Being able to live a safer and fuller life, thanks to OIT

Freedom Allergy, Pediatric Allergist, Peachtree City, Marietta, Georgia, Peanut Oral Immunotherapy, Eczema

Chloe_OIT_2

Being able to live a safer and fuller life, thanks to OIT

Written by Carri P.

Dealing with a peanut allergy and eczema has been a way of life for our family since Chloe was a baby. The eczema came first and probably should have been a warning sign that food allergies were a possibility. Having no prior experience with food allergies or eczema, we didn’t know much about either. Unfortunately, I also didn’t know the severity of the situation when she had her initial reaction at 16 months old to an amount of less than a teaspoon of peanut butter. We were told to give her Benadryl and that was that. Looking back, I am so thankful that the reaction didn’t progress. A few days later, we were given a prescription for an EpiPen, and told to avoid all nuts by our pediatrician.

The next several years for Chloe were not exactly normal, as most food allergy parents would understand. It didn’t take long for us to acquire a wealth of both knowledge and anxiety. Our family had all been conditioned to check food labels and life revolved around keeping our little girl safe from accidental exposure. We were lucky to not have any further reactions from peanuts since her initial exposure. I say lucky, because at some point, no matter how careful a parent is – mistakes can and do happen. We sought out a peanut free preschool and learned that we had to educate parents on what that truly meant. We then had to decide about elementary school and were lucky to find a peanut free private school. Chloe was extremely saddened when it closed at the end of her first grade year. That left us with no peanut free options and we were not prepared to have her in a public school setting even with precautions.

Eczema continued to be ongoing struggle. Summer humidity, time spent in the sun and sunscreen all seemed to be culprits that aggravated Chloe’s eczema. She would scratch until she made bloody sores. The most noticeable eczema would appear on her eyelids and below her eyes. The eczema was something that Chloe suffered with, but in comparison to the worry over accidental ingestion of peanuts, it wasn’t high on my list to seek a doctor’s opinion.

In the fall of 2015 Chloe was attending an online public school, which equated to homeschooling in her mind. The situation was less than ideal to her after being happy in her peanut free school the previous year. I was at all time low emotionally struggling about what the right path was for her. It was then that I first heard about OIT. I was immediately intrigued and also frightened. It took me a few months to make the call to Dr. Agrawal’s office to set up a consultation for OIT. At our first appointment in January of 2016, we discussed her food allergies and eczema. The decision to begin OIT was immediately clear once I had met Dr. Agrawal. He explained the protocol and informed us about the use of a good probiotic with specific strains that help with eczema. Chloe did an oral challenge for all tree nuts, except pecan and walnut. She passed that and we decided to address pecan and walnut after she reached maintenance for peanut. For the first time in Chloe’s life, we had someone on our team to help us overcome the struggles and isolation of allergic living. We were excited so to get started at the end of January of 2016.

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Early stages of OIT – dosing with liquid peanut solution.

Chloe’s experience with OIT was a relatively smooth journey. She didn’t have any problems other than her skin. The amazing thing is that her eczema improved dramatically throughout her up dosing phase, even during the summer months. Applying cortisone cream was a daily occurrence prior to OIT. During OIT, she had a few mild flares that I think were related to up dosing and also the summer humidity. The main issue we had with her skin was the occurrence of a random, small hive appearing usually on her arms or hands. These never progressed and would always subside within half an hour. These were quite alarming at first until we learned that it was just a sign that her body was learning to accept the allergen. At some points along the way, she would experience this several times a day and other days nothing would appear. It just became our normal to notice it and then make sure that it didn’t progress. During OIT, we had to learn to let go of some of the fear when we were cleared for cross contamination. Sometimes the mind has to catch up to the body. The daily dosing and observation period became routine. When we had questions or concerns, we knew Dr. Agrawal was only a text or phone call away.

Before we knew it, Chloe was nearing maintenance. She had been taking her probiotics daily, just like her peanut dose. Her eczema had become practically nonexistent. We had slowly begun to enjoy the freedom that OIT brings. We had sheltered Chloe in almost every way possible to keep her safe. She had not had play dates at friend’s houses, but always at her own home. She had only been to peanut free schools. We had never had ice cream scoops at a parlor. She was always the one at the sports banquet who couldn’t enjoy the cake like the rest of the team. We tended to frequent the same restaurants that made us feel safe for her to eat. Imagine a nine year old’s delight to finally go to friends’ homes, go along with other families to a movie theatre and be able to eat the birthday cake that everyone else is having. These are the small freedoms that mean so much!

Chloe reached maintenance at the end of November 2016. Overall, it took about 10 months, which would have been less without some scheduling issues on our part. Maintenance has been going well for two months. Chloe has passed an oral challenge for pecans and walnuts so tree nuts are no longer a concern. She has continued the probiotics to keep her skin healthy. She has not experienced any eczema or random hives since reaching maintenance. We have continued to enjoy new freedoms and Chloe has tried several new foods that were off limits in the past due to cross contamination. What we don’t do anymore is check labels and live in fear. The biggest change planned for this August, is that Chloe will start 4th grade at public school. I cannot thank Dr. Agrawal enough for providing the means to allow Chloe to have a safer, fuller life without the fear of peanuts holding her back.

Please visit www.smashingpeanuts.blogspot.com to read about Chloe’s experience with OIT in greater detail.

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A day of celebration – the day Chloe reached her peanut maintenance dose.

 

Back to School Allergy and Asthma Tips

Pediatric Allergist, Peachtree City, Fayetteville, Georgia

ACAAI Back to School Tips

With the new school year now underway, you may consider these back-to-school allergy and asthma tips from the American College of Allergy, Asthma and Immunology. These simple tools can help set up you and your child for success in this exciting new school year!

Teacher Teacher – While your child’s teacher is the first line of defense at school in helping reduce sniffing, wheezing and sneezing, the right systems must be established at home before they get on the bus. If your child takes an allergy or asthma medication, make sure they take them at home, and that good avoidance measures are set up to keep their triggers under control. If your child’s teacher knows your child’s triggers, she may be able to help them steer clear in the classroom as well.

Too cool for school? Nah. – Discuss how to handle emergencies with the school principal and school nurse. Since 2010, all 50 states have laws protecting students’ rights to carry and use asthma and anaphylaxis medications at school. Children who are at risk for a life-threatening allergic reaction (anaphylaxis) from certain foods or insect stings should have epinephrine auto-injectors immediately available for treatment.  Be sure your child and school staff know how to use emergency medications. Continue reading

Back to School with Food Allergies

Pediatric Food Allergy Doctor, Peachtree City, Fayetteville, Georgia

Back to School

School is right around the corner, and along with the excitement of new clothes, bright supplies, and fresh possibilities, your child may also have a few butterflies in the stomach. For a parent of a child with a severe food allergy, you may have some butterflies of your own. Many parents worry their child will accidentally eat a food they’re allergic to while at school, and suffer a severe reaction. Setting your child up at school with an epinephrine auto-injector (EAI) is important, but this also requires staff and personnel who can recognize an anaphylactic reaction and can correctly use the EAI.

Children need help from adults in managing their food allergies. One survey out of Mississippi schools revealed 97% had at least one child with a food allergy, but only 30% had action plans for these students. Schools were more likely to have action plans when the school nurse had received appropriate information from a physician. If you need refreshing on how to use your EAI, or would like assistance in educating personnel at your child’s school on recognizing and treating anaphylaxis, call our office today. Anaphylaxis action plans can also be written by physicians and distributed in daycares and schools.

Reference: O’Keefe AW, De Schryver S, Mill J, et al. Diagnosis and Management of Food Allergies: New and Emerging Options: A Systematic Review. Journal of Asthma and Allergy. 2014;7:141-164.

Allergist Versus Ear, Nose, and Throat Doctor

Allergy Doctor, Peachtree City, Atlanta, Georgia

Freedom Allergy, Ruchir Agrawal, Peachtree City, Fayetteville, Georgia

Why Choose an Allergist for your Allergy and Asthma?

Allergies and asthma are both chronic conditions, and warrant visiting a specialist for the best management. However, with so many specialists out there, how do you know which one to choose?  Read the FAQ below.

My allergies bother my ears, nose and throat – doesn’t this mean I should see an ear, nose and throat doctor?

Many times, patients go directly to an ear, nose and throat (ENT) doctor for their allergy symptoms. After all, don’t allergies bother your ears, nose and throat?

Ear, Nose and Throat doctors are surgeons who specialize mainly in structural problems that can be corrected with surgery. But many of these problems, such as difficulty breathing through the nose, or having a raspy voice or having trouble hearing, are actually due to allergies.  Allergies, eczema, and asthma are all chronic conditions that fall under the same umbrella of allergy medicine, and more than 50% of sinus problems are caused by allergies.  The other 50% are often caused by a combination of both allergy and non-allergy related problems. Continue reading

Spring Allergies

Spring Allergies, Allergy Doctor, Peachtree City, Georgia

Allergy Doctor Ruchir Agrawal Peachtree City Georgia

Spring is right around the corner, and now is the time to schedule a visit with your allergist.  The American College of Allergy, Asthma & Immunology (ACAAI) suggests five things you should know about spring allergies.  Click Here to read more!

  1. Allergies are on the rise.

Studies show pollen counts have been gradually increasing over time, and even if you’ve never had allergies before, you could start developing them.  You can track Peachtree City pollen counts Here.

  1. It matters when you medicate!

If you suffer spring allergies, ACAAI recommends starting your medication two weeks before your symptoms typically begin.

  1. No “cure” exists for spring allergies…

…but allergy shots (immunotherapy) can help your symptoms in a big way.

  1. Allergies can trigger or worsen asthma.

If you are coughing, wheezing, or having trouble breathing, this could be asthma that is triggered by your allergies.  Be sure to talk to your allergist about these symptoms.

  1. “When in doubt, get checked out.”

If you have been suffering symptoms for more than two weeks, such as coughing, ongoing colds, nasal congestion, or trouble breathing, it would be a good idea to see an allergist for allergy testing and potential treatment.

Conditions & Procedures

Allergy & Asthma Doctor, Peachtree City, Marietta , Georgia

Conditions We Treat

  • Adverse Drug Reactions
  • Angioedema
  • Asthma
  • Allergic Rhinitis
  • Allergies (Seasonal, Food, Environmental)
  • Anaphylaxis
  • Aspirin Allergy and Desensitization
  • Chronic Cough
  • Cough from Allergies
  • Dry Eyes from Allergic Rhinitis
  • Dry Throat and Runny Nose
  • Eczema
  • Eosinophilic Esophagitis
  • Eosinophilic Disorders
  • Food Allergy
  • Food Intolerance (Comprehensive Diagnosis and Management)
  • Environmental Allergies
  • Functional Medicine
  • Headaches, Fatigue and Cold Symptoms
  • Hives/Urticaria
  • Immunodeficiency
  • Integrative Medicine
  • Recurrent Infections
  • Sinus and Nasal Infections
  • Sinusitis (Acute)
  • Sinusitis (Chronic)
  • Skin Rashes
  • Sneezing (Frequent and Prolonged)
  • Stuffy Nose
  • Vocal Cord Dysfunction
  • Wheezing

Procedures We Offer

Conditions We Treat

  • Adverse Drug Reactions
  • Angioedema
  • Asthma
  • Allergic Rhinitis
  • Allergies (Seasonal, Food, Environmental)
  • Anaphylaxis
  • Aspirin Allergy and Desensitization
  • Chronic Cough
  • Cough from Allergies
  • Dry Eyes from Allergic Rhinitis
  • Dry Throat and Runny Nose
  • Eczema
  • Eosinophilic Esophagitis
  • Eosinophilic Disorders
  • Food Allergy
  • Food Intolerance (Comprehensive Diagnosis and Management)
  • Environmental Allergies
  • Functional Medicine
  • Headaches, Fatigue and Cold Symptoms
  • Hives/Urticaria
  • Immunodeficiency
  • Integrative Medicine
  • Recurrent Infections
  • Sinus and Nasal Infections
  • Sinusitis (Acute)
  • Sinusitis (Chronic)
  • Skin Rashes
  • Sneezing (Frequent and Prolonged)
  • Stuffy Nose
  • Vocal Cord Dysfunction
  • Wheezing

Allergies

Allergy Doctor, Atlanta, Peachtree City, Georgia 

An allergy occurs when your body’s immune system responds to a harmless substance (allergen) similarly to how it would attack a germ or pathogen.  In the presence of an allergen, your immune system releases an antibody called Immunoglobulin E (IgE), which causes cells to release chemicals that can irritate the skin, nose, sinuses, throat, lungs, and sometimes stomach.   Symptoms can range from something as small as a stuffy nose, to something as large as a whole-body reaction called anaphylaxis.  The most common allergens include pollen, dust, food, insect stings, animal dander, mold, medications and latex.    Read More.

Allergy Facts

  • Allergic rhinitis, often called hay fever, is a common condition that causes symptoms such as sneezing, stuffy nose, runny nose, watery eyes and itching of the nose, eyes or the roof of the mouth.
  • Allergic diseases, which include asthma, are the fifth most prevalent chronic diseases in all ages, and the third most common in children.
  • 8.3 million American children have respiratory allergies.
  • An estimated 9.5 million American children have skin allergies.
  • Food allergies in children are on the rise, affecting nearly 6 million or 8% of children.

Learn More!

Source: American College of Allergy, Asthma & Immunology.  Allergy Facts.  2014.  http://www.acaai.org/allergist/news/Pages/Allergy_Facts.aspx.
Video #1 Courtesy of American Academy of Allergy Asthma & Immunology
Video #2 Courtesy of PBS

When Should I see an Allergist?

Allergy Asthma Doctor Atlanta Peachtree City Georgia

When Should I See An Allergist?

Asthma and allergies are two of the most common health problems in America.  Approximately 50-55 million Americans suffer from asthma, hay fever, eczema, food allergies and other allergic disorders.

You should schedule an appointment with an allergist if your asthma or allergic disorders are not controlled by over the counter medications or current prescription medications.

Board certified allergists are medical doctors who complete three years of internal medicine or pediatric training, and then go on to complete two- to three more years of fellowship training. Allergist are trained to diagnose and treat conditions ranging from uncontrolled runny nose and congestion to severe immune deficiency disorders.

Let’s talk about a few conditions for which you should see an allergist:

Allergic Rhinitis (Hay Fever): Allergic rhinitis plagues many Americans.  If your allergies are not controlled by over-the-counter (OTC) antihistamines (Zyrtec, Allegra, Claritin, Benadryl, etc.) or nasal steroids (Nasacort is approved OTC, and Flonase will be available OTC in 2015), you should schedule an appointment with an allergist.  An allergist will evaluate your allergy triggers and suggest treatments accordingly.  Treatments may include medications, sublingual (under the tongue) allergen immunotherapy, or allergy shots. Allergen immunotherapy is a very effective long-term allergy treatment, and 85-90 percent of patients experience relief with this treatment. Continue reading