SECOND OPINION | Food Allergies Episode | BCBS
14
October

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


Child: THERE ONCE WAS A TIME WHEN WE WERE
TRULY FREE – FREE OF WORRY, FREE OF FEAR, FAR FROM DOUBT. THAT IS STRENGTH. THAT IS POWER. THAT IS FEARLESS. “SECOND OPINION” IS BROUGHT TO YOU BY BlueCross/BlueShield,
ACCEPTED IN ALL 50 STATES. LIVE FEARLESS. NARRATOR: “SECOND OPINION” IS PRODUCED IN ASSOCIATION
WITH THE UNIVERSITY OF ROCHESTER MEDICAL CENTER, ROCHESTER, NEW YORK. PETER SALGO: THIS IS “SECOND OPINION,” AND I’M YOUR HOST,
DR. PETER SALGO. THIS WEEK, MYTH OR MEDICINE — ARE ALLERGIES
TO PEANUTS ON THE RISE? CAROLINA MARCUS: EVERY CHILD WITH A FOOD ALLERGY REALLY SHOULD
BE SEEN AND FOLLOWED CLOSELY BY AN ALLERGIST/IMMUNOLOGIST. PETER SALGO: SPECIAL GUEST STACEY SAIANTZ IS WITH US. HER YOUNG SON LIVES WITH SEVERE FOOD ALLERGIES. SHE’S HERE FOR A SECOND OPINION. STACEY SAIONTZ: HE WAS ALLERGIC TO SOY, DAIRY, EGG, WHEAT,
OAT, RYE, BARLEY, NUTS, TREE NUTS, SESAME, AND THEN A COUPLE OTHER ALTERNATIVE GRAINS. PETER SALGO: STACEY, THANK YOU SO MUCH FOR BEING HERE. YOU’VE GOT QUITE A STORY. YOU AND I SPOKE A LITTLE BIT BEFORE WE STARTED. I WANT TO SHARE ALL OF THAT WITH OUR AUDIENCE
AND OUR PANEL HERE. YOU’RE HERE FOR A SECOND OPINION. AND WE’VE GOT GREAT PEOPLE HERE FOR YOUR SECOND
OPINION TOO, AND BEFORE WE GET GOING, I WANT TO INTRODUCE THEM TO YOU. WE HAVE DR. LOU PAPA FROM THE UNIVERSITY OF ROCHESTER
MEDICAL CENTER. AND DR. SHAHZAD MUSTAFA FROM THE UNIVERSITY OF ROCHESTER
MEDICAL CENTER AND ROCHESTER GENERAL’S ALLERGY, IMMUNOLOGY, AND RHEUMATOLOGY DIVISION. THAT’S A MOUTHFUL. DID I GET IT ALL RIGHT? DR. SHAHZAD MUSTAFA: ABSOLUTELY. THANK YOU FOR HAVING US. PETER SALGO: NOW, STACEY, YOU HAVE TWO BOYS. STACEY SAIONTZ: YES. PETER SALGO: THE FIRST BOY IS NOT WHAT WE’RE GOING TO START
TALKING ABOUT — IT’S THE SECOND ONE. STACEY SAIONTZ: YES, IT’S MY YOUNGER SON. PETER SALGO: TELL ME A LITTLE BIT ABOUT JARED. STACEY SAIONTZ: WELL, WHEN HE WAS FIRST BORN, HE WAS ACTUALLY
A GREAT NURSER AND HE WAS EATING A LOT, BUT HE WAS VOMITING CONSTANTLY. AND HE HAD RASHES ALL OVER, AND HE WOULD CONSTANTLY
SCRATCH HIMSELF — PETER SALGO: OUCH. STACEY SAIONTZ: YEAH, SO WE PUT THOSE LITTLE BABY GLOVES ON
HIM, AND HE WOULD SCRATCH THROUGH, SO HE WAS ALWAYS VOMITING AND SCRATCHING. PETER SALGO: NOW, THIS CAN’T BE GOOD, FROM A PARENT’S PERSPECTIVE. STACEY SAIONTZ: NO. PETER SALGO: WHAT WERE YOU THINKING? STACEY SAIONTZ: WE WERE VERY WORRIED, AND I WAS AFRAID HE
MIGHT HAVE BEEN ALLERGIC TO SOMETHING. PETER SALGO: OKAY, SO YOU WENT TO YOUR PEDIATRICIAN. STACEY SAIONTZ: WENT TO THE PEDIATRICIAN, WHO SAID, YOU KNOW,
MAYBE I WAS BEING A LITTLE BIT OVERPROTECTIVE. HE HAD BAD BABY ECZEMA, AND HE HAD REFLUX. PETER SALGO: I’VE GOT TO TELL YOU, THAT’S RULE ONE IN MEDICAL
SCHOOL — WHEN IN DOUBT, BLAME THE PATIENT OR THE MOM. STACEY SAIONTZ: [ LAUGHS ] PETER SALGO: BUT THAT DIDN’T SATISFY YOU. STACEY SAIONTZ: NO, BECAUSE — SO THEY PUT HIM ON REFLUX MEDICINE
— PETER SALGO: REFLUX MEDICINE WOULD BE — THEY THOUGHT HE
WAS VOMITING? STACEY SAIONTZ: WELL, HE WAS VOMITING A LOT AFTER HE ATE.
AND SO THEY PUT HIM ON THE REFLUX MEDICINE, BUT IT DIDN’T STOP — HE WAS STILL VOMITING. AND HE JUST — I MEAN, MY OTHER SON MIGHT
HAVE HAD A LITTLE BIT OF ECZEMA WHEN HE WAS A BABY, BUT NOTHING LIKE THIS, AND SO I THOUGHT
THERE WAS SOMETHING WRONG. PETER SALGO: OKAY, BUT I’M AT A LOSS — GUYS, THEY PUT
HER BABY ON REFLUX MEDICINE, BUT WHEN YOU TELL THE STORY, THAT’S NOT THE PRIMARY COMPLAINT,
RIGHT? THE PRIMARY COMPLAINT IS ITCHING, RASH, ECZEMA,
GLOVES. THAT’S NOT REFLUX. IS IT, LOU? DR. LOU PAPA: IT’S INTERESTING, BECAUSE ONE OF MY TWINS
HAD REFLUX, BUT I THINK THE TIP-OFF HERE IS THOSE OTHER ALLERGIC-TYPE SYMPTOMS — THE
RASH AND THE ITCHING AND THAT KIND OF IS A TIP-OFF THAT THERE MAY BE SOMETHING MORE GOING
ON. PETER SALGO: THIS IS THE FIRST TIME I THINK YOU’VE REALLY
HEARD THIS STORY — IS THERE ANYTHING THAT’S TIPPING YOU ONE WAY OR THE OTHER? DR. SHAHZAD MUSTAFA:
WELL, ATOPIC DERMATITIS, OR ECZEMA, IS OFTEN A RISK FACTOR FOR FOOD ALLERGIES AND OTHER
THINGS, SO…VOMITING IN ITSELF MAY BE REFLUX — IF YOU PUT IT TOGETHER WITH THE ECZEMA
AND THE ITCHY RASH, THEN YOU’VE GOT TO START MAYBE THINKING ABOUT OTHER THINGS. PETER SALGO: OKAY, SO YOU’RE SLOWLY – AND I DO MEAN SLOWLY,
BECAUSE YOU WENT TO YOUR PEDIATRICIAN, DERMATOLOGIST, THEN DID YOU SAY YOU WENT TO AN ALLERGIST? I KNOW YOU DID. STACEY SAIONTZ: YEAH, SO THEN I JUST DECIDED ON MY OWN TO
TAKE HIM TO AN ALLERGIST, BECAUSE I THOUGHT HE MIGHT HAVE BEEN ALLERGIC, AND IT TURNED
OUT, YOU KNOW, THEY DID A BLOOD TEST AND A SKIN TEST. I GUESS BEFORE THE AGE OF ONE, THEY’RE NOT
CONCLUSIVE, BUT HE CAME BACK ALLERGIC TO EVERYTHING — DAIRY, EGG, WHEAT, OAT, RYE, BARLEY — PETER SALGO: CAN I JUST STOP JUST FOR A MOMENT, BECAUSE
I KNOW THE STORY GETS MORE COMPLICATED, BUT I HEAR THIS OCCASIONALLY FROM PARENTS — “MY
KID WAS TOLD BY THE ALLERGIST THAT HE OR SHE IS ALLERGIC TO…” EVERYTHING. HOW CAN YOU BE ALLERGIC TO EVERYTHING? DR. LOU PAPA: THE PROBLEM WITH — AT LEAST, FROM MY PERSPECTIVE
AS A PRIMARY CARE DOCTOR, THE PROBLEM WITH THE SKIN TESTING IS, IT HAS TO BE DONE WITH
SOME, SOME HINGE, SOMETHING THAT YOU’RE HANGING YOUR HOOK ON, BECAUSE OTHERWISE IT JUST GIVES
YOU MORE INFORMATION. IT JUST KIND OF TELLS YOU WHAT YOU REACT TO. IT MAY NOT NECESSARILY TELL YOU WHAT YOU’RE
ALLERGIC TO. PETER SALGO: OKAY, BUT — DR. SHAHZAD MUSTAFA: THIS IS A VERY IMPORTANT POINT, AND STACEY
SAID THAT THE TEST IS NOT CONCLUSIVE, AND THE TEST IS NOT CONCLUSIVE, NOT JUST IN A
ONE-YEAR-OLD, BUT IN ANYONE. AND LIKE LOU SAID, THE TEST ONLY MEANS ANYTHING
IF IT’S DONE IN THE RIGHT CLINICAL SETTING. PETER SALGO: NOW, WHEN I HEAR VOMITING AND ALLERGY, I’M
THINKING FOOD ALLERGY. IS THAT WHAT YOU WERE THINKING AS WELL AND
WHAT THE ALLERGIST THOUGHT? STACEY SAIONTZ: YES. PETER SALGO: SO WHAT DID THEY SUGGEST AT THAT POINT? STACEY SAIONTZ: WELL, SO AFTER WE FOUND OUT HE WAS ALLERGIC
TO EVERYTHING, WE FOUND A GREAT ALLERGIST WHO THEN BROUGHT US IN, AND IN ADDITION TO
THE BLOOD AND THE SKIN TESTS, WOULD ACTUALLY, YOU KNOW, WE’D DO A FOOD CHALLENGE, WHERE
THEY WOULD TRY THE FOOD — DEPENDING ON MY SON’S NUMBERS, IF THE NUMBERS WERE IN AN ACCEPTABLE
RANGE — PETER SALGO: NUMBERS ON THE LAB TEST — STACEY SAIONTZ: YEAH, THE IgE — THEY CAN PROBABLY EXPLAIN
A LITTLE BETTER — BUT THE IgE NUMBERS, IF THEY WERE IN AN ACCEPTABLE RANGE, WHERE SOME
KIDS CAN TOLERATE, EVEN THOUGH THEY’RE SHOWING ALLERGIC, THEY CAN MAYBE TOLERATE IT. SO THEY WOULD — WE CAME IN, AND SOY WAS ONE
OF THE MANY THINGS HE WAS ALLERGIC TO, AND SO FOR SOY, THEY TESTED HIM IN THE DOCTOR’S
OFFICE, AND HE WAS ABLE TO EAT SOY. PETER SALGO: RIGHT, NOW, WHEN YOU SAY SOMEBODY’S GETTING
A CHALLENGE, A FOOD CHALLENGE, THE KID IS ALLERGIC. ONE OF THE THINGS THAT WOULD WORRY ME IS,
YOU GET SOMETHING CALLED ANAPHYLAXIS, WHICH IS, YOU GIVE THIS KID A CHALLENGE WITH A PARTICULAR
FOOD, AND THE KID BASICALLY DIES, RIGHT THERE IN THE OFFICE. THEN YOU RESCUE THIS KID, BUT IT’S DANGEROUS,
RIGHT? DR. SHAHZAD MUSTAFA: SURE. IT IS DANGEROUS. YOU DO A CHALLENGE IN TWO SETTINGS. THE TESTING IS NOT PERFECT, SO YOU DO IT WHEN
THE DIAGNOSIS IS IN QUESTION. OR TWO, IT’S VERY IMPORTANT TO NOTE, PEOPLE
OUTGROW FOOD ALLERGIES, PARTICULARLY CHILDREN. SO YOU DO A CHALLENGE TO SEE IF THEY’VE OUTGROWN
IT. WHEN YOU DO THE CHALLENGE, YOU’RE TRYING TO
MINIMIZE RISK, BUT THERE IS ALWAYS A RISK OF A REACTION, BUT THERE’S TONS OF LITERATURE
THAT CHALLENGES, DONE IN THE APPROPRIATE HANDS ARE QUITE SAFE. PETER SALGO: OKAY, SO YOU WORK THROUGH ALL OF THE FOODS,
YOU CHALLENGE AS MUCH AS YOU CAN, AND THE WHOLE POINT OF YOUR IgE COMMENT IS, IF THE
IgE WAS WRONG OR REALLY HIGH, PROBABLY THE FOOD CHALLENGE WOULD BE TOO DANGEROUS, IS
THAT — STACEY SAIONTZ: RIGHT, THEY ONLY CONDUCT THE FOOD CHALLENGE
IF THE IgE LEVEL FALLS WITHIN A CERTAIN RANGE. PETER SALGO: OKAY, SO WHAT FOODS WAS JARED ALLERGIC TO,
AT THE END OF THE DAY? STACEY SAIONTZ: WELL, BEFORE HE HAD HIS FOOD CHALLENGES? LET’S SEE, HE WAS ALLERGIC TO SOY, DAIRY,
WHEAT, OAT, RYE, BARLEY, NUTS, TREE NUTS, SESAME, AND THEN A COUPLE OTHER ALTERNATIVE
GRAINS — DR. LOU PAPA: BASED ON WHAT, THE SKIN TESTING AND THE BLOOD
TEST? STACEY SAIONTZ: THE SKIN TESTING AND THE BLOOD TEST. DR. SHAHZAD MUSTAFA: I THINK THERE’S A SMALL POINT TO BE MADE THERE,
BUT IT’S IMPORTANT — THAT HE PROBABLY — SOME OF THESE FOODS THAT HE PASSED THE CHALLENGE,
HE WASN’T TRULY ALLERGIC. THE TEST SHOWED ANTIBODY THAT JARED MADE,
BUT HE WASN’T TRULY ALLERGIC, AND ONE THING ABOUT FOOD-ALLERGY TESTING, IT’S NOT LIKE
A PREGNANCY TEST — IT’S NOT A YES/NO. IT’S MORE OF A SPEED LIMIT. SO IF YOU’RE GOING 61 MILES ON THE HIGHWAY,
YOU’RE SPEEDING, BUT NO ONE’S GOING TO PULL YOU OVER. SO YOU HAVE TO INTERPRET THIS AS KIND OF A
SPECTRUM OF ZERO TO 100. PETER SALGO: ALL RIGHT, WHAT STRUCK ME, THOUGH, IS THAT
THIS IS A PROCESS, AND JARED IS GOING ALONG, GETTING TESTED. HE HAD FOUR MONTHS BEFORE THIS TESTING BEGAN. THE TESTING TOOK TIME. ALL THIS WHILE, I’M ASSUMING, HE’S VOMITING,
HE’S NOT HAPPY, AND AT SOME POINT, NOW THAT YOU’VE GOT THIS ALL STRAIGHTENED OUT, HE’S
ALMOST NOT EATING, RIGHT? STACEY SAIONTZ: RIGHT, WELL, AFTER — BECAUSE HE WAS VOMITING
SO MUCH EARLY IN LIFE WHILE WE WERE TRYING TO FIGURE OUT WHICH FOODS AND WHICH FORMULAS
WERE SAFE FOR HIM, HE — WHAT THEY SAID — ASSOCIATED EATING WITH PAIN, AND SO HE ALSO MISSED THE
BOAT ON CHEWING AND SWALLOWING BECAUSE HE WAS VOMITING SO MUCH EVERY TIME HE ATE. SO WE HAD TO BRING IN A FEEDING THERAPIST
TO HELP HIM. PETER SALGO: BUT I DID READ SOMETHING, AND I TALKED TO
YOU ABOUT THIS BEFORE — THEY WERE CONSIDERING LITERALLY MINOR SURGERY, PUTTING IN A FEEDING
TUBE THROUGH HIS SKIN INTO HIS STOMACH TO GIVE HIM NUTRITION. STACEY SAIONTZ: WELL, THEY WERE CONSIDERING PUTTING IN A FEEDING
TUBE BECAUSE HE WAS “FAILURE TO THRIVE,” AND HE WASN’T GROWING, HE WASN’T GAINING WEIGHT,
AND SO WHAT WE WOULD DO IS, EVERY TIME WE FED HIM, WE WOULD HAVE TO MARK DOWN THE EXACT
AMOUNT OF FOOD THAT WE HAD FED HIM AND KEEP TRACK. AND SO THEY WERE REALLY WORRIED THAT, YOU
KNOW, HE WASN’T GETTING ENOUGH NUTRITION AND THAT IT WAS TAKING SO LONG TO FEED HIM, BUT
WE WERE ABLE TO BYPASS THE FEEDING TUBE, BECAUSE I WAS — YOU KNOW, I’D JUST MUCH RATHER SPEND
ALL DAY FEEDING HIM THAN PUT IN THIS FEEDING TUBE. AND SO WE WORKED WITH THE FEEDING THERAPIST,
AND WE WERE ABLE TO ACTUALLY GET HIM TO GROW. PETER SALO: SO YOU GOT HIM ON A DIET THAT HE COULD EAT. STACEY SAIONTZ: RIGHT. PETER SALGO:
BUT IT’S A LIMITED DIET. STACEY SAIONTZ: IT’S A VERY LIMITED DIET. PETER SALGO: I UNDERSTAND YOU BROUGHT YOUR OWN FOOD TO RESTAURANTS, YOU
BROUGHT YOUR OWN FOOD EVERYWHERE YOU WENT, AND THE ENVIRONMENT AROUND HIM WAS DANGEROUS. STACEY SAIONTZ: RIGHT, WELL, YOU KNOW, IT’S NOT EASY, HAVING
A CHILD WHO’S ALLERGIC TO EVERYTHING, BECAUSE WHEN YOU GO TO A RESTAURANT, NOT ONLY CAN’T
YOU EAT THE FOOD, BECAUSE THERE COULD BE CROSS-CONTAMINATION OR WHATNOT, YOU KNOW, THE TABLE WHERE THE
KIDS SIT — ANYONE SITS AND EATS HAS CRUMBS AND HAS, YOU KNOW, THOSE FOOD PROTEINS. SO EVERY TIME WE TAKE HIM TO A RESTAURANT,
I HAVE MY WIPES, AND I WIPE DOWN THE SEAT AND THE TABLE AT — SO IT’S EASIER, NOW THAT
HE’S OLDER, BUT WHEN HE WAS A BABY, AN INFANT, YOU KNOW, YOU’RE STICKING YOUR HANDS ON EVERYTHING
AND STICKING YOUR HANDS IN YOUR MOUTH. AND SO IT WAS VERY SCARY. PETER SALGO: THIS SOUND FAMILIAR TO YOU? IS THIS THE KIND OF STORY YOU’RE USED TO HEARING? DR. SHAHZAD MUSTAFA: WE HEAR THIS STORY A LOT, AND I THINK THERE’S
IMPORTANT POINTS. JARED IS A LITTLE MORE OF AN EXTREME CASE
THAN WE TYPICALLY SEE. I THINK IT’S VERY IMPORTANT TO KNOW THE COMMON
FOOD ALLERGENS. I DON’T THINK I’VE EVER SEEN SOMEONE ALLERGIC
TO LETTUCE, FOR EXAMPLE. SO IN ADULTS, IT’S REALLY PEANUTS, OTHER NUTS,
TREE NUTS, AND SHELLFISH — THOSE ARE THE COMMON FOOD ALLERGIES IN ADULTS. IN CHILDREN, YOU ADD IN MILK, EGGS, WHEAT,
SOY. THOSE, YOU KNOW, SIX TO EIGHT FOODS COVER
ABOUT 90% TO 95% OF FOOD ALLERGIES, SO THAT’S A GOOD STARTING POINT IN A DIAGNOSIS. PETER SALGO: ALL RIGHT, IN THE MEANTIME, THE WORLD IS DANGEROUS
FOR JARED. NOW, WE MENTIONED ANAPHYLAXIS AS A POTENTIAL
CONSEQUENCE OF TESTING HIM FOR FOODS. IN THE MEANTIME, JARED HAD ANAPHYLAXIS THREE
TIMES? STACEY SAIONTZ: HE’S HAD ANAPHYLAXIS THREE TIMES. THE FIRST TIME, HE WAS ABOUT ONE YEAR OLD,
AND HE TOUCHED — HIS BROTHER HAD A SIPPY CUP THAT HAD MILK IN IT. THERE WASN’T — WELL, THERE MUST HAVE BEEN
SOME TYPE OF THE PROTEIN ON THE OUTSIDE OF IT. AND HE TOUCHED IT AND MUST HAVE RUBBED
HIS EYE OR STUCK HIS HAND IN HIS MOUTH, AND HE WENT INTO ANAPHYLAXIS. PETER SALGIO: AND ANAPHYLAXIS IS WHERE THE IMMUNE SYSTEM
LITERALLY CAUSES YOUR BLOOD PRESSURE TO GO AWAY, YOUR BREATHING TO STOP, AND HOW DO YOU
TREAT ANAPHYLAXIS? DR. SHAHZAD MUSTAFA: THERE’S ONLY ONE TREATMENT FOR ANAPHYLAXIS,
AND THIS IS WHAT WE STRESS IN THE OFFICE — IT’S EPINEPHRINE. PETER SALGO: WHICH IS ADRENALINE. DR. SHAHZAD MUSTAFA: WHICH IS ADRENALINE. PETER SALGO: AND YOU HAVE TO INJECT IT. DR. SHAHZAD MUSTAFA: YOU DO HAVE TO INJECT IT INTRAMUSCULARLY. IT’S A VERY IMPORTANT POINT THAT IT’S AN ANXIETY-PROVOKING
THING TO DO, BUT EPINEPHRINE IS PROFOUNDLY A SAFE MEDICATION, ESPECIALLY IN CHILDREN,
BUT EVEN IN ADULTS. DR. LOU PAPA: EVEN IN ADULTS, I MEAN, IT’S VERY IMPORTANT. THE EPI SHOT IS THE KEY THING. THE KEY THING IS TRYING TO REMIND PEOPLE THAT
THEY HAVE TO CARRY IT WITH THEM ALL THE TIME, LIKE SOMEBODY WHO HAS ASTHMA OR NITROGLYCERINE,
BUT A LOT OF PEOPLE DON’T. PETER SALGO: SO YOU WALK AROUND WITH WHAT’S CALLED AN EPIPEN,
WHICH IS AN INJECTOR LOADED UP WITH ADRENALINE, TO USE IN CASE OF EMERGENCY, AND SPEED IS
OF THE ESSENCE. DR. SHAHZAD MUSTAFA: YEAH, YOU WANT TO USE IT QUICKLY. WHAT’S IMPORTANT TO NOTE IS, WHAT IS NOT A
TREATMENT FOR ANAPHYLAXIS IS BENADRYL, OR DIPHENHYDRAMINE, OR ANTIHISTAMINES, WHICH
ALL TOO MANY PEOPLE THINK IT IS. PETER SALGO: NOW, TELL ME JUST A LITTLE BIT BEFORE WE BREAK
AWAY. WE’VE HEARD ABOUT THE ALLERGIES. WE’VE HEARD WHAT THEY DO. BUT WHY? WHAT CAUSES THESE ALLERGIES? DR. SHAHZAD MUSTAFA: THAT’S THE MILLION-DOLLAR QUESTION. ALL ALLERGIC DISEASES – NOT JUST FOOD ALLERGIES,
BUT ECZEMA, ASTHMA, SEASONAL ENVIRONMENTAL ALLERGIES, ALLERGIC RHINITIS, ARE ALL ON THE
RISE. AND WE DON’T KNOW. PETER SALGO: SO WE DON’T KNOW WHAT CAUSES ALLERGIES? DR. SHAHZAD MUSTAFA: WE DON’T KNOW WHY IT’S ON THE RISE. IT’S INTERESTING — PETER SALGO: IT’S A DIFFERENT QUESTION, THOUGH. “A,” WHAT CAUSES IT? DR. SHAHZAD MUSTAFA: SO WE DON’T KNOW EXACTLY WHY JARED HAS ALLERGIES,
WHERE HIS OLDER BROTHER APPARENTLY DOES NOT, NO, WE DON’T HAVE A GREAT ANSWER. THERE ARE THEORIES. PETER SALGO: AND WE’RE GOING TO DISCUSS WHY THEY’RE ON
THE RISE, IF THEY’RE ON THE RISE. BUT WHAT WE WANT TO DO RIGHT NOW IS JUST WAIT
FOR JUST A MINUTE. CAN YOU STAY WITH US? THAT WOULD BE JUST GREAT. WE’RE HERE TO TALK ABOUT ALLERGIES, BUT WHEN
WE COME BACK, I WANT TO HEAR MORE OF YOUR STORY. IN THE MEANTIME, HERE’S THIS WEEK’S “MYTH
OR MEDICINE.” NARRATOR: PEANUT BUTTER AND JELLY SANDWICHES HAVE LONG
BEEN A STAPLE OF A KID’S DIET, BUT NOWADAYS IT SEEMS THAT PEANUTS HAVE BECOME A NIGHTMARE
IN THE SCHOOL CAFETERIA. ALLERGIES TO PEANUTS MUST BE ON THE RISE. IS THAT MYTH OR MEDICINE? CAROLINA MARCUS: FOOD ALLERGY TO PEANUTS IS ON THE RISE. THAT’S MEDICINE. AND I’LL TELL YOU WHY. I’M CAROLINA MARCUS, AND I AM AN ASSISTANT
PROFESSOR OF PEDIATRICS AND MEDICINE AT THE UNIVERSITY OF ROCHESTER. WE DO KNOW THAT FOOD ALLERGIES ARE ON THE
RISE — FOOD ALLERGIES IN GENERAL, BUT CERTAINLY PEANUT ALLERGY AS WELL. OVER THE LAST DECADE, PEANUT ALLERGY HAS JUST
ABOUT DOUBLED IN PREVALENCE. AND IT’S PROBABLY A COMBINATION OF VARIOUS
FACTORS. BUT THE LEADING THEORY AT THIS POINT IS CALLED
THE HYGIENE HYPOTHESIS. AND BASICALLY, WHAT THAT MEANS IS THAT, AS
WE, AS A SOCIETY, HAVE SHIFTED OUR FOCUS TREMENDOUSLY OVER THE LAST SEVERAL DECADES TO INFECTION
PREVENTION AND ATTENTION TO HYGIENE, THE IMMUNE SYSTEM, WHICH USED TO REALLY BE UTILIZED EARLY
ON IN LIFE TO FIGHT INFECTION, IS ACTUALLY SHIFTING ITS ATTENTION TOWARDS OTHER THINGS
THAT IT’S IDENTIFYING AS ALLERGENS, SUCH AS THINGS IN THE ENVIRONMENT OR DIET. NARRATOR: TOM FROM VIRGINIA ASKS, “DO YOU HAVE A PEANUT
ALLERGY FOR LIFE?” CAROLINA MARCUS: ABOUT 20% OF CHILDREN OUTGROW PEANUT ALLERGY
BY AROUND THE AGE OF SIX. SO IT REALLY IS A MINORITY OF CHILDREN WHO
OUTGROW PEANUT ALLERGY. THAT SAID, 1 IN 5 WILL OUTGROW IT. ANY CHILD WITH A FOOD ALLERGY REALLY SHOULD
BE SEEN AND FOLLOWED CLOSELY BY AN ALLERGIST/IMMUNOLOGIST. THERE ARE VARIOUS TESTS WE CAN DO TO SEE IF
A CHILD MIGHT BE STARTING TO OUTGROW A FOOD ALLERGY. IT GIVES US AN IDEA — THINGS SUCH AS ALLERGY
SKIN TESTING OR BLOOD IgE LEVELS. I DO ENCOURAGE CHILDREN WITH A FOOD ALLERGY
TO BE SEEN BY AN ALLERGIST/IMMUNOLOGIST TO GET A SENSE AS TO WHETHER THEY ARE OUTGROWING
SOME OF THEIR FOOD ALLERGIES AND ALSO TO DISCUSS SAFETY. AND THAT’S MEDICINE. NARRATOR: NOT SURE IF IT’S MYTH OR MEDICINE? CONNECT WITH US ONLINE. WE WILL GET TO WORK AND GET YOU A SECOND OPINION. PETER SALGO: AND WE’RE BACK. WE’RE HERE WITH STACEY – WELCOME BACK — WHOSE
SON JARED, IN 2007, WOUND UP HAVING ALL KINDS OF HORRIBLE FOOD ALLERGIES BUT, YOU KNOW,
I WAS THINKING ABOUT THIS DURING THE BREAK. YOUR OLDER SON DID NOT. SO I’M GOING TO TAKE ADVANTAGE OF OUR EXPERTS
OVER HERE. HOW CAN ONE SON HAVE ALL THESE ALLERGIES,
AND THE OTHER ONE DOESN’T? DR. SHAHZAD MUSTAFA: WE DON’T KNOW WHY SOMEONE DEVELOPS AN ALLERGY
VERSUS NOT. PETER SALGO: HOW DID I KNOW YOU WERE GOING TO SAY THAT? DR. SHAHZAD MUSTAFA: THAT’S THE SAD PART, RIGHT. WE KNOW A LOT IN MEDICINE, BUT WE STILL DON’T
UNDERSTAND WHY MANY THINGS OCCUR, BUT WE KNOW HOW TO TREAT THEM. PETER SALGO: ALL RIGHT, SO IT’S ENOUGH THAT WE KNOW HOW
TO TREAT THEM, BUT IT’S NOT REALLY ENOUGH. IT WOULD BE GREAT TO KNOW WHY. DR. SHAHZAD MUSTAFA: ABSOLUTELY, BECAUSE PREVENTION WOULD CERTAINLY
BE A LOT BETTER THAN TREATMENT. PETER SALGO: WHICH BRINGS UP THE OTHER QUESTION — IS HOW
CAN YOU BE ALLERGIC TO SOMETHING YOU’VE NEVER BEEN EXPOSED TO? I ALWAYS THOUGHT THAT AN ALLERGY IS, YOU’RE
EXPOSED TO SOMETHING ONCE, YOU DEVELOP ANTIBODIES OR OTHER ALLERGIC CELLS, THEN YOU GET IT THE
SECOND TIME, AND BANG, THAT’S WHEN ALL TROUBLE BREAKS LOOSE. DR. SHAHZAD MUSTAFA: ABSOLUTELY TRUE — THE SECOND TIME OR SUBSEQUENT
TIMES. YOU CAN DEVELOP AN ALLERGY AT ANY POINT. BUT THE PROBLEM IS, WHEN IS EXPOSURE? WAS JARED EXPOSED IN UTERO? DID STACEY NURSE JARED, AND WAS HE EXPOSED
THROUGH BREAST MILK EXPOSURE IS HARD TO DEFINE WHEN THAT FIRST EXPOSURE IS. ALTHOUGH YOU CANNOT BE ALLERGIC TO SOMETHING
YOU’VE NEVER SEEN BEFORE, MANY PEOPLE TELL US, THE FIRST TIME I HAD FOOD X IS WHEN THEY
HAD THE REACTION. SO THEY’VE CERTAINLY BEEN EXPOSED UNKNOWINGLY
BEFORE. PETER SALGO: SO, NOW, STACEY, HEARING ALL OF THIS, HEARING
THE “I DON’T KNOWs”, LEAVES YOU, AS A MOM, KIND OF OUT IN LIMBO, DOESN’T IT? MAKES YOU FEEL INSECURE? STACEY SAIONTZ: WELL, YOU KNOW, NOW THAT WE’VE HAD JARED FOR
FIVE YEARS, WE’VE BECOME A LITTLE BIT OF AN EXPERT ON HOW TO — YOU KNOW, LIFE ISN’T AS
SPONTANEOUS AS SOME OF OUR FRIENDS, BUT WE NOW HAVE, YOU KNOW, OUR WIPES AND OUR EPIPEN
THAT GO WITH US EVERYWHERE, AND I BRING FOOD WHENEVER WE’RE GOING TO A RESTAURANT, AND,
YOU KNOW, WE ALL WASH OUR HANDS, AND THE SCHOOLS DO THINGS, SO… PETER SALGO: YEAH, BUT JARED IS STILL YOUNG, AND HE’S GROWING
UP, AND YOU CAN KEEP HIM KIND OF COCOONED, IF YOU WILL, BUT HE’S ABOUT TO LEAVE YOUR
NEST MORE AND MORE AND MORE. DOES THAT WORRY YOU? STACEY SAIONTZ: IT’S VERY WORRISOME, AND THAT’S WHY WE WORK
WITH THE SCHOOLS TO EDUCATE THEM AND TO EDUCATE THE PEOPLE WHO ARE GOING TO BE RESPONSIBLE
FOR HIM WHEN I’M NOT WITH HIM 24/7. PETER SALGO: HOW DO YOU BALANCE ALLERGIES — SEVERE ALLERGIES
— WITH LIFE — GOING OUT IN THE REAL WORLD AND LIVING? DR. LOU PAPA: WELL, IT’S ONE OF THOSE THINGS — IT’S — UNLIKE
MANY OTHER THINGS THAT WE DEAL WITH IN MEDICINE, IT’S ALL AVOIDANCE. SO I THINK A BIG PART OF IT IS, JUST LIKE
SHAHZAD HAD SAID, IS KNOWING FOR SURE THAT HE’S REALLY ALLERGIC TO THAT STUFF, YOU KNOW,
DOING THAT CHALLENGE TESTING OR ELIMINATION TESTING, MAKING SURE — BECAUSE IT CAN BE
A BIG PROBLEM IF YOU’RE ALLERGIC TO EVERYTHING. AND THE SECOND THING IS, EVEN GETTING BEYOND
— WHEN HE GOES INTO COLLEGE — YOU CAN GET VERY COMPLACENT IF YOU HAVEN’T HAD AN ANAPHYLACTIC
ATTACK FOR A WHILE AND THINK YOU’RE OKAY, AND I THINK IT’S VERY IMPORTANT TO STRESS
TO THEM, EVEN AS ADULTS, BECAUSE WITH ADULT PATIENTS OF MINE, I DEAL WITH IT ALL THE TIME
THAT THEY DON’T CARRY THEIR EPIPEN WHEREVER THEY GO. THEY’VE GOT TO — IT’S LIKE THEIR SIXTH FINGER. PETER SALGO: BUT KIDS ARE KIDS, RIGHT? DR. SHAHZAD MUSTAFA: KIDS ARE KIDS, AND I THINK THERE IS — WE
DON’T KNOW EVERYTHING, WE DON’T KNOW A LOT SOMETIMES, BUT WE KNOW –WE’VE LEARNED A LOT,
AND DIFFERENT FOODS HAVE DIFFERENT RISKS OF REACTIONS, AND WE NEED TO KNOW THE REAL INFORMATION
BEHIND THE RISK OF IT AND REACTION WITH CONTACT AND AIRBORNE EXPOSURE, VERSUS INGESTION, AND
THESE RISKS ARE VERY DIFFERENT. PETER SALGO: BUT THAT’S A LOT FOR A 5-YEAR-OLD, 6-YEAR-OLD,
7-YEAR-OLD TO ABSORB AND TO LIVE WITH EVERY DAY. I MEAN, HIS KIDS ARE EATING PEANUT BUTTER
SANDWICHES — HIS FRIENDS. THEY’RE HAVING FOODS HE CAN’T HAVE. AND THERE HE IS. DR. SHAHZAD MUSTAFA: THAT’S WHY I AGREE WITH LOU, THE DIAGNOSIS
IS SO IMPORTANT, BECAUSE ALTHOUGH THERE ARE DEATHS FROM FOOD ALLERGY, THEY ARE FAR LESS
THAN THE FOLKS WHO ARE ADVERSELY AFFECTED SOCIALLY WITH FOOD ALLERGIES — CHILDREN IN
SCHOOL, SOCIAL OSTRACIZATION, BULLYING. THIS IS OFTEN WHAT I SPEND MY TIME DOING MUCH
MORE. OBVIOUSLY, EPINEPHRINE FOR ANAPHYLACTIC REACTIONS,
BUT THERE’S A LOT MORE TO THE MANAGEMENT — DR. LOU PAPA: YOU DON’T WANT THAT ALARM FATIGUE, RIGHT,
WHAT THEY ALWAYS TALK ABOUT WITH TORNADOES, RIGHT? IF THE INDIVIDUAL IS TOLD THEY’RE ALLERGIC
TO EVERYTHING, AND IT’S REALLY A REALLY BAD ALLERGIC REACTION FOR MAYBE JUST 10 OF THOSE
THINGS, THEY’RE NOT GOING TO HAVE THE SAME VIGILANCE FOR 50 THINGS, VERSUS FIVE. PETER SALGO: AND I WANT TO GET BACK TO EPIPENS, BECAUSE
THEY’RE REALLY IMPORTANT, BUT THE OTHER THING THAT I ALWAYS HEAR FROM PARENTS, FROM PEDIATRICIANS,
FROM ALLERGISTS, IS, SOMETIMES THE KIDS GROW OUT OF THESE ALLERGIES. HAS JARED GROWN OUT OF ANY? STACEY SAIONTZ: IRONICALLY, JARED HAS GROWN OUT OF PEANUT. SO HE’S ALLERGIC TO TREE NUTS, BUT HE’S NOT
ALLERGIC TO PEANUT, WHICH, WHENEVER PEOPLE THINK OF FOOD ALLERGIES, THEY JUST AUTOMATICALLY
ASSUME, “OH, JARED IS ALLERGIC TO PEANUT,” AND THAT’S, YOU KNOW, ONE OF THE ALLERGENS
HE ACTUALLY GREW OUT OF. PETER SALGO: CAN YOU GROW OUT OF THESE THINGS? DR. SHAHZAD MUSTAFA: ABSOLUTELY. THE VAST MAJORITY OF CHILDREN OUTGROW EGG,
WHEAT, AND SOY ALLERGY. 80% TO 90% OUTGROW MILK ALLERGY. AND, YES, 20% OF PEANUT-ALLERGIC INDIVIDUALS
WILL OUTGROW PEANUT ALLERGY. 15% TREE NUTS — PETER SALGO: THAT’S ENCOURAGING. I HEARD JARED IS OUTGROWING MILK TOO, HE’S
PASSED THE BAKED MILK CHALLENGE? STACEY SAIONTZ: HE PASSED A BAKED MILK CHALLENGE — PETER SALGO: WHAT IS THAT? STACEY SAIONTZ: WELL, WHEN MILK IS COOKED, THE PROTEIN CHANGES,
AND SO HE DID A CHALLENGE WHERE YOU COOK IT TO A CERTAIN DEGREE FOR A CERTAIN AMOUNT OF
TIME. AND HE’S NOW ABLE TO TOLERATE IT BAKED. HE’S NOT — HE WOULD STILL HAVE AN ANAPHYLACTIC
REACTION TO TOUCHING MILK OR DRINKING MILK, BUT WHEN IT’S IN THAT OTHER FORM. PETER SALGO: NOW, EPIPENS. I PROMISED WE’D GET BACK TO THIS. IT’S REALLY IMPORTANT, OBVIOUSLY, THAT IF
THE ALLERGIC REACTION IS REALLY DANGEROUS, THAT THE RELIEF FOR THAT BE AVAILABLE QUICKLY,
WHICH IS THE EPIPEN. BUT YOU HAD A PROBLEM WITH JARED’S SCHOOL. STACEY SAIONTZ: WELL, THERE IS — IN OUR SCHOOL DISTRICT,
THE EPIPEN WAS TO BE IN THE NURSE’S OFFICE IN A LOCKED BOX, AND THAT, TO ME — SO JARED
ACTUALLY GOES TO A PRIVATE SCHOOL WHERE THEY’RE AMAZING, AND THEY HAVE — THE NURSE HAS AN
EPIPEN IN THE NURSE’S OFFICE, BUT I HAVE A LITTLE FANNY PACK, WHAT YOU CALL IT, WITH
TWO EPIPENS AND BENADRYL IN IT, AND THE TEACHER HAS IT, AND WHEN HE GOES TO ART, IT GOES TO
ART, AND WHEN HE GOES TO MUSIC, IT GOES – IT FOLLOWS HIM, BECAUSE IF — PETER SALGO: LET ME JUST — I’M HAVING TROUBLE GETTING
MY MIND AROUND THIS. –>Display at 01:19:48:26
HERE’S A KID WHO COULD DIE, WITH A KNOWN, EFFECTIVE DRUG WHICH IS VERY SAFE AND EASY
TO USE, BUT SOME SCHOOLS WON’T ALLOW THE TEACHER TO DO IT. YOU’VE BOTH HEARD THIS, I’M SURE. DR. LOU PAPA: IT’S UNFORTUNATELY A POLICY, IT’S A BLANKET
POLICY THEY HAVE FOR ALL MEDICATIONS, SO THAT THEY HAVE THE WHEREWITHAL AND THEY CAN SHOW
THAT THEY’RE ABLE TO DISPENSE THE MEDICATION. UNFORTUNATELY, ONE SIZE DOESN’T FIT ALL, YOU
KNOW, WHETHER A CHILD GETS THEIR MEDICATION FOR THEIR A.D.D. OR FOR THEIR DIABETES SO THEY CAN SHOW IT’S
BEEN ADMINISTERED — THAT’S A LITTLE BIT DIFFERENT, VERSUS THE EPIPEN, WHICH YOU HOPE YOU’LL NEVER
HAVE TO USE, BUT IT’S GOT TO BE READY AND ON HAND. PETER SALGO: SO I’M JUST GOING TO SUM THIS UP BY SAYING,
IN THIS DOCTOR’S OPINION, THIS IS CRAZINESS. THE EPIPEN NEEDS TO BE THERE. EDUCATE THE TEACHERS, AND LET’S GO FORWARD. FAIR ENOUGH? STACEY SAIONTZ: VERY FAIR. PETER SALGO: BECAUSE I WANT TO GET ON TO SOMETHING ELSE,
WHICH IS REALLY INTERESTING SCIENTIFICALLY. TELL ME ABOUT IMMUNOTHERAPY. DR. SHAHZAD MUSTAFA: YEAH, SO IMMUNOTHERAPY, WHICH A LOT OF PEOPLE
KNOW AS ALLERGY SHOTS FOR THEIR ENVIRONMENTAL ALLERGIES, IS MAKING SOMEONE LESS SENSITIVE
TO WHAT THEY’RE HYPERSENSITIVE TO, OVERLY SENSITIVE TO. SO RECENTLY THERE HAS BEEN A LOT OF RESEARCH,
AND IT’S VERY EXCITING, ABOUT ORAL IMMUNOTHERAPY FOR FOODS. IF IT WORKS FOR ENVIRONMENTAL STUFF, DOES
IT WORK FOR FOODS? AND THERE IS AN IMPORTANT POINT. IT HAS BEEN SHOWN TO MAKE SOMEONE LESS SENSITIVE
TO A FOOD — IT DESENSITIZES THEM –BUT IT, UNFORTUNATELY, DOES NOT MAKE THEM UN-ALLERGIC. PETER SALGO: I HEARD SOME STIRRING TO MY LEFT. STACEY SAIONTZ: [Laughs] WELL, NO, WE’VE BEEN VERY EXCITED
ABOUT THE STUDIES THAT HAVE BEEN GOING ON FOR THE ORAL IMMUNOTHERAPY. AND SO, YOU KNOW, WE’VE BEEN ASKING AND WANTING
TO PUT JARED INTO THIS TYPE OF STUDY, BUT — AND I THINK THIS IS GOING TO BE THE WAVE
OF THE FUTURE, BUT I KNOW THAT THERE’S A STUDY THAT CAME OUT OF BALTIMORE, I THINK, WITH
DR. WOOD, WHERE IT WAS JUST FOR ONE ALLERGEN FOR
MILK, AND I THINK FIVE YEARS AFTER THE FACT — I DON’T HAVE THE ACTUALFACTS — BUT SOME
— A LOT OF THE KIDS IN THE STUDY ARE NOW — THE ALLERGY HAS COME BACK. AND SO, TO ME, THAT’S THE SCARIEST THING — DR. SHAHZAD MUSTAFA: SO WHAT YOU’RE DOING IS, YOU’RE ADMINISTERING
FIXED INCREASING DOSES OF WHATEVER FOOD — PETER SALGO: A LITTLE MILK, A LITTLE MORE MILK, A LITTLE
MORE MILK — DR. SHAHZAD MUSTAFA: RIGHT, WHICH COMES WITH A HUGE RISK OF ANAPHYLAXIS,
BUT IT’S BEEN DONE SAFELY IN A RESEARCH SETTING, AND THEN ONCE YOU GET TO A TOP DOSE, HERE’S
THE KICKER — THE INDIVIDUAL HAS TO TAKE A FIXED AMOUNT OF THAT FOOD ON A DAILY BASIS
— PETER SALGO: BECAUSE IF YOU STOP, THEN THE IMMUNE SYSTEM
RECOGNIZES IT AGAIN AS FOREIGN, AND YOU START FROM SCRATCH. DR. LOU PAPA: JUST LIKE IMMUNOTHERAPY. DR. SHAHZAD MUSTAFA: JUST LIKE IMMUNOTHERAPY. SO WE’RE NOT MAKING THEM UN-ALLERGIC. WE’RE JUST KEEPING THEM LESS SENSITIVE WHILE
THEY’RE ON THE FIXED DOSE. PETER SALGO: NOW, STACEY, YOU’VE ALREADY, OBVIOUSLY, TUNED
IN TO THE FACT WE’VE GOT EXPERTS HERE FOR YOU. YOU’RE HERE FOR A SECOND OPINION. IN THE FEW MINUTES REMAINING, THIS IS YOUR
SHOT — ASK AWAY. STACEY SAIONTZ: WELL, DO YOU THINK IF — THE MULTI-ALLERGEN
IMMUNOTHERAPY STUDY WOULD BE SOMETHING YOU WOULD PUT YOUR 5-YEAR-OLD IN? DO YOU THINK SOMEONE AT THIS AGE CAN HANDLE
BEING FOR–ESSENTIALLY, YOU KNOW, UNDERSTANDING THAT THEY HAVE TO TAKE THAT DOSE EVERY DAY
AND…? PETER SALGO: YOU’VE GOT ABOUT A MINUTE. DR. LOU PAPA: I WOULD SAY, FROM MY PERSPECTIVE IN PRIMARY
CARE, THERE’S TWO QUESTIONS THERE. ONE IS BEING IN A STUDY. SO IF YOU’RE GOING TO BE IN A STUDY, THE OVERALL
GOAL OF THAT STUDY IS THAT YOU ARE BENEFITING SOCIETY. THAT’S THE NUMBER-ONE THING. AND THERE MAY BE SOME BENEFIT TO YOU. TWO, YOU KNOW YOUR CHILD BEST. AND IF YOUR CHILD HAS BEEN WELL EDUCATED,
UNDERSTANDS THE IMPORTANCE OF IT, AND YOU FEEL YOU HAVE A GOOD CONNECTION AND UNDERSTANDING
FOR THIS CHILD — AND YOU HAVEN’T HIT THE TEENAGE YEARS — EVERYTHING, YOUR WHOLE WORLD
WILL TURN UPSIDE DOWN THEN. THAT’S WHERE MY GRAY HAIR COMES FROM. PETER SALGO: LET ME GIVE SHAHZAD THE LAST WORD. DR. SHAHZAD MUSTAFA: I THINK ORAL IMMUNOTHERAPY IS VERY EXCITING. ALTHOUGH I DON’T THINK IT’S READY FOR PRIME
TIME, I DO THINK THERE’S INDIVIDUALS HERE WHO IT WOULD BENEFIT –THE BENEFITS WOULD
OUTWEIGH THE RISKS — AND THAT HAS TO BE INDIVIDUALIZED. PETER SALGO: GUYS, THANK YOU SO MUCH FOR BEING HERE. STACEY, THANK YOU SO MUCH FOR COMPRESSING
THIS VERY COMPLICATED STORY INTO OUR BRIEF TIME PERIOD. IT WAS NICE OF YOU TO SHOW UP. STACEY SAIONTZ: THANKS FOR HAVING ME. PETER SALGO: AND BEFORE WE LEAVE TODAY, FOR THE LAST WORD
ON FOOD ALLERGIES, I WANT TO PAUSE AND GO TO THIS WEEK’S “SECOND OPINION 5.” DR. PRITA MOHANTY HELLO, I’M DR. PRITA MOHANTY, AND I’M HERE TO TELL YOU THE
FIVE THINGS YOU SHOULD KNOW ABOUT FOOD ALLERGIES. THE FIRST THING TO KNOW ABOUT FOOD ALLERGIES
IS THE BIG EIGHT — THE MOST COMMON FOOD ALLERGENS IN CHILDREN ARE MILK, EGG, WHEAT, SOY, PEANUT,
TREE NUT, FISH, AND SHELLFISH. THE NEXT THING TO KNOW IS THE INFLUENCE OF
AGE. COW’S MILK AND EGG ALLERGIES ARE HUGELY OUTGROWN
DURING CHILDHOOD AND TEENAGE YEARS. PEANUTS, TREE NUT, AND SHELLFISH ALLERGIES
ARE MORE LIKELY TO PERSIST INTO ADULTHOOD. THE THIRD THING TO KNOW IS THE SYMPTOMS. AFTER INGESTION OF A SPECIFIC FOOD, A PERSON
MAY HAVE MILD SYMPTOMS, SUCH AS A FEW HIVES, ITCHY OR WATERY EYES; OR A SEVERE, LIFE-THREATENING
REACTION CALLED AN ANAPHYLAXIS, SUCH AS SHORTNESS OF BREATH, WHEEZING, AND SWELLING OF THE THROAT. THE FOURTH THING TO KNOW IS THE MANAGEMENT. THE BEST MANAGEMENT FOR A SEVERE REACTION
IS A MEDICINE CALLED EPINEPHRINE. A PERSON SHOULD KEEP THE EPIPEN WITH THEM
AT ALL TIMES. IN CASE OF A SEVERE ALLERGIC REACTION, INJECT
THE EPIPEN, AND CALL 9-1-1. THE LAST THING TO KNOW IS PREVENTION. WITH CONFIRMED FOOD ALLERGIES, YOU SHOULD
IMMEDIATELY CLEAR EVERY ITEM YOU OR SOMEONE ELSE CAN’T EAT FROM YOUR HOUSEHOLD, AND ALSO
MAKE SURE YOU CLEAN AND SANITIZE YOUR COOKING UTENSILS AND KITCHEN. YOU WILL ALSO WANT TO LET YOUR CHILD’S SCHOOL,
FRIENDS, AND FAMILY KNOW ABOUT THEIR FOOD ALLERGY. AND THAT IS YOUR “SECOND OPINION 5.” PETER SALGO: THANK YOU SO MUCH FOR WATCHING “SECOND OPINION.” WE HOPE YOU CONTINUE THIS CONVERSATION ON
OUR WEBSITE, WHERE YOU CAN COMMENT ON THIS SHOW, SEND US YOUR SHOW IDEAS, SHARE YOUR
HEALTH STORY WITH US AND MAYBE WE’LL INVITE YOU TO BE ON THE SHOW WITH US. THE WEB ADDRESS IS secondopinion-tv.org. I’M DR. PETER SALGO. I’LL SEE YOU NEXT TIME FOR ANOTHER “SECOND
OPINION.” Child: THERE ONCE WAS A TIME WHEN WE WERE
TRULY FREE – FREE OF WORRY, FREE OF FEAR, FAR FROM DOUBT. THAT IS STRENGTH. THAT IS POWER. THAT IS FEARLESS. “SECOND OPINION” IS BROUGHT TO YOU BY BlueCross/BlueShield,
ACCEPTED IN ALL 50 STATES. LIVE FEARLESS. NARRATOR: “SECOND OPINION” IS PRODUCED IN ASSOCIATION
WITH THE UNIVERSITY OF ROCHESTER MEDICAL CENTER, ROCHESTER, NEW YORK.


Leave a Reply

Your email address will not be published. Required fields are marked *