Allergy & Asthma Care of Fairfield County

Allergy blood tests - easy to order, hard to interpret

The allergy blood test, often called the RAST, tests for the presence of allergic antibody, or IgE, in the blood. Over the past several years, this test has become increasingly popular. While the allergy blood test has become more accurate over the years, and can be useful in diagnosing allergies, particularly food allergies, it has its limitations. The blood test is often best used in conjunction with allergy skin testing, which is more sensitive. Contrary to what some people think, the allergy blood test does not give a yes or no answer about whether someone has an allergy. Rather, the blood test gives a statistical likelihood of whether or not an allergy exists, and falsely positive tests are common. Interpretation of allergy test results depends upon the medical history of the patient, and upon the experience and expertise of the physician who ordered the test. When the skin and blood test are inconclusive, oral challenges to foods can
help with diagnosis of food allergy. Board certified allergists have the best training and experience for interpreting allergy test results. A recent article in the Wall Street Journal discusses the limitations of food allergy testing and the importance of correct interpretation of the results. Please click here to see the full article.

Penicillin allergy testing now available

Penicillin allergy testing is once again available at Allergy & Asthma Care. Penicillin allergy is a major problem, with patients unable to take a large number of antibiotics related to penicillin. As a result, patients often have to take stronger, broader spectrum antibiotics, with more potential adverse effects. Additionally, the use of the broader spectrum antibiotics leads to increasing resistance, meaning that when they are needed for future infections, they may not work. Resistance to antibiotics in our communities is a growing problem, so the ability to use penicillin antibiotics remains important.

Fortunately, most patients with a history of possible reactions to penicillin can safely take them again. Approximately 85% of penicillin allergic patients will lose the allergy after ten or more years. Additionally, many rashes that develop while taking antibiotics are not due to an allergic reaction, but it is often difficult to know for sure. Penicillin testing materials have been unavailable for about 5 years, since the sole company who made them opted to discontinue production. However, a company called Allerquest has brought penicillin testing materials back to the allergy community.

Allergy & Asthma Care of Fairfield County is pleased to be able to offer penicillin allergy testing to our patients. Please call (203) 259-7070 to schedule an appointment.

H1N1 Vaccine available at Allergy & Asthma Care

Allergy & Asthma Care of Fairfield County, LLC, has a limited quantity of H1N1 vaccine available. We can now offer this to all patients as directed by the CDC. In light of the continued H1N1 pandemic, it is recommended that everyone be vaccinated for this influenza virus. For egg allergic patients, we can test with the vaccine to determine if it can be safely administered. This can also be done with seasonal influenza vaccine, when available. Please call our office for an appointment or further information.  

Sublingual immunotherapy - not ready for prime time

There have recently been a number of practitioners, mostly non-allergists, offering sublingual immunotherapy, or "allergy drops." Allergy drops have become increasingly popular in Europe, where high concentration drops are approved and available. While studies in Europe have shown that these drops have some efficacy, they have generally been found less effective than subcutaneous immunotherapy (allergy shots). Studies showing efficacy have only been done with individual allergens, and there is no evidence that sublingual immunotherapy has any effect when multiple allergens are used. Additionally, there are no FDA approved extracts for sublingual immunotherapy in the United States, and any sublingual immunotherapy performed is not FDA approved. Since there are no sublingual extracts available for use in this country, many practitioners offering this unapproved procedure are using the extracts approved for use in allergy shots. These extracts are not concentrated enough to deliver the high doses shown to be effective in sublingual immunotherapy, which requires far higher doses than the injections. Therefore, the vast majority of practitioners offering sublingual immunotherapy in the United States are offering doses too low to provide any real benefit, as well as providing multiple allergens which further dilutes any possible effect. The safety and efficacy of this procedure is unproven, and severe reactions have been reported. At Allergy & Asthma Care, we provide only approved and proven treatments. If sublingual immunotherapy becomes FDA approved, appropriate extracts become available and are proven safe and effective, we will be happy to offer it to our patients. Please see the following article for more information. Download Sublingual immunotherapy.

Food allergy awareness key to successful management in schools

Food allergy is a growing safety concern across the United States and creates challenges for all educators and parents in our nation’s schools. As the State of Connecticut begins another school year, it is important to point out that public awareness about the seriousness of food allergies is growing. Connecticut is a national leader in developing food allergy management plans and State legislation to promote the safety and well-being of children with severe food allergy. By working collaboratively, with the school staff, other parents, students, and family physicians, parents of children with food allergy can promote a safe and successful school experience for every child.

In 2006, the Connecticut State Department of Education in conjunction with the State Department of Public Health has developed Guidelines for Managing Life-Threatening Food Allergies in Connecticut Schools to assist Connecticut schools in effectively managing the health and safety needs of children with life-threatening food allergies. Connecticut law requires each public school district to "implement a plan based on the guidelines for the management of students with life-threatening food allergies.” In 2009, Governor Rell signed into law legislation to further promote the safety of children with severe food allergy in Connecticut.  The legislation requires every Connecticut public school district to make its plan available on every School Board of Education’s or school’s Web site or publically available if no web sites exist, and it must provide annual notice of the plan’s implementation to the State Department of Education, as well as to parents and guardians.

The following are key links regarding the issues:

CT Guidelines:  http://www.sde.ct.gov/sde/lib/sde/PDF/deps/student/health/Food_Allergies.pdf

CT Act 09-155:  http://www.cga.ct.gov/2009/ACT/PA/2009PA-00155-R00SB-00755-PA.htm

The Food Allergy Initiative:  http://www.faiusa.org

Dr. Bloom Joins our Practice

Allergy & Asthma Care of Fairfield County is pleased to announce Katherine Bloom, MD has joined our practice. Dr. Bloom has expertise in the full range of allergic disorders, with particular interest in food allergy and immunodeficiency. She is board certified in pediatric and adult allergy and asthma. Click for more information.

Hypoallergenic Hotel Rooms Advance

Connecticut Allergist Kenneth Backman, MD, notes many companies, including hotels, are becoming more sensitive to those with allergies. The following is a brief part of a larger story from the New York Times. Click for the full story.

From the Fairmont Vancouver Airport hotel to the Mandarin Oriental in Miami, hotels are doing everything from replacing feather duvets to installing air purifiers in guest rooms. Some are ripping out carpets and drapes, which tend to harbor dust and trap odors, and replacing them with smooth surfaces. Hilton and Millennium Hotels, each of which is testing the concept in a few hotels, said they might consider expanding it to more properties depending on demand. NYLO Hotels, a new brand scheduled to open its first hotel in Plano, Tex., in November, plans to offer at least one floor of allergy-friendly rooms at each of its locations. Hotels say it’s not uncommon to get special requests from guests with allergies. “We get a lot of requests for special blankets, special pillows, no spray in the rooms,” said Maureen O’Brien, director of sales at the Premier, a Millennium Hotel, which spent $30,000 to convert three floors to Pure rooms this year.

Sublingual Immunotherapy help kids with Food Allergies?

Despite some recent studies exploring the use of oral or sublingual immunotherapy, Dr. Kenneth Backman emphasizes that it is still experimental and should not be tried at home. As the story from HealthDay News notes below, there are many dangers in their use. Also, sublingual immunotherapy is not approved in any form for use in the US, and there are no FDA approved extracts available.

July 5 -- Doctors have long used allergy shots to desensitize children and adults to environmental allergens such as bee stings, pollen, mold and dust mites. Now researchers are trying to apply that theory to food allergies, through processes called oral immunotherapy and sublingual immunotherapy. They believe they can build up a child's tolerance for a food that prompts an allergic reaction by exposing the child to tiny amounts of that food. Trials involving eggs, peanuts and milk have produced positive results, said Dr. Scott Sicherer, an associate professor of pediatrics at the Jaffe Food Allergy Institute at the Mt. Sinai School of Medicine and chair of the allergy and immunology for the American Academy of Pediatrics. "The studies are promising in that some individuals are able to get to high doses of the food used in treatment," he said. Sublingual immunotherapy works by placing an extract of the food allergen under the child's tongue.

But Sicherer warns these therapies are still in the experimental stage. "All of the experts working in this treatment currently believe it is too early to attempt widespread use and that much more needs to be done to see if this is a viable treatment," he said. For one thing, there's still a risk of severe allergic reaction prompted by even the tiny amounts used in immunotherapy.

Warning: Zicam Nasal Products

Says Dr. Backman: Patients should immediately discontinue using Zicam products, and discard any of the listed items so they are not accidentally used in the future. 

Discontinue use of three Zicam Nasal Gel/Nasal Swab products sold over-the-counter as cold remedies as they are associated with the loss of sense of smell that may be permanent. The FDA received 130+ reports of loss of sense of smell. Many who experienced a loss of smell said the condition occurred with the first dose; others reported a loss of the sense of smell after multiple uses. 

People who have experienced a loss of sense of smell or other problems after use of the affected Zicam products should contact their health care professional. Click for more Information.

Asthma Study: Self-Management Plan Means Disease Control

Asthma affects the daily lives of so many people, but self-management can help you take control, says Dr. Backman and Dr. Veksler of Allergy & Asthma Care of Fairfield County. See the story below, or link here for the full story.

Asthma patients who spend as little as 30 minutes with a health care pro to develop a personal self-management plan show improved adherence to medications and better disease control, says a new study by researchers at the Univ. of Calif., San Francisco. Twenty million people in the US have asthma, and despite the availability of treatments, the disease remains poorly controlled among many people. The study says that in a clinical setting, personal self-management education coupled with self-monitoring may be a cost-effective way to empower patients to better control their disease, said the study's lead author Susan L. Janson, a clinical specialist in pulmonary disease.

 

Enjoy Your Lunch, Worry-Free

Successfully eating out is a challenge for many, but if you are careful you can enjoy it, say Dr. Backman and Dr. Veksler of Allergy & Asthma Care of Fairfield County and the Food Allergy Center of Connecticut. The Food Allergy Initiative has the following suggestions. Click for the full story.

Ask to be seated far from the kitchen. This will help you to avoid airborne allergens from cooking and preparing food. The hostess, manager, and wait staff should be clear about your food allergy. Ask that your food allergy card be shown to the chef.  Never be embarrassed if you feel you’re not communicating effectively. Ask what is in your dish and how it’s prepared. Make sure your server understands what you are allergic to, and explain that cross-contamination must be avoided. If you have to ask lots of complicated questions about the menu, ordering more simple fare—like a baked potato or steamed vegetables—may be the safest. Avoid fried foods. Both the grill and the frying oil are ripe for cross-contamination. Save dessert for home. Desserts are major sources of hidden allergens, and the restaurant staff may not be able to provide a complete list of ingredients. 

CT Magazine Lists Dr. Backman

Kenneth Backman, MD, who is board certified in Adult and Pediatric Allergy and Immunology, has again been selected as one of the "Top Doctors In Connecticut" by Connecticut Magazine. Dr. Backman, who is board certified in Adult and Pediatric Allergy and Immunology, received his bachelor of science in Biology with distinction from Yale University, and his medical degree from Cornell University Medical College. Allergy and Asthma Care of Fairfield County is located in Fairfield and Monroe.

Therapy Against Peanut Allergy?

At a meeting of the American Academy of Asthma and Immunology this past week, Dr. Kenneth Backman of Allergy and Asthma Care of Fairfield County heard a ground-breaking report on a promising new potential therapy for those suffering from allergies to peanut products. A brief report March 15 by the AP is below.

Scientists have the first evidence that life-threatening peanut allergies may be cured one day. A few kids now are allergy-free thanks to a scary treatment — tiny amounts of the very food that endangered them. Doctors monitored the youngsters closely in case they needed rescue, and there’s no way to dice a peanut as small as the treatment doses required. But over several years, the children’s bodies learned to tolerate peanuts. Immune-system tests show no sign of remaining allergy in five youngsters, and others can withstand amounts that once would have left them wheezing or worse, scientists reported Sunday. More rigorous research is under way to confirm the pilot study, released at a meeting of the American Academy of Asthma and Immunology. If it pans out, the approach could mark a major advance for an allergy that afflicts 1.8 million people in the United States.

Prepared for Spring Allergies?

Winter's over, and spring is here. Take charge of your life before allergies take over. There are some measures you can take, and effective treatments are available. If you are unsure what you may be allergic to, or desire more effective treatment options, call the office of Dr. Kenneth Backman and Dr. Irena Veksler at 203-259-7070 for an appointment at our Fairfield or Monroe office. 

Spring is a beautiful time, but if your allergies act up because of the blooms and pollen you may not think of it as such a nice time. Here are proactive ways that you can take control of your life and, if not enjoy, at least survive the spring.

• Change your heating and air conditioning filters now so that regardless of the temperature outside, you can remain comfortable inside with the windows closed.
• Clean your windows before the season starts.
• If you use your garage for storage, clean it out now so you can park your car there.
• If you work in an office with a garage, you might want to pay for a space during the height of allergy season to avoid coming in contact with a pollen coated car at the end of the day.
• Clean your property now. Eliminate weeds whose blooms may cause you problems.
• Use a portable high efficiency particle arresting (HEPA) air purifier to clear away allergy triggers such as house dust, dust mites, mold and mildew, pollen, pet dander, bacteria and viruses.
• See your physician now to begin appropriate medications. Medications work best when started before symptoms develop.

Food Allergies Increase in Kids

FROM  DR. BACKMAN AND DR. VEKSLER: We are seeing more food allergy issues among children and adults. There are measures you can take to minimize your reaction and exposure. See health library at left. For the full story dated Oct. 22, 2008 from MD News, click here. 

Child food allergies are up 18% over the last decade, the CDC reports. Four out of every 100 U.S. kids under age 18 now suffer food allergies, which doubles their risk of asthma and triples their risk of skin or respiratory allergies. "It is a significant trend -- food allergies do appear to be continuously increasing over the decade," CDC health statistician Amy Barnum, MSPH , tells WebMD. "And if you look at hospital discharges with any diagnosis related to food allergy, there has been a significant increase." The new CDC data confirms what pediatricians and allergists have been suspecting, says Hugh Sampson, MD, director of the Jaffe Food Allergy Institute at Mount Sinai Hospital, New York. "There was the impression food allergy is increasing in children, but we only had data on peanut allergy" Sampson tells WebMD. "This report shows it is food allergy in general. That goes along with what a lot of pediatric allergists and pediatricians have been thinking."

Dr. Backman Named Allergy Chief at Bridgeport Hospital

Dr. Backman has been named Chief of Allergy at Bridgeport Hospital. Dr. Backman, who is board certified in Adult and Pediatric Allergy and Immunology, received his medical degree from Cornell University Medical College. He completed his residency at the University of Chicago Hospitals, and fellowship in Adult and Pediatric Allergy and Immunology at Northwestern Memorial Hospital and Children’s Memorial Hospital in Chicago.  

Bridgeport Hospital is the most comprehensive hospital in Fairfield County with 425 licensed beds, 2,600 employees, 530 physicians representing 70 subspecialties, 220 medical/surgical residents and fellows in programs affiliated with Yale University School of Medicine.