Ask the Expert

Allergy is a harmful condition. Allergic individuals are sensitive to substances, which are not harmful to the majority of people. It is almost the opposite of Immunity, which is a protective resistance usually to harmful substances such as viruses, bacteria, and cancer cells. Allergy is a genetically inherited problem, not a contagious disease. Allergies affect as many as 40 to 50 million people in the US. Allergy is the sixth leading cause of chronic diseases in the United States. Approximately 36 million people in the US have seasonal allergic rhinitis (hay fever), and 16.7 million office visits to healthcare providers yearly are because of allergic rhinitis.

Allergy is an adverse reaction to certain foods, dust, dust mites, molds and mildew, pollens, other parts of plants, pets, cosmetics, metals, chemicals, and medications. The immune system overreacts producing inflammation, irritation, and even life-threatening respiratory distress. Over 20% of Americans suffer from these genetic diseases, which are very disruptive to the patient and the family. The allergic reaction can affect the nose and sinuses causing frequent respiratory infections and sinus diseases; the lungs causing asthma; the skin causing eczema and hives; or more serious symptoms called anaphylaxis (allergic shock).

The symptoms of allergy and asthma include itchy, swollen and watery eyes; runny, stuffy, and itchy nose; coughing, shortness of breath, wheezing, and tightness in the chest. Many people respond to allergic disease in less obvious ways and may not realize that allergies are the cause of chronic cough, frequent respiratory and ear infections, sinus symptoms, sinus headaches, migraines, dizziness, loss of smell and taste, hearing loss, hives, eczema, other skin rashes, sores in the mouth and tongue, diarrhea, nausea & vomiting. Allergy to medications and insects can be severe at times.

Yes, this happens frequently. Fatigue is usually the result of difficult or unnatural breathing, lack of sleep because of abnormal breathing, or because of other allergy symptoms. Fatigue can also be caused by some of the sedating allergy medications used to control allergy symptoms. We see mouth breathing, snoring, and a constant runny or stuffy nose in allergic rhinitis and sinusitis. Disturbing night cough and shortness of breath are common asthma symptoms to deprive asthmatics of sleep. Impaired breathing results in impaired night sleep and both can result in fatigue, learning disabilities, poor quality of life, hypertension, irregular heartbeats, coronary artery disease, obesity, and diabetes. You should be ahead of these complications by early diagnosis and treatment of allergic diseases.

Accurate diagnosis is the key to effective treatment. We obtain the most complete and accurate patient history available; evaluate the patient's lifestyle and environment, specific physical examination is done, skin tests performed if indicated, selected blood tests, and evaluation of lung function also done if indicated. This leads to a correct diagnosis, rapid treatment, and fast relief. Although there is no cure for allergic diseases, almost complete long-term control of symptoms is achievable through environmental and food control, special avoidance programs, certain medications, and by desensitization allergy shots (immunotherapy). The latter form of treatment carries approximately an 85% success rate.

Your best approach, which frequently results in long-term and maybe a lifetime improvement of allergic diseases is to have a thorough evaluation by an allergist followed by an accurate diagnosis which leads to accurate and hence effective treatment. Both physicians and patients concomitantly must define the objectives of the allergy treatment from the first day of the allergy evaluation. We consider it necessary to obtain a comprehensive analysis of the patient’s history followed by a detailed physical examination of the body systems involved and getting pertinent laboratory and clinical tests including allergy skin testing and lung function evaluation. Once an accurate diagnosis is made, management of allergic diseases usually carries approximately an 85% chance of success.

If you can’t get rid of your pet, allergy desensitization (immunotherapy) should help. It is exceptionally effective in treating allergies to cats. Keeping the pet will not work without desensitization. Dog or cat hair is not the major allergen; it is the dried urine, saliva, and dead cells from the pet skin (dander), which permeate the whole house, office, or car and even the clothes and body of individuals exposed to the pets. Direct exposure to the pet and indirect exposure through another person who has the pet should be avoided.

Allergy affects approximately 50 million people in the US and can cause allergic rhinitis(Hay Fever), asthma, eczema, hives, allergy to medications, and stinging insects. Some of these diseases can be serious and even fatal. More than 36 million people in the US have seasonal allergic rhinitis (hay fever) with approximately 17 million doctors office visits yearly. The estimated overall cost of allergic rhinitis in the US is close to $8 billion. Absenteeism and reduced productivity due to allergies cost U.S. companies more than $350 million a year. Nasal allergy symptoms are very uncomfortable and affect the lifestyle of patients and can lead to more serious complications such as asthma and chronic sinus disease.

These are common allergy symptoms. Allergy causes the nose to swell and secret excess mucus, resulting in a stuffy and runny nose and postnasal drip, which initiates the cough to clear your throat. Cough can also be from the lungs if the nose allergy advances to the chest causing asthma, which happens in 85% of the cases of nasal allergy. More symptoms are an itchy nose, nosebleeds, and loss of smell and taste, frequent sinus & ear infections, headaches, and eye irritation. Allergy treatment should be beneficial to you.

Allergy is a common cause of loss of smell and taste. When allergy affects the nose and sinuses, the inflammation and swelling of the nasal passages affect the smell mechanism. Usually, this can be reversible if the allergy is diagnosed and adequately treated early. Loss of smell can also be the result of neurological damage which is usually irreversible. You should seek the correct diagnosis of what you are allergic to and implement an appropriate and aggressive treatment program then the chance to regain your smell is more favorable. You can call or write us for more advice.

Chronic sinusitis (inflammation of the nasal sinuses), affects more than 35 million Americans each year. Approximately 60% of allergy patients develop chronic sinusitis. People suffering from sinusitis miss an average of four days of work each year. There are more than 20 million office visits to primary care physicians for sinusitis annually. The yearly cost of caring for sinusitis in the US is approximately $8 billion. There is a serious association between sinusitis and asthma. Approximately 60% of asthma patients have chronic sinusitis and their asthma is triggered by the sinusitis.

Nose sprays are commonly used for allergic diseases of the nose and sinuses. Many patients do not use them correctly, which decreases the benefit of this useful form of treatment. One should shake the canister, remove the cover, and prime it by pumping 2-3 times before the first time use. Blow your nose to clear the passage, and keep your head in a normal position, but do not tilt it back. Insert the tip in one nostril at a time and activate the sprayer pointing its tip away from the septum toward the ear lobule on the same side. Inhale or gently sniff as you spray the medicine.

Rhinitis is an inflammation of the mucous membrane of the nose, which can be caused by allergy or other causes, such as microbial infections. Symptoms include runny nose, itchy nose, roof of the mouth, throat, eyes and ears and watery eyes and sneezing. Allergic rhinitis may be only seasonal or all year (perennial). Sinusitis is inflammation of the nasal sinuses which gives pain behind the eyes and around the nose, long-lasting congestion, colored nasal discharge, postnasal drip, pressure in the face, headache and sometimes fever or chronic cough. Allergies predispose you to sinusitis which happens frequently.

Asthma is a serious disease. The death rate from asthma is declining in adults but not in children. In both ages, the incidence is rising for unknown reasons. Quality of life deteriorates in both age groups for patients and families. Asthma causes frequent pneumonia and lung collapse; and can lead to emphysema, which is non-reversible damage to both lungs. Allergy is the most common cause of asthma in all ages. Detecting and treating the allergies will prevent the progression of a potentially life-threatening disease. Early treatment of asthma will prevent the incidence of permanent damage to the lungs when permanent changes occur in the lungs as a consequence of asthma.

Asthma commonly affects children but is also common in adults. It was thought that asthma is a disease of children only but we see it commonly in teenagers, childbearing-age of women, middle-aged men and women, and more recently asthma strikes in the senior years for the first time (55, 65, and 75 years of age and beyond). Asthma symptoms are cough, shortness of breath, wheezing, and chest tightness. Not all the symptoms are necessarily present at the same time. Asthma regardless of the age of the patient should be dealt with aggressively since the consequences and possible complications can be serious. You should seek a correct diagnosis and treatment.

Yes, you can. It is a common event. Allergies and asthma are very common as a first-time illness at 55, 65, and 75 years of age or even at older ages. Both allergy and asthma are disruptive to the afflicted persons and to their families. In the senior years, the chance for complications such as pneumonia and emphysema is more common compared to younger ages. Allergy is the most common cause of asthma in all ages including seniors. Anyone who has allergies, especially in their senior years, is widely open to getting asthma.

Allergies are the most common cause of asthma in all ages. A cause is different from a simple trigger. Allergies, certain virus infections in infants and children, some industrial and laboratory chemicals, some medications, exercise, and exposure to cold air are true causes of asthma. However, triggers are non-specific elements that bring about asthma symptoms in an asthmatic individual. When allergic asthma is treated by allergy immunotherapy (shots), the effect of these non-specific triggers is usually controlled to a large extent. Some asthma triggers are upper respiratory infections, chronic sinusitis, tobacco smoke, perfumes, car exhaust, chemical fumes, and exertion.

The severity of asthma is remarkably different in different individuals. Even in the same individual asthma severity can change frequently. The change in severity in the same individual can happen so suddenly and to a great extent to affect the comfort, sleep, school or work performance, or even endanger the individual’s life. Classifying asthma as mild, moderate, or severe carries a great risk since it implies that mild asthma does not change to moderate or severe which is a common event. Also, loss of life from asthma does not necessarily relate to the severity of asthma, it happens even when the asthma is so-called mild.

You will be able to get the same medicine in your asthma inhaler because it will remain the same. Only the chemical used to push the medicine out of the inhaler will be different. Many countries including the USA have committed themselves to stop the usage of propeller chlorofluorocarbons (CFCs) because they affect the ozone layer. The FDA mandated that manufacturers of asthma inhalers use hydrofluoroalkane (HFA) instead which is not harmful to the environment. No CFC inhalers were sold after December 31, 2008.

Asthma is the most common serious disease in children. It is caused by inflammation of the bronchial tubes in the lungs. This makes the airways smaller, which makes it more difficult to breath. Asthma symptoms are coughing, shortness of breath, tightness in the chest, and wheezing. The most common cause of asthma in children is allergy. Common allergens which trigger asthma are dust mites, mold, animal dander, pollen, and cockroaches. Asthma is a serious disease, but it can be well managed. If properly treated, the asthmatic child should be able to live a normal life.

The severity of asthma bears no relationship to age. However, asthma in children is more difficult to control because children do not know how to express their respiratory distress to their caregivers. Parents, school nurses or teachers, babysitters, and nurseries do not easily or accurately detect respiratory distress in infants and children. Unfortunately, the mortality rate of asthma in children has been climbing and not restrained or reversed like the marked control of asthma mortality in adults. It is essential that parents, school staff, and even the medical community take asthma in children more seriously and deal with it in a more positive manner.

Most asthmatics (80%) when they exercise develop asthma symptoms and should not continue the exercise. In normal individuals, the airways dilate during the exercise but in asthmatics, the airways constrict during the exercise. Another form of asthma is called exercise-induced asthma in which case the airways close after 5-8 minutes of near-maximum physical activity. This can cause symptoms such as coughing, wheezing, shortness of breath, and chest tightness. Once the exercise stops, most people with exercise-induced asthma recover even without treatment and it is not necessary that they stop the exercise and they can continue.

Pollens are the reproductive parts of plants. They are microscopic and usually are carried by air to other plants for fertilization in certain seasons (Airborne Pollinosis). Trees, grasses, and weeds are allergenic vegetation in Florida. When the pollens are inhaled or contact the skin of allergic individuals they cause the release of certain chemicals in the body (histamine and related compounds), which cause allergy symptoms commonly in the nose, sinuses, lungs and skin, and sometimes in other organs of the body. The key is to identify the pollen(s) involved to achieve successful treatment.

This is not easy; both are very widespread. You should still try if a correct diagnosis was made to incriminate them. We suggest windows kept shut at night, use air conditioners with filters, limit early morning outdoor activities, keep car windows up, stay indoors if it is windy or humid, don’t mow the lawn or be close when being mowed, avoid raking leaves, avoid indoor plants and dry your laundry indoors. The surest method of controlling diseases caused by molds and pollens is allergy desensitization treatment (immunotherapy).

Yes, indeed and it is on the rise. Allergy to certain foods can affect different systems in the body and can cause a large variety of symptoms. Affecting the skin it can cause hives and eczema; the GI system resulting in flatulence, abdominal cramps, vomiting, diarrheas with or without rectal bleeding, and chronic improper digestion and mal-absorption of ingested foods resulting in malnutrition anemia, and chronic weight loss. Allergic symptoms in the nose and sinuses and/or asthma can also be triggered by food allergies. Anaphylaxis is allergy shock, which can be a serious manifestation of an allergy to certain foods especially nuts, eggs, soy, milk, fish, and crustaceans. Accurate diagnosis and identifying the food are essential. Food additives can also cause allergic symptoms. Avoidance and emergency adrenalin should be on hand at all times.

Allergy to foods is a common reality. Many symptoms are attributed to drinking or eating certain foods. Six percent of children younger than six years have symptoms related to food allergy. In adults, an estimated 3.5% are allergic to foods. There seems to be a true increase in the prevalence of food allergy not just increased awareness of the problem. Alone, allergy to peanuts and/or tree nuts (walnuts, almonds, and cashews) affects about three million Americans. Approximately 100 people in the United States die each year from food-related anaphylaxis.

Contact dermatitis (CD) or eczema, is a skin rash that is caused by an irritant substance that accidentally contacts the skin, or more frequently is an allergy to a given substance to which the skin has come in contact over an extended period of time. Irritants causing (CD) are usually harsh, industrial or laboratory chemicals such as acids, alkalis, chemical solvents, and certain soaps and detergents, which injure the skin. Common causes of allergic (CD) are medicinal creams and ointments, chemical additives in medicines and cosmetics, sunscreens, jewelry, coins, hair dyes, plants, shoes; leather, and rubber products.

Allergy testing is done by skin tests or by blood tests. Skin tests are the preferred method because they yield much more reliable results than blood tests. Allergy skin testing is needed in cases of asthma, chronic bronchitis, emphysema, hay fever, chronic sinusitis, frequent respiratory infections, chronic middle ear disease in children and adults, food sensitivity resulting in eczema or respiratory symptoms, food sensitivity resulting in the stomach or intestinal symptoms, food sensitivity resulting in hives or food-induced anaphylaxis (allergy shock). Allergy tests are also done for allergy reactions to penicillin and local anesthetics, insects, and latex.

Allergies frequently affect the eyes resulting in allergic conjunctivitis. This can be an isolated eye disease or part of allergic rhinitis (hay fever). Symptoms are red itchy eyes, watery eye discharge, and blurred vision. It is uncommon that allergies affect only one eye. Symptoms can be seasonal usually when the pollen count is high or perennial occurring all year around. Swelling of the eyelids or eczema of the eyelids (Atopic Dermatitis) is common. Allergies have no relation to cataracts and do not affect the cornea. Allergy testing is effective in making the diagnosis and immunotherapy (allergy shots) are an effective treatment for allergies.

Trees, grasses, and weeds are the major allergenic plants in Florida. Trees pollinate from the end of October to the end of march. An exception is the Melaleuca trees which pollinate several times a year. Grasses pollinate from February to September and weeds pollinate almost 12 months of the year. All Florida pollens are very allergenic and can cause itchy, swollen and watery eyes; runny, stuffy, and itchy nose; chronic coughing, asthma, frequent respiratory/ear infections, sinus symptoms, headaches, dizziness, loss of smell and taste, hives and skin swellings.