pollen and allergen count https://allergyasthmanetwork.org/weather/
• 10 Ways to Stay Healthy During the September Asthma Peak Week https://allergyasthmanetwork.org/news/10-ways-to-stay-healthy-during-september-asthma-peak/
• Seasonal allergies: https://allergyasthmanetwork.org/news/seasonal-allergies/
• Asthma attack: https://allergyasthmanetwork.org/what-is-asthma/asthma-attack/
• What if I Can’t Afford My Asthma Medication? https://allergyasthmanetwork.org/what-is-asthma/what-if-i-cant-afford-my-asthma-medication/ 
• Asthma Management and Control (2:2:1 Rule) https://allergyasthmanetwork.org/what-is-asthma/asthma-management-and-control/
• AirQ https://www.airqscore.com/en/main-page.html 
• ACT Test https://www.asthmacontroltest.com/welcome/ 

We want to thank AstraZeneca for sponsoring this episode.

Disclaimer: This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

Why talk to a hematologist about mast cell disease and systemic mastocytosis treatment?

Dr. Douglas Tremblay, a leading hematologist, joins Dr. G and Kortney to discuss the role of a hematologist-oncologist in diagnosing and treating mastocytosis. We discuss bone marrow's vital role in diagnosing and treating systemic mastocytosis. 

Dr. Tremblay discusses the latest KIT inhibitors, a promising group of medications, and explains the difference between indolent and advanced systemic mastocytosis. He clarifies how KIT inhibitors work and emphasizes the importance of managing side effects. Finally, Dr. Tremblay provides insights into the future of KIT inhibitor approval and explores the possibility of participating in a clinical trial for Bezulastinib. 

What we cover in this episode about treating systemic mastocytosis:

• What is a hematologist looking at with mast cell disease patients?
• Mast cell diseases and the role of bone marrow
  • Bone marrow biopsy for systemic mastocytosis 
  • What is a bone marrow biopsy?
  • Information bone marrow biopsy provides for diagnosis
• KIT mutation 
• KIT mutation testing in bone marrow and blood (digital droplet PCR)
• Indolent Mastocytosis versus Advanced Mastocytosis
• Current research for treating mast cell disease
• How KIT inhibitors work
• Do KIT inhibitors weaken the immune system?
• KIT Inhibitors discussed in this episode:
  • Avapritinib
  • Bezulastinib
  • Elenestinib
• Are KIT inhibitors a cure for mast cell disease?
• Determining the tolerance for side effects of medications when researching and adding new medicines for diseases 
• The meaning of ‘NIB’ in the medication names
• The timeline for the new KIT inhibitors approval
• The type of patient that can participate in the clinical trials for Bezulastinib

Resources about mast cell disease:

• Dr. Tremblay: https://profiles.mountsinai.org/douglas-a-tremblay

  • Dr. Tremblay’s email: douglas.tremblay@mssm.edu 

• Mast Cell Disease Overview: https://allergyasthmanetwork.org/health-a-z/mast-cell-diseases/

• What is Anaphylaxis? https://allergyasthmanetwork.org/anaphylaxis/

• What is Epinephrine? https://allergyasthmanetwork.org/anaphylaxis/what-is-epinephrine/

• The Mast Cell Disease Society: https://tmsforacure.org/

• Current studies enrolling patients: https://tmsforacure.org/clinical-trials/

What is it like when an unpredictable disease like systemic mastocytosis forces you to change the trajectory of your life?

As we continue to unpack mast cell disease, Dr. G and Kortney wanted to get the patient's perspective on living with such a complex disease. Tammie joins the podcast to discuss her journey battling mastocytosis, a rare condition affecting mast cells in the body.

If you ever feel alone on your chronic health journey, know you aren’t! Tammie's resilience and wisdom serve as a beacon of hope. We hope this inspires you to approach your health journey with determination and a sense of community.

 

What we cover in this episode:

• Tammie’s mastocytosis journey

• The challenges of not getting a proper diagnosis

• The pros and cons of being able to google medical conditions

• What do to when a doctor does not want to take you on as a patient 

• How Tammie separates the disease from her life 

• How do you navigate work with a chronic disease?

• Working with a mental health team

• How do you ask your family/friends for help

• Patient's relationship with their healthcare team

• Pros and cons of an online community for chronic disease and the importance of a real-life community

 

Connect with Tammie online:

• TikTok https://www.tiktok.com/@rachelllargentphillips
• Instagram https://www.instagram.com/tammie_rachell/

 

Resources about mast cell disease:

• Mast Cell Disease Overview: https://allergyasthmanetwork.org/health-a-z/mast-cell-diseases/

• What is Anaphylaxis? https://allergyasthmanetwork.org/anaphylaxis/

• What is Epinephrine? https://allergyasthmanetwork.org/anaphylaxis/what-is-epinephrine/

• The Mast Cell Disease Society: https://tmsforacure.org/

Can a low-histamine diet help with mast cell disease? Why is stress a big trigger for mast cell disease?

Dr. Milner joins us again to discuss two hot topics in managing mast cell disease. We start by demystifying the low histamine diet and sharing when appropriate. The answer may be different from what you expect or want to hear. We also talk about stress, a topic we are learning impacts so many chronic diseases, especially those related to mast cells. Stress can worsen symptoms, and in this episode, both doctors emphasize the importance of stress management techniques.  

What we cover in this episode about low histamine diet and stress management

• Why go on a low histamine diet?
• What is histamine intolerance? 
• How well do low histamine diets work for mast cell disease?
• The impact of stress on mast cell disease
• Stresses impact on the gut
• Stress management is integral in mast cell disease treatment 

More resources about mast cell disease:

• Mast Cell Disease Overview: https://allergyasthmanetwork.org/health-a-z/mast-cell-diseases/
• What is Anaphylaxis? https://allergyasthmanetwork.org/anaphylaxis/
• What is Epinephrine? https://allergyasthmanetwork.org/anaphylaxis/what-is-epinephrine/
• The Mast Cell Disease Society: https://tmsforacure.org/

Where do you begin with mast cell disease treatment when there is such variation among patients? 

Dr. Milner is back with us to discuss the difficulties in treating mast cell activation syndrome and mastocytosis. We will discuss the different approaches to treating mast cell disease and the medications used for mastocytosis treatment. Since no single treatment plan works for everyone, we will explore multiple strategies that can be helpful in managing this condition.

A note: when you hear MCAS mentioned, it stands for Mast Cell Activation Syndrome.

What we cover in our episode about treating mast cell diseases:

• What are the steps taken to treat mast cell diseases?

• Histamine blockers: antihistamines for mast cell disease and H2 blockers

• Mast cell stabilizers: Cromolyn and Ketotifen

• Xolair 

• Other medications that have been used but not recommended: aspirin, steroids, Singulair

• Epinephrine and anaphylaxis

• Tyrosine kinase inhibitors (TKI) for Mastocytosis: Avapritinib, Midostaurin

• Safety concerns and side effects of Tyrosine kinase inhibitors

•  Multidisciplinary approach to managing mast cell disease

About our guest - Dr. Josh Milner

Joshua Milner, MD, is a renowned leader in discovering and understanding genetic diseases leading to allergic symptoms, including Hereditary Alpha Tryptasemia Syndrome, PLAID, PGM3 deficiency, ERBIN mutation, and others. With a background in biology from MIT and an MD with distinction in immunology from Albert Einstein College of Medicine, Dr. Milner has extensive experience in pediatrics and allergy and immunology, serving as chief of the Laboratory of Allergic Diseases at NIAID.

His vision is to leverage genetic variation to improve diagnosis and care for patients with allergic diseases through comprehensive genetic sequencing and functional studies, aiming for personalized medicine and interdisciplinary collaboration in pediatric allergy, immunology, and rheumatology.

More about Dr. Milner: 

• https://www.pediatrics.columbia.edu/profile/joshua-milner-md

More resources about mast cell disease:

• Mast Cell Disease Overview: https://allergyasthmanetwork.org/health-a-z/mast-cell-diseases/

• What is Anaphylaxis? https://allergyasthmanetwork.org/anaphylaxis/

• What is Epinephrine? https://allergyasthmanetwork.org/anaphylaxis/what-is-epinephrine/

• The Mast Cell Disease Society: https://tmsforacure.org/

• FDA Approves AYVAKIT® (avapritinib) as the First and Only Treatment for Indolent Systemic Mastocytosis: https://ir.blueprintmedicines.com/news-releases/news-release-details/fda-approves-ayvakitr-avapritinib-first-and-only-treatment

Our episode on eyelash allergies was so interesting we had to bring you more from our favorite eye Doc, Dr. Luk. We delve into the fascinating world of eyelash health and hygiene, from the importance of cleanliness to the latest trends like eyelash serums and magnetic extensions. We discuss the importance of hygiene, eyelash serums, and magnetic eyelash extensions.

What we cover in this episode on how to clean eyelash extensions:

• Eyegiene: why you need to clean your eyelashes

• How to clean your eyelid margin

• How often should you clean your eyelid margins

• How to know if it is eczema or blepharitis

• What to consider when using lash serums

• Are magnetic eyelash extensions a better alternative to traditional eyelash extensions?

Put on your detective hat because we will be diving into how to diagnose mast cell disease!

Dr. G and Kortney are joined by Dr. Josh Milner, one of the top experts in the field of mast cell disease, as they dive into the complexities of diagnosing mast cell disorders, focusing on cases of unexplained anaphylaxis and using this as our guide to understanding all of the tests that doctors do to figure out what is happening with your mast cells. 

From histories to blood and urine tests to Darier's sign, bone marrow biopsies and more, we dig into the many tests needed for the detective work diagnosing mast cell disease. We learn that a nuanced approach is required to diagnose mast cell disorders and the importance of thorough evaluation to differentiate between potential causes.

This podcast was made in partnership with Allergy & Asthma Network. We thank Blueprint Medicines for sponsoring this podcast.

What we cover in our episode about diagnosing mast cell disease:

• Unexplained anaphylaxis could be linked to mast cell disorders.

• Diagnostic tools:

  • Blood tryptase test (fast but time-sensitive)

  • Urine metabolite tests (easier, longer window)

  • Skin rash assessment (urticaria pigmentosa)

  • Bone marrow biopsy (serious cases)

• Symptoms: Sudden episodes, chronic issues like fatigue, depression.

About our guest - Dr. Josh Milner

Joshua Milner, MD, is a renowned leader in discovering and understanding genetic diseases leading to allergic symptoms, including Hereditary Alpha Tryptasemia Syndrome, PLAID, PGM3 deficiency, ERBIN mutation, and others. With a background in biology from MIT and an MD with distinction in immunology from Albert Einstein College of Medicine, Dr. Milner has extensive experience in pediatrics and allergy and immunology, serving as chief of the Laboratory of Allergic Diseases at NIAID.

His vision is to leverage genetic variation to improve diagnosis and care for patients with allergic diseases through comprehensive genetic sequencing and functional studies, aiming for personalized medicine and interdisciplinary collaboration in pediatric allergy, immunology, and rheumatology.

More about Dr. Milner: 

• https://www.pediatrics.columbia.edu/profile/joshua-milner-md

More resources about mast cell disease:

• Mast Cell Disease Overview: https://allergyasthmanetwork.org/health-a-z/mast-cell-diseases/

• What is Anaphylaxis? https://allergyasthmanetwork.org/anaphylaxis/

• What is Epinephrine? https://allergyasthmanetwork.org/anaphylaxis/what-is-epinephrine/

• The Mast Cell Disease Society: https://tmsforacure.org/

Have you ever wondered why your doctor puts their membership in their bios? Why is it relevant to a patient that your allergist is a member of the ACAAI?

This podcast is made possible through Allergy & Asthma Network’s partnership with the American College of Allergy, Asthma and Immunology.

Dr. G and Kortney had the special privilege of interviewing Dr. Gailen Marshall, the president of the American College of Allergy, Asthma, and Immunology (ACAAI). He explains what the ACAAI, also known as the College, does and why this matters to patients. We learn about the resources provided by the College, which offer patients invaluable support in managing their allergies. From accessing specialized care through the "Find an Allergist" tool to engaging with the ACAAI's educational materials and advocacy opportunities, patients are empowered to take control of their treatment journey.

We also dive into Dr. Gailen Marshall's work in psychoneuroimmunology, which sheds light on how both external and internal environments impact allergic reactions. We touch upon Dr. Marshall's Presidential Initiative, CAAPER, which bridges the gap between community and academic allergists, driving innovation in patient treatment. As allergy research continues to advance, Dr. Marshall's leadership underscores the importance of interdisciplinary collaboration and patient-centred care in navigating the complexities of allergic diseases.

What we cover in the episode

• Dr. Marshall’s field of study: Psychoneuroimmunology
• What does the American College of Allergy Asthma and Immunology (ACAAI) do?
• How is the ACAAI relevant to patients?
• How can a patient take advantage of the resources the ACAAI has?
• How can patients be involved with the ACAAI?
• Why should you see an allergist?
• Dr. Marshall’s Presidential Initiative - Community and Academic Allergist Partnership in Education and Research (CAAPER)

About our guest, Dr. Marshall

Gailen D. Marshall, Jr. MD, PhD, FACP, is the president of the American College of Allergy, Asthma and Immunology and holds distinguished roles as Chair of Allergy and Immunology, Professor of Medicine and Pediatrics, Vice Chair for Research, Director of the Division of Clinical Immunology and Allergy, and Chief of the Laboratory of Behavioral Immunology Research at the University of Mississippi Medical Center in Jackson. 

With a background in both Immunology and Medicine from the University of Texas Medical Branch in Galveston and extensive training at institutions like the University of Iowa and the University of Tennessee at Memphis, Dr. Marshall is renowned for his expertise in integrative approaches to managing inflammatory diseases. His research delves into the impact of psychological stress and environmental factors on immune responses, aiming to identify biomarkers for stress susceptibility.

With over 200 publications and active engagement as a speaker in regional, national, and international forums, Dr. Marshall also served as Editor-in-chief of the Annals of Allergy, Asthma and Immunology, showcasing his leadership in the field. Additionally, he plays a vital role in professional societies like the Southern Society for Clinical Investigation, where he serves as Secretary-Treasurer and contributes to various committees, highlighting his commitment to advancing clinical research and education.

 

Have you ever considered whether your nasal congestion, IBS, brain fog, and hives are related? 

This podcast was made in partnership with Allergy & Asthma Network. We thank Blueprint Medicines for sponsoring this podcast.

Dr. Anne Maitland joins us as we delve into the complex world of mast cell disease. From the confusing range of symptoms to the unpredictable nature of each person's experience, we unravel the mysteries that make mast cell disorders so uniquely difficult to tackle.

Dr. Maitland is an expert in allergy and immunology and sheds light on the diverse manifestations of mast cell dysfunction, from headaches and nasal congestion to gastrointestinal issues and skin reactions like hives.Dr. Maitland emphasizes the importance of recognizing mast cell dysfunction's impact across different organs for accurate diagnosis and management.

What we cover in our episode about mast cell disease:

• Symptoms of mast cell disease

• How to connect the dots of mast cell disease symptoms

• What is a sign that your symptoms are related to mast cells

• The job of mast cells and their scientific history

• Is an anaphylactic reaction a mast cell disease?

• What triggers mast cell disease? 

• Mast cell targetted medications and how this can hide your symptoms

About our guest - Dr. Maitland

Dr. Maitland is a highly respected physician and a Fellow of the American College of Allergy, Asthma, and Immunology. She was named New York Times' Super Doctors in 2011 and one of America's Top 21 Women's Doctors by Lifescript.com in 2009. Dr. Maitland is actively involved in creating awareness of immune-mediated disorders and researches to enhance treatments for allergies, asthma, and recurrent infections. She specializes in allergic skin disorders, allergic rhinitis, drug allergies, food allergies/sensitivities, asthma, and recurrent infections. 

Dr. Maitland holds an MD and PhD from the University of Pennsylvania and completed her residency in Internal Medicine at Brigham and Women's Hospital in Boston. She also pursued a Fellowship in Allergy and Immunology at Brigham and Women's Hospital and Mount Sinai Hospital in New York.

More about Dr. Maitland: 

• https://www.metrodora.co/anne-maitland

• https://www.drannemaitland.net/dr-anne-maitland

More resources about mast cell disease:

• Mast Cell Disease page: https://allergyasthmanetwork.org/health-a-z/mast-cell-diseases/

• What is Anaphylaxis? https://allergyasthmanetwork.org/anaphylaxis/

• What is Epinephrine? https://allergyasthmanetwork.org/anaphylaxis/what-is-epinephrine/

• The Mast Cell Disease Society: https://tmsforacure.org/

Are you allergic to your eyelash extensions?

Eyelash extensions have become increasingly popular in recent years, offering a way to achieve fuller, longer lashes without the hassle of applying mascara every day. However, some potential risks are associated with eyelash extensions, including allergic reactions.

Dr. Janice Luk joins Dr. G and Kortney to discuss eyelash extensions and what happens when things go wrong. We dive into eyelash extension allergies and contact dermatitis, what the reactions look like, how to treat the reactions best and why you need to take care of your biofilm.

No one wants to play with their vision or have an allergic reaction around the eye; this episode will help you better understand what could happen and how to prepare your lash extensions properly.

What we cover on eyelash extension allergies:

• What are eyelash extensions?

• How eyelash extensions differ from what you can do at home

• What does the allergic reaction to eyelash extensions look like?

• Contact dermatitis versus an IgE-mediated allergic reaction

• What glues are being used, and what would cause the reaction?

• Symptoms and treatment for a lash extension allergy

• Why you don't want to use over-the-counter medication for your eyes

• The importance of keeping a clean biofilm

• Eyegiene

• Traction alopecia caused by lash extensions

• When should you seek medical attention for eyelash extension reactions

• What is the difference between an ophthalmologist and an optometrist

The basic science of mast cells is the first episode in our 6-part series exploring Mast cell diseases. To start the series, we explore the intricate workings of mast cells by diving into how they work and what happens when something is off balance.

Have you ever wondered what releases histamine and how this happens? Then this episode is for you!

What we cover in our episode about mast cell disease:

• What are mast cells, and what do they do?

• What are the different types of mast cell diseases?

  • Mastocytosis

  • Mast Cell Activation Syndrome

  • Hereditary Alpha-tryptasemia

• The 7 types of mastocytosis

• The cause of mast cell disease

  • KIT gene mutation in Mastocytosis

More resources about mast cell disease:

• Mast Cell Disease page: https://allergyasthmanetwork.org/health-a-z/mast-cell-diseases/

• What is Anaphylaxis? https://allergyasthmanetwork.org/anaphylaxis/

• What is Epinephrine? https://allergyasthmanetwork.org/anaphylaxis/what-is-epinephrine/

We thank Blueprint Medicines for sponsoring this podcast.

This episode is a quick-fire round covering the misunderstood aspects of chronic spontaneous urticaria (CSU), a condition that perplexes many due to its spontaneous nature. With over 1.7 million people affected, it's more common than you might think and deserves a closer look. Despite its prevalence, many misconceptions persist about what causes CSU, its symptoms, and how it can be treated.

Kortney and Dr. Gupta tackle the myths and misconceptions around CSU. Unpacking its impacts on quality of life and the challenges those living with the condition face. They explore the realities of living with CSU, from the pervasive itch to the emotional toll it can take. Whether you're a patient, caregiver, or healthcare professional, this episode offers valuable insights into the realities of managing CSU.

This podcast was made in partnership with Allergy & Asthma Network. We thank Novartis for sponsoring this podcast.

The chronic spontaneous urticaria myths and misconceptions we cover in our episode

• CSU is caused by allergies.
• CSU is contagious.
• CSU is a rare condition.
• CSU is not a serious condition.
• Stress is the main cause of CSU.
• CSU only affects the skin.
• CSU will go away quickly.
• There isn’t any treatment for chronic hives.
• Antihistamines are the only treatment for CSU.
• Changing your diet will help CSU.
• CSU can be cured.
• Once CSU goes away, it will never come back again.
• Men and women are equally affected by CSU.
• You can always pinpoint the exact cause of hives in patients with CSU.
• Autoimmune conditions are more common in people with CSU.
• Scratching hives is harmless.
• Once my hives are controlled, I need to be on the medication forever.
• All hives look the same.
• Only adults get CSU.
• CSU hives are always accompanied by other allergic symptoms like swelling or difficulty breathing.
• Having CSU doesn’t affect quality of life.
• The itch in CSU is not a big deal.
• Allergy testing will help me figure out why I have CSU.

More resources about chronic spontaneous urticaria: 

• Chronic Urticaria Management, Resources & Glossary of Terms: https://allergyasthmanetwork.org/health-a-z/chronic-urticaria/management-and-resources/
• What is Chronic Urticaria: https://allergyasthmanetwork.org/health-a-z/chronic-urticaria/ 
• More information about Omalizumab (Xolair): https://www.xolair.com/chronic-spontaneous-urticaria.html

Disclaimer: This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

Fear and anxiety are very common when managing food allergies and anaphylaxis. It can come from the unknown, where the allergen can show up. It can also come from the way your allergies are discussed.  How do you motivate patients to use their epinephrine without causing crippling anxiety?

Dr Golden joins us as we explore the delicate balance of doctors using fear to underscore the urgency of administering epinephrine during anaphylaxis. We discuss the crucial interplay between fear and anxiety, emphasizing the need for a sensitive approach to motivate patients to use their epinephrine without overwhelming those already grappling with anxiety. 

We discuss the mind-body connection and the similarities between anxiety attacks and allergic reactions when talking about anxiety caused by the fear of having an anaphylactic reaction. Dr. Golden also provides more information about the risk and co-factors associated with severe anaphylaxis.

What we cover in this episode about anxiety related to anaphylaxis:

• Balance of fear and anxiety to get patients to use Epinephrine 
• Mind-body connection around anxiety and anaphylaxis - anxiety attack’s similarity to a reaction 
• Environment allergies - why you do  not need to carry an Epinephrine device 
• Risk factors and co-factors of severe reaction 
• Epinephrine option for severe asthma

Helpful links:

• More about our guest Dr. David Golden
• What is Anaphylaxis? https://allergyasthmanetwork.org/anaphylaxis/
• What is Epinephrine? https://allergyasthmanetwork.org/anaphylaxis/what-is-epinephrine/
• What is a Food Allergy? https://allergyasthmanetwork.org/food-allergies/
• What If I Can’t Afford my Epinephrine Medication? https://allergyasthmanetwork.org/anaphylaxis/what-if-i-cant-afford-my-epinephrine/
• Episode sponsored by https://aquestive.com/anaphylm/.

Is a needle-free option for administering epinephrine coming out? Yes! 

Dr. Golden joins us again in this episode to explore the new products in development for administering epinephrine.

What we cover in our episode about anaphylaxis and epinephrine:

• The new types of ways to administer epinephrine:

  • Inhaler

  • Nose spray

  • Sublingual film 

• Why it has been challenging to find alternative ways to administer epinephrine other than an autoinjector.

• How do we know the new forms of delivery will work? 

• How are companies proving that the new delivery method will work like the auto-injectors do?

• How will studies be done to show the FDA that the new methods should be approved for patients to use?

• Why do we need new ways to administer epinephrine? 

• Will there be hesitation to use the new forms of epinephrine delivery?

• The importance of having doctors on board with these new forms of delivery.

More Resources about anaphylaxis and epinephrine:

• More about our guest Dr. David Golden

• More about Anaphylaxis: https://allergyasthmanetwork.org/anaphylaxis/

• More about Epinephrine: https://allergyasthmanetwork.org/anaphylaxis/what-is-epinephrine/

• What if I can’t afford my epinephrine? Learn more here: https://allergyasthmanetwork.org/anaphylaxis/what-if-i-cant-afford-my-epinephrine/

We want to thank Aquestive for sponsoring this episode.

 

Listen to episode 59 for more information on Anaphylaxis and Epinephrine

Biologic medications are supposed to help you live your life as normally as possible, but still, one has to wonder, can you travel while taking biologic medicines?

After releasing the episode on biologics for asthma, Dr. G and Kortney decided to explore how to travel while on a biologic successfully. They unpack what considerations patients need to take when planning their trip. 

What we cover in our episode about traveling while taking a biologic medication

• Can you travel while on biologics, or can you only travel between doses?
• Can you travel with biologics that need to be administered by IV?
• Should patients get the green light from their doctor to travel?
• Is it possible to travel out of state or internationally?
• What should a patient consider when thinking about traveling

More about biologics, check out episode 56: https://www.itchpodcast.com/episodes/56-asthma-biologics 

 

Have you ever wondered if it's anaphylaxis or just a severe allergic reaction? And how do you know when to use epinephrine? Diagnosing anaphylaxis can be challenging, and in this episode, we dive into this topic with our guest, Dr. David Golden.

What we cover in this episode:

• What is anaphylaxis
• When to use an Epinephrine device?
• How to determine if it is an allergic reaction or an anaphylactic reaction?
• How safe is it to use Epinephrine?
  • Why is epinephrine used to treat anaphylaxis?
  • Does epinephrine always work to treat anaphylaxis? Why would it not work?
  • What are the side effects of Epinephrine?
  • Do you have to go to the hospital after using Epinephrine?
• How does Epinephrine work?
• Why antihistamines do not work to treat anaphylaxis or a severe asthma attack
• Other treatments that are in the pipeline for anaphylaxis?
• Epinephrine dosing - how to know the right dose for kids and adults.
• When do you need a second dose of Epinephrine?
• Carrying two epinephrine devices
• Will the next anaphylactic reaction be worse?
• Why should we encourage having stock Epinephrine in schools, on planes, etc?

Helpful links:

• More about our guest Dr. David Golden
• More about Anaphylaxis: https://allergyasthmanetwork.org/anaphylaxis/
• More about Epinephrine: https://allergyasthmanetwork.org/anaphylaxis/what-is-epinephrine/
• What if I can’t afford my epinephrine? Learn more here: https://allergyasthmanetwork.org/anaphylaxis/what-if-i-cant-afford-my-epinephrine/

In the second episode of the Allergy, Asthma & Immunology Innovations Podcast Series, Dr. G and Kortney dive into the critical topic of controlled and uncontrolled asthma. They shed light on various aspects of asthma, including its types, severity levels, medications, and the importance of asthma action plans.

This episode is especially important to our hosts as asthma has personally impacted them.

What we cover about controlled asthma:

• A quick review of asthma

• Types and severity levels of asthma

• Asthma can manifest in various forms, including:

  • Allergic asthma (triggered by allergens).

  • Non-allergic asthma (triggered by factors other than allergens).

  • Occupational asthma (caused by workplace exposure).

  • Exercise-induced asthma.

  • Cough-variant asthma (primarily chronic cough).

  • Aspirin-exacerbated respiratory disease (AERD).

  • Late-onset asthma (developing in adulthood).

  • Eosinophilic asthma (inflammation-related).

  • Asthma can be categorized as mild, moderate, or severe based on symptoms and lung function tests. Severity impacts treatment strategies.

• Medications for asthma management

  • Rescue or emergency medication (for mild asthma).

  • Controller medication (for moderate to severe asthma). Controller medications include inhaled steroids, other medications, and biologics for severe cases.

• Assessing asthma control

• Asthma control is evaluated based on the "Rule of 2s". If you have two or more of the following, your asthma may not be controlled;

  • Symptoms more than two days a week.

  • Quick-relief medication usage more than two times a week.

  • Nighttime awakenings due to asthma more than two times a month.

  • Asthma exacerbations require oral steroids twice a year.

• What is good asthma control, and why is this important

• The long-term effects of uncontrolled asthma

• Asthma Peak Week.

• Creating an asthma action plan

• Working with healthcare providers and asthma coaches

Resources to help you with your asthma control:

Asthma Management and Control: https://allergyasthmanetwork.org/what-is-asthma/asthma-management-and-control/ 

Asthma Action Plan: https://allergyasthmanetwork.org/what-is-asthma/asthma-action-plan/  This page is great because it has multiple types of Asthma Action Plans.

Infographic about asthma peak in September: https://allergyasthmanetwork.org/images/Asthma/September_Asthma_Peak_July2023v1.pdf

Asthma Coach: www. AsthmaCoach.org and https://allergyasthmanetwork.org/free-asthma-coach-program/.

Lifestyle Changes to Manage Asthma: https://allergyasthmanetwork.org/what-is-asthma/lifestyle-changes-to-manage-asthma/

Biologic medications: www.BiologicMeds.org

Type 2 Inflammation: eosasthma.org https://allergyasthmanetwork.org/news/when-asthma-more-than-asthma-type-inflammation/

Itchy, watery eyes? It may be an allergy that only impacts your eyes!

Dr. Luk joins Dr. G and Kortney to discuss ocular allergies, which are allergic reactions that affect the eyes. 

Ocular allergies are common and can cause significant discomfort and impaired vision. However, many people are unaware of the different types of ocular allergies, the treatments available, or the importance of prevention. If you always find yourself with itchy, red and watery eyes or around certain things, this episode is for you!

What we cover about ocular allergies:

• The difference between an ophthalmologist and an optometrist

• Ocular allergy - what is this, and how is it different from systemic allergies? 

• The different types of ocular allergies: 

  • Seasonal allergic conjunctivitis

  • Perennial allergic conjunctivitis

  • Vernal keratoconjunctivitis

  • Atopic keratoconjunctivitis

• Treatment options for ocular allergies

• The dangers of rubbing your eyes and what to do instead

• All you need to know about eye drops

More about ocular eye allergy expert: Dr. Janice Luk

Dr. Janice Luk is a Toronto native who graduated with honors from the Doctor of Optometry and Bachelor of Science programs at the University of Waterloo. She is passionate about expanding her knowledge and bridging the gap between ocular aesthetics and dry eye disease. Janice communicates openly with her patients and volunteers with organizations like VOSH and Fighting Blindness Canada. She is an active member of multiple optometry associations.

Connect with her: https://www.instagram.com/ilukateyes/

Part of the series: Allergy, Asthma & Immunology Innovations Podcast

This podcast was made in partnership with Allergy & Asthma Network, with funding support from AstraZeneca.

In this episode, we explore a new form of asthma treatment, Biologics. These innovative treatments offer targeted relief by addressing the underlying causes of asthma, leading to improved symptom control and a better quality of life. Dr. G and Kortney discuss the current biologics on the market for asthma treatment. 

As this is a true deep dive, we have provided some more information about the Biologics discussed to help you build a better understanding. We have included images and graphs you can use when listening to the episode. 

What we cover in this episode:

• A background on how Biologic treatments work.
• The Biologics available for asthma - discuss who is a candidate, how they each work, how they are taken and some side effects. 
  • Omalizumab (Xolair)
  • Mepolizumab
  • Reslizumab
  • Benralizumab
  • Dupilumab
  • Tezepelumab

Helpful links:

Images and graphs discussed in this episode: www.itchpodcast.com/episodes/56-asthma-biologics

A look at biologics in more depth: www.biologicmeds.org

More about type 2 inflammation: https://allergyasthmanetwork.org/news/when-asthma-more-than-asthma-type-inflammation/

Breaking down the facts behind a bee sting allergy and more!

In this episode, we delve into the world of venom allergies, focusing on allergic reactions caused by flying insects and fire ants. Our hosts are joined by Dr. Farah Khan, who shares her valuable expertise, in explaining the underlying mechanisms of allergic reactions to venom allergies. 

What we cover in this episode:

• What types of insects can cause a venom allergy and lead to anaphylaxis; honey bees, bumble bees, wasps, hornets, yellow jackets and fire ants.
• Why mosquitos are not a concern for anaphylaxis.
• What a normal versus an allergic reaction to venom looks like.Local versus systemic reactions. What is the difference, and when do you need to worry that you will potentially have an anaphylaxic reaction.
• When should you see a doctor regarding your insect bite.
• Why testing is not straightforward for insect stings (venom allergy): insect sting allergies are rare, and we do not want to over-test. What happens after you have reacted a venom and how to work with your allergist.
• Only test people who have had an allergic reaction to a sting. Types of tests that would be used once you have reacted to venom. 
• How to determine whether you are a candidate for immunotherapy. 
• Why allergist test for systemic mastocytosis when talking about venom allergies.
• What to do when you get stung and the best medications to take.
• How to best prepare yourself to avoid getting stung.
• Advice to someone afraid of a stinging insect.

More information about this episode can be found here: www.itchpodcast.com/episodes/55-venom-allergy

What is early allergen introduction for babies?

Are you still confused about when to feed your baby allergens? Over the past few decades, there has been quite a shift in thinking about the early introduction of food allergens for babies, so your confusion is wholly justified. Dr. G dives into this exact topic and talks to two professionals, Meenal Lele and Dr. Katie Marks-Cogan, in the field of early introduction. She explores why the guidelines for introducing allergens have changed and how to introduce allergens safely and consistently. 

What we cover in this podcast about the early introduction of food allergens:

What inspired Meenal and Katie to develop products to help parents with early allergen introduction?

What is early food introduction? Why are we no longer avoiding food allergens in babies? 

What studies have shaped the protocol change around introducing allergens to babies? How does this impact 'high-risk' children?

The challenges for the studies and compliance hurdles parents faced.  

Why do babies develop food allergies? What hypotheses point to the increase in food allergies in children over the past three decades?

The guidelines for early introduction of allergens. How to feed allergens to infants safely?

Why do you want to consider the early introduction of allergens with your babies? 

The role of food allergies in a baby's eczema: if your baby has eczema, will they develop food allergies? When to see an allergist for your baby?

What is the best practice for diagnosing a baby's allergies, and why is testing not always appropriate? How to work with your medical team and rely on something other than online information. 

Fundamental studies about the early introduction of allergens: The LEAP study, EAT study, PETIT study

Guest Bios

Meenal Lele is the founder of Lil Mixins, an allergy prevention company for babies. With experience as a food allergy parent and clinical knowledge, she created the company to provide options for parents introducing allergenic foods to their babies. Meenal holds an engineering and business degree from the University of Pennsylvania. She is the author of The Baby and the Biome, a book exploring the connection between a child's microbiome and their health.

Dr. Katie Marks-Cogan, MD, FAAAAI, FACAAI, specializes in allergies, asthma, and sinus disease. She is the head allergist at Ready.Set.Food and provides top-notch care to both kids and adults at Clear Allergy in Downtown Culver City, CA. As a mom of two, Dr. Marks-Cogan was inspired to work with Ready.Set.Food. Originally from Cleveland, OH, she graduated with honors from the University of Maryland School of Medicine after earning a Bachelor of Science Degree in Physiology and Neurobiology from the University of Maryland College Park.

Tips on how to make the best of your atopic dermatitis management and care plan.

 

Atopic dermatitis is not a diagnosis that you should go at alone. Your care team can consist of multiple health care professionals, from your GP to a nurse, a therapist, and even your pharmacist. Additionally, you should be an active member in creating your healthcare plan since you are the one who needs to follow through with it day in and day out. 

In this final episode of our Atopic Dermatitis in Skin of Color series, Dr. G and Kortney talk to Tonya Winders, the president of Allergy Asthma Network, to discuss the nurse's role in AD management and shared decision-making. Tonya also shares her experiences of having a daughter with atopic dermatitis and the psychological toll the disease can have on patients. 

 

What we cover in this episode:

- Who can all be a part of your healthcare team

- Telehealth for atopic dermatitis

- Why decision aids are essential to use

 

Interview with Tonya Winters: 

- Nurses in an outpatient setting - understanding their role in patients with atopic dermatitis.

- Nurse versus a nurse practitioner

- Developing an atopic dermatitis plan - asking what your goals are.

- Allergy and Asthma Network is working to help more nurses and physician assistants to become certified in managing atopic dermatitis.

- Shared decision making - what is it, and how can you be sure you are practicing this with your healthcare team

- How to talk to your doctor about your financial situation when making your treatment plan

- Using shared decision aids to help with shared decision making and as a guide to talking with your care team.

- The importance of addressing psychological health for people with atopic dermatitis

 

Helpful Links:

The role of the nurse in the care and management of patients with atopic dermatitis - Paper co-authored by Tonya: https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-020-00494-y

Shared Decision Making Aids: www.ithcpodcast.com

Imagine being so itchy that you’d consider cutting off your skin just for relief. That’s what it can be like living with chronic spontaneous urticaria.

We sit down with Heather, a patient living with chronic spontaneous urticaria, as she candidly shares her experiences from the initial diagnosis to navigating the complex landscape of treatments and mental health support. Her story sheds light on the day-to-day struggles and triumphs of managing CSU, offering hope and practical advice for those in similar situations.

Dr. G unpacks Heather's diagnosis and treatment journey, including antihistamines and Omalizumab. Dr. G also highlights the importance of managing mental health. Kortney shares her experience of itch and, with Heather, discusses the impact of chronic itching on quality of life and how to explain this to friends and family.

What we cover in our episode about living with chronic spontaneous urticaria

• Heather's Journey with CSU: Heather shares her initial diagnosis and the rollercoaster of emotions and challenges that followed.
• Anaphylaxis vs. CSU: Understanding the critical differences between these two conditions.
• Finding the Right Treatment Plan: The journey to discovering effective medications like antihistamines and the injectable - Omalizumab (Xolair).
• Mental Health Support: The importance of therapy and online resources in managing life with CSU.
• Management strategies: Heather shares what works for her in managing exacerbating situations. 
• Advice for New Patients: Heather offers valuable advice for those beginning their CSU journey.

More resources about chronic spontaneous urticaria: 

• Chronic Urticaria Management, Resources & Glossary of Terms: https://allergyasthmanetwork.org/health-a-z/chronic-urticaria/management-and-resources/
• What is Chronic Urticaria: https://allergyasthmanetwork.org/health-a-z/chronic-urticaria/ 
• More information about Omalizumab (Xolair): https://www.xolair.com/chronic-spontaneous-urticaria.html
• Episode Heather talks about where she learned to call her condition Lynda: https://www.itchpodcast.com/episodes/71-living-with-mastocytosis 

Disclaimer: This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

You have been diagnosed with atopic dermatitis or you are experiencing an eczema flare, now what can you do to treat it? 

In the fourth part of the series on atopic dermatitis in skin of color, Dr. G and Kortney discuss all medications available to treat AD, from topicals (creams) to oral medication and injections. 

They also discuss how other strategies to treat AD that is more budget-conscious if your insurance does not cover certain medications. 

What we cover in this atopic dermatitis in skin of color episode:

- Topical steroids: what are they, how to use them and their side effects

- Topical steroid withdrawal

- Other topicals that do not contain steroids

- Oral medication that may be prescribed for atopic dermatitis: oral steroids, antibiotics and antihistamines

- Biologics: what are they and their side effects

- Wet wrapping

- Phototherapy

From Shiv

- How to wet wrap and why she likes this form of treatment

Helpful atopic dermatitis in skin of color resources:

Non-Steroidal Topicals

1. Calcineurin inhibitors - tacrolimus ointment (Protopic) and pimecrolimus cream (Elidel)
2. Phosphodiesterase 4 inhibitor - crisaborole (Eucrisa)
3. JAK inhibitors. 

Bleach bath recipe from the American Academy of Allergy, Asthma and Immunology (AAAAI)

• Add ¼ - ½ cup of common 5% household bleach to a bathtub full of water (40 gallons). 
• Soak your torso or just the affected part of your skin for about 10 minutes
• Limit diluted bleach baths to no more than twice a week. 

 

More information about AD in skin of color: https://eczemainskinofcolor.org/eczema-diagnosis-skin-of-color/

Practical tips about skin care maintenance for atopic dermatitis

In the third part of our 5 part series in collaboration with the Allergy & Asthma Network on atopic dermatitis in skin of color we are talking all about taking care of your skin and how to make your living environment more atopic dermatitis friendly.

 

Dr. G and Kortney the importance of skin hydration; the best ways to moisturize and shower. They also share ways to ensure your living environment is optimized for good skin conditions, from cleaning products to carpets. Finally, they go over the psychological side of atopic dermatitis and how to maintain balance in the body and the mind. 

 

What we cover in this atopic dermatitis in skin of color episode:

Understanding the importance of keeping atopic skin hydrated.

How to break the itch-scratch-rash cycle.

Skincare: bathing and moisturizing - the preferred types of cleansers and moisturizers to use.

How to make your living environment atopic dermatitis friendly.

Sleep hygiene for atopic dermatitis.

Managing stress to help control eczema - some things that can help you.

Strategies to stop scratching.

 

From Shiv

How moving helped her flares.

Seeking therapy was important to her mental health and skin healing.

 

Helpful atopic dermatitis in skin of color resources:

Resource for AD in skin of color:  https://eczemainskinofcolor.org/eczema-diagnosis-skin-of-color/

Dr G and Kortney discuss yoga for asthma - many of the tips can also apply to atopic dermatitis:https://allergyasthmanetwork.org/news/does-yoga-benefit-asthma/ 

More eczema episodes: https://www.itchpodcast.com/eczema

Yoga for asthma podcast: https://www.itchpodcast.com/episodes/48-yoga-asthma

Meet Shiv on Instagram: https://www.instagram.com/shivaika/ 

How do doctors diagnose atopic dermatitis in skin of color?

In the second part of our 5 part series in collaboration with the Allergy & Asthma Network  on atopic dermatitis in skin of color we are talking about diagnosis!

Dr. G and Kortney discuss all of the tests involved in diagnosing atopic dermatitis (AD) in people with skin color. They also cover all of the skin conditions that are ruled out when a doctor is making a diagnosis and the importance of patient history in diagnosis. 

 

What we cover in this episode:

• A quick overview of what AD looks like in skin of color

• Skin conditions that may look like atopic dermatitis and common misdiagnosis

• The symptoms doctors look for when diagnosing atopic dermatitis

• Explanations of the  tests doctors use to diagnose atopic dermatitis- IgE blood test, component blood test, skin prick test, patch testing,and  skin biopsy

• How to diagnose eczema in babies and the link to food allergies

• The other factors that doctors take into account when diagnosing AD - the importance of patient history

 

From Shiv:

• Shiv shares her experiences with being diagnosed with atopic dermatitis and her experiences with different doctors.

 

Helpful Links:

• Link to images of AD in skin of color: https://eczemainskinofcolor.org/image-library/

• “What is eczema” from Allergy & Asthma Network: https://allergyasthmanetwork.org/what-is-eczema/

• More about Shiv: https://www.instagram.com/shivaika/

This is the first episode of our 5 part series in collaboration with the Allergy & Asthma Network about atopic dermatitis in skin of color. 

In the first episode, we are going to talk about atopic dermatitis (AD) in people with skin of color. Atopic dermatitis affects everyone differently, which means it does not look the same on everyone or in every skin color. It is important to recognize this and to raise awareness on how AD impacts certain populations differently than others. 

Along with Kortney, Dr. G will be sharing her expertise as an allergist and will be overviewing the basics of AD. Special guest Shiv Sewlal shares her personal experiences with atopic dermatitis. 

 

What we cover in this episode

• Why are we doing a podcast series about atopic dermatitis (AD) in people with skin of color?

• What is atopic dermatitis?

• Is eczema the same thing as atopic dermatitis?

• What is the difference between child onset versus adult-onset atopic dermatitis? Can you develop AD as an adult?

• Why is atopic dermatitis more prominent in people with skin of color?

• How can housing impact your skin? 

• Why air conditioning can be helpful for people with atopic dermatitis.

• Why is atopic dermatitis underdiagnosed in patients with skin of color?

• What are the symptoms of AD in different skin colors?

• What are triggers? How do these make atopic dermatitis worse?

• How does mental health impact atopic dermatitis?

• What is the itch-scratch cycle?

• Who should you see if you think you have atopic dermatitis?

 

From Shiv

• Shiv shares what her atopic dermatitis looks like

• Shiv and her mom’s experience with therapy to help with her skincare

 

Helpful Resources

•  All our past atopic dermatitis episodes: https://www.itchpodcast.com/eczema

• More about Shiv: https://www.instagram.com/shivaika/

• "What is eczema" from Allergy & Asthma Network: https://allergyasthmanetwork.org/what-is-eczema/

Can yoga help with asthma management and control?

We are releasing the ‘Yoga breathing exercises for asthma’ panel discussion that Dr. G and Kortney had in the late fall of 2021. This was one of 3 Living Well with Asthma Virtual Events organized by Allergy & Asthma Network and sponsored by GSK.

What we cover in this climate change episode:

- The benefits of yoga for your breath, asthma and overall health. 

- How yoga gives you more body awareness that helps with asthma management. 

- How to choose which form of yoga to do.

- When to use an albuterol inhaler before yoga.

- How to prepare for your first yoga class and what to look for. 

- The difference between doing yoga at home vs doing yoga in a studio.

 

Q&A section:

- Can yoga help with vocal chord dysfunction?

- How about going to a studio during the pandemic?

- Do you need to modify your yoga practice due to age?

- Are there any medical conditions that would stop you from doing yoga?

What are the impacts of climate change on human health?

Climate change is a large public health threat, it impacts all aspects of human health from physical to mental. Dr. Neelu Tummala joins us to discuss how we are seeing the direct effects of climate change on human health. She also shares ways that both patients and doctors can take action to help combat climate change. 

The face of climate change is no longer the polar bear, it is your son, your grandma, your neighbour, and even you!

What we cover in this climate change episode:

• How is climate change impacting our health? 

• Why are doctors are concerned about the increased length of pollen allergy season? 

• What can doctors and patients do to make a difference with climate change?

  • Understanding what changes the government can do such as the Build Back Better Act

  • Supporting local organizations 

  • Energy efficiency home

• Building awareness: if you are living with a condition that is affected by climate change and your environment - talk about it!

• How climate change is impacting lower-income communities more than wealthy communities?

• Dr. Tummala explains why you want to talk about climate change with your doctor

• The importance of being aware of the air quality index

• How much impact does an individual have versus a government or big company?

• Plant-based diet - what if you love eating steak?

• Is recycling actually worth it?

Helpful resources:

More about Dr. Neelu Tammula

• Dr. Neelu Tummala is a board-certified physician, surgeon, writer and climate advocate who has a special interest in education and advocacy concerning the health effects of climate change and environmental injustice. 

• She is on the Steering Committee for Virginia Clinicians for Climate Action and is a trained Climate Reality Leader. She has worked with the American Lung Association, Union of Concerned Scientists, The Medical Society Consortium on Climate and Health, and Environment Virginia as a volunteer activist and educator.

• Follow Dr. Tummala on social media:

  • https://www.instagram.com/neelutummala/

  • https://www.linkedin.com/in/neelu-tummala-55600196/

  • https://twitter.com/neelutummala

How are headaches related to allergies?

If you have allergies or don’t have allergies, but you get your fair share of headaches and or migraines this episode is for you. 

We are joined by Dr. Huma Sheikh a board-certified Neurologist-Headache and Vascular Disorder Specialist. She gives us the 101 on all things headaches and migraines and lays out the connection between headaches and allergies. If you say you have sinus headaches then you will be sorely surprised to learn that is not a medical condition. 

 

What we cover in this importance of sleep episode 

What are headaches?

What is the trigeminal nerve, why is it important in headaches?

What is homeostasis?

Primary and secondary headaches - when headaches are a symptom and when is a headache the main disease such as a migraine. 

How are allergies and headaches linked?

The link between allergies and migraines?

What is a sinus headache?

Cross-over between allergies of the eyes and nose and headaches. 

What is trigeminal neuralgia? How to differentiate it from allergies. 

When should someone see a headache specialist?

Comorbidities and migraines.

How are migraines diagnosed?

Can certain foods and food intolerances cause headaches?

Can histamines cause headaches?

How are headaches and migraines treated?

NSAIDs - how do these medications work? What is an NSAID allergy?

How do you know that you need to see a doctor about your headaches?

 

ADDITIONAL INFO

Dr. Sheikh: @headachesnyc: https://www.instagram.com/headachesnyc/?hl=en

www.headachesnyc.com

 

NSAID list: 

https://www.hopkinsmedicine.org/transplant/programs/kidney/living_donors/NSAIDs%20List%20to%20Avoid.pdf

What is the importance of sleep? Why is it something we want to talk about on a podcast about asthma, allergies, and eczema?   Sleep is the center of health, so naturally, it would have an impact on asthma and environmental allergies. Dr. Carol joins us to discuss the importance of sleep from how it impacts your overall health, mood, productivity, hunger, and more! She unpacks what good sleep looks like, how to figure out if you are getting enough sleep, and of course how sleep impacts allergies and vice versa.   What we cover in this episode: - Why is sleep so important? - How much sleep do you need? - The pros and cons of napping. - What is more important sleep quality or quantity? - What does good quality sleep look like? - How do you know if you are getting enough sleep? - How do allergies impact sleep and vice versa? - How to get better sleep? - What is sleep hygiene? - Can air purifiers help you with your sleep quality? - How does special bedding, like dust mite covers, help people with environmental allergies? - Best practice for sheet care and mattress care for people with environmental allergies. - Do any allergy medications impact sleep? - Restless leg syndrome and how this can be impacted by allergy medication. - When should you go see a sleep specialist?   Additional resources: - More about Dr. Carol: Telehealth: bhaisleephealth.com  and follow her on Instagram: @bhaisleephealth - Epworth sleepiness scale: https://nasemso.org/wp-content/uploads/neuro-epworthsleepscale.pdf - Air purifier: https://breathesans.com- get a discount using Gupta50 to get $50 off - How to claim CME credits from this episode: https://www.adaptrack.com/welcome/the-itch-podcast

Oral Immunotherapy, OIT, has been on a lot of food allergy minds lately, especially with the FDA approval of PALFORZIA (the peanut pill).

Dr. G and Kortney talk with Dr. Gharfeh is a double board-certified pediatric trained allergist/immunologist practicing in Oklahoma City. She has first-hand knowledge when it comes to OIT as she practices in clinic and has recently undergone OIT with her daughter. 

What we cover in this episode on Oral Immunotherapy

• The types of immunotherapy including OIT, SLIT, and epicutaneous.
• The current research and status of OIT for the different allergens.
• The status of peanut for OIT. 
• Unpack the advantages and disadvantages of Palforzia, the FDA-approved peanut pill.
• Outline the process of OIT at the allergist office.
• What happens is if you react during OIT.
• How allergists ensure the protein in the doses are used for OIT. 
• The pros and cons of doing oral immunotherapy as a patient and as a family such as the time commitment and risks of OIT.
• The reason why OIT is mostly targeted to under 18s. 
• The side effects of OIT.
• Risk of developing EOE during OIT. 
• Current unknown of OIT - will the desensitization last? How long will the patient need to take the maintenance dose?
• What should a patient think about when considering OIT
• How many foods you can do at a time with OIT
• Dr Gharfeh shares her personal experience doing OIT with her daughter

Additional resources on Oral Immunotherapy

• Palforza: https://www.palforzia.com/
• Dr. Wasserman, the protocol Dr. Garfeh and her colleagues follow: https://www.allergypartners.com/northtexas/doctors/?providerid=796
• Dr. Maya N. Gharfeh's bio: https://oklahomaallergy.com/team/maya-gharfeh/
•  Dr. Garfeh on Instagram @allergistmama and Twitter @Maya Gharfeh MD

How to claim CME credits from this episode: https://www.adaptrack.com/welcome/the-itch-podcast

A bonus episode that digs into the possibility of being allergic to semen. We talk with Dr. Wright about human seminal plasma allergy (Hypersensitivity) - what is it and how common is it. Of course, you can't talk about intercourse without talking about kissing, so we also chat about how to safely kiss after your partner has consumed a food allergen.   This episode was sponsored by Allergy Insider.   What we cover in the episode - Can you be allergic to semen? - Can a food allergen be found in semen as it can in saliva? - What is the likelihood you could have a reaction via intercourse due to your partner eating an allergen? - What can you do if you have an allergy to semen? - How to test whether your allergy was from semen or something else? - What about kissing your partner if they have consumed a food allergen?   More helpful resources: - Kissing, Sex and Food Allergies - how to talk to your partner about your allergy and getting intimate. https://thezestfull.com/kissing-sex-food-allergies/ - Getting intimate with eczema https://www.itchpodcast.com/post/intimacy-and-allergies - Episode with Amanda and Dan about dating and alcohol when you have food allergies. https://www.itchpodcast.com/post/episode-24 Intimacy for people with latex allergies (later in the post) https://www.itchpodcast.com/post/intimacy-and-allergies

Yes, there are more options than antihistamines to treat chronic spontaneous urticaria. We dive into them! 

Dr. Sheila Gogate joins us to discuss the chronic spontaneous urticaria (CSU) treatments currently available for patients. Dr. Shaila Gogate outlines the treatment journey for CSU with an emphasis on shared decision-making.  

This episode emphasizes the importance of following treatment guidelines and adjusting medications as needed. We discuss the available treatments for urticaria, including antihistamines, omalizumab (Xolair for hives), and Cyclosporine. The episode also explores the journey of managing CSU symptoms through both medical and non-medical approaches.

What we cover in our episode about chronic spontaneous urticaria treatments

• Treatment Path and Guidelines: Overview of doctors' steps to treat CSU. The importance of shared decision-making in the treatment plan. 
• Antihistamines: Role of oral antihistamines and H2 blockers in managing hives, dosing options, side effects, when to change medications, and how to choose the right antihistamine.
• Advanced Treatments: If antihistamines fail, the following steps include omalizumab (Xolair) injections or Cyclosporine. An overview of both dosing options and side effects.
• Emerging Therapies: Treatments like Remibrutinib and Dupilumab.
• Quality of Life and Non-Medical Management: The Urticaria Activity Score (UAS7). Mental health screening for CSU patients and strategies like stress reduction and if special diets are effective.

About our guest, Dr. Shaila Gogate

Dr. Shaila Gogate, board-certified by the American Board of Allergy & Immunology, has been with Colorado Allergy & Asthma Centers since 2014. She completed her medical education at Chicago Medical School, her residency at Washington University, and her fellowship at National Jewish Health in Denver. Dr. Gogate has served as an Assistant Professor at the University of Colorado, has extensive clinical research experience, and emphasizes strong patient-provider communication to develop effective treatment plans.

More resources about chronic spontaneous urticaria: 

• Chronic Urticaria Management, Resources & Glossary of Terms: https://allergyasthmanetwork.org/health-a-z/chronic-urticaria/management-and-resources/
• What is Chronic Urticaria: https://allergyasthmanetwork.org/health-a-z/chronic-urticaria/ 
• How Mast Cells Work Video_ mast cell video - explanation of mast cell (07:20): https://youtu.be/OF7tBIvMK_0?si=osJaIpTrivUP1Owr
• Urticaria Activity Score (uas7): https://www.mdcalc.com/calc/10226/urticaria-activity-score-uas

More information about XOlair: https://www.xolair.com/chronic-spontaneous-urticaria.html

Time to tackle some common food allergy myths and listener questions.

Dr. Wright, a board-certified allergist and Medical Director at Thermo Fisher Scientific, joins Dr. G and Kortney to bust common misconceptions that circulate around food allergies as well as answer your questions.

What we cover in this episode:

- The difference between food allergy and food intolerance.

- How an allergist diagnoses a food intolerance.

- What medication exists for people with intolerances and how they work.

- How likely is it for your second child to develop a food allergy if their sibling does.

- Should you get your child tested for an allergy before introducing an allergenic food?

- If your child has eczema will they develop a food allergy?

- If you are allergic to peanuts will you also be allergic to legumes?

- If taking a food out of your diet will lead you to become sensitized to it and potentially develop an allergy to it?

- Is it true that when your allergen appears on a may contain label, you have to 100% avoid eating it?

- When it is appropriate to use Benadryl for an allergic reaction. 

- The importance of epinephrine auto-injectors.

- Why you should not become complacent about having “little reactions”. 

- Can antihistamines mask anaphylaxis?

- Will throwing up the food with an allergen in it lessen your chances of having a reaction?

-  Could you have an allergic reaction if you did not swallow the food with your allergen in it?

 

This episode was sponsored by Allergy Insider.

 

Additional Resources:

Allergy Insider

- Allergy Insider: https://www.thermofisher.com/diagnostic-education/patient/us/en/allergy.html?cid=0so_3pc_01062021_L5HBXE

- Follow @allergyinsider on Instagram for more information on allergies: https://www.instagram.com/allergyinsider/

- Follow Allergy Insider on Facebook: https://www.facebook.com/AllergyInsiderUS/

- Follow Dr. Wright on Instagram: https://www.instagram.com/dr.wright_allergist/

 

More information about:

- Food Allergy vs. Food Intolerance: https://www.thermofisher.com/diagnostic-education/patient/us/en/blog/food-allergy-vs-food-intolerance-blog.html?redirect=false&cid=0so_3pc_01062021_L5HBXE

- How to read a label: https://www.thermofisher.com/diagnostic-education/patient/us/en/blog/how-to-read-a-food-label.html?redirect=false&cid=0so_3pc_01062021_L5HBXE

- How to Prepare for a Food Allergy Emergency: https://www.thermofisher.com/diagnostic-education/patient/us/en/blog/how-to-prepare-for-a-food-allergy-emergency.html?redirect=false&cid=0so_3pc_01062021_L5HBXE

 

Relevant The Itch Episodes:

- Ep. 22: Food Allergy Myth Busting - https://www.itchpodcast.com/post/episode-22

- Ep. 42: What are cross-reactive allergens? - https://www.itchpodcast.com/post/cross-reactive-allergens

- Ep. 2: The science behind an allergic reaction - https://www.itchpodcast.com/post/episode-2

Do certain foods make your mouth itchy? We may have the reason why!

In this episode, Dr. G and Kortney are joined by Dr. Wright, a board-certified allergist and Medical Director at Thermo Fisher Scientific, as they demystify cross-reactivity in food allergies. 

What we cover in this episode:

- What is cross-reactivity? Cross-reactivity with pollen versus cross-reactivity between IgE mediated allergens.

- What is oral allergy syndrome (OAS), and why do allergists prefer pollen food allergy syndrome?

- The difference between OAS and true food allergies causing anaphylaxis.

- How do you know it is an allergy due to pollen cross-reactivity (OAS)? 

- What are the symptoms of OAS?

- How is oral allergy syndrome diagnosed?

- Can you have anaphylaxis to foods that OAS causes?

- Are there some fruits and vegetable varieties that are better for people to eat who have OAS?

- When do people start to develop OAS?

- Who would typically develop OAS?

- The cross-reactive pollens and their cross-reactive foods.

- The types of tests available for testing cross-reactive allergens: skin prick, blood test and component testing. 

- How to determine if a food is an allergen due to pollen cross-reactivity or IgE mediated.

- Why would you consider getting component testing?  

- How component testing can help determine if you can tolerate baked eggs and baked milk.

- How to determine if you are a candidate for an oral challenge.

 

This episode is sponsored by Allergy Insider.

Additional Resources:

Allergy Insider

- Follow @allergyinsider on Instagram for more information on allergies: https://www.instagram.com/allergyinsider/

- Follow Allergy Insider on Facebook: https://www.facebook.com/AllergyInsiderUS/

- Allergy Insider’s #ThatKid Campaign: https://www.thermofisher.com/diagnostic-education/patient/us/en/that-kid.html

- Follow Dr. Kia Wright on Instagram: https://www.instagram.com/dr.wright_allergist/

More information about:

- Understanding allergy cross-reactivity: https://www.thermofisher.com/diagnostic-education/patient/us/en/understanding-allergies/cross-reactivity.html 

- OAS (oral allergy syndrome): https://www.thermofisher.com/diagnostic-education/patient/us/en/allergy-symptoms/head-eyes-ears-nose-throat-heent-allergy-symptoms/oral-allergy-syndrome-oas.html

- Component testing: In the US, component testing available: Milk, egg, peanuts, some tree nuts (hazelnuts, walnuts, Brazil nuts, cashew)

- More information about allergy testing: https://www.thermofisher.com/diagnostic-education/patient/us/en/testing-for-allergy-triggers.html

Relevant The Itch Episodes:

- Ep. 34: What are allergies of the eyes and nose (environmental allergies): https://www.itchpodcast.com/post/episode-34

- Ep. 35: How to treat environmental allergies (allergies of the eyes and nose): https://www.itchpodcast.com/post/episode-35

- Ep. 5: The types of food allergy testing & why they can be so hard to interpret: https://www.itchpodcast.com/post/episode-5

Air quality and climate change’s impact on asthma and allergies   The quality of our environment has a direct impact on our health. As temperatures rise, pollen seasons grow longer and pollution worsens due to warmer air, which helps to form ground-level ozone, sometimes called smog.   Kenneth Mendez, President & CEO, Asthma & Allergy Foundation of America (AAFA), joins us to discuss air quality and climate change’s impact on asthma and allergies. We discuss all the factors that can impact air quality and how this impacts our health, focusing mainly on asthma and seasonal allergies. Kenneth also shares more information about the Allergy Capital Report put out annually by AAFA. What we cover in this episode:

• Impact of climate change and air pollution for seasonal allergies and asthma.
• What are seasonal allergies?
• Air quality:
  • Why people with environmental allergies and asthma should pay attention to it
  • Air quality index
  • Indoor air quality should not be ignored.
• Climate change:
  • Warmer temperature’s impact pollen
  • Earlier pollen season, frost comes later
• Covid-19 and asthma:
  • The outcomes are not worse
  • How to differentiate if it is Covid-19 or seasonal allergies (Hay Fever does not mean fever is a symptom)
• Why talking to your doctor and getting your asthma under control is so important for your health
• What mask-wearing can signal about your asthma
• Signs of uncontrolled asthma
• Allergy Capitals Report and Asthma Capitals Report made by AAFA
  • What are they measuring and why is this important?
  • Cities/urban environments are a good place to look at what the impacts of climate change will look like in the future for individuals with asthma and allergies
• How to minimize your allergy symptoms

Additional resources:

• AAFA Online community: aafa.org/join
• AAFA’s 2021 Allergy Capitals™ report: allergycapitals.com
• Healthy Home
• Indoor Air Quality
• Control Indoor Allergens
• SYMPTOMS CHART: IS IT COVID-19, THE FLU, A COLD, ALLERGIES OR ASTHMA?

Follow AAFA:

• Facebook: @AAFANational
• Instagram: @aafanational
• Twitter: @AAFANational

Dr. G and Kortney chat with Dr. Manisha Relan about how food allergies are portrayed in the media both the bad and good sides. They briefly talk about the medical side of anaphylaxis before diving head first into breaking down some famous food allergy scenes. 

 

Dr. Manisha Relan is a pediatric allergist and clinical immunologist at a private practice in central New York, where she sees both children and adults for all things allergy. She loves learning and teaching. During fellowship, she was in charge of anaphylaxis training via a simulation lab experience; in her practice she is passionate about women’s health, food allergies, rhinitis, and immunotherapy. She maintains a personal professional Instagram account @pedsallergymd where you can follow her for more.   

What we cover in this episode:

The 3 definitions of anaphylaxis.

How movies and TV shows help patients describe their allergic reactions.

How allergists use movies and TV shows to help understand what their patients have experienced.

Why media should ensure they are properly portraying food allergies.

The negative impacts of media using food allergies as a joke.  How does this directly impact the food allergy community?

The misinformation being portrayed by the media when showing an allergic reaction. 

Beyond humour, the other focus in media is harming people who have food allergies. How does this bullying impact people managing allergies?

Should kids sit at an allergy table?

What shows are doing it right? 

The scenes discussed in this podcast episode: Adults Reacting

Friends: https://www.youtube.com/watch?v=Ub3sE1ww6ac

1. Allergy: kiwi.
2. Ross is allergic to lobster, peanuts, kiwi. He eats a kiwi-lime pie thinking it was key-lime. 
3. Symptoms: throat/tongue swelling
4. Treatment: goes to hospital

Hitch: https://www.youtube.com/watch?v=SdDPoFcBZEY

1. Allergy: seafood. 
2. Symptoms: throat feels itchy (trying to scratch the throat), swelling. 
3. Treatment: Running to a pharmacy, buying Benadryl is not an accurate way to treat it.

Monster-in-Law: https://www.youtube.com/watch?v=MHpyl6uVPrw, https://www.youtube.com/watch?v=l8XC_Zee8XA

1. Allergy: almonds. 
2. Symptoms: tongue swelling and lips. 
3. Treatment: not shown

Peter Rabbit: https://www.youtube.com/watch?v=9VwWPnHZMrs

1. Allergy: blackberry
2. Symptoms: not really shown
3. Treatment: Has epipen on him, no hesitation to use it. 

Kids/Teens Reacting

Daniel Tiger: https://www.youtube.com/watch?v=ysEk_aLvGYg

1. Allergy: peach
2. Symptoms: itchy, hives - red bumps, tummy ache 
3. Treatment: liquid medication

Arthur: https://www.youtube.com/watch?v=QZ5JB7z7nOk

1. Allergy: peanut
2. Symptoms: itchy
3. Treatment: adrenaline pen

Freaks and Geeks: https://www.youtube.com/watch?v=VE65VbUBGbI

1. Allergy: peanut
2. Symptoms: we just see him on a stretcher with an oxygen mask, coma
3. Treatment: called ambulance

Additional resources:

• List of other scenes portraying allergic reactions from Everyday Allergen-Free 
• Opper, C. E. (2015). Food Allergy Framing in Entertainment Media: The Use of Humor and Its Influence on Health Thoughts and Behavior [Senior Honors Thesis, University of North Carolina at Chapel Hill]. Carolina Digital Repository.

Urticaria, also known as hives can be triggered by many things. From the heat to water, to the spontaneous hive, these can be a burden for many patients. Knowing what triggers urticaria can help manage hives and lessen their impact on the quality of life. Hives may feel mysterious, but they don’t have to be.

Today Dr Patel, a double board-certified Allergist/Immunologist, joins us to discuss the causes of urticaria, how urticaria is diagnosed and how it is treated. 

What we cover:

• What is urticaria, more commonly known as hives. 
• What does urticaria look like? How do you know they are hives?
• Who typically gets urticaria?
• What are the causes of urticaria?
• What is a rash? A hive is a kind of rash.
• Chronic versus acute hives. 
• Types of urticaria:
• Idiopathic urticaria (spontaneous urticaria) 
• Physical urticarias: 
  • Dermatographic
  • Pressure urticaria
  • Vibration urticaria
  • Aquagenic urticaria
  • Cholinergic urticaria (exercise)
  • Cold urticaria
  • Heat urticaria
  • Solar urticaria 
• How stress impacts hives and allergic responses. 
• How is urticaria diagnosed?
• Why you want to see an allergist about urticaria.
• Ways to treat urticaria: Antihistamines, Xolair (omalizumab), Immunosuppressants, Topic medication, Oral steroids
• Are urticaria and eczema linked?
• Impact of having hives on daily life. 

Useful Links: The two meditation apps Kortney highly recommends are Insight Timer and Waking Up.

Dr. Lacey Robinson joins Kortney and Dr. G to discuss where we are at with understanding allergic reactions to the two mRNA COVID-19 vaccines (Pfizer-BioNTech and Moderna).    Dr. Robinson outlines the current theories on what may be causing these allergic reactions, who should get an allergy test before having the vaccine, and what the other symptoms that could appear like an allergic reaction to the vaccine are.    Important note about this episode, as things are changing rapidly in what we know about the COVID-19 vaccines:

• This episode was recorded on January 21, 2021, released January 26, 2021
• Discussions about the COVID-19 vaccines refer to the Pfizer-BioNTech vaccine and Moderna vaccine, both mRNA vaccines. 

What we cover in this episode:

• How common are vaccine allergies? 
  • Stat: 1.31 cases of reactions per 1 million doses given.
  • The CDC reviewed the Pfizer vaccine given in December 2020. They found 21 cases of confirmed anaphylaxis in 1.89 million does, which is 11.1 cases per 1 million does. Only 7 of the 21 had a history of anaphylaxis.
• What are the symptoms that can be mistaken for an allergic reaction when receiving the COVID-19 vaccine?
• What studies are in the pipeline to look at allergy to the COVID-19 vaccines, specifically mRNA vaccines. 
• Types of anaphylactic reaction:
  • IgE medicated reaction
  • Non-IgE mediated: Mast cell activation or compliment mediated anaphylaxis
• Some symptoms that you can expect when getting the COVID-19 Vaccine:
  • Large local reaction
  • Tired
  • Muscles aches and pains
  • Headaches
  • Fever
• Timing of an allergic reaction (true allergy) versus other typical symptoms coming from the vaccine. 
• What they suspect are the reasons that people are having an allergic reaction to the COVID-19 vaccine
  • Note mRNA vaccines do not contain any food allergies.
  • Polyethylene glycol (PEG) is the suspected allergen. PEG is a common ingredient in many medical products. A very rare allergy 4 cases per year. 
• Could you be reacting to the mRNA that you are making from the vaccine?
• Who should consider getting an allergy test for the COVID-19 vaccine. 
• How are people being treated if they are having an allergic reaction to the COVID-19 vaccine?
• If you had a reaction to the vaccine or you have a PEG allergy, what are the steps involved in evaluating if you can get the COVID-19 vaccine.
• How allergist test PEG allergy. 
  • What is the likelihood of a false negative test result?

Resources:

• Allergic Living article Kortney quotes: https://www.allergicliving.com/2021/01/03/likely-more-than-one-cause-for-covid-19-vaccine-reactions/
• Our episode about understanding the COVID-19 Vaccines: https://www.itchpodcast.com/post/episode-37

A mini popup episode for you!

MILK versus MYLK, what's the deal? Amanda from the blog Everyday Allergen-Free joined Kortney to explore what spelling milk with an 'I' versus milk with a 'Y' means and how it can impact someone’s experience with that food.   This lead to a discussion about feeling left out when you have food allergies and whether getting an allergy-safe version of a classic food makes you feel included or different. What we cover:

• Inclusive language for those with food allergies.
• When did the alternative spelling of MYLK show up? 
• How does speaking milk with a y help or hinder those with a dairy allergy?
• Feeling left out/longing for what you can’t have, especially when you have food allergens in the house.
• Does an allergy-safe version of a food make you feel included or different?
• What terms can you use to talk about allergy-safe food replacements. 
• The attitude to have when trying to recreate foods that contain an allergen.
• What does the ‘real’ version of a recipe mean for an allergy person?
• The different trends in plant based milk.

Helpful links:

• More about the language we use when talking about food allergies
• Oatmilk recipe from Amanda's blog Everyday Allergen-Free
• Our Instagram, @theitchpodcast, tell us how you think we should spell plant based milk

Dr Purvi Parikh joins us to talk about the two available Covid-19 vaccines currently available. Dr Parikh and Dr G discuss the nitty-gritty of the two mRNA vaccines, the allergic reactions associated with them and more. What we cover in this episode

• Understanding herd immunity.
• What are mRNA vaccines, how do they work and when did they first get developed.
• Can people with food allergies get the Covid-19 Vaccine?
• Could you be allergic to the protein that the mRNA is producing?
• The side effects of the Pfizer Covid-19 Vaccine.
• Why you should get the Covid-19 Vaccine.
• Why the vaccine is in two does.
• Differences and similarities with data for Moderna and Pfizer/Biotech vaccines.
• What does the vaccine rollout look like?
• What are the other vaccines being developed?
• Why are people skeptical about vaccines?
• Can pregnant and lactating women get vaccinated?
• You can get the flu vaccine with an egg allergy.

Resources:

• Article from Allergic Living about soy in PEG: https://www.allergicliving.com/2020/12/16/faq-on-allergy-concerns-and-the-mrna-covid-19-vaccine/
• Find more about Dr Parikh: FACEBOOK, INSTAGRAM

Registered dietician Alida Iacobellis joins Dr. G and Kortney to discuss how intuitive eating, diet culture, and food anxiety impacts those managing food allergies. Alida uses intuitive eating as a tool to help her clients find food freedom and believes it can also work to help people with food allergies gain a positive relationship with food. 

Alida is registered with the College of Dietitians of Ontario and holds membership with Dietitians of Canada. She also manages multiple food allergies, so she knows first hand how it feels to experience types of food fear surrounding allergens and anaphylaxis. 

What we cover in this episode

• The difference between a registered dietitian and a nutritionist 
• What is disordered eating and how to recognize it in yourself or others
• How disordered eating and living with food allergies can cross paths
• People with food allergies have an increased risk of developing eating disorders
• The role of diet culture in disordered eating and how it also impacts those managing food allergies 
• Anxiety around food - the underlying factors behind disordered eating
• Questions a doctor can ask to figure out if their patient may be experience disordered eating
• How can people with food allergies develop a better relationship with food
• Intuitive eating and how people with food allergies can adapt it
• What are food rules - why it is important to identify them and where they came from
• Thinking food will be a quick fix to our problems and how this is not always true
• What are the determinants of health and the role food has
• How to start your intuitive eating journey: food rules and listening to your body
• What does respecting your body mean for people with food allergies? It is about eating everything you can and having a good variety in your diet to meet your needs
• Emotional eating, turning to food to soothe or not eating at all due to anxiety
• Meal planning for intuitive eating
• Parent anxiety transferring to their child and how intuitive eating can help
• How to help someone or yourself identify disordered eating and first steps to reclaiming food freedom

Helpful Resources:

• Kortney’s her journey with disordered eating: Disordered eating hiding behind my food allergies 
• Intuitive eating resources for food allergies
• The graph on the determinants of health
• Dietician directory Websites: Dieticians of Canada, Health Profs
• Intuitive Eating Website

More about Alida Iacobellis RD: website, Instagram @alida.iacobellis.rd

 

Dr G and Kortney take another deep dive, this time exploring how to treat environmental allergies (allergies of the eyes and nose). A quick recap - when we talk about allergies of the eyes and nose, we are talking about allergic rhinitis and conjunctivitis. These are two forms of allergic responses that can be caused by things such as environmental allergens like pollen and grass, dust mites, and animal dander. What we cover in this episode

• Treatments for allergies of the eyes and nose: avoidance, natural methods, drug therapy and immunotherapy.
• Types of drug therapy for treating allergies of the eyes and nose: antihistamines, nasal sprays, eye drops
• If avoidance is not possible tips to create a safe space free from environmental allergies
• Demystifying hypoallergenic pets
• When to use and care for a Netti pot
• Different types of nasal sprays: intern-nasal antihistamines, intern-nasal decongestants, intern-nasal steroids.
• What to look out for and tips for using eye drops and artificial tears
• Topical antihistamine for the eyes
• Mast cell stabilizer eye drop & steroid eye drops
• Is it possible to use one treatment to treat both allergies of the eyes and nose?

Additional Information & Links

• Signs of allergies of the eyes and nose and they are diagnosed.
• How to use nasal spray: https://www.youtube.com/watch?v=ICqBAN28Tgo

How is the black community impacted by food allergies?

Dr. Carla Davis joins Dr. G and Kortney to discuss the impact of social determinants of health on food allergy outcomes within the Black community. Dr. Davis highlights historical factors like redlining and insurance disparities that exacerbate health disparities, resulting in higher prevalence rates of food allergies and multiple allergies among Black patients. These disparities often lead to increased emergency room visits and barriers to accessing allergen-free foods, compounded by socioeconomic challenges and food insecurity.

Dr. Davis also underscores how cultural differences significantly influence the management of food allergies within families, particularly during gatherings, and emphasizes the crucial role of media representation in raising awareness and promoting acceptance.

We discuss the critical need for increased Black representation in research trials, recognizing the challenges posed by longstanding mistrust in the medical community among Black patients.

Key Points Covered in This Episode:

• Health Disparities: Social factors significantly impact food allergy outcomes in the Black community.
• Limited Healthcare Access: Redlining and insurance disparities restrict healthcare access, worsening health outcomes.
• Food Insecurity: Challenges in accessing allergen-free foods are heightened by food insecurities and food deserts.
• Cultural Factors in Food Allergy Management: Cultural influences play a crucial role in managing food allergies within families.
• Resources for Food Allergies: Essential support from food banks and allergy organizations for managing allergies and food insecurity.
• Communication Tips for Patients: Practical advice for effective communication and advocacy with healthcare providers.
• Historical Mistrust of the Medical Community: Historical discrimination contributes to mistrust in healthcare, affecting access and outcomes.

Helpful Resources

• Health Disparities in Allergy, Asthma and Immunologic Diseases (New Webinar July 16, 2024): https://allergyasthmanetwork.org/webinars-updates/health-disparities-diseases/
• Black People Like Me Virtual Conference Series 2024: https://allergyasthmanetwork.org/trusted-messengers-project/black-people-like-me-2024/
• Food Allergy Resources: https://allergyasthmanetwork.org/allergies/ 
• School Plans for Students with Food Allergies: https://allergyasthmanetwork.org/news/school-plans-students-food-allergies/

Food Equality Initiative - Food Allergy Friendly Food Bank Resource: https://www.foodequalityinitiative.org/

A deep dive episode about allergic conjunctivitis and allergic rhinitis, also known as allergies of the eyes and nose respectively.    These are the two most common types of allergies affecting individuals. In the first part of our deep dive, Dr G goes into detail about the symptoms of the allergies of the eyes and nose, some things that may pose as them, and more. Part two will cover how to treat allergies of the eyes and nose.  What we cover in this episode

• What are allergic conjunctivitis (eyes) and allergic rhinitis (nose)?
• How common are allergies of the eyes and nose?
• Can you develop symptoms at any age?
• Signs and symptoms of allergies of the eyes and nose
• What you should know about environmental allergies.
• Environmental allergies, and the difference between seasonal and perennial allergies. 
• Why uncontrolled asthma can make allergies of the eyes or nose worse.
• How allergies of the eyes and nose are diagnosed and the testing involved: patient history, skin prick, blood test, intradermal testing, and patch testing. 
• Other conditions that look like allergic rhinitis and conjunctivitis
• Allergies of the eyes and nose in pregnancy
• Nasal Polyps
• Medications that can cause a runny nose/congestion. 
• Why you need to be cautious when using Afrin.

Additional Information & Links

• Pollen count app to download: Klarify
• American Lung Quit Smoking
• What to know about skin testing
• What are allergic shiners
• What is the Allergic Salute

A bonus 'mini' episode all about wearing a mask to help prevent catching and spreading COVID-19.

This is an excerpt focusing on face masks from episode #32 about COVID-19 and asthma with Melanie Carver of Allergy Asthma Foundation of America. 

What we cover in this episode:

• Best practices for handling a face mask
• What to look for when buying or making a face mask
• How to clean your face mask
• Can you wear a face mask with asthma

September is known as September Asthma Epidemic or Asthma Peak Week because of the increased hospitalizations due to asthma. Since we are entering the fall during the COVID-19 pandemic there are some additional preventative steps those with asthma should take this year.    Dr G and Kortney are joined by Melanie Carver, the chief mission officer of Asthma and Allergy Foundation of America. Melanie has been working on creating more resources surrounding COVID-19 and Asthma. She shares her expertise about the impacts of COVID-19 on asthmatics, schools, and wearing face masks.    What we cover in this episode:

• Why September is a peak month for asthma
• What you can do to help ensure you will not be negatively impacted by your asthma during September peak
• How COVID-19 impacts those with asthma 
• Back to school: what are asthma triggers that kids are being exposed to and how you can address them
• Back to school: what you need to know about preparing for being in the classroom
• The symptoms of COVID-19 versus the symptoms of asthma
• Does wearing a mask impact asthma
• Tips on wearing a mask
• What you can do to help protect yourself from COVID-19 this fall/winter (get a flu shot!)

Additional resources:

• Full list of resources for COVID-19 from AAFA
• Information about face masks
• September asthma peak information
• COVID-19 and Schools
• How to use a spacer with your inhaler
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How do you set up a 504 plan for food allergies and asthma?   Whether it is food allergies, asthma, ADHD or another disability, a 504 plan is an essential part of your child's school experience because it states in black and white why they need accommodations and what they are.   Kristin Osborne joins Kortney and Dr G as she outlines how to set up a 504 plan, what accommodations you can arrange for food allergies and asthma, what happens if your child's 504 plan is violated, and more! Kristin is a trained disability advocate and mom to three boys with multiple life-threatening food allergies, so you bet she knows all about what it takes for setting up a plan and navigating the federal school system.   What we cover in this episode:

• What is a 504 plan and who can get one?
• When can you start a 504 plan for your child? Preschool to high school.
• Can you have a 504 plan if your child goes to private school?
• How to qualify for a 504 plan: the eligibility meeting, the criteria, and who is involved in this process.
• The types of accommodations food allergies and asthma can have in a 504 plan.
• What would be considered a violation of the 504 plan?
• The steps to take if the 504 plan has been violated.
• The role of class parents in ensuring the 504 plan is respected.
• When and how you should get your food allergy child involved in the 504 planning process.
• What is your doctor’s role in setting up a 504 plan.
• Could COVID impact your 504 plan?
• Kristin’s honey and hot sauce method

Helpful Resources:

• Kristin's website and how to get in touch with her: www.theprioritizedgroup.com
• Sample Section 504 Plans for Managing Food Allergies from Kids with Food Allergies
• SAMPLE ACCOMODATIONS FOR 504/IEP/IHP from FAACT
• Section 504 and Written Management Plans from FARE
• Megan explains what she has in her son's plan for food allergies and EOE from Allergy Awesomeness