Skip to main content

Why I Do What I Do

I've recently started offering oral immunotherapy for foods in my practice. I debated with myself for almost a year before implementing protocols for this therapy, because it was incredibly important to have strict and detailed procedures in place, given the serious risks associated with food challenges in highly sensitive individuals. I take food allergy extremely seriously, and it isn't something one "dabbles in". So, it was beyond gratifying to have the following conversation with a patient a few weeks ago:

Me: "You're doing really well with advancements in dosing. If we keep moving along at this pace, pretty soon, you'll be dosing with wheat bread instead of capsules!"
Patient: "Awesome..."
Me: "Don't get too excited. It is going to start with a tiny little morsel of bread, not a sandwich!"
Patient: "You have no idea. I am going to glorify that little morsel! I have been waiting for this for such a long time."

Totally. Made. My. Day.

And this, dear reader, is why I love my job.


Comments

  1. It's great when you are able to help someone enjoy something that they once did. Think of the smile on their face they day they get to eat that sandwich.. Makes it all worth while.

    Mike

    ReplyDelete
  2. I can only imagine what it must be like to taste something you've been craving for years or a whole lifetime. That's incredible! I wish more doctors were willing to practice immunotherapy. Such a wonderful concept!!!!

    Jennifer
    itchylittleworld.wordpress.com

    ReplyDelete
  3. What is oral immunotherapy? I have oral allergy syndrome and allergic to all things corn and sunflower, carrots, celery, onion, tomatoes, bell pepper, cucumber, cauliflower, cabbage, brussel sprouts, green beans, peas, peaches, melons, raspberries... I think I got them all, there might be more. Its mostly because of ragweed.
    When I eat anything corn or sunflower (including high fructose corn syrup, sunflower lecithin, etc), my throat closes up and I have to administer an EpiPen and go to the emergency room. The other ones, I have a difficulty breathing, shortness of breath, etc.
    Please, can you help me?

    ReplyDelete
  4. Oral immunotherapy is a method of reducing a patient's sensitivity to a food by administering gradually increasing doses of that food by mouth over an extended period of time.

    I can not stress enough that there are very significant risks associated with the treatment, including life-threatening allergic reactions. Therefore, it is not appropriate for all patients. In addition, the therapy is not widely available, as many still consider oral immunotherapy to be in the research phase.

    It would be inappropriate for me to offer specific medical advice in this forum. However, I recommend that you discuss your situation with a Board-Certified Allergist, who can help you determine a strategy to control your allergy symptoms. There are many effective treatments (including traditional subcutaneous immunotherapy) available. Many patients are surprised to find that the older, time-tested therapies are actually their best option.

    ReplyDelete
  5. Do you know of any doctors in CA offering OIT? If I lived closer to you, I would bring my son but his food allergies are so severe that we hesitate to fly.

    ReplyDelete

Post a Comment

Thanks for taking the time to comment on this blog's posts! Let's keep the discussion engaging and free of frivolous advertising or vulgarity. It's a family show, folks!

Popular posts from this blog

Keratosis Pilaris - Or, Why My Kid Looks Like a Plucked Chicken

The skin is the body's largest organ. The condition of the skin is, in many ways, a window into our internal health. Therefore, it is only natural that people become immediately concerned by rashes. We often neglect our own elevated blood pressure, achey joints, or other ailments. The onset of a new rash, on the other hand, can quickly lead to a call to the doctor.

Interestingly, there is one rash I see in my practice which rarely causes alarm among patients and parents. In fact, it is common for a parent to state, "Oh, that? His sister has that too. In fact, so do I!"

Keratosis Pilaris is a common, heritable disorder which results in small bumps consisting of accumulated skin cells and keratin at the sites of hair follicles. It is especially common in people who have a history of allergies.
Although it can be mildly itchy, the rash generally does not cause discomfort. Commonly described as "gooseflesh", keratosis pilaris can be a concern cosmetically, leading…

When Food Allergy Treatments are Sensationalized, it is the Allergist's Role to Bring Us All Back Down to Earth

Sharing a recent post from my practice Facebook page, in response to concerns raised by the recent publication of a meta analysis on anaphylaxis rates during food allergen oral immunotherapy: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30420-9/fulltext
I hope my comments are helpful at proving some context for patients currently pursuing or consider food allergen desensitization therapy. 
I am a non-alarmist by nature, and feel it is 100% possible to integrate new data without falling prey to the sensationalization of these publications by the media. It is frustrating to read in the news one day, "Researchers find CURE for peanut allergies!" (WRONG!!!) and the next day read "Experimental treatment for food allergy causes more life-threatening reactions than avoidance!" (Hmmm...a bit misleading). No nuance, no thoughtfulness, no concern for the impact of such a black & white approach to a decidedly grey issue. And why would there be? Nuance …

Why Drug Allergies Matter (Or Why Penicillin Allergy is Responsible for My Son's Lopsided Neck)

My 6 year son old just got over a rite of passage - strep throat and scarlet fever. Unfortunately, before we could even celebrate his recovery, I noticed a swelling on the left side of his neck. It was red and tender, and it was GROWING. The pediatrician in me worried, "Damn. Lymphadenitis (infected lymph node)". No sooner had we finished one course of antibiotics than we were onto another, and the side effects were bad enough to keep him out of school for another three days.

Why did my munchkin suffer so? My answer: Drug allergy.

Group A streptococcal bacteria (the cause of strep throat and scarlet fever) is remarkably sensitive to penicillin. Penicillin is the first choice treatment for strep throat, and has been proven to reduce the risk of developing rheumatic fever, a post-infectious complication which can result in chronic heart disease.

Problem is, my son is allergic to antibiotics in the penicillin family. At 11 months of age (8 days into his second ever course of am…