Food Allergy Action Month

May is ‘Food Allergy Action’ month and the week of May 8-14 is Food Allergy Awareness Week. Of note, I have been asked to present at the 51st Riley Pediatric Conference, May 10th at the first plenary session on the hot topic of food allergy prevention.

A few weeks ago I was asked to write a piece about an aspect of food allergy. I chose a topic that is somewhat unique to what we do in our clinic- Food Challenges. I was very steadfast in the message I wanted to say. In an effort to make a long story short, the editor and I did not share the same perspectives. I withdrew the article- regretting the giving up the opportunity to post what we do with a larger audience, but I had to remain firm on the content. What follows is the article;

Important stops to consider during your journey through the world of food allergy; the role of the food challenge.

The first step has been taken, your child has had a reaction to a food. You have reached out for direction and the guidance given may have included allergy testing or a referral to an expert in food allergy. Your suspicions have been verified by an allergy test, but there are unexpectedly more items found during the evaluation. Additional tests were performed and now you have a concerning list of allergenic foods to avoid. This list may contain foods that were eaten frequently without any reactions or foods that your child has never ingested. The obvious advice you are given is full and strict avoidance. The journey becomes more precarious. You and your child are afraid of the dismal prospects for a life without fear of a reaction. The quality of life suffers and the child’s nutrition may suffer. There is also the concern about the cost that surrounds special diets, schools, and medical supplies for reactions.

There are a few questions that you need to ask;
1. Is there a chance that this food allergy will go away?
2. Is there a chance that some of these test results are falsely positive?

Is there a way to verify an allergy test result?

The answer to that is an emphatic YES! Food allergy challenges can provide the correct direction-eat or avoid.
The food allergy challenge is also an allergy test and it is the gold standard test for food allergy.
When the history is obvious and the skin test supports the suspicion, a blood test called specific IgE may help sort out the risk of a reaction. If the risk is low, then a food challenge is a consideration.
We offer food challenges in a controlled clinical environment where we have the “e’s’;
1. Experience
2. Expertise
3. Equipment
The idea behind the food challenge is the gradual introduction of the allergenic food. There are about 10 exposures, each step is twice the amount until a full serving has been given. The procedure takes about 4 hours.
When you arrive we take care of registration, vital signs, and an examination. We review the history and have you sign a consent. We take time to answer any questions. We explain the procedure to the child as to what to expect and we make it very clear that at any time there is a concern, we stop and evaluate. The decision to continue is made together with the team, the parent, and the child.
Yes, we have had reactions that have caused us to stop. We have had concerns that led to a long waiting periods prior to stopping or continuing. We have had to place barrier creams on the face to keep the child from having a rash from wearing the food. We have had long talks with the children who are scared because they have been told of dire consequences due to the food. Some of the children are so well educated about avoidance that it makes the food challenge very hard to do.
What is our food allergy experience? We have done food challenges for egg, milk, wheat, peanut, soy, fish, shellfish, sesame seed, corn, watermelon, and tree nuts. Our track record is a pass in 80%.
The food challenge has serves many purposes; it paves the way for good nutrition. It helps with quality of life issues, it ends the need for injectable epinephrine, and importantly, it helps resolve the fear of a food allergy.

FEL 5/1/2016

May 1, 2016 · fleickly · No Comments
Tags: , , ,  · Posted in: Allergies, Allergy in Children, Allergy Testing, Food Allergies, Food Challenges

A Peanut-Free Indianapolis Indians Baseball Game- Summary and Thanks

May begins Food Allergy Action month. Locally we got things started on Friday night (April 29th, 2016) with the second annual Indianapolis Indians ‘peanut’ free baseball game. Thanks to the hard work by the FASI (Food Allergy Support Indianapolis-formerly known as POCHA) team, the event was a success. Imagine a youngster who loves “America’s Game” and may fear for his safety by attending a game. Peanuts have been strongly linked to baseball- I wonder about the history of that relationship. Thanks to FASI and the Indianapolis Indians organization, that youngster could go to the ballpark, feel safe, have fun, and cheer the tribe on to another victory.

I need to also thank the announcer for the game (a few words were shared about our cause)-for the very kind words he shared with the crowd about my role in this struggle of food allergy. I think HIPPA precludes me from mentioning full names, but thank you Doug- that took me totally by surprise. Doug also sang a slightly altered version of that popular 7th inning stretch song- ‘Take me out to the ballgame….”. Note, that with the intent of keep this a peanut free event- two words were changed in the song to keep it peanut free. There is a funny story behind the choice of words to substitute for ‘ … buy me some peanuts and cracker jack’.

I had a chance to go to the broadcast booth during the second inning. It was for a live interview during the game. I sat next to Howard, wore the headset, had a great view of the game and between the action, fielded his questions about peanut allergy and food allergy in general. That was a great experience.

The hard work behind the scenes and my sincere thanks go out to Lauren, Amy, Jennifer, Chelsea, and Sue – your FASI team. Also a warm applause to the Indians organization and to everyone who was there. And thanks to my family for supporting my efforts with all this. Grandson Calvin-having not peanut but tree nut allergy, said of the event-‘This is the best place I have ever been’- his first baseball game ever, but a frequent attendee of our Indy FARE Walk. In August we have our next major awareness and fund raising event for food allergy – the FARE (Food Allergy Research and Education) walk at White River State Park Saturday August 20th, 2016.

FEL 5/1/2016

 

May 1, 2016 · fleickly · No Comments
Tags: ,  · Posted in: Allergies, Food Allergy Community Events, Interesting Stories, Peanut Allergy, PoCHA Indianapolis

Indianapolis Pollen Counts for April 2016 (and a 4 year comparison)

The pollen counts for the past week have ‘impressive’. Four of the seven days of the week had very high tree pollen counts with one of the highest counts at over 1600 grains of tree pollen per cubic meter of air sampled. The recent pollens have been from cottonwood, maple, ash, and birch.

To summarize the 2016 pollen season so far- we saw it come earlier and it has given some very impressive numbers. The graph is very busy, but the visual impact of the peaks comes across. The past four years of pollen counts for the month of April appear on the second graph.

If you are tree pollen sensitive, consider the following;

  • Avoidance- the number one best allergy treatment- stay inside, shower at night to remove pollen that may be in your hair, sleep with closed windows, and that doggy who ventures outside may bring pollen into your home. Also, if the eyes are involved- KEEP THE DIRTY HANDS AWAY FROM THE EYES -rubbing only makes it worse.
  • Better living through chemistry- nasal steroid sprays, oral antihistamines, decongestants, leukotriene modifiers
  • Immunotherapy- injections of the pollen allergen to stimulate an immune response.

Tree Pollen Summary April 2016 200

 

 

 

 

 

Tree Pollen Summary April 2013-2016 175- Copy

 

 

 

 

 

FEL 5/1/2016

May 1, 2016 · fleickly · No Comments
Tags: , , ,  · Posted in: Pollen Counting, Pollen Counting- Indianapolis, Seasonal Allergies, Seasonal Allergies-Pollen Counts, Tree Pollen Counts

Indianapolis Pollen Counts for Thursday April 21st, 2016

Beginning on Monday April 18th, we have had 4 consecutive days of very high pollen counts; 793, 910, 559, and 1129. For those days the pollens were from cottonwood/poplar (hard to distinguish between the two under the microscope), birch, maple, and walnut trees. Over the past four years I have been keeping spreadsheets on my pollen counts. The spreadsheet has my actual count, the types of pollen and selected information from the weather page of the Indianapolis Star- pollen prediction, temperature ranges for the day, the pithy saying of what kind of a day we will have, and the rainfall amounts for the day, for the month and cumulative for the year. I also have a column for data from my favorite fictional website- pollen dot com. Of note the newspaper uses pollen dot com for their counts but for some reason they do not always match up.

Today was quite a contrast- I saw a very high count of 1129 grains of tree pollen per cubic meter of air sampled for the day. Any count over 499 would be considered very high. Today’s count was the highest this year and it was the fourth  highest count that I have recorded for an April day for the past 4 years. Today would have clearly been a very high count. Contrast that to the website and newspaper that declared today we would have a low count. Note low is a tree pollen count between 1 and 14. Quite a contrast in information.

April 21, 2016

 

 

 

 

 

FEL 4/21/2016

 

 

April 21, 2016 · fleickly · No Comments
Tags: , , ,  · Posted in: Pollen Counting, Pollen Counting- Indianapolis, Seasonal Allergies, Seasonal Allergies-Pollen Counts, Tree Pollen Counts

Indianapolis Pollen Counts Sunday April 17, 2016

This is the time of the year that we see reports on just how bad the pollen is going to be this year. That was what got me started doing pollen counts. Claims were made that each year was remarkable for more pollen and more misery. Not once did a report say that it will not be so bad or it is just about like was the last time you asked. These reports are done without any local data.

The graph below has the past 4 years of results.

Black line – 2016, Grey- 2015, Blue- 2014, and Brown- 2013

The scale is 1-9 is a low count, 9-49 is a moderate count, 50-499 is a high tree pollen count, and any count over 500 is a very high count.

We had maple, birch, walnut, and poplar/cottonwood tree pollen out there over the past week.

April 17, 2016 150

 

 

 

 

FEL 4/17/2016

April 17, 2016 · fleickly · No Comments
Tags: , , ,  · Posted in: Pollen Counting, Pollen Counting- Indianapolis, Seasonal Allergies, Seasonal Allergies-Pollen Counts, Tree Pollen Counts

Indianapolis Pollen Counts- March 28th through April 3rd, 2016

Pollen counts for the past week- Monday March 28th through today April 3rd, 2016 were low and moderate; Monday low-3, Tuesday low-6, Wednesday moderate-41, Thursday low-12, Friday moderate- 30, Saturday moderate-17, and Sunday moderate at 15.
The tree pollens were from maple, elm, cedar, hickory, cottonwood, birch, and alder.

April 3 2016

 

 

 

 

 

FEL 4/3/2016

April 3, 2016 · fleickly · No Comments
Tags: , , ,  · Posted in: Pollen Counting, Pollen Counting- Indianapolis, Seasonal Allergies, Seasonal Allergies-Pollen Counts, Tree Pollen Counts

Indianapolis Pollen Counts for Easter Weekend 2016

Tree pollen counts were low on Friday at 5, low on Saturday at 6 and high today at 114. The pollens have been from maple, cedar, hickory, birch, and alder.

March 27, 2016

 

 

 

 

FEL 3/27/2016

March 27, 2016 · fleickly · No Comments
Tags: , , ,  · Posted in: Pollen Counting, Pollen Counting- Indianapolis, Seasonal Allergies, Seasonal Allergies-Pollen Counts, Tree Pollen Counts

Indianapolis Pollen Counts for Wednesday March 23rd, 2016

Today’s count was 142 for tree pollen which is in the high range. Due to technical (power) issues, no counting was available for Monday or Tuesday this week. The tree pollens seen were mostly maple tree pollen. I also saw elm, hickory, walnut, pine, and birch.

The graph is a bit deceiving. I need to figure out how to deal with ‘no count’ days vs. zero days. The zero points for Monday and Tuesday represent – No Data Available.

March 23, 2016

 

 

 

 

 

FEL 3/23/2016

 

March 23, 2016 · fleickly · No Comments
Tags: , , ,  · Posted in: Pollen Counting, Pollen Counting- Indianapolis, Seasonal Allergies, Seasonal Allergies-Pollen Counts, Tree Pollen Counts

Indianapolis Pollen Counts for Friday through Sunday March 18th-20th, 2016

Pollen levels were low at 13 on Friday, moderate at 19 on Saturday, and low again today, Sunday at 5 grains of tree pollen per cubic meter of air sampled for the day. The tree pollens seen on the rods were from cedar, maple, hickory, and alder.

March 20, 2016

 

 

 

 

FEL 3/20/2016

March 20, 2016 · fleickly · No Comments
Tags: , , ,  · Posted in: Pollen Counting, Pollen Counting- Indianapolis, Seasonal Allergies, Seasonal Allergies-Pollen Counts, Tree Pollen Counts

Indianapolis Pollen Counts for Wednesday March 16th and Thursday 17th, 2016

Wednesday we had a tree pollen count of 246 – high and today the count was moderate at 28. For both days the pollens were from maple, cedar, hickory, and alder.

March 15,16, 2016

 

 

 

 

FEL 3/17/2016

March 17, 2016 · fleickly · No Comments
Tags: , ,  · Posted in: Pollen Counting, Pollen Counting- Indianapolis, Seasonal Allergies, Seasonal Allergies-Pollen Counts, Tree Pollen Counts