By Adem Lewis / in , , , , , , , , , , , , , , , , /


>>WITH THE COMING OF SPRING, WE MOVE RIGHT FROM FLU SEASON TO ALLERGY SEASON. ALLERGIES: NOTHING TO SNEEZE AT. TONIGHT, “ON CALL WITH THE PRAIRIE DOC.”>>GOOD EVENING, AND WELCOME TO “ON CALL WITH THE PRAIRIE DOC.” AS THE SNOW FINALLY MELTS, AND THE TEMPERATURES SLOWLY RISE, WE ARE BEGINNING TO THINK OF THE SPRING ALLERGY SEASON WHEN EVERYTHING IS BLOOMING AND THE AIR IS FULL OF POLLEN. BUT THERE ARE MANY OTHER ALLERGENS THAT WE ENCOUNTER EACH DAY. FIRST, LET’S TAKE A LOOK AT THIS WEEK’S “PRAIRIE DOC” QUIZ QUESTION. TRUE OR FALSE: NASAL WASHES CLEANSE ALLERGENS AND IRRITANTS FROM THE NOSE. TRUE OR FALSE? VIEWERS WHO CALL IN THE CORRECT ANSWER WILL BE ENTERED INTO A DRAWING TO WIN A SIGNED COPY OF OUR BOOK, “THE PICTURE OF HEALTH.” EACH OF MY ESSAYS, ORIGINALLY WRITTEN FOR THIS SHOW, COMES WITH A WONDERFUL ACCOMPANYING PHOTOGRAPH BY DR. JUDITH PETERSON. WE WILL ANNOUNCE THE ANSWER AND THE WINNER AT THE END OF THE SHOW. REMEMBER, YOU ONLY HAVE TEN MINUTES TO GET YOUR ANSWER IN. WE ANSWER YOUR QUESTIONS CONCERNING ALLERGIES AS THEY ARE CALLED IN OR SENT TO US VIA FACEBOOK OR EMAIL. CALL IN QUESTIONS TO 1-888-376-6225. OR SEND US AN EMAIL TO THE ADDRESS ON THE SCREEN. JOINING US TONIGHT ARE TWO GREAT FRIENDS OF “ON CALL,” I THINK THEY’VE BOTH BEEN ON THE SHOW, WHAT, 20, 30, 40,000 TIMES EACH? [ Laughter ] DR. TOM LUZIER WITH ABERDEEN ASTHMA AND ALLERGY AND DR. MARK BUBAK WITH DAKOTA ALLERGY AND ASTHMA. BOTH ALLERGISTS. ONE FROM ABERDEEN, ONE FROM SIOUX FALLS. GOOD FRIENDS ACTUALLY AND WE APPRECIATE YOU BEING HERE.>>WE ARE TICKLED TO BE HERE.>>THE QUESTION I’D LIKE TO START WITH THE HYGIENE THEORY. ABOUT THE FACT THAT THERE IS SO MUCH MORE ALLERGY HAPPENING NOWADAYS OVER THE LAST, YOU KNOW, 30, 50 YEARS, REALLY, THAN BEFORE. SO WHAT WOULD — LET’S START WITH YOU, MARK. WHAT IS THE HYGIENE THEORY?>>THE HYGIENE HYPOTHESIS IS THAT THE MORE STUFF WE GIVE OUR IMMUNE SYSTEM TO TAKE CARE OF WITH THE GERMS AND BEING SICK, THE LESS LIKELY YOU ARE TO HAVE ALLERGIES. AND SO BY CLEANING THINGS UP, WE TEND TOWARDS THE ALLERGIC SIDE AND THAT’S ACTUALLY BEING SEEN WITH FOOD ALLERGY EVEN, THAT OUR BACTERIA IN OUR STOMACHS, IN OUR INTESTINES MAKE SUCH A DIFFERENCE AND WHICH ONES ARE THERE? DO WE KILL OFF THE WRONG ONES WITH OUR ANTIBIOTICS? AND IT MAKES A HUGE SWAY OF GOING ALLERGIC OR NONALLERGIC. THINK ABOUT FARMERS. THEY HAVE A FAR LOWER INSTANCE OF ALLERGY AND ASTHMA THAN OUR CITY DWELLERS.>>AND IT’S BECAUSE THEY’RE EXPOSED TO ALL THE DIRT AND THE DUST AND THE BACTERIA –>>THAT’S RIGHT. THE GOOD OLD COW STUFF.>>COW STUFF.>>YEAH.>>ANY RESPONSE TO THAT?>>WELL, THE STUDIES WERE JUST AMAZING BECAUSE THEY STARTED WITH GERMAN FAMILIES WHO HAD THIS LOW INCIDENCE OF ALLERGY AND THAT’S BECAUSE THEIR ANIMALS LIVE BASICALLY JUST WITH THEIR HOUSE.>>UNDER THE HOUSE.>>RIGHT. AND DAIRY FARMERS WERE PARTICULARLY LOW AND THERE IS A BACILLUS WHICH IS IN COW MANURE, AND THAT BACILLUS IS STIMULIZED AND IT STIMULATES TH1 WHICH IS DOESN’T MEAN MUCH TO YOU, BUT WE HAVE TWO ARMS AND THE TH-2 IS THE ALLERGIC ARM. WELL, WHEN YOU’RE TAKING CARE OF VIRUSES AND BACTERIA, IT TENDS TO MAKE THE TH-2 MORE SUBTLE AND NOT AS REACTIVE. AND WHAT MARK WAS TALKING ABOUT WAS THEY SHOWED THAT PEANUT INTRODUCTION IN ISRAEL IS VERY EARLY. THAT’S WHAT THEY HAVE FOR THEIR TEETHING BABIES AND THEY HAVE A LOWER INCIDENCE OF PEANUT SENSITIVITY, WE THINK BECAUSE THEY INTRODUCE IT EARLY HAD THE G.I. TRACT IS READY TO DO THAT. READY TO TAKE CARE OF THAT.>>SO I MEAN, WE NEED OUR IMMUNE SYSTEM. IT FIGHTS OFF CANCERS AS WELL AS INFECTIONS AND SO ON AND SO FORTH. BUT IT’S A DIFFERENT SIDE OF IT THAT IS THE ALLERGY PART OF IT. WHAT DO YOU SEE IN THE FUTURE?>>I REALLY SEE US ADMINISTERING THE CORRECT TYPE OF BACTERIA AT A CERTAIN AGE. SO THAT WE CAN PREVENT THE ALLERGY OR THE ASTHMA FROM COMING ON IN THE PATIENT IF AT ALL.>>SO EXPOSURE TO CERTAIN –>>WE’RE DOING THAT NOW WITH PEANUTS. IF YOU’VE GOT ATOPIC DERMATITIS, ANY TYPE OF ECZEMA STUFF, WITH YOUR KID, WE KNOW YOU GIVE THEM THE PEANUT, GO DOWN THE G.I. TRACT, THE TOLERANCES DEVELOP. AND SO THERE ARE CERTAIN BACTERIA THAT TALK TO OUR INTESTINAL IMMUNE SYSTEM, AND THAT MAKES SUCH A DIFFERENCE WITH WHETHER YOU’RE GOING TO BE FOOD ALLERGIC. AND SO WE COULD MANIPULATE THAT.>>SO WE’RE TALKING ABOUT THE MICRO BIOME.>>SURE. SO THIS MICRO BIOME THING, YOU KNOW, WHEN YOU’RE A C-SECTION BABY, YOU DON’T GET THE MICRO BIOME. YOU DON’T GO THROUGH BIRTH CANAL. SO THERE ARE SUGGESTIONS AND PEOPLE DOING THIS THAT TAKE THE PERINEAL FLUID AND ADMINISTER IT TO THE BABY. YOUR MOM’S BACTERIA IS YOUR PERFECT BACTERIA, WHICH LOWERS YOUR INCIDENCE OF ALLERGIC DISEASE. >>WOW. AND OF COURSE, YOU KNOW, THAT BABY CRAWLING UP ON THE MOM, OVER MAMA’S BELLY AND FINDING THE BREAST AND SUCKLING THE BREAST AND OF COURSE A SWEATY DIRTY MOM WHO’S BEEN, YOU KNOW, GOING THROUGH LABOR, AND THAT BABY GETS THE MICRO BIOME OF THE MOM AND THAT MAKES THAT BABY SO MUCH HEALTHIER.>>THE BIRTH CANAL IS THE SECRET SPOT FOR THEM.>>ALL RIGHT. BUT DESPITE ALL THIS THEORY, IT ISN’T 100%, RIGHT?>>THAT’S CORRECT.>>THERE’S SOME EXCEPTIONS TO ALL OF IT AND PEOPLE WHO HAVE NO ALLERGY BACKGROUND IN THEIR GENETICS WILL POP UP WITH ALLERGIES.>>WE THINK SOMETIMES THERE ARE VIRUSES THAT TRIGGER THAT, LIKE MONOVIRUS IS A DISEASE OF LYMPHOCYTES, SO THEY GET KIND OF GOOFED WHEN THEY GET MONO BECAUSE IT DOESN’T LEAVE YOU AFTER YOU HAVE GONE THROUGH THE MONO ILLNESS. IT’S JUST CONTROLLED.>>IT IS PART OF YOUR MICRO BIOME.>>CELLULAR BIOME.>>BUT I THINK THE BIOME THING IS A VERY IMPORTANT ADDITION TO WHAT WE’RE DOING IN MEDICINE. I MEAN, THEY’VE RECENTLY SHOWED THAT PREBIOTIC IS PROBABLY A LITTLE MORE EFFECTIVE THAN PROBIOTIC BECAUSE IT’S HARD FOR THE BACTERIA TO GET THROUGH THAT STOMACH REALM WHICH IS SO ACIDIC.>>KILLS THEM OFF.>>SO IF YOU TAKE A PREBIOTIC, IT MAKES WHAT YOU GROW ALREADY IN YOUR GUT MORE LIKELY TO GROW THE RIGHT STUFF.>>BUT EXPLAIN A PREBIOTIC –>>LIKE THERE’S ONE CALLED INULIN, IT PROVIDES A STRUCTURE. IT’S A SUGAR. IT PROVIDES A STRUCTURE FOR THE BACTERIA THAT YOU LIKE TO GROW.>>OKAY.>>IN YOUR INTESTINE AND IT MAKES IT THROUGH THE STOMACH WITHOUT BEING CHANGED DRAMATICALLY.>>ALL RIGHT. SO YOU DON’T SUGGEST GOING OUT AND BUYING A BUNCH OF PREBIOTIC RIGHT NOW.>>PREBIOTIC IS NOW INCLUDED WITH PROBIOTIC AS KIND OF A REGULAR COMBINATION.>>AND DO YOU FIND A NATURE MADE OR A BRAND, OVER THE COUNTER –>>OVER THE COUNTER BRAND?>>WHAT IS IT CALLED.>>CULTURELLE MAKES ONE. IT SAYS ON IT, PRE AND PROBIOTIC.>>PARTICULARLY IF YOU’RE GOING TO BE TAKING ANTIBIOTICS.>>ABSOLUTELY. ANTIBIOTIC –>>I DON’T THINK WE KNOW ENOUGH WHICH BACTERIA TO BE PUTTING IN THERE. AND THERE’S SO MANY POSITIVE AND NEGATIVE COUNTER-STUDIES ON THIS STUFF, I’M STILL NOT HAPPY WITH WHICH ONE SHOULD I BE RECOMMENDING?>>SO WE HAVE SOME DISAGREEMENT THAT THAT’S, YOU KNOW, WHAT? WE CAN AGREE TO DISAGREE.>>AND I DON’T THINK IT WOULD REALLY HURT SOMEBODY. WE DON’T HAVE ENOUGH DATA TO SAY IS IT REALLY WORTH SPENDING YOUR MONEY ON THAT, IS WHAT I THINK.>>THERE YOU GO. WELL, IT DEPENDS. I CAN TELL YOU RIGHT NOW, I HAD AN INFECTION IN MY LIVER, SO I HAVE A CYST THAT IS WITH A CATHETER AND THE DRAINING A TUBE RIGHT NOW. SO I AM LOADED WITH ANTIBIOTICS. MR. CONSERVATIVE, DON’T PRESCRIBE ANTIBIOTICS AND I’M GETTING THEM EVERY DAY, AND MY MICRO BIOME IS GOING, OOH, OW, AH!>>BUT IT’S NOT JUST ANTIBIOTIC THAT CHANGES YOUR MICRO BIOME.>>WHAT IS IT?>>THINGS LIKE SPLENDA.>>IN A GOOD WAY?>>NO, NOT IN A GOOD WAY. SO THERE ARE OTHER THINGS THEY’RE DISCOVERING THAT REALLY ALTER YOUR MICRO BIOME. SO YOU HAVE TO BE — YOU KNOW, THAT HEALTHY DIET THAT YOU TALK ABOUT, IT REALLY IS HEALTHY BECAUSE IT DOES PROVIDE A BETTER MICRO BIOME. THE GREEN STUFF –>>ALL THOSE GREENS, ALL THOSE VEGETABLES –>>MORE THAN JUST THE FIBER IN IT. THERE’S THINGS ON IT.>>THERE’S A LOT OF DATA ABOUT GREEN SALADS THAT ARE WAY MORE IMPORTANT THAN WE PREVIOUSLY THOUGHT. EAT YOUR GREEN SALADS. LET’S PUT IT THAT WAY. PARTICULARLY IF YOU’RE ON A ANTIBIOTIC.>>AND BE SURE TO WASH YOUR KALE. THEY USE A LOT OF PESTICIDES OR HERBICIDES.>>BE CAREFUL THOUGH IF YOU’RE TREE NUT ALLERGIC AND YOU PUT SOME TREE NUTS ON IT.>>TREE NUTS? WHEN YOU HAVE YOUR MIXED SALAD AND WE THROW ON OUR NUTS, AND THEN YOU GIVE IT TO THE ANAPHYLACTICALLY ALLERGIC PERSON.>>READ YOUR LABELS TOO BECAUSE SOMETIMES THEY PUT SESAME IN HUMMUS.>>SESAME IS THE NEW ALLERGEN. MUSTARD AND SESAME. MARK AND I HAD THAT DISCUSSION AND I HAD MUSTARD AND SESAME ON MY –>>MORE PEOPLE ARE BECOMING ALLERGIC TO THOSE TWO.>>OKAY.>>SO WHILE WE’RE TALKING ABOUT — LET’S TALK ABOUT ANAPHYLAXIS. I HAD A PATIENT WHO WAS IN THE GRADY HOSPITAL. OUTPATIENT CLINIC. HE HAD A SORE THROAT. THE INTERN ORDERS A SHOT OF PENICILLIN FOR A SORE THROAT. AND YOU DON’T DO THAT ANYMORE. AND I THINK THAT’S THE LAST TIME DR. BRIA EVER ORDERED IT, BECAUSE THE GENTLEMAN WAS SITTING OUTSIDE. THE NURSE SAYS, YOU KNOW, YOU JUST SIT THERE. HE KNOCKED ON THE DOER, I DO FEEL VERY WELL. KIND OF PASSED OUT. SO SHE SAT HIM DOWN ON THE FLOOR, AND HE’S SITTING THERE, AND BY THE TIME I GOT THERE, HE WAS SITTING THERE, AND HE’S GOING, OH, I’M GOING TO VOMIT. AND HE GRABBED THE WASTE BASKET AND LEANED FORWARD TO VOMIT, AND THEN HE JUST TOTALLY PASSED OUT. AND HE HAD NO BLOOD PRESSURE. SO HE HAD AN ANAPHYLACTIC REACTION. HIS VEINS COMPLETELY DILATED, AND THERE WAS NO BLOOD PRESSURE. SO WHAT DO YOU THINK WE DID?>>I HOPE YOU GAVE HIM EPINEPHRIN.>>THAT’S EXACTLY RIGHT.>>HEY! [Talking at the same time]>>I’M INTERESTING TROUBLE WITH MY QUESTIONS. I KNOW WE’VE GOT QUESTIONS, BUT I CAN’T SEE WHAT THEY ARE DOING ON THIS TABLET.>>THE PROBLEM CHILD.>>IT’S A PROBLEM CHIDE.>>DEFINITION STANDPOINT FOR OUR VIEWERS, ANAPHYLAXIS IS AN ALL OVER THE BODY REACTION. YOU HAVE TO HAVE TWO SYSTEMS AFFECTED. MOST PEOPLE HAVE AN ITCH. BUT THERE’S I CAN’T BREATHE. THERE MIGHT BE VOMITING, DIARRHEA, TYPES OF THINGS AND THE BIG THIN IS THE BLOOD PRESSURE GOING AWAY.>>YOUR HEART STOPS. THAT’S A BAD THING.>>YOU GIVE THEM A DOSE OF EPINEPHRINE AND IT SITS THERE BECAUSE NO CIRCULATION IS HAPPENINGS.>>YOU GOT TO MOVE IT AROUND FOR THEM.>>YOU GOT TO GIVE IT TO THEM IN THE MUSCLE.>>THIS MAN WAS TOTALLY GONE, AND ONE OF THE ATTENDINGS SAID MAYBE YOU SHOULD HAVE SHOT IT UNDER THE TONGUE. THE GUY DID SURVIVE. WE GOT AN I.V. IN. I DON’T KNOW HOW. BUT WE DID. AND WE FILLED HIM FULL OF SALINE WATER.>>NOT A PERIOSTEAL, WHICH IS INTO THE BONE. AND THAT WORKS WHEN NOTHING ELSE DOES. THAT’S A PEDIATRICIAN SPEAKING.>>ABSOLUTELY.>>SO — WELL, WE’RE — THAT’S, YOU KNOW, THE ISSUE OF ANAPHYLAXIS, THE TAKE-HOME MESSAGE IS WHAT.>>THERE’S SO MANY MESSAGES. AND MARK HAS POINTED THIS OUT A LOT. HE’S DONE SOME WORK WITH ANAPHYLAXIS. AND IF YOU KNOW YOU’RE ALLERGIC, YOU NEED TO HAVE YOUR EPINEPHRIN WITH YOU. THAT’S ONLY A 50% THING. YOU SHOULD PROBABLY AVOID IT. THAT’S PROBABLY ONLY ABOUT AN 80% THING. AND THEN MARK IDENTIFIED THE FACT THAT 56% OF THE TIME, THE PERSON’S GOT IT WITH THEM, BUT THEY DON’T KNOW HOW TO USE IT.>>THERE YOU GO.>>SO THEY’VE BEEN TRYING OR THEY DON’T REMEMBER OR WHATEVER IT IS.>>OR THEY’RE AFRAID TO USE IT.>>WELL, AND THERE’S SOMEBODY THAT’S RIGHT HERE AT THIS TABLE THAT USED AN EPI-PEN AND GAVE THE AUDIENCE AN ABSOLUTELY EXCELLENT VIEW OF HOW IT GOES. AND I USE THAT.>>YEAH, DO YOU USE THAT –>>I USED YOUR VIDEO.>>I THINK IT MAY NOT BE THIS ONE. IT’LL BE THE NEXT ONE.>>OKAY.>>ALLERGIES ARE A LIFE LONG EVENT. THEY MAY CHANGE OVER TIME, BUT YOU’LL ALWAYS HAVE TO BE AWARE OF THEIR PRESENCE.>>ONCE I GOT OLD ENOUGH TO REALIZE THAT I HAD THEM AND WHAT THEY WERE, I ACTUALLY HAD TO ASK MY MOM. I HAD NO IDEA WHEN THEY STARTED. HOW WE LEARNED ABOUT IT THE FIRST TIME. MOM JUST SAID THAT WHEN I WAS A YOUNG KID AROUND THE AGE OF THREE OR FOUR, I ALWAYS HAD ISSUES AROUND MY DAD, WHICH MY DAD WAS A FARMER. HE STILL IS. EVERY TIME HE’D COME BACK IN THE HOUSE FROM BEING OUTSIDE WORKING AROUND DUST AND POLLENS AND CROPS AND THINGS LIKE THAT, I WOULD HAVE ALLERGY ISSUES. SO SHE FINALLY FIGURED OUT SOME CORRELATION THERE AND WENT OUT AND DID AN ALLERGY PANEL, FOUND OUT A NUMBER OF THINGS THAT I’M ALLERGIC TO. MY MOM FIGURED OUT THAT I HAD PEANUT ALLERGIES, AND THAT’S BEEN THE SERIOUS ONE MY WHOLE LIFE. THE REST OF THEM ARE JUST ANNOYING. TWO EXPOSURES THAT I REMEMBER TOTALLY ACCIDENTAL, OF COURSE, ONE OF THEM WAS A CONTAMINATION ISSUE THAT I DIDN’T SEE COMING. THE OTHER ONE, I WAS EATING A KIND OF A GRANOLA BAR, AND SO WERE SOME OF MY FRIENDS, AND MINE WAS A FLAVOR I CAN HAVE, THEIRS IS A FLAVOR I CANNOT. THEY LOOK THE SAME. THE TEXTURE’S THE SAME. I ACCIDENTALLY PICKED UP THEIR BAR, TOOK A BITE, AND THAT WAS THE FIRST REAL EMERGENCY ROOM EXPERIENCE I HAD WITH A PEANUT ALLERGY. I DIDN’T KNOW HOW SERIOUS THE ONSET OF THAT WAS. AND IT WAS VERY FIERCE. AND MY EYELIDS SWELLED SHUT, GOT REALLY THICK, MY EAR LOBES AND THE BACK OF MY LEGS STARTED ITCHING. I STARTING FEELING INDIGESTION. AND I KIND OF PANICKED A LITTLE BIT. BUT IT WAS ONLY A COUPLE MINUTES UNTIL I REALIZED, I STARTED TO FEEL MY AIRWAY GET TO BE QUITE A BIT RESTRICTED. SO I WAS WITH SOME FRIENDS AT THE TIME, AND I SAID, LOOK, YOU GUYS, WE GOT TO GO TO THE E.R. WE GOT TO THE HOSPITAL INSTEAD. I DIDN’T HAVE AN EPI-PEN. ONCE I GOT THERE, THEY TOOK ONE LOOK AT ME, GOT SOME EPINEPHRIN IN ME, BENADRYL, AND I SPENT MOST OF THE DAY THERE UNTIL THAT SUBSIDED. WE JUST THOUGHT CASUALLY IN SEEING DOC RECENTLY FOR A PHYSICAL THAT I HAD TO HAVE, HE ASKED ME IF THERE’S ANY REFILLS AND THINGS, AND I HAVE ALLERGY INDUCED ASTHMA. USUALLY AN INHALER IS KIND OF MY RESCUE THERE. AGAIN, NOT AS SERIOUS AS THE PEANUT THING, BUT HE ASKED IF I NEEDED ANY MORE EPI-PENS. YEAH, AND I WENT TO THE PHARMACY TO LEARN THAT THEY’RE $723. FOR A REFILL. ON MY EPI-PENS, THAT I HOPE I NEVER, EVER HAVE TO USE. WE HAVE THEM NOW. I DON’T HAVE IT ON ME NOW. I DON’T HAVE IT WITH ME AT WORK EVERY DAY. BUT IT’S NEVER FARTHER AWAY FROM ME THAN IT WOULD NEED TO BE TO GET TO IT IN AN EMERGENCY. SO I KEEP IT IN A TRAVEL BAG IF I’M TRAVELING OR MY WIFE KEEPS IT IN HER PURSE WHICH IS ALWAYS ON HER. SO THE I’M TRAVELING WITH MY WIFE OR I’M TRAVELING WITH MY BATHROOM SUPPLIES, BUT I’VE NEVER HAD TO USE MY OWN YET. >>SO CLINTON FOUND THAT HE NEEDED TO HAVE SIGNIFICANT HELP WHEN HE WAS EXPOSED TO HIS REACTIVE ALLERGENS. ONE OF THOSE EMERGENCY TREATMENTS WAS THE USE OF AN EPI-PEN. THEY ARE EASY TO USE AND VERY EFFECTIVE. AND HERE COMES THE DEMONSTRATION.>>AN ACTUAL DEMONSTRATION. THIS IS NOT A PRACTICE PEN. THIS IS A REAL PEN. I’M NOT HAVING AN ALLERGIC REACTION, BUT I’M NOT AFRAID OF IT BECAUSE I KNOW I’VE GOT GOOD GUYS TO PROTECT ME. BUT IT’S A SAFE THING TO DO EVE IF YOU DIDN’T NEED IT, RIGHT?>>EXACTLY. I MEAN, THIS IS A WONDERFUL DEMONSTRATION.>>SO WE SHOULD NOT BE AFRAID TO USE IT IF YOU MIGHT NEED IT.>>IF YOUR THROAT’S SWELLING, YOU’RE ITCHING, HARD TO BREATHE, FEEL LIKE YOU’RE GOING TO THROW UP, ANY OF THOSE THINGS ARE SIGNS OF AN ANAPHYLACTIC REACTION.>>OR, YOU KNOW, YOU’VE BEEN STUNG AND, YOU KNOW, THERE’S SOMETHING — I CALL IT THE FEELING OF IMPENDING DOOM. AND YOU SHOULD DO SOMETHING.>>SO I’M HAVING AN IMPENDING DOOM. I WAS JUST BITTEN BY A WASP OR I MEAN STUNG BY A WASP OR I JUST ATE A PEANUT AND I KNOW IF I DO THIS, IT’S NOT GOING TO PUT ME AT RISK. SO I WANT TO DO THIS. SO THIS IS THE EPI-PEN. THERE’S ANOTHER PRODUCT. THEY’RE BOTH THE SAME, RIGHT?>>RIGHT. QUICKLY WITHIN A COUPLE OF MINUTES, HELP TURN THAT ALLERGIC REACTION AROUND.>>ALL RIGHT, AND THEN YOU GET TO THE EMERGENCY ROOM?>>YES, YOU DO.>>ALL RIGHT, SO THIS IS A REAL PEN. I’M GOING TO TAKE IT OFF THE TOP.>>BRING IT OUT OF THE PROTECTIVE CASE. GET RID OF THAT.>>THROW THAT.>>AND THEN PEN COMES OUT.>>THE COVER COMES OFF.>>THROW IT AWAY.>>ALL RIGHT.>>IT’S FULLY ARMED.>>NOW WE’RE READY?>>ON YOUR SIDE?>>THROUGH MY CLOTHES. AND THEN I’M GOING TO PUSH IT IN AND HOLD IT FOR TEN SECONDS. >>THERE YOU GO. ONE, TWO, THREE, FOUR, FIVE, SIX, SEVEN, EIGHT, NINE, TEN.>>AWESOME. I COULD FEEL IT. IT HURT A LITTLE. NOT BAD.>>NO, JUST A SURPRISE. BECAUSE YOU’VE GOT –>>AND IN A MINUTE OR SO HERE, YOU’RE GOING TO FEEL TH zT YOUR HEART STARTS BEATING FAST AND YOU FEEL A LITTLE JITTERY LIKE YOU JUST GOT SCARED AT THE MOVIE THEATER –>>OR HAD WAY TOO MUCH COFFEE. [Talking at the same time]>>THE ITCHINESS IS GOING TO START RECEDING. AND YOU’LL BE FEELING A LOT BETTER, AND ICK YOU CAN MAKE YOUR WAY TO MEDICAL CARE NOW. >>VERY GOOD. THAT’S GREAT. THANK YOU FOR PROVIDING US A PEN AND FOR BEING HERE.>>THANK YOU FOR A WONDERFUL HOUR. FOR ACTUALLY DEMONSTRATING IT. THAT WAS AWESOME. >>WASN’T THAT FUN? I THOUGHT IT WAS A GOOD –>>YOU WERE GREAT. THANKS FOR SHOWING FOLKS.>>YEAH. THIS IS YOUR PROGRAM, AND YOUR QUESTIONS ARE KEY TO THE DIRECTION OF OUR DISCUSSION. PLEASE CALL IN YOUR QUESTIONS TO 1-888-376-6225.1-888-376-6225. OR SEND US AN EMAIL TO [email protected] WELL, WE’VE GOT SOME QUESTIONS. ONE VIEWER ASKS, WHAT IS THE BEST WAY TO AVOID SEASONAL ALLERGIES?>>WELL I THINK THAT, YOU KNOW, AGAIN, THE BEST WAY IS TO KEEP YOUR WINDOWS CLOSED. IN THE EVENING. I MEAN, IT’S IMPRACTICAL TO SAY THAT YOU STAY IN ALL THE TIME. BUT IF YOU’RE GOING TO DO AN ACTIVITY THAT’S GOING TO GET YOU A PARTICULARLY LARGE EXPOSURE, WEAR A MASK. ANYTHING ELSE? >>I THINK THE — IF THE PERSON CAN TAKE A LITTLE VACATION AWAY, PARTS THAT DON’T HAVE YOUR ALLERGEN, THAT’S FINE. BUT OTHERWISE, HOUSE CLOSED UP. USE YOUR AIR CONDITIONER. THOSE THINGS MAKE A DIFFERENCE. ADDING FILTERS RARELY CLINICALLY MAKES A DIFFERENCE –>>AND THEY SURE COST CAN A LOT AND THEY PROMISE A LOT BUT THEY DON’T MAKE A LOT OF DIFFERENCE.>>SO INSTEAD I’D LIKE PEOPLE TO THINK ABOUT, GET READY WITH YOUR MEDS. JUMP IN WITH THE NASAL STEROID SPRAY ABOUT TEN DAYS BEFORE YOU KNOW THE SEASON’S GOING TO HIT. TAKE IT EVERY DAY THROUGH YOUR SEASON. AND HAVE SOME FUN WITH LIFE. IT’S REALLY HARD TO BE A HERMIT.>>WHEN YOU’RE ALL STUFFED UP AND FEELING BAD. WE HAVE A QUESTION FROM SIOUX FALLS. A WOMAN STATES, IT SEEMS LIKE OLDER PEOPLE ALWAYS HAVE RUNNY NOSES. WHY WOULD THAT BE, AND HOW WOULD WE STOP IT?>>WELL, THE RUNNY NOSE OF — IS A JOY OF AGING.>>THE JOY OF AGING.>>AND IT’S WAS FONDLY CALLED VASO MOTOR RHINITIS AT ONE TIME BECAUSE THEY THOUGHT — AND NOW WE JUST CALL IT CHRONIC LINT AND IT RESPONDS VERY NICELY TO MEDICINES THAT CONTAIN — SO THERE’S A NUMBER OF PRESCRIPTION NASAL SPRAYS THAT LAST ABOUT FOUR TO FIVE HOURS, MARK, MAYBE? THAT WILL CUT IT DOWN. IT’S NOT SOMETHING THAT CURES IT. AN YOU JUST USE IT FOR TIMES WHEN YOU HAVE A RUNNY NOS. AND ALSO THOSE PEOPLE HAVE TROUBLE WHEN THEY EAT FOOD THAT’S SPICY. THAT’S A TYPE OF RUNNY NOSE THAT WE HAVE A MEDICATION –>>IT’S A PRESCRIPTION?>>WHAT IS THE BRAND?>>EPIPODIUM NASAL SPRAY.>>WE’RE KIND OF HOARDERS OF DISEASE AS WE GO ALONG, AND IF YOU HAD DUST MITE DISEASE WHEN YOU’RE 30, YOU MIGHT HAVE IT WHEN YOU’RE 80. THE DRAINAGE ISN’T RIGHT, YOU’RE GOING TO KEEP THAT GOING AND SO THEN WE HAVE THESE OTHER NEW DISEASES THAT WE GET, AND SOME PEOPLE AT 60, DEVELOP ALLERGY FOR THE FIRST TIME EVER AND THEY’RE NOW ALLERGIC TO THEIR DOG OR DUST MITES.>>LET’S TALK ABOUT DUST MITES. THAT’S NOT A SEASONAL –>>MOSTLY.>>THERE IS A FALL SEASONALITY TO IT. IF YOU DON’T KEEP YOUR HOUSE DEHUMIDIFIED, BUT IT DOES RISE UP. BUT IT’S ALL YEAR ROUND. >>AND IT’S REALLY BUG PARTS, RIGHT? BUG POOP?>>IT’S THE WASTE PRODUCT OF THE DUST MITE.>>OF THAT LITTLE — OKAY.>>HE JUST LIKES TO SAY THAT WORD. THAT’S A FUN WORD –>>YEAH, EXACTLY. SO — AND THE ANSWER IS TO — HOW DO I LOWER THE DUST MITE COUNT IN MY HOUSE.>>MOVE HIGHER THAN A MILE HIGH. MAKES THINGS — LOW HUMIDITY. YEAH, SO DEHUMIDIFY.>>HUMIDITY IN THE 40% RANGE HELPS OUT. ENCASEMENTS FOR YOUR MATTRESSES AND PILLOWS.>>DO YOU THINK THOSE WORK? THERE’S A LOT OF DEBATE ABOUT THAT I HEARD.>>I’M NOT CONVINCED THAT IN SOUTH DAKOTA YOU CAN DROP THE DUST MITE CONCENTRATION ENOUGH. YOU CAN REALLY WORK HARD AT IT AND IT MIGHT MAKE A DIFFERENCE SO THAT IF YOU DO THE IMMUNOTHERAPY ALLERGY SHOTS AND BECOME LESS ALLERGIC, AND IT TAKES MORE OF IT TO GET YOU SICK. AND THEN SOME MEDICATION ON TOP OF THAT.>>BUT I REALLY — THE DUST MITE THING, IT’S THE NUMBER ONE ALLERGEN IN THE WORLD. SO — AND IT IS A VERY MUCH A ANTIGEN THAT CAUSES ASTHMA OR AIRWAY ACTIVITY. SO I DON’T THINK WE SHOULD DIMINISH HOW IMPORTANT DUST MITE IS BECAUSE I DO HAVE PATIENTS WHO’S ALL THEIR AIRWAY ACTIVITY OR ASTHMA IS BASED ON THEIR TREMENDOUS DUST MITE SENSITIVITY, WHICH THEY CARRY THAT AIRWAY REACTIVITY, WAY PAST THEIR EXPOSURE. THEY’VE SHOWN IF YOU HAVE YESTERDAY TO YOUR EPITHELIAL, YOU REMEMBER THAT EVEN WHEN YOU’VE LEFT THE ANTIGEN. SO THAT REACTIVITY, BOTH IN YOUR NOSE WHICH STARTED THIS, WELL, THAT PERSON COULD BE ALLERGIC TO SOMETHING AND THAT VASO MOTOR RHINITIS, THEY HAD THE BASIS IN ALLERGY.>>SO MY THOUGHT IS WHEN PEOPLE HAVE WHAT WE THINK IS THE DUST ALLERGY, I TRY TO ENCOURAGE THEM TO NOT HAVE CARPET. AND I TRY TO ENCOURAGE THEM TO HAVE A CLEANING PERSON COME AND CLEAN REALLY WELL WHEN YOU’RE NOT — AND YOU DON’T DO THE CLEANING. AND MAKE SURE THAT, YOU KNOW, THE CURTAINS ARE CLEAN AND THAT YOUR BEDROOM IN PARTICULAR IS DUST-FREE.>>TO KNOW IF YOU ACTUALLY HAVE AN ALLERGY BEFORE YOU EXPEND ALL THE ENERGY AND THE COST. KNOW WHAT YOU HAVE. AND YOUR OUTCOME’S GOING TO BE A LOT BETTER.>>AND THE WAY YOU KNOW THAT IS GOING TO?>>YOU GET TESTED BY YOUR — A ALLERGIST WILL DO THAT. YOUR FAMILY DOC MAY ORDER A BLOOD TEST THAT WOULD SAY, IS THIS A DUST MITE OR IS THIS MY DOG. SKIN TESTING IS GOING TO BE A LOT LESS EXPENSIVE AND MORE ACCURATE.>>ONE’S A BIOLOGIC TEST. YOU’RE PRICKING THE SKIN RIGHT WHERE THE ACTION IS RATHER THAN MEASURING WHAT’S IN THE BLOOD WHICH IS HIGH MAYBE IF YOU’VE HAD EXPOSURE, MAYBE NOT INDICATIVE OF WHAT YOUR DAILY ACTIVITY IS.>>SO THE SKIN PRICK TEST IS A BETTER DEAL?>>IT IS.>>AND YOU GUYS DO THAT.>>YEAH.>>I THINK IT WAS TWO YEARS AGO, WHEN THE TWO OF YOU WERE ON THE SHOW, WE TALKED ABOUT THE NEW STUDY THAT REALLY SHOWED THE VALUE OF DESENSITIZATION SHOTS. >>OH, YEAH, IT’S SO UNBELIEVABLE — EVEN AS ALLERGISTS, WE ARE AMAZED EVERY TIME WE HAVE PATIENTS COME IN AND I AM, WE HAVE TROUBLE GETTING TO STOP THEIR SHOTS AFTER THEY’VE SHOWN APPROPRIATE RESPONSE BECAUSE THEY DON’T WANT TO GO BACK.>>RIGHT, IT’S LIKE THE SHOTS GIVE THEM RELIEF.>>HELPS WITH THE NASAL, THE ASTHMA, LESS SINUS INFECTIONS, EAR INFECTIONS. LESS EXPENSIVE. SO — IT’S REALLY HELPFUL.>>A VIEWER IS WONDERING, IS TENDERNESS OF THE — EXCUSE ME, THE SCLERA OF YOUR EYES POTENTIALLY RELATED TO ALLERGIES? SCRATCHY, ITCHY EYES.>>YOU NEED TO HEAR ITCHY. YOU’D WANT TO HEAR ITCHY. I DON’T THINK SO MUCH THE TENDERNESS.>>YEAH, I’D BE A LITTLE CONCERNED ABOUT TENDERNESS. AGAIN, YOU KNOW, THERE’S — AND SOMETIMES PEOPLE COME TO ME, AND SAY, WELL, I’VE GOT THIS REDNESS IN THE WHITE PART OF MY EYE. SCLERAL REDNESS. DO I HAVE ROSACEA OR SOMETHING LIKE THAT. DRY EYE, THERE’S THAT. >>WE HAD AN OPTHAMOLOGY SHOW A COUPLE WEEKS AGO. I DO THINK THAT PEOPLE WHO HAVE ITCHY EYES AND A RUNNY NOSE, THAT INDICATES AN ALLERGIC –>>YEAH, IT’S NICE TO HAVE SOMETHING ELSE.>>BOTH SIDES? NOT JUST THE ONE EYE?>>SO WHEN YOU HAVE ONE EYE AND THERE’S RED AND THERE’S PAIN, GET THEE TO THE EYE DOCTOR.>>YEAH.>>OUT OF BOLT, LA BOLT, SOUTH DAKOTA, POPULATION 68, A WOMAN TO LIKE TO ADDRESS A WEIRD ALLERGY TO BIRCH POLLEN. IT IS A THIN SKINNED TREE FRUIT. CAN YOU ELABORATE MORE ON THIS TOPIC? HAVE EITHER ONE OF YOU HEARD OF BIRCH POLLEN ALLERGY?>>WELL, YES, IT’S RELATIVELY COMMON IN AREAS THAT HAVE BIRCH AS THEIR PRIMARY TREE. AND IT HAS SOME CROSS-REACTIVITY TO OTHER THINGS THAT ARE OUT THERE. YEAH.>>BIRCH IS PRETTY COMMON.>>HUGE THING IN NORTHERN EUROPE, LIKE NORWAY. AND –>>THE REASON WE’RE SMILING IS BECAUSE HE’S BEEN TO NORWAY.>>BUT IT’S A HUGE THING EVEN HERE IN SOUTH DAKOTA. LOTS OF ITCHY, SNEEZY, RUNNY, AND A LOT OF FOLKS WITH ALLERGY HAVE ORAL ALLERGY SYMPTOMS SO THEY BITE INTO THEIR APPLE OR SOME CHERRIES, AND THEIR MOUTH ITCHES. THEY DON’T GO ON TO ANAPHYLAXIS. IF YOU COOK THE APPLE, YOU’RE FINE. IT’S REALLY A NEAT THING –>>A NEAT THING?>>FROM AN ALLERGIST’S STANDPOINT. THE SCIENCE IS PHENOMENAL. REGULAR WEED DOES THE SAME ORAL ALLERGY SYNDROME WITH MELONS.>>SO IF YOU EAT MELONS IT HURTS?>>ITCHES YOUR MOUTH. IT FEELS KIND OF PUFFY ON THE INSIDE.>>I’VE NEVER HEARD THIS. SO IF YOU HAVE BIRCH TREE ALLERGY –>>MIGHT HAVE AN ISSUE WITH PEARS AND APPLES. AND CHERRIES.>>QUICKLY, AND WE’VE GOT A LOT OF QUESTIONS. THE SEASON OF ALLERGY IS STARTING RIGHT NOW?>>AND BIRCH IS ONE OF THE FIRST ONES. [Talking at the same time]>>TREES IN LATE MARCH, APRIL, INTO MAY.>>TREES IN LATE APRIL, MARCH AND APRIL, AND MAY. GRASSES START IN MAY.>>THE VERY END OF IT.>>AND ESPECIALLY JUNE, END OF JULY IS THE GRASS SEASON.>>AND THEN THE SEASON FOR WEEDS –>>END OF JULY, AUGUST, SEPTEMBER.>>UNTIL FROST.>>AND MOLD IS WHEN WE DON’T HAVE SNOW.>>AND YOU DON’T HAVE A BARN.>>OKAY.>>THAT’S YEAR ROUND.>>THAT’S YEAR ROUND. A RED FIELD WOMAN SAYS SHE HAS NEVER HAD ALLERGIES BEFORE. SHE SPENDS A LOT OF TIME OUTSIDE, BUT IN THE LAST FIVE YEARS OR SO, SHE’S HAD ALLERGY SYMPTOMS.>>I THINK YOU ANSWERED THAT.>>FOR GALS, IT’S AS THEY GO ALONG. LITTLE GUYS GET IT. THE GIRLS CATCH UP LATER. AND BY THE TIME WE’RE 70, IT’S EVEN STEVEN. SOMETIMES AROUND THE 40s AND 50s ESPECIALLY FOR GALS.>>AND JUST FOR INTEREST SAKE, PREGNANCY USUALLY CAUSES TH-2 ALLERGY TO BE LESS. BECAUSE YOUR IMMUNE SYSTEM HAS A GRAFT, THAT’S THE BABY — SO THAT DOWN REGULATES ALLERGIES, SO A LOT OF TIMES I’LL HAVE A PATIENT WHO IS SEEING ME AS A TEENAGER, HAS BABIES, I DON’T SEE THEM FOR A LONG TIME. THEY COME BACK AND SEE ME IN THEIR 40s AS THEY ARE SIX OR EIGHT YEARS FROM THEIR LAST BABY.>>BROOKINGS WOMAN ASKS, HOW DO I KNOW IT’S A COLD, NOT ALLERGY? SUDDENLY I WAKE UP, MY NOSE IS FULL. I’M SNEEZING A LOT. I DON’T HAVE ITCHY EYES. I KIND OF ACHE ALL OVER. I’M DEALING WITH THIS OTHER THING IN THE LIVER. BUT SOMETHING’S HAPPENING BECAUSE I’VE REALLY GOT A LOT OF NASAL RHINITIS. YOU THINK AS VIRUS?>>YOU DIDN’T SAY ITCHY. YOU SAID ACHY. ALLERGIES DON’T REALLY GIVE YOU ACHY. THE PROOF WILL BE THAT A WEEK OR SO FROM NOW YOU’LL BE BETTER, AND IF YOU HAD ALLERGIES, IT’S GOING TO GO ON FOR ABOUT THREE TO FOUR WEEKS BECAUSE THIS IS TREE SEASON AND EACH OF THOSE POLLINATES FOR ABOUT THREE TO FOUR WEEKS AND THEN THEY’RE DONE. >>BUT THEN I’M SEEING ALL OF THIS SNOW MOLD.>>UNDERNEATH THE SNOW IS THE GRASS. AND THERE’S A NATURAL MOLD THAT’S COMMENSURATE WITH THE GRASS. AND SO AS THE SNOW GOES, NOW IT’S EXPOSED. IT DRIES UP. THAT’S WHEN THE MOLD SPORES. AND IT JUST NEEDS A LITTLE BIT OF WIND OR YOU WALKING, ALL YOU HAVE TO DO IS JUST WALK OVER THE GRASS AND IT PUFFS UP.>>SO BASICALLY IT’S JUST COMING OUT. IT’S BEEN HIDDEN UNDERGROUND BY LOVELY SNOW.>>IT’S UNDERNEATH.>>AND THERE’S NO FOOD IN THE SNOW.>>IS IT SAFE TO TAKE OVER THE COUNTER ALLERGY MEDICINE EVERY DAY AND WHAT ARE THE BEST CHOICES?>>EVERYTHING OVER THE COUNTER USED TO BE PRESCRIPTION. IT’S SO SAFE THAT YOU CAN TAKE ALL OF THEM EVERY DAY.>>NOW THEY SAY CLARITIN IS WEAKER –>>IT’S A LITTLE BIT. IF ONE OF THOSE DOESN’T WORK, THAT MEANS YOU NEED TO GO TO THE NASAL STEROIDS. THEY HAVE TO BE USED EVERY DAY IN ORDER TO WORK BECAUSE IT TAKES THREE TO FOUR DAYS FOR THE STUFF TO EVEN START UP, AND SO THE MAIN MISTAKE WITH THEM IS ONLY USING THEM UNTIL YOU’RE BETTER, THEN YOU QUIT, AND ALL YOUR SYMPTOMS COME BACK, AND IT’S THIS UP AND DOWN –>>STEROID NASAL SPRAY FOR A WEEK BEFORE –>>IF YOU KNOW YOU’RE TREE ALLERGIC, YOU SHOULD BE STARTING IT RIGHT NOW. AND WHEN YOU ADMINISTER IT, YOU SHOULD LOOK AT YOUR TOES WHEN YOU SPRAY YOUR NOSE. YOUR NOSE DOES NOT GO THIS WAY.>>OH. SO — THAT’S ALL RIGHT. IS IT SAFE TO — SO, BUT WHAT ABOUT BENADRYL? >>DON’T USE BENADRYL! IT MAKES YOU –>>FOGGY.>>YOU CAN’T THINK AND YOU’RE NOT COORDINATED. THERE’S A CLASSIC STUDY, WHO DRIVES THE BEST, THE DRUNKS. THEY ACTUALLY HAD VOLUNTEERS THAT WOULD GET INTOXICATED TO .08. SOME TOOK BENADRYL OR AND OTHERS TOOK IS A LEG AREA AND ACTUALLY THE DRUNKS DROVE BETTER THAN THE BENADRYL PEOPLE. I CAN’T TELL IF YOU’RE LOW BLOOD PRESSURE OR YOU’RE FALLING ASLEEP BECAUSE OF THE BENADRYL.>>AVOID THE BENADRYL.>>AND IT’S A NATIONAL MOVEMENT TO USE ZYRTEC INSTEAD FOR ANY OF THE ITCH STUFF INSTEAD.>>AND HOW ABOUT TOPICAL BENADRYL –>>THAT’S OKAY. EXCEPT IT’S SENSITIZING. [Talking at the same time] >>THEN YOU GET A RASH.>>BASIC THING IS, THERE ARE REALLY SAFE, HIGHLY EFFECTIVE ANTIHISTAMINES THAT DON’T HAVE THE SAME SIDE EFFECTS. ALLEGRA, ZYRTEC, CLARITIN.>>DO THOSE, THEY WORK JUST AS WELL –>>OR BETTER.>>OR BETTER AND THEY DON’T HAVE THE SIDE EFFECTS. NO BREN YA DRILL.>>AND IF THEY DON’T WORK, THEN YOU GOT TO MOVE ON TO THE NEXT TREATMENT.>>IS IT TRUE THAT EATING LOCAL HONEY –>>NOT PROVEN.>>DISPROVEN.>>NOT PROVEN.>>YES, I MEAN, BUT HAVING HONEY, HONEY IS A GOOD SOURCE OF SWEETENER, AND THAT’S A GOOD THING, BECAUSE I’D MUCH RATHER HAVE YOU USE HONEY THAN ONE OF THE ARTIFICIAL ONES FOR JUST YOUR GENERAL HEALTH.>>AND PROBIOTIC WISE, NO HARM THERE?>>NO HARM.>>WE LIKE HONEY EXCEPT FOR SMALL BABIES. DON’T GIVE IT TO SMALL BABIES — [Talking at the same time]>>BOTULISM.>>IF I’M ALLERGIC TO SOMETHING, IS IT LIKELY MY KID MIGHT BE TOO?>>THE TENDENCY TO HAVE ALLERGY THINGS MEANING ALLERGY NOSE, ASTHMA, OR ECZEMA IS INHERITED, BUT THE — WHICH THINGS YOU’RE GOING TO BE ALLERGIC IS NOT. IT’S MORE YOU’RE GOING TO BE EXPOSED TO THE SAME THINGS YOUR MOM IS GOING TO BE EXPOSED TO.>>IT’S NOT REALLY AN INHERITED THING — AN ENVIRONMENTAL THING. YOU AGREE WITH THAT?>>YEAH, I MEAN, THE INHERITANCE IS NOT REALLY SUPER WELL WORKED OUT. IT’S A MULTI-ALLELE KIND OF THING SO I DON’T THINK ALL OF THE ANSWERS ARE IN ON THAT.>>BUT FOR THE MOST PART, IT IS A GLARING YES OF WHY YOU’RE ALLERGIC –>>IT’S AMAZING HOW MANY FAMILIES, EVERYBODY’S ALLERGIC TO THE RAG WEED TYPE OF THING AND I’VE GOT SOME KIDS THAT THREE THE KIDS ARE ALLERGIC TO PEANUT AND DAD IS TOO.>>SO I MEAN, YOU’RE JUST COUNTERING WHAT YOU JUST SAID.>>NO, THOSE ARE SMALL NUMBERS, AND WHEN YOU LOOK AT BIGGER STUDIES –>>IT DILUTES IT OUT. [ Laughter ]>>I MEAN, AND I HAVE A PERSONAL BIAS THAT I THINK IF THE MOM’S ALLERGIC, THEN WE TEND TO HAVE MORE KIDS ALLERGIC THAN IF THE DAD’S ALLERGIC, SO THERE’S SOMETHING ABOUT MOM CARRY KIND OF THING.>>WE CAN BLAME MOMS MORE ON THAT?>>DON’T BLAME ANYBODY.>>BUT I DO KNOW THIS. PEOPLE WHO HAVE ASTHMA SEEMS TO RUN IN FAMILIES. NO?>>YES. BUT THAT’S THAT WHOLE AIRWAY REACTIVITY AND ARE YOU GOING — EPITHELIAL DAMAGE AND ALL THAT STUFF.>>ASTHMA IS THE SAME GENETICS, THOUGH, AS THE ALLERGY NOSE AND THE AS YOU GO THROUGH LIFE, YOU CAN SWITCH AROUND WHICH ONES YOU HAVE.>>WOW. WHAT’S THE CORRELATION BETWEEN WHAT THE DOCTORS PREVIOUSLY DISCUSSED WITH NASAL SPRAYS, EPI-PENS, AND ASTHMA? WELL, THE EPI-PEN SHOULD WORK FOR ASTHMA. AND NASAL SPRAYS, I DON’T KNOW WHERE THAT IS RELATED, EXCEPT THAT –>>MOST PEOPLE WITH ASTHMA ALSO HAVE THAT SAME SWELLING THAT’S GOING ON IN THE BRONCHIAL TUBES UP IN THEIR NOSE. YOU’RE GOING TO NEED A NASAL STEROID PLUS AN INHALED CORTICOSTEROID FOR YOUR LUNGS.>>SHOULD PEOPLE TAKE THE EPI-PEN TWO PACK TOGETHER, OR IS IT OKAY TO SEPARATE THEM?>>PROBABLY TOGETHER.>>OKAY FOR BOTH. THEY’RE BETTER TOGETHER, BECAUSE SOMETIMES YOU NEED TWO SHOTS.>>FIVE MINUTES LATER, THEY’RE IN EXTREMIS AGAIN, GIVE THEM THE SECOND ONE.>>SOMETIMES THEY FAIL. SOMETIMES PEOPLE GRAB THEM BACKWARDS, AND THEY’RE TRYING TO GET YOUR KID, AND YOU STAB IT INTO YOURSELF. NOW YOU CAN GRAB THE SECOND ONE, DO IT CORRECTLY THIS TIME AND SAVE YOUR KID.>>OKAY. INTO THE MUSCLE, RIGHT? THAT’S WHAT THE SHOT –>>HOPEFULLY INTO THE KID TO BEGIN WITH.>>INTO THE KID’S MUSCLE. [ Laughter ]>>THE PATIENT.>>AN ABERDEEN WOMAN ASKS ARE EMERGENCY INHALERS CONSIDERED ALLERGY OR ASTHMA TREATMENTS?>>ASTHMA TREATMENTS. EMERGENCY INHALERS.>>ALTHOUGH WE SAID EARLIER THAT AN ASTHMA INHALER, MAY BE HELPFUL WHEN A PERSON IS HAVING AN ANNA FILL YAK TICK REACTION.>>REMEMBER PROBABLY 80% OF ASTHMATICS, ALLERGIES IS PROBABLY A BIG PART OF WHY THEY HAVE SYMPTOMS.>>YOU’RE LIKELY TO TARGET YOUR LUNG AS THE ORGAN THAT’S INVOLVED. AS A MATTER OF FACT IF YOU GET A TRANSPLANT OF AN ASTHMA LUNG INTO YOUR YOU AND YOU’RE NOT ASTHMATIC, YOU’LL HAVE AS THAT. ASTHMA. YOUR BRAIN — THAT COMES WITH IT.>>WOW. OKAY, QUICK ANSWERS. WHAT DO YOU DO WITH IDIOPATHIC POST NASAL DRIP.>>A LOT OF THE TIMES IT’S THE NASAL STEROID PLUS A COMBO IS PRETTY COMMON. >>AN IPSWICH MAN SAYS, MY DAUGHTER HAS ASTHMA. WHAT CAN BE DONE THROUGH MEDICATION OR DO I HAVE TO CORRECT THIS ISSUE AND CAN YOU ELABORATE MORE. EOSINOPHILS, CAN YOU EXPLAIN VERY QUICKLY?>>IT’S A TYPE OF ASTHMA. IT RESPONDS VERY NICELY TO STEROIDS, SO INHALED STEROIDS IS OUR FIRST LINE OF THERAPY.>>AND THE JUST REPRESENT — >>RIGHT, AND YOU COULD BE ALLERGIC ALSO, AND THAT’S WHY YOU HAVE THE –>>SOMETHING TO WORRY MIGHT BE IF YOU HAVE A LOT OF — IN YOUR BLOOD, I’D WORRY IT MIGHT NOT JUST BE ASTHMA. THERE ARE SOME OTHER DISEASES –>>FUNGAL DISEASE CALLED ASPERGILLUS.>>WHEN I AM EXPOSED TO MOLD OR DUST, MY JOINTS ARE SORE THE NEXT DAY. COULD THIS BE AN ALLERGIC REACTION?>>NO.>>DIFFERENT ALLERGY.>>IT’S A T-CELL.>>YEAH, DIFFERENT SIDE OF THE IMMUNE SYSTEM. NOT ALLERGY.>>SIOUX FALLS MAN SAYS AS A YOUNGSTER THIS PERSON HAD RATHER SEVERE AS MAT BUT NOW DOES NOT HAVE ASTHMA ANYMORE. SO CAN ASTHMA GO AWAY?>>YEP, AND IT CAN COME BACK. >>AND IF YOU MEASURE HOW TWITCHY THE AIR WATCHES ARE, THEY MAY — IT’S USUALLY STILL THERE. >>LITTLE –>>WILL SHOW THAT. I READ ABOUT A PROCEDURE CALLED CLARIFIX, NASAL CAUTERY. IS THAT EFFECTIVE FOR THE CHRONIC RUNNY NOSE?>>I DO NOT KNOW.>>HAVE YOU HEARD OF IT?>>NOT SEEN GOOD STUDIES ON THAT.>>FOR — A WOMAN SAYS I’M HIGHLY ALLERGIC TO ANIMALS. ARE THERE SHOTS THAT SOMEONE CAN TAKE TO RESOLVE THIS?>>THE ANSWER IS YES.>>YES, THE ANSWER IS YES.>>MIGHT NOT WORK IF YOU DO IT UNDER THE TONGUE. WE CAN’T GET IT DONE THAT WAY, BUT BY SHOT, YES.>>HOW DO ALLERGIES AFFECT COPD? THERE’S A CROSSOVER SYNDROME AND THAT CAN BE VERY IMPORTANT AND IS OFTEN OVERLOOKED BECAUSE YOU’VE GOT YOUR CHRONIC OBSTRUCTIVE DISEASE AND THEN YOU HAVE AIRWAY — YOU’RE ALREADY COMPROMISED.>>I THINK THERE’S A LOT OF PEOPLE WHO MAY WELL HAVE ASTHMA AS A YOUNGER PERSON AND THEN GO ON TO COPD, WHICH IS EMPHYSEMA, REALLY, AND THEY MAY NOT HAVE BEEN A SMOKER.>>AGREED, BUT YOU DON’T HAVE TO SMOKE VERY MUCH. IF YOU’RE A PERSON –>>IT’S GOING TO BE MORE OF THE BRONCHITIS TYPE.>>IF YOU’VE GOT ASTHMA, STAY AWAY FROM THE CIGARETTES. WOMAN SAYS WHEN SHE EATS AVOCADOS, GETS A SEVERE STOMACH PAIN AND CRAMPING.>>YES. IT COULD BE. I’M STILL LOOKING FOR ITCHING. OTHER SYMPTOMS.>>OTHER THAN JUST THE TUMMY ACHE. ALMOST ALWAYS HAS MULTIPLE PLACES THAT IT’S SHOWING UP. I CAN’T BREATHE. MY THROAT’S SWOLLEN. MY TONGUE IS BIG.>>BUT INTOLERANCES ARE, EVERY TIME YOU EAT IT, YOU DON’T FEEL GOOD. THE TREATMENT FOR THAT IS DON’T EAT IT. [Talking at the same time]>>ONE WOMAN ASKS, A WHILE BACK I HAD A SEVERE SHOCK — MOST PHYSICIANS DON’T SEEM TO UNDERSTAND MY FEAR. HOW DO I BEST COMMUNICATE MY WORRIES TO THEM?>>I THINK ACTUALLY JUST TALKING WITH YOUR MAIN DOC IS REALLY HELPFUL. AND PEOPLE UNDERESTIMATE THE ANXIETY, THE FEARS, THAT HAVING A BAD ANAPHYLACTIC REACTION.>>EPINEPHRIN PEN AND MOVE ON AND LIFE.>>TWO QUESTIONS. SIOUX FALLS MAN ASKS IS THERE ANY WAY TO OVERCOME AN ALLERGY TO THE FLU SHOT?>>YES.>>AND THAT MEANS — AND THEN THE OTHER QUESTION, IS THERE A CONNECTION BETWEEN MIGRAINES AND ALLERGIES?>>HIGHER INSTANCE OF MIGRAINES IN ALLERGIC PATIENTS, JUST BARELY, BUT ALLERGIES DON’T CAUSE THE MIGRAINE, BUT WHEN YOU’RE SICK WITH YOUR ALLERGIES, ANY KIND OF HEADACHE IS WORSE.>>IT’S A REASONABLE TRIGGER.>>ALL RIGHT.>>AND NOW FOR THE WINNER OF TONIGHT’S “PRAIRIE DOC” QUIZ QUESTION. TRUE OR FALSE: NASAL WASHES CLEANSE ALLERGENS AND IRRITANTS FROM THE NOSE. TRUE OR FALSE? AND THE ANSWER IS TRUE. IT WAS: ANY COMMENT?>>IT’S TRUE. AND I’M NOT SURE WHO ANSWERED THE QUESTION CORRECTLY. BUT WE WILL GET A BOOK TO YOU IN THE MAIL. AT — VERY SOON, AS SOON AS WE CAN FIND IT. OH, IT WAS FRANCIS NEWSMA. HEY, NORTH DAKOTA, THANK YOU, FRANCIS, AND WE’LL GET A BOOK TO YOU SOON. WE’LL BE RIGHT BACK AFTER THIS.>>BY PROVIDING USEFUL INFORMATION BASED ON USEFUL SCIENCE IN A RESPECTFUL AND COMPASSIONATE MANNER. PRAIRIE DOC PHYSICIANS AND EITHER PROFESSIONALS CONTINUE TO ANSWER YOUR QUESTIONS EACH WEEK CREATING A VAST PRAIRIE DOC LIBRARY OF MEDICAL INFORMATION AVAILABLE TO YOU AND YOUR FAMILY 24 HOURS A DAY. MAKE SURE YOU DON’T MISS A THING. FOLLOW THE PRAIRIE DOC ON FACEBOOK AND YouTube FOR FREE AND EASY ACCESS TO THE ENTIRE PRAIRIE DOC LIBRARY.>>MS. A. WAS IN THE BAGEL SHOP LINE AND TOLD THE SERVER SHE WAS ALLERGIC TO PEANUTS. THE SERVER REASSURED HER THERE WERE NO PEANUTS IN THE BAGEL BUT WAS UNAWARE SOME PEANUT BUTTER WAS LEFT ON THE KNIFE FROM AN EARLIER SANDWICH. AFTER A FEW BITES OF THE BAGEL, MS. A.’S FACE AND LIPS STARTED SWELLING. SHE ITCHED ALL OVER, SLIPPED OFF HER CHAIR, VOMITED, AND FELL FLAT, LOSING CONSCIOUSNESS. WHEN THE AMBULANCE ARRIVED, THE EMERGENCY TEAM KEPT HER FLAT, GAVE AN INTRAMUSCULAR, OR I.M., INJECTION INTO HER THIGH MUSCLE OF EPINEPHRINE, ALSO CALLED ADRENALINE, THEN TOOK HER OFF TO THE HOSPITAL. ANAPHYLAXIS IS A SEVERE ALLERGIC REACTION THAT CAN FOLLOW EXPOSURE TO AN ALLERGIC TRIGGER AND WILL HAPPEN IN THE LIFETIME OF ONE OR TWO OUT OF EVERY ONE HUNDRED PEOPLE. SYMPTOMS ARE SECONDARY TO THE RELEASE OF HISTAMINE AND OTHER MEDIATORS CAUSING A SEVERE DROP IN CIRCULATING BLOOD PRESSURE. TRIGGERS CAN BE FROM FOOD SUCH AS PEANUTS, WHEAT, NUTS, SHELLFISH, OR MILK; AN INSECT BITE OR STING; OR A MEDICATION LIKE PENICILLIN. THE FULL LIST IS LONG. ASIDE FROM AVOIDING THE TRIGGER IN THE FIRST PLACE, THE SINGLE MOST IMPORTANT TREATMENT FOR ANAPHYLAXIS IS EPINEPHRINE WHICH IS A HORMONE RELEASED FROM OUR ADRENAL GLANDS. THERE ARE FEW REASONS NOT TO GIVE AN INJECTION OF EPINEPHRINE IF THERE IS A CHANCE THAT ANAPHYLAXIS IS HAPPENING. OUR BODIES MAKE NATURAL EPINEPHRINE WHEN WE ARE FACED WITH FIGHT OR FLIGHT SITUATIONS. ANTIHISTAMINES LIKE BENADRYL, CLARITIN, AND OTHERS HAVE NO ROLE IN THE PREVENTION OR TREATMENT OF ANAPHYLAXIS AS THEY ONLY HELP THE ITCH. THE SINGLE TREATMENT FOR ANAPHYLAXIS IS EPINEPHRINE, PERIOD. HAVE INJECTABLE EPINEPHRINE AVAILABLE AND NEAR PERSONS AT RISK AND USE IT IF WORRIED. TO OBTAIN A SELF-INJECTOR OF EPINEPHRINE, YOU NEED A PRESCRIPTION. THERE ARE NOW FIVE TYPES AVAILABLE, AND THEY ALL WORK WELL. ASK YOUR PHARMACIST TO GET YOU THE LEAST EXPENSIVE ONE, AND BE SURE YOU KNOW HOW TO USE IT. THE PRICE FOR A KIT WITH TWO AUTO-INJECTORS RUNS FROM $375 TO $600. THE COST TO THE MANUFACTURER TO MAKE ONE AUTO-INJECTOR WAS REPORTED AS UNDER $30 BY NBC NEWS IN 2016 AFTER A U.S. HOUSE COMMITTEE LOOKED AT THE PRICE OF AUTO-INJECTORS. I BELIEVE EXCESSIVE MARKUP OF THE PRICES OF MEDICINE BY DRUG MANUFACTURERS IS UNETHICAL, AND WE NEED TO PRESSURE OUR NATIONAL LEGISLATORS TO DO SOMETHING ABOUT IT. PATIENTS WITH ANAPHYLACTIC ALLERGIES MUST KNOW WHAT TO AVOID, HAVE EPINEPHRINE AVAILABLE, USE IT WHEN NECESSARY, AND, AFTER ANY REACTION, SEE THEIR PROVIDER. MS. A RECOVERED FINE AND NEVER WENT WITHOUT HER EPINEPHRINE RESCUE INJECTOR AGAIN. >>REMEMBER, YOU CAN FOLLOW OUR DISCUSSION AND AN EXTENSIVE LIBRARY OF PAST SUBJECTS ON OUR INTERNET SITES, EITHER PRAIRIEDOC.ORG OR OUR FACEBOOK PAGE. THIS IS IN ADDITION TO THE RADIO PROGRAMS AND NEWSPAPER ARTICLES THAT ARE AVAILABLE EACH WEEK. A BIG THANK-YOU TO OUR GUESTS MARK AND TOM FOR ONCE AGAIN VOLUNTEERING TO COME TO OUR STUDIO IN YEAGER HALL ON THE CAMPUS OF SOUTH DAKOTA STATE UNIVERSITY. THEIR EXTENSIVE KNOWLEDGE AND GENUINE FRIENDSHIP HELP MAKE THIS PROGRAM SUCCESSFUL. THANK YOU, GENTLEMEN.>>ABSOLUTELY.>>GO, GIRLS.>>GO, GUYS. GO, GIRLS. THAT DOES IT FOR US TONIGHT. FROM ALL OF US HERE AT “ON CALL WITH THE PRAIRIE DOC,” UNTIL NEXT TIME, STAY HEALTHY OUT THERE, PEOPLE. >>DURING THE CIVIL WAR, WITH EVERY THREE SOLDIERS KILLED IN BATTLE, FIVE MORE DIED OF DISEASE. WE’LL LOOK AT THE PROGRESS WE’VE MADE SINCE THEN. MEDICINE AT WAR: NEXT TIME, “ON CALL WITH THE PRAIRIE DOC.”>>FOR MORE THAN A DECADE, DR. HOLM AND HIS ROLE AS THE PRAIRIE DOC HAS EMERGED AS A LEADER OF COMMUNICATION AND EDUCATION IN SOUTH DAKOTA AND ACROSS THE COUNTRY. EVERY WEEK DR. HOLM AND OTHER MEDICAL PROFESSIONALS VOLUNTEER MANY HOURS TO SHARE SCIENCE BASED TRUTH ABOUT HEALTH CARE ON PUBLIC TELEVISION, ON THE RADIO, IN OUR NEWSPAPERS AND ONLINE. AND BEST OF ALL, EVERYONE HAS FREE, EASY ACCESS TO THE ENTIRE PRAIRIE DOC LIBRARY. HI, I’M JENNIFER MAY OF RAPID CITY. AS A BOARD MEMBER OF THE HEALING WORDS FOUNDATION, I ASK YOU TO CONSIDER MAKING A DONATION. PLEASE HELP US CONTINUE THIS IMPORTANT WORK. GO TO PRAIRIEDOC.ORG AND MAKE A DONATION TODAY. THANK YOU.


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