The Allergist AnewsletterfromtheOklahomaAllergy&AsthmaClinic Fall2017

The Allergist

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Ragweed allergy is one of the primary causes of fall allergies in the United States. A soft-stemmed weed, ragweed grows in most of the United States. It is tough and hardy and thrives in places where the soil has been disturbed. Rag-weed has 17 species and it belongs to a larger family of plants called Composi-tae. Other family plants include: sage; burweed march elder; rabbit brush (bur ragweed); mugworts, groundsel bush, and goldenrods, marigolds, zinnias, sunflowers.

Common ragweed plants only live for one season. Each plant alone produces up to one billion pollen grains. As the nights get longer, ragweed flowers ma-ture and release pollen. Plants grow in rural areas and urban waste spaces, Pollen levels are highest shortly after dawn. Airborne pollen peaks between 10 a.m. and 3 p.m. depending on the weather. Rain and morning tempera-tures below 50 degrees can block of slow pollen from releasing. Unfortu-nately, ragweed continues to release pollen from late summer to fall until the first hard freeze.

Ragweed pollen has been measured to travel 400 miles out to sea and two miles up in the atmosphere. However, most pollen grains fall near their sourc-es. Ragweed plants are often found along roadsides, riverbanks, vacant lots and in fields. Ragweed seeds are very hearty and can survive for decades in soil – growing again when conditions are favorable.

If you are struggling health-wise when ragweed counts are high, you may be allergic to ragweed. Approximately 10-20 percent of Americans suffer from ragweed allergy. If you are allergic to one type of plant pollen or to dust, ani-mals or even fungi, you will typically de-velop allergies to other pollens.

Those with an allergy to ragweed may experience symptoms such as mouth itching when eating cantaloupe and ba-nanas. Sunflower seeds, chamomile tea or honey containing pollen from Com-positae plant family members occasion-ally can cause severe reactions includ-ing anaphylactic shock.

Ragweed Allergy Symptoms• Eye irritation – itching, swelling and

redness

• Repeated sneezing

• Runny or stuffy nose

• Itchy throat and inside of ears

• Symptoms of asthma – including chronic cough, wheezing or diffi-culty breathing

Ragweed Allergy DiagnosisFirst, your allergist will ask your medical history, timing of symptoms and exami-nation. A skin test may be recommend-ed to confirm a suspected allergy.

TreatmentsAntihistamines often work well to con-trol symptoms of allergic rhinitis or hay fever. Nasal steroid sprays are also help-ful in conjunction with antihistamines and typically work best if started before or at the beginning of ragweed season and if they are used daily. Ragweed pol-len can also trigger asthma symptoms – such as coughing, wheezing, tight-ness in the chest or difficulty breathing. Your allergist can prescribe medicines that provide immediate relief and for long-term control. Immunotherapy for ragweed allergen which can come in the form of an injection or tablet, can help build your immunity to ragweed to help improve symptom control and po-tentially decrease the need for medica-tions.

Ragweed Continues its Fall Siege across Oklahoma

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During last year’s flu season, 715 people were hospitalized and 28 people died in Oklahoma, according to the Oklahoma State Commissioner of Health Dr. Terry Cline. The influenza vaccination is rec-ommended for everyone 6 months of age and older. Cases of influenza hospi-talizations have already been reported for this season.

Live attenuated influenza vaccine (LAIV) – or the nasal spray vaccine – is not recommended for use during the 2017-2018 season because of concerns about its effectiveness.

Can I get a flu vaccine if I am allergic to eggs?The recommendations for people with egg allergies are the same as last sea-son. People who have experienced only hives after exposure to egg can get any licensed flu vaccine that is otherwise appropriate for their age and health.

People who have symptoms other than hives after exposure to eggs, such as angioedema, respiratory distress, light-headedness, or recurrent emesis; or who have needed epinephrine or an-other emergency medical intervention, also can get any licensed flu vaccine

that is otherwise appropriate for their age and health, but the vaccine should be given in a medical setting and be su-pervised by a health care provider who is able to recognize and manage severe allergic conditions. (Settings include hospitals, clinics, health departments, and physician offices).

Do some children require two dos-es of flu vaccine?Some children 6 months through 8 years of age will require two doses of flu vaccine for adequate protection from flu. Children in this age group who are getting vaccinated for the first time will need two doses of flu vaccine, spaced at least 28 days apart. Children who have only received one dose in their lifetime also need two doses. Your child’s doctor or other health care professional can tell you if your child needs two doses of flu vaccine.

What can I do to protect children who are too young to get vaccinated?Children younger than 6 months old are at high risk of serious flu complications, but are too young to get a flu vaccine. Because of this, safeguarding them from flu is especially important. If you live with or care for an infant younger than 6 months old, you should get a flu vaccine to help protect them from flu. Everyone else who is around the baby also should be vaccinated. Also, studies have shown that flu vaccination of the mother during pregnancy can protect the baby after birth from flu infection for several months.

In addition to getting vaccinated, you and your loved ones can take everyday preventive actions like staying away from sick people and washing your hands to reduce the spread of germs. If you are sick with flu, stay home from work or school to prevent spreading flu to others.

Visit with your OAAC allergist about the flu vaccine.

It’s time to get your Flu Shot

For more information, visit www.carecredit.com

CareCredit: An Option to Pay

for Medical TreatmentsOklahoma Allergy & Asthma Clinic has partnered with CareCredit as a way for our patients to be able to afford medi-cal treatments.

What is CareCredit?CareCredit is a healthcare credit card designed for your health, beauty, and wellness needs. It’s a way to pay for the costs of many treatments and pro-cedures and allows you to make conve-nient monthly payments. For complete details of healthcare financing terms, please review the CareCredit account agreement within the application.

Where can I use CareCredit?CareCredit is accepted at over 175,000 providers nationwide for LASIK and Vi-sion Care, Cosmetic and Dermatology Procedures, Dentistry, Veterinary, Hear-ing Care and other specialties. CareC-redit is now also accepted at select re-tail locations.*

How is CareCredit different from my other bank cards?

CareCredit extends special financing of-fers that you can’t get when using your Visa or MasterCard to pay for health, beauty and wellness care at enrolled providers. With shorter term financing options of 6, 12, 18 or 24 months no in-terest is charged on purchases of $200 or more when you make the minimum monthly payments and pay the full amount due by the end of the promo-tional period. If you do not, interest is charged from the original purchase date.

CareCredit also extends longer term healthcare financing for 24, 36, 48 or 60-month periods with a Reduced APR and Fixed Monthly Payments Required until paid in Full. Purchases of $2,500 or more qualify for the 60-month offer with a 16.9% APR (24, 36 and 48 financ-ing terms are for purchases of $1,000 or more with a 14.9% APR).

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“The Allergist” is published quarterly by the Oklahoma Allergy & Asthma Clinic. Contents are not intended to provide personal medical advice, which should be obtained directly from a physician.

“The Allergist” welcomes your letters, comments or suggestions for future issues.Send to:The Allergist750 NE 13th Street Oklahoma City, OK 73104-5051Phone: 405-235-0040www.oklahomaallergy.com

Oklahoma Allergy & Asthma ClinicEditorial Advisory BoardDean A. Atkinson, M.D.Laura K. Chong, M.D.Scott B. Dennis, MHAWarren V. Filley, M.D.Richard T. Hatch, M.D.Bret R. Haymore, M.D.Gregory M. Metz, M.D.Patricia I. Overhulser, M.D.Shahan A. Stutes, M.D.Karen Gregory, DNPStefanie Rollins, APRN-CNPElisa Thompson, APRN-CNP

How to Have a Safe and Fun Halloween For children with allergies and asth-ma, Halloween can be a real bummer. Something as innocent as an ingredient in candy or in Halloween make up could cause a life-threatening allergic reac-tion. How can you keep your children safe this year?

The Teal Pumpkin Project is now in its fourth year as a national awareness campaign led by the Food Allergy Re-search & Education (FARE) set up as a way to create a happier, safer Hallow-een. The Teal Pumpkin Project encour-ages people to provide non-food treats on Halloween.

In the U.S., one in 13 children have at least one food allergy and anaphylactic reactions have climbed dramatically in recent years. By posting a FARE flyer at your home or a teal pumpkin on your porch, families will know that this is an allergy-free stop during trick or treat night.

How can you participate as a Teal Pumpkin supporter?Provide non-food treats for trick-or-treaters: glow sticks, bracelets, or neck-

laces, pencils, pens, crayons or markers, bubbles, Halloween erasers or pencil toppers, mini Slinkies, whistles, kazoos, or noisemakers, bouncy balls, finger puppets or novelty toys, coins, spider rings, Vampire fangs, mini notepads, playing cards, bookmarks, stickers or stencils.

You can also have candy at your home for those who are not food allergic – just keep it in a separate container.

Costumes are also a fun part of Hallow-een. For children with asthma, it might be better to skip wearing a mask so it won’t obstruct breathing. If your child has eczema or other skin allergy con-dition, consider using hypoallergenic makeup. Always test a small area of

skin first to see if there is a skin reaction before using makeup.

Parents, be prepared be-fore you go trick-or-treating with your kids. Carry a fully charged cell phone, emer-gency epinephrine and a bag of allergy-safe food treats for your little goblin. You can drop off safe treats to your neighbors so your child can go trick-or-treat-

ing in your neighborhood. Teach your child to say no thank you to homemade treats or ones that might cause an al-lergic reaction.

If you suspect your child may have aller-gies or asthma, make an appointment with an OAAC allergist for an evalua-tion.

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For more information, visit with your OAAC allergist.

Source: Asthma and Allergy Foundation of America

Ragweed Allergy...

If you needed to be tested for food allergies, OAAC employee Jean Jones probably had a hand in it. Originally from Watonga, Jean grew up in Okla-homa City graduating from Central High School. She spent two years at Cla-remore Junior College before moving back to Oklahoma City with her hus-band. She is a widow and spends most of her free time at church and sings in a ladies gospel singing group.

Jean joined the OAAC 18 years ago working in the record room. She was re-cruited by then employee Sherry Hubbard to join the dietician department and then took over that area when Sherry retired.

Jean shops, purchases and then prepares fresh foods for allergy testing. She maintains an inventory of the food, watches food expiration dates and keeps the stock up to date.

She works carefully with the staff to know how the food should be pre-pared. Whether it is a skin prick test for a child with a reaction to Goldfish crackers to preparing a food patch for an adult with eosinophilic esophagi-tis, Jean loves her job and loves interacting with the staff and the patients.

No matter what the suspected allergen is – Jean is a detective to hunt down that type of food and make sure it is available for testing.

OAAC Employee Spotlight: Jean Jones

If you have food allergies or someone in your family, you need to be a food de-tective and learn how to read the food labels on everything you buy. “Avoidance is really the only way to pre-vent a food-allergy reaction,” said OAAC Allergist Dr. Greg Metz. “Just looking at the food, you can’t tell if it contains an allergen. You have to carefully examine the label.”In 2004, the Food Allergy Labeling and Consumer Protection Act (FALCPA) made it clearer in the labeling process to identify food ingredients and to help avoid allergens. Even if you have purchased the food for years, ingredi-ents and manufacturing processes can change. Advisory labeling is voluntary by manufacturers. No laws require la-beling. Even if the product does not have an advisory label – this doesn’t mean the product is safe.“It’s best to make a habit out of care-fully reading labels to avoid allergens,” Metz said.Unfortunately, FALCPA only covers the eight most common allergens: milk, eggs, peanut, tree nuts, soy, wheat, fish, and shellfish. Molluscan shellfish –

oysters, clams, mussels or scallops are not required to be labeled as a major allergen. When you are reading the label, FAL-CPA-regulated allergens are listed in three ways: using the allergen’s com-mon name; “contains” the major food allergen, and the name in parenthesis when the ingredient is a less common form of the allergen, for example, albu-min (egg).Tree nuts, fish and crustacean shellfish must be specifically listed such as al-mond, tuna and crab, for example.Even a small amount of an FACPA-reg-ulated ingredient must be listed. Non-FALCPA regulated ingredients such as sesame and mustard might be part of the list if it is considered part of a spice or flavoring. These types of ingredients can be listed as “natural flavorings.”Labels can also say “this was processed in a facility that also processes or made on equipment with…” These warnings usually follow the ingredients listed.Phrases such as peanut free and egg free are not regulated. Labels can have these phrases but the product could be manufactured where allergens are

Food Allergies: Help with Reading Food Labelspresent. Contact the manufacturer for questions about the ingredients and manufacturing facility.

More Tips:• Research your allergens and know

what the uncommon names might be listed that you aren’t familiar with.

• Don’t buy a product that doesn’t have an ingredients list.

• Use caution with imported products. Food labeling regulations vary by country. Imported items are supposed to follow FALCPA and other US-food labeling laws but occasionally they do not.

• Educate your food-allergic child to start reading food labels as soon as he or she starts to read. Practice at home and when you are shopping together.

If you suspect you or your child might have a food allergy, contact the OAAC for a food allergy evaluation. The Food Allergy Network (foodaller-gynetwork.org) is a helpful online re-source guide to learn more about food allergies and reading labels.

Jean Jones