Springtime Allergies | On Call with the Prairie Doc | Apr 28, 2016
17
October

By Adem Lewis / in , , /


>>NOTHING TO SNEEZE AT, NEXT “ON CALL WITH THE PRAIRIE DOC.” >>GOOD EVENING, AND WELCOME TO “ON CALL WITH THE PRAIRIE DOC.” ALLERGIC SYMPTOMS CAN BE ANYTHING FROM HIVES OR RASH FOLLOWING AN ANTIBIOTIC, AN UPSET STOMACH AFTER CERTAIN FOODS, A RUNNY NOSE AND SCRATCHY EYES IN THE SPRING, TO A DANGEROUS DROP OF BLOOD PRESSURE FROM A BEE STING OR A PEANUT BUTTER SANDWICH. ALLERGY PROBLEMS HAVE RESULTED IN A SUB-SPECIALTY WHERE THE EXPERT UNDERSTANDS NOT ONLY WHAT CAN CAUSE THESE ANNOYING AND DANGEROUS SYMPTOMS, BUT KNOWS HOW BEST TO IDENTIFY THEM AND TREAT THEM.>>>FIRST, LET’S TAKE A LOOK AT THIS WEEK’S PRAIRIE DOC QUIZ QUESTION. ONE RAGWEED PLANT CAN PRODUCE HOW MANY POLLEN GRAINS IN A SEASON? A) 100 B) 5,000 C) ONE MILLION D) ONE BILLION 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 10 MINUTES TO GET YOUR ANSWER IN, BUT YOU HAVE THE WHOLE SHOW TO CALL IN ANY QUESTION, TONIGHT ABOUT ALLERGY. WE ANSWER YOUR MEDICAL QUESTIONS ABOUT 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. RETURNING TO HELP US UNDERSTAND THIS COMPLICATED FLD AND TO ANSWER YOUR QUESTIONS ABOUT ALLERGY IS DR. MARK BUBAK, MD, INTERNIST, AND ALLERGIST. THANKS FOR JOINING US, MARK.>> MORE THAN HAPPY TO.>>THE SPECIFIC QUESTION ABOUT ALLERGY THAT HAS BEEN MAKING MY HEAD SCRATCH, NOT TO MENTION MY EYES AND NOSE, DR. BUBAK, IS HOW DIFFERENT PEOPLE SEEM TO BE, WITH REGARD TO ALLERGY. SOME ARE SO SENSITIZED TO EVERY DARN THING IN THE UNIVERSE, AND SOME ARE NOT BOTHERED BY ANYTHING, OR ONLY BY THIS ONE THING OR THAT THING. ARE WE REALLY THAT DIFFERENT AND WHY IS THERE SUCH A DIFFERENCE? >>HUMANS ARE FUN AND, BOY, WE ARE DIFFERENT.>>WE ARE DIFFERENT, AREN’T WE? >>PROBABLY ABOUT 80% OF PEOPLE DON’T HAVE AN ALLERGY AT ALL. SO, IT’S JUST — IT’S THE MINORITY, AND IT HAS TO DO WITH HOW WE REACT TO OUR ENVIRONMENT AND THERE ARE SUBSTANCES CALL INTERLEUKINS THAT IN SOME PEOPLE ARE GENETICALLY PROGRAMMED TO MAKE AN ALLERGY. AND THEN THERE ARE THINGS WE DO, LIKE WE DON’T FEED OUR KIDS PEANUT BUTTER UNTIL THEY’RE 2 YEARS OF AGE AND THEY GET PEANUT BUTTER ON THEIR SKIN INSTEAD OF DOWN THEIR G.I. TRACK, IT LEANS THEM TOWARD THE ALLERGY STUFF. SO IT’S FUN TO SEE WHAT WE CAN DO TO CHANGE THAT.>>SO, GENETICS AND IT’S ENVIRONMENT. >>AND THE COMBO. AND EVEN WHEN WE GET AN INFECTION, AT A CERTAIN POINT IN OUR LIFE CAN MAKE A BIG DIFFERENCE.>>DIFFERENT KINDS OF INFECTION. >>THE KIDS WHO GET THEIR RSV WHEN THEY’RE REAL LITTLE, SEEMS LIKE THERE’S SOMETHING THAT MAKES THOSE PEOPLE MORE LIKELY TO GO DOWN THE ASTHMA PATHWAY. WHEREAS, IF YOU GET, LIKE, GOOD BACTERIAL PNEUMONIA, THOSE PEOPLE ARE MORE LIKELY NOT TO GET ALLERGIES, OF COURSE, THEY MAY ALSO DIE FROM THEIR PNEUMONIA. SO, THERE’S SOME BENEFITS OF NOT GETTING — — NOT GETTING A BAD INFECTION. >>THEY SAID THAT ALL OF THESE AUTOIMMUNE ALLERGIC THINGS HAVE BEEN ON THE RISE, MORE ASTHMA, ALL OF THIS, WHILE ALL THE DEATHS FROM INFECTIONS AND SANITATION ISSUES HAVE GONE DOWN IN HUMANKIND. DOES THAT CORRELATE?>>THAT’S THE HYGIENE HYPOTHESIS. THERE’S SOME CORRELATION, IT’S NOT 100%. SO, YOU KNOW, THIGHS DAYS, NOW, WE’RE AS ALLERGISTS TALKING ABOUT INTERVENTIONS. SO THE BIG THING IS FEEDING YOUR CHILDREN PEANUT BUTTER AND EGG STARTING AT ABOUT AGE 4 MONTHS OF AGE. WE’RE THINKING THAT IT’S GOING TO CUT THE INCIDENCE OF PEANUT AND EGG ALLERGY BY HALF. >>REALLY, JUST BY FEEDING THEM THAT EARLY?>>FEEDING THEM EARLY. AND IF YOU HAVE A MILD ALLERGY OR AN ALLERGY AT 4 MONTHS OF AGE, IT’S GOING TO SHOW UP AS A LITTLE BIT OF HIVES OR A LITTLE MILD REACTION RATHER THAN LATER ON WHERE IT’S A LOT MORE DRAMATIC.>>AND WOULD IT DESENSITIZE THEM, DO YOU THINK? >>NO. >>NO, BUT YOU’LL SEE IT.>> WHAT’S HAPPENING IS THAT BY EATING THE FOOD, OUR G.I. TRACK IS SET UP TO TOLERATE THINGS. IT’S HOW WE GET OUR NUTRITION. SO IF YOU WANT TO NOT BE ALLERGIC, HAVE THE FIRST EXPOSURES THROUGH THE — THROUGH THE G.I. TRACK RATHER THAN ON OUR SKIN WHICH IS MORE LIKELY TO GET ALLERGY. >>THAT’S VERY INTERESTING.>> THAT’S THE WHOLE — THE BIG NEW THRUST NOW. >>IS G.I. TRACT –>>EXPOSE PEOPLE YOUNG SO THAT THEY GET TOLERANCE. >>SO THAT LEADS ME IN THE DIRECTION OF THE BOOK THAT YOU WROTE JUST RECENTLY, YOU KNOW, YOU JUST CAME OUT WITH A BOOK ON ESOPHAGITIS. NOW, THAT’S GENERALLY A G.I. TRACT KIND OF A GASTROENTEROLOGIST TERRITORY. AND, SO, YOU’RE AN ALLERGIST, BUT YOU’VE DONE THIS BOOK. TELL ME WHAT GOT YOU INTO THAT AND DOES THAT HAVE ANYTHING TO DO WITH WHAT YOU JUST SAID ABOUT G.I. EXPOSURE?>>IT’S LIKE HAVING TERRIBLE REFLUX, THAT THE MEDS DON’T HELP. THERE ARE THESE WHITE BLOOD CELLS, FOOD GETS CAUGHT, THROWING UP, THINGS LIKE THAT. AND IT’S BEEN FOUND THAT FOOD OR A COUPLE OF FOODS THAT YOU EAT ARE USUALLY WHAT CAUSES IT. WE DON’T KNOW WHY A PERSON ALL OF A SUDDEN BECOMES SENSITIZED, BOOK GIVES YOU A MONTH OF DIETARY SUGGESTIONS, KEEP YOU OFF OF MILK, SOY, PEANUTS, SHELL FISH, AT THE END OF A MONTH OR TWO, YOUR SYMPTOMS SHOULD BE ALL GONE, BEING OFF THOSE FOODS IS GOING TO FIX YOU UP.>>SHELL FISH, PEANUTS, MILK.>>EGG.>>EGG. >>WHEAT.>>WHEAT. >>OKAY.>>SIX FOOD FAMILIES. >>ALL RIGHT.>>AND IT WORKS. >>SO THE ALLERGY GOES AWAY. ESOPHAGITIS GOES AWAY.>>THEN WE START ADDING BACK FOODS. IT COMES OUT THAT IT’S ONE, TWO OR THREE OF THOSE FOODS FOR MOST PEOPLE.>>AND THEN THEY CAN — SO, I MEAN, WHAT’S BEEN DONE SO FAR WAS STEROID NASAL SPRAY BUT YOU SWALLOW IT, THAT’S THE TREATMENT. >>THAT WOULD BE THE BIG THING. REAL HIGH DOSE PROTON PUMP INHIBITOR. >>OMEPRAZOLE, PRILOSEC.>>80 MILLIGRAMS A DAY.>>HOPEFULLY YOU CAN GET OFF OF THOSE THINGS. >>GET OFF THE MEDS, BE A LOT BETTER SINCE PEOPLE HAVE THIS DISEASE THEIR WHOLE LIFE. >>SO THEY’RE GOING TO BE ALLERGIC TO ONE OF THOSE THINGS, FINDING IT IS INTERESTING.>>RIGHT NOW, THIS IS THE HOT TIME FOR AN ALLERGIST TO BE ON OUR SHOW BECAUSE IT’S SO ALLERGIC RIGHT NOW. IT’S THE TREE ALLERGY SEASON. >>THIS IS TREE SEASON AND THIS YEAR IS TOUGH. I THOUGHT LAST YEAR WAS KIND OF A BUMP, BUT, BOY, PEOPLE ARE JUST MISERABLE, ITCHY, RED EYES, SNEEZING FITS, PLUGGED-UP NOSE.>>SNORING AT NIGHT, AS MY WIFE POINTS OUT. I CAN’T GET MY AIRWAY TO OPEN, RIGHT, AND SO, I’M SNORTING AND SNORING AT NIGHT, MISERABLE.>>KIND OF A UNIQUE YEAR. ALLERGY TREATMENT HAS CHANGED IN THE LAST YEAR. MOST EVERYTHING IS OVER THE COUNTER. AND, SO, IF YOU KIND OF WATCH YOUR SYMPTOMS, OKAY, EVERY APRIL AND MAY, I’M TERRIBLE, EVERY AUGUST, YOU CAN START UP AND, YOU KNOW, IF YOU KNOW THAT A CLARITIN FIXES YOU, THAT’S ALL YOU NEED. BUT MOST PEOPLE WITH ALLERGY, IT’S WORSE, AND THE NASAL STEROIDS ARE THE BIG THING. AND, SO, A WEEK OR TWO BEFORE YOU KNOW YOUR SEASON’S GOING TO START, START YOUR NOSE SPRAY, TAKE IT ALL THE WAY THROUGH THE SEASON, EVERY DAY. AND, REMEMBER, A SQUIRT TODAY IS MORE SO FOR ABOUT A WEEK OR SO FROM NOW.>>WE HAVE AN ANIMATION SHOWING HOW TO SPRAY. WHAT IS THE CORRECT WAY TO USE A NASAL SPRAY?>>IT’S EVERY DAY.>>OKAY. AND YOU LEAN FORWARD?>>LEAN FORWARD, KIND OF BEND OVER, AIM KIND OF AT THE INSIDE OF THE EYEBALL ON THE SAME SIDE, SQUIRT ONE OR TWO TIMES, YOU DON’T HAVE TO SNIFF IN AT ALL.>>RIGHT. >>AND THE MATERIAL JUST KIND OF DRIPS DOWN THE BACK A LITTLE BIT, COATED THE INSIDE OF YOUR NOSE. YOU RUN OFF AND HAVE FUN FOR THE DAY.>>SO, DO YOU SPRAY OUTWARDS, TOWARD THE OUTWARDS OR INWARDS TOWARD THE MIDDLE?>>THIS IS THE LEFT SIDE, TO YOU’RE AIMING THE SPRAY TO HIT THE TURBINATES, SO THAT’S OUTWARD. AND IF YOU SQUIRT THE MIDDLE OF YOUR NOSE, IT’S THE SEPTUM AND YOU’LL GET A HIGHER INCIDENCE OF NOSE BLEEDS.>>SO YOU WANT TO GO MORE OUTWARD?>> YEAH. >>YOU WANT TO LEAN FORWARD?>> THAT’S THE BEST.>>AND YOU DON’T NEED TO SNIFF? >>IT’S A LITTLE BETTER IF YOU DON’T BECAUSE THEN YOU DON’T HAVE THE DRIPPING IN THE BACK OF YOUR THROAT.>>AND YOU THINK THAT THE STEROID SPRAYS ARE BETTER THAN THE ANTIHISTIMINE PILLS?>>IT WORKS ABOUT TWICE AS WELL. IF CONGESTION IS AN ISSUE, YOU HAVE TO GO TO THE NOSE SPRAY WITH THE STEROID IN. >>SO LET’S SHOW THE DIFFERENT KINDS OF NASAL SPRAY THAT IS ARE OVER THE COUNTER. THERE’S TWO OF THEM HERE.>> NASACORT AND THE FLONASE AND RHINOCORT, JUST THE LAST COUPLE OF MONTHS CAME OUT.>> THESE ARE ALL PRETTY EQUAL?>> YUP. >>ABOUT THE SAME PRICE.>>15 BUCKS OR SO. AND FOR A MONTH SUPPLY. >>15 BUCKS FOR A MONTH SUPPLY. AND YOU DO TWO SPRAYS ONCE A DAY, EACH NOSTRIL. >>ONE OR TWO SQUIRTS. YUP. ADD THE ZYRTEC OR CLARITIN ON TOP, SOME EYE DROPS, LIKE, ALCON OR ZADITOR OR WHICHEVER YOU LIKE. >>THOSE ARE OVER THE COUNTER, TOO.>>OVER THE COUNTER. IF THOSE AREN’T WORKING, YOUR DOC WILL GIVE YOU A LITTLE PREDNISONE, QUITE OFTEN YOU’LL END UP DOING ALLERGY SHOTS. THEY CAN REALLY HELP OUT. IF — IT’S BEEN KIND OF NEAT. ABOUT A YEAR OR SO AGO, UNDER THE TONGUE TREATMENT CAME OUT. IT WAS FINALLY A DOSE THAT WAS FOUND TO BE EFFECTIVE IN A LOT OF PEOPLE. AND, SO, YOU PUT A TAB OF RAGWEED UNDER YOUR TONGUE EACH DAY, OR A TAB OF GRASS. AND IF YOU’RE JUST ALLERGIC TO THE ONE THING, BOY, IT CAN MAKE A DIFFERENCE. IF YOU’RE ALLERGIC TO MORE THAN ONE, THE SHOTS ARE A LOT MORE ECONOMICAL. THE NEAT THING ABOUT THE TABS IS YOU CAN DO IT AT HOME. THE BAD THING IS THAT HISTORICALLY ONLY 20% OF PEOPLE COMPLETE A COURSE OF TABS. WHEREAS, WITH SHOTS ABOUT 75% OF PEOPLE MAKE THE FULL THREE YEARS. AND MOST PEOPLE WANT TO DO FIVE. >>SO, I MEAN, WOULD YOU DO THAT KIND OF SHOT THERAPY OR THE TABS, WHICHEVER? YOU GOT TO KNOW WHAT YOU’RE ALLERGIC, THOUGH, TO TO DO THE TAB. WOULD YOU DO THAT ALL YEAR-ROUND FOR A GUY WHO HAS TWO WEEKS OF PROBLEMS IN THE SPRINGTIME? >>IF YOU HAVE TWO HORRIBLE WEEKS AND YOUR MEDS DON’T WORK AND YOU CAN’T GET BY, ONE COULD DO THAT AND IT WOULD HAVE A HIGH LIKELIHOOD OF REALLY HELPING OUT AND MAKING YOU WAY LESS ALLERGIC, YOU STOP THE TREATMENT AFTER THE FIVE YEARS, AND YOU KEEP DOING WELL IS WHAT WE FIND MOST FOLKS.>>WOW.>>TRUTHFULLY, THERE’S, YOU KNOW, THE LONGER THE SEASON, THE MORE LIKELY YOU ARE YOU’RE GOING TO WANT TO DO THE SHOTS. IF YOU HAVE TWO WEEKS, YOU KNOW, SOME OF US WOULD JUST SAY, I’M NOT SURE I REALLY WANT TO, I’LL BE HONEST. >>YEAH.>>BUT IF YOU HAVE AUGUST AND SEPTEMBER AND OCTOBER, DESPITE ALL THE MEDS AND YOU CAN’T BREATHE, YOU CAN’T SLEEP, IT COULD BE LIFE SAVING.>>YEAH. MAKE YOUR WIFE HAPPY, ANYWAY. >>YEAH, THAT’S WHAT I MEANT. >>LIFE SAVING.>>LIVING THINGS ARE DIVIDED FIRST INTO TWO KINGDOMS, PLANTS AND ANIMALS. SOMETIMES THE PLANT KINGDOM CAUSES DISTRESS AND DISCOMFORT FOR THE ANIMAL KINGDOM.>> WELL, JUST ABOUT EVERY FLOWER, EVERY PLANT IS GOING TO PRODUCE A FLOWER AT SOME POINT IN ITS LIFE. SOME MIGHT NOT DO IT RIGHT AWAY. THERE CAN BE A JUVENILITY PERIOD IN MANY KINDS OF PLANTS, BUT IN GENERAL, MOST ADULT TREES, SHRUBS, FLOWERS, PLANTS, THEY ARE GOING TO FLOWER AT SOME POINT AND THEY WILL GENERALLY PRODUCE POLLEN AND THAT POLLEN, DEPENDING ON THE KINDS OF PLANTS, IS — IN SOME CASES MORE READILY BLOWN AROUND BY THE WIND. SOME CASES IT’S NOT VERY MUCH BLOWN AROUND BY THE WIND. IT MIGHT BE VERY STICKY AND NOT MOVE AROUND EXCEPT BY INSECTS AND SO FORTH TOUCHING IT. BUT WHEN YOU TALK ABOUT TREES, THEY’RE UP IN THE AIR. WE HAVE A LOT OF WIND IN SOUTH DAKOTA. SO IT’S VERY EASY FOR MANY KINDS OF TREE SPECIES FOR THE WIND TO PICK UP THAT POLLEN AND MOVE THAT ALL OVER THE PLACE. SO, IF YOU GO OUTSIDE AND YOU HAPPEN TO BE ALLERGIC TO THAT PARTICULAR KIND OF POLLEN, IT MAY AFFECT YOU. KIND OF A LATE-SUMMER FLOWERING PLANT, PEOPLE SEE IT, SOMETIMES THEY JUST SEE IT AND THEY ALREADY THINK THEIR NOSE STARTS RUNNING, THEIR EYES START WATERING, THE GOALEN ROD IS TERRIBLE, CAUSING ALL THE HAY FEVER FOR ME. IT HAS A STICKY POLLEN, IT’S ATTRACTIVE TO INSECTS THAT LIKE TO EAT THE POLLEN. BUT IT DOESN’T BLOW AROUND. HOWEVER, AT THE SAME TIME, RAGWEED, WHICH IS PROBABLY ONE OF THE WORST POLLEN-PRODUCING PLANTS THAT WE SEE, AND THERE IS A LOT OF IT OUT THERE ON THE LANDSCAPE AND ON THE COUNTRYSIDE, THAT POLLEN IS VERY LIGHT, FLIES AROUND IN THE AIR VERY EASILY, SO, GOLDEN ROD, THAT’S WHAT’S CAUSING MY PROBLEM, IT’S REALLY THE RAGWEED THAT’S GROWING DOWN BELOW THAT PEOPLE MIGHT NOT EVEN NOTICE WHEN THEY’RE WALKING THROUGH IT. GOLDEN ROD GETS A BAD RAP, IT HAPPENS TO BE THE SHOW IPLANT WHEN IT’S THE RAGWEED DOWN BELOW CAUSING THE REAL POLLEN. YOU CAN HAVE SPORES FROM FUNGI AND MOLDS, ESPECIALLY AFTER THE SNOW MELTS, YOU’VE GOT DEAD GRASS, DEAD LEAVES, IF IT’S A WET SPRING, IN PARTICULAR, THOSE THINGS CAN START FEEDING ON THE DECAYING MATERIAL. THEY RELEASE SPORES, THE SPORES GET UP INTO THE AIR, AND IT CAN ALSO CAUSE A ALLERGIC REACTION FOR SOME PEOPLE. IT CAN ALSO BE SPORES FROM OTHER KINDS OF ORGANISMS. IF YOU HAVE PROBLEMS, CHECK WITH AN ALLERGIST, WATCH YOUR LOCAL TELEVISION SHOWS, THEY’LL OFTEN GIVE YOU WHAT THE POLLEN COUNTS AND WHAT THE ALLERGY PROBABILITIES ARE. AND THAT CAN GIVE YOU SOME BETTER IDEA AS TO IF YOU’RE GOING TO BE SUFFERING FROM ONE THING OR ANOTHER. AND ONCE YOU FIND OUT WHAT YOU’RE ALLERGIC TO, THAT’S GOING TO GIVE YOU A BETTER IDEA OF, OKAY, I BETTER REALLY WATCH IT THE FIRST PART OF JUNE BECAUSE THAT’S WHEN THIS PLANT IS IN BLOOM. MIGHT WANT TO STAY INDOORS MORE FREQUENTLY OR USE SOME OF THAT MEDICINE. >>DAVID GRAPER WAS A GUEST ON OUR PRAIRIE DOC RADIO PROGRAM YESTERDAY AND HE HAD SOME GREAT ADVICE AND INFORMATION. IF YOU WANT TO FIND OUT MORE ABOUT PLANTS, ALLERGIES, ETC. WE HAVE THE RADIO SHOW ON OUR WEBSITE PRAIRIEDOC.ORG. MARK, HAVE YOU NOTICED ANY CHANGES IN THE TIMING OF SPRING ALLERGIES OVER THE YEARS? I MEAN, THEY SAY THAT THERE’S SOMETHING — THAT THERE’S — SOMETHING’S HAPPENING WITH OUR GLOBAL WARMING. TELL ME YOUR OPINION ON ALL OF THAT. >>YEAH, THERE’S A LOT OF TALK WITH THE ALLERGISTS ABOUT THE GLOBAL WARMING AND IT MAY HAVE AN EFFECT ON POLLINATION AND A LOT OF RESEARCH IS ACTUALLY ONGOING. AND I CAN’T TELL YOU THE FULL EFFECT, BUT, BOY, I NEVER THOUGHT OF TREE SEASON SO MUCH IN MARCH AS WE HAD THIS YEAR. PEOPLE JUST REALLY KICKED IN HARD. >>SO, THIS HAS BEEN A HEAVY, HEAVY TREE SEASON, POLLEN SEASON MORE THAN USUAL. >>WE’RE A PRAIRIE STATE. WE’RE NORMALLY A GRASS-HEAVY.>> RIGHT. BOY, THERE’S BEEN A LOT OF TREE STUFF.>>YUP.>>OKAY. I’VE GOT — >>A FEW QUESTIONS THERE.>> I’LL TRADE YOU QUESTIONS.>> THERE YOU GO.>>82-YEAR-OLD MAN FROM FREDERICK, SOUTH DAKOTA, ASKS, I HAVE DRY MOUTH AND EYES. COULD THIS BE DUE TO ALLERGIES? DRY MOUTH.>>A DRY MOUTH, IT COULD BE FROM ALLERGIES IF YOUR NOSE IS SO PLUGGED UP YOU CAN’T BREATHE THROUGH IT AND YOU’RE MOUTH BREATHING. BUT THE COMBINATION WITH DRY EYES, IT PROBABLY IS NOT ALLERGY. IT WOULD BE ONE OF THE SICCA SYNDROMES. BUT I NOTICE THAT — >>OR MEDS. >>OR THE MEDS. — THIS SEASON, I HAD THIS HUGE STUFFINESS, BUT MY MOUTH WAS DRY, I THINK THAT WAS REALLY MOUTH BREATHING.>> MOUTH BREATHING STUFF. WITH ALLERGIES, YOU WANT WATERY EYES. AND THEN KIND OF RED IN THE WHITES OF THE EYES.>>THE DIFFERENTIAL WOULD BE A VIRAL INFECTION.>>YEAH, YEAH. >>WHAT ELSE WOULD COME WITH VIRUS?>>USUALLY, IT COULD BE ONE EYE OR TWO, FEEL MORE GRAVELY. >>OKAY.>>AND NOT A LOT OF NOSE SYMPTOMS. AND THE SNEEZING FITS, ISN’T THERE WITH THE VIRUS. THE HAY FEVER FROM TREES AND STUFF, AND IT ITCHES CRAZY AND THAT SCRATCHY, ITCHY, BACK BETWEEN YOUR EARS, AT THE ROOF OF YOUR MOUTH. POLLEN ALLERGY.>>YEAH. OKAY. THAT’S IT. THAT’S WHAT I’VE GOT. 65-YEAR-OLD WOMAN, I WANT YOU TO KNOW I WAS USING THE NASALCORT NASAL SPRAY, IT MADE A LOT OF DIFFERENCE, LUBRICATED THINGS SO I COULD SLEEP BETTER. 65-YEAR-OLD WOMAN FROM SIOUX FALLS, DEVELOPED A PEANUT AND EGG ALLERGY AS AN ADULT. WHY DOES THIS HAPPEN IN ADULTHOOD?>>BAD LUCK IS ABOUT THE BEST I CAN SAY. WE DON’T KNOW WHY PEOPLE ALL OF A SUDDEN DO IT. IT’S INTERESTING, IN GALS, THEY LIKE TO GET ALLERGY LATER THAN GUYS DO. AND, SO, THE LITTLE BOYS AND THEN BY THE TIME WE’RE 70, EVERYBODY CATCHES UP.>>SO, THE GUYS ARE WORSE. LITTLE BOYS. SO IT ISN’T TESTOSTERONE AT ALL?>>NO.>> WHAT THE HECK IS THE REASON? >>WE DON’T KNOW YET.>>ARE WE PLAYING OUTSIDE MORE?>>NO. THAT ACTUALLY WOULD MAKE YOU LESS LIKELY TO HAVE ALLERGIES. SO, FARMERS HAVE FEWER ALLERGIES THAN CITY DWELLERS DO.>>BECAUSE OF HYGIENE THEORY AGAIN, RIGHT? >>YOU’RE EXPOSED TO ALL THAT DIRT.>>THAT’S THE IDEA. >>WOMAN FROM PIERRE ASKED, TENDERNESS, RED BUMPS AND SCALES ON THE HANDS. DO YOU THINK THIS IS ALLERGY, WHAT’S CAUSING IT, WHAT CAN BE DONE? TENDERNESS, RED BUMPS.>> TENDER, I THINK IS OFTEN THE ALLERGY, WE LIKE TO HEAR ITCHY, ITCHY, ITCHY. AND, SO, IT COULD BE, BUT IT COULD JUST BE A REGULAR HAND ECZEMA. THAT’S A DIFFERENT KIND OF ALLERGY THAN, SAY, THE HAY FEVER. THOSE ARE I.G.E., THE HAND STUFF OFTEN IS A CONTACT DERMATITIS, MORE IN THE POISON IVY CATEGORY. >>DYSHIDROTIC ECZEMA IS SOMETHING I’VE SEEN A LOT. LITTLE BLISTERS, LOTS OF BUMPS ON THE HANDS. YOU THINK THAT’S MORE CONTACT, SOMETHING ALLERGIC THAT YOU’RE TOUCHING? >>NO. USUALLY THAT ONE IS JUST A CONDITION THAT YOU HAVE. AND THEN THEY SEEM TO GET OTHER ALLERGY OR AN ALLERGY ON TOP OF IT BECAUSE THE SKIN’S OPEN. IS EXPOSED TO THINGS. AND THEY USE A LOT OF STUFF ON THEIR HANDS. >>THAT’S DOCTOR TALK, THOUGH. THAT’S A CONDITION YOU HAVE. IN OTHER WORDS, WE DON’T KNOW WHY THE HECK YOU HAVE IT, YOU JUST HAVE IT. >>DYSHIDROTIC ECZEMA, ONE OF THOSE RASHES THAT YOU GET ON YOUR HANDS AND YOUR FEET. [ Laughter ]>>I LIKE THAT. BE HONEST. >>I DON’T KNOW WHAT THAT IS. >>32-YEAR-OLD MAN FROM YANKTON ASKS, I HAD PNEUMONIA IN HIGH SCHOOL AND DEVELOPED AN ALLERGY TO PENICILLIN AT THE TIME. I RAISED MY OWN BEEF TO AVOID PENICILLIN, WHEN I EAT OUT AND GET STEAK, I DON’T FEEL WELL. IS THAT AN ALLERGIC REACTION TO ANTIBIOTICS GIVEN TO THE CATTLE AND ALSO I TAKE SOME KIND OF SCHISANDRA, I DON’T KNOW WHAT THAT IS, TO HELP WITH SYMPTOMS, HEAVY CONGESTION, WHAT ARE YOUR THOUGHTS ABOUT THAT DRUG?>> DON’T KNOW WHAT THAT IS. >>NEVER HEARD OF IT. I DON’T KNOW WHAT IT IS. BUT WHAT ABOUT ANTIBIOTICS IN THE CHICKENS AND THE TURKEYS AND THE BEEF AND THE CATTLE AND THE PORK? I MEAN, I THINK THERE IS SOMETHING TO THAT, THAT ANTIBIOTICS IN THEM WILL GIVE PEOPLE PROBLEMS. >>THERE’S A LOT OF REGULATION AS TO HOW SOON BEFORE SLAUGHTER YOU CAN EVEN HAVE THAT AND HOW MANY OF THEM GET THROUGH. FOR A LONG TIME, CHRONIC URTICARIA OR CHRONIC HIVES WAS THOUGHT TO BE PERHAPS FROM THAT.>>RIGHT. >>AND IT’S BEEN FOUND THAT THE CHRONIC URTICARIA PEOPLE ACTUALLY HAVE AUTO ANTIBODIES AGAINST PART OF THEIR SKIN RATHER THAN BEING ALLERGIC TO THE PENICILLIN AND SUCH. SO A PERSON WHO — RAISES THAT QUESTION TO, IF YOU HAVE A KID, BREAKOUT WITH INFECTION, YOU THOUGHT IT WAS FROM THE ANTIBIOTIC, THERE IS TESTING FOR PENICILLIN NOW, AND A LOT OF PEOPLE WILL HAVE OUTGROWN THAT. SO IS IT REALLY THE ANTIBIOTIC, BECAUSE THAT’S NOT A MAJOR PROBLEM THAT YOU SIGH CLINICALLY. THERE’S A LOT MORE OTHER G.I. DISORDERS OR GALLBLADDERRER, THINGS, FROM THAT KIND OF A MEAL THAT’S GOING TO BE FAR MORE LIKELY.>>AND YOU HEARD IT, I WAS KIND OF SUPPORTIVE OF THIS GENTLEMAN WHO IS WORRIED ABOUT ANTIBIOTICS IN ANIMALS. I’VE SAID THAT VETERINARIANS AND TO FARM PEOPLE, SDSU, CATTLE PEOPLE, AND THEY POOHPOOH IT, IT ISN’T THAT BIG OF A DEAL. >>IT’S RARE.>>IT CAN OCCUR. >>IT WAS A QUESTION THAT I ANSWERED THIS WEEK IN A PATIENT. >>RIGHT.>>YOU KNOW, I THINK THE BIGGER THING IS, ANTIBIOTICS WITH ANIMALS IS RESISTANCE. >>TO THE ANTIBIOTIC.>>TO THE ANTIBIOTIC, SO THAT WHEN WE GET SICK WITH SOMETHING, THE BACTERIA FROM THE COW, WHICH WE GOT INTO US AND IT TRANSFERRED THE RESISTANT GENE AND NOW WE CAN’T GET SAVED FROM OUR PNEUMONIA. THAT’S THE BIGGER CONCERN.>> THAT’S THE BIGGER CONCERN.>> YEAH.>>BUT THIS MAN MAY TRULY BE VERY SENSITIVE IN ANTIBIOTIC. >>YUP.>>THAT COULD BE THE PROBLEM WITH HIM. WHAT ABOUT THE STRIPS ON THE NOSE FOR PEOPLE WHO HAVE CONGESTION? WHAT DO THEY CALL THEM? BREATHE STRIPS.>>BREATHE RIGHT TYPE OF THINGS. JUST KIND OF OPENS THINGS UP. IT CAN BE HELPFUL. NONMEDICATED WAY. AND CAN BE QUITE HELPFUL. ACTUALLY E.N.T. PROCEDURES THAT DO SOMETHING LIKE THAT WHERE YOU KIND OF SHRINK THE INSIDE OF THE NOSE. IF THE CONGESTION’S BIG. IT’S EASY TO PUT THOSE ON.>> EASIER THAN A SURGICAL PROCEDURE. SO YOU WERE TALKING ABOUT URTICARIA, WHICH IS HIVES.>> HIVES. >>LET’S TALK A LITTLE BIT ABOUT THAT BECAUSE A LOT OF PEOPLE SAY, OH, WELL, I’M JUST ALLERGIC TO THIS, I HAVE HIVES, I’M ALLERGIC TO THAT AND I HAVE HIVES. IS IT DIFFERENT THAN THE REST OF THE ALLERGIES? >>ACTUALLY, HIVES IS JUST A RELEASE OF HISTAMINE FROM YOUR MASS CELLS. ALLERGY IS ONE OF MANY CAUSES OF RELEASING THAT HISTAMINE. SO, IF YOU HAVE A FOOD ALLERGY, YOU KNOW, AS PART OF YOUR ANAPHYLACTIC REACTION, YOU’LL HAVE HIVES. AND IT’S REALLY RARE THAT YOU WOULD EVER GET ONLY HIVES FROM A FOOD ALLERGY. YOU SHOULD GET SOME THROAT SWELLING, NAUSEA, VOMITING, SHORT OF BREATH, ALL AT THE SAME TIME THAT YOU’RE GETTING THE HIVES. SPREAD THE PEANUT BUTTER ON YOUR SKIN, YOU’RE GOING TO GET HIVES THERE, THAT’S A CONTACT TYPE OF HIVES, THE DOG LICKING YOU. >>RIGHT.>>BUT NOW, CHRONIC, URTICARIA IS ANOTHER BIRD ALTOGETHER, CORRECT?>>YUP. >>SAY THAT JUST A LITTLE BIT. >>BEFORE I DO THAT, LET ME ALSO SAY, INHALED ALLERGIES, GRASS AND RAGWEED STUFF, YOU HAVE TO HAVE A HORRIBLE STUFFY NOSE BEFORE YOU’RE GOING TO GET ANY HIVES FROM CONTACT FROM THAT. CHRONIC URTICARIA, LIKE YOU WERE ASKING, IS A WHOLE DIFFERENT BOAT. IT’S ALMOST NEVER FROM AN ALLERGY. IT’S AN AUTOIMMUNE DISEASE FOR ALMOST EVERYBODY WHERE THE ANTIBODIES ATTACKING THE MASS CELLS IN YOUR SKIN.>>AND WOULD THAT BE LIKE LUPUS OR RHEUMATOID ARTHRITIS? >>FOR SOME OF THE FOLKS ACTUALLY IT IS. IT’S VERY SIMILAR TO THAT AND CAN BE A SPINOFF OR PRECURSOR, MOST PEOPLE WITH CHRONIC HIVES, IT’S TWO YEARS. >>RIGHT. SO, A LOT OF PEOPLE WILL HAVE, WHEN THEY’RE HAVING HIVES, OR WHEN THEY’RE A SEVERE ALLERGIC REACTION, THEIR AIRWAY WILL CLOSE OFF. AND — >>ANAPHYLAXIS.>>YES.>> THEY’RE IN BIG-TIME TROUBLE. I HAVE A FRIEND WHO CARRIES — WHEN WE GO SAILING, HE TAKES HIS EPIPEN WITH HIM.>>UM-HUM. >>AND THAT’S AN IMPORTANT TREATMENT. ANY COMMENTS ABOUT PEOPLE WHO HAVE HAD ANAPHYLAXIS, THE EPIPEN, AND WE HAVE A VIDEO THAT WE COULD USE TO SHOW THAT. ANY COMMENTS ABOUT EPIPENS?>> EPINEPHRINE CAN BE LIFE SAVING AND IF YOU OR YOUR LOVED ONE IS STARTING TO HAVE A REACTION, THE FASTER YOU CAN GET THAT IN, THE MORE LIKELY YOU ARE TO SAVE SOMEBODY.>> AND IT’S NOT A MAJOR THING.>> JUST A LITTLE TEENY SHoT GOES INTO YOU, GIVES IT AUTOMATICALLY.>>OKAY.>>IT’S EASY. >>LET’S LOOK AT THE VIDEO.>> SO WE’RE GOING TO DO 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 EVEN 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 WE THINK WE MIGHT NEED IT. HOW WOULD 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. >>PARTICULARLY IF YOU KNOW THAT YOU’VE HAD A PREVIOUS REACTION OR YOU KNOW YOU’VE BEEN STUNG AND YOU KNOW THAT THERE’S SOMETHING — I CALL IT THE FEELING OF IMPENDING DOOM. YOU SHOULD DO SOMETHING.>> SOMETHING TO DO. SO I’M HAVING THAT IMPENDING DOOM. I WAS JUST BITTEN BY A WASP — I MEAN, STUNG BY A WASP. OR I JUST ATE A PEANUT AND I’M IN TROUBLE. AND I KNOW THAT IF I DO THIS, IT’S NOT GOING TO PUT ME AT RISK AND IF I DON’T DO THIS, IT’S GOING TO PUT ME AT GREAT RISK. SO I WANT TO DO THIS. SO THIS IS — THIS IS THE EPIPEN. THERE’S ANOTHER PRODUCT, THEY’RE BOTH THE SAME, RIGHT? >>RIGHT. THEY’LL DO THE SAME THING. THEY’LL SAVE YOUR LIFE.>> 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. AND I’M GOING TO — >>OUT OF THE PROTECTIVE CASE. GET RID OF THAT.>>THROW THAT. >>PEN COMES OUT. >>THE COVER COMES OFF.>> THROW IT AWAY.>>ALL RIGHT.>> FULLY ARMED.>>FULLY ARMED. NOW WE’RE READY?>>YOU READY? >>ON YOUR THIGH.>>I PUT IT ON MY THIGH THROUGH MY CLOTHES. >>THROUGH YOUR CLOTHES.>>I’M GOING TO PUSH IT IN.>>AND HOLD IT FOR TEN SECONDS. THERE YOU GO, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10.>>AWESOME.>>I COULD FEEL IT. >>WAY TO GO.>>IT HURT A LITTLE. NOT BAD.>>NOT MUCH. >>NO, JUST A SURPRISE. BECAUSE — >>YEAH.>>IN A MINUTE OR SO HERE, YOU’RE GOING TO FEEL THAT YOUR HEART STARTS BEATING FAST. >>OKAY.>>AND YOU FEEL A LITTLE JITTERY LIKE YOU JUST GOT SCARED AT THE MOVIE THEATER. >>DRANK WAY TOO MUCH COFFEE. >>I WAS GOING TO –>>THE SWOLLEN THROAT, THE ITCHINESS IS GOING TO START RECEDING. AND YOU’LL BE FEELING A LOT BETTER AND 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. >>WELL, THANK YOU.>> WONDERFUL ALLERGIST.>>FOR ACTUALLY DEMONSTRATING IT. THAT WAS AWESOME.>>GREAT. THANK YOU. THANKS FOR LISTENING. STAY HEALTHY OUT THERE, PEOPLE. >>WELL, I WAS A LITTLE JITTERY AFTER THAT. BUT IT WASN’T LIFE-THREATENING. NO BIG DEAL. AND IF THAT HAD BEEN A POSSIBLE, YOU KNOW, MAYBE EVEN A SLIGHTLY POSSIBLE CHANCE THEN IT’S BETTER TO DO IT. TAKE-HOME?>>IF YOU THINK YOU NEED IT, YOU PROBABLY SHOULD HAVE ALREADY GIVEN IT.>>SO GET THAT EPIPEN, IF THERE’S A POTENTIAL CHANCE OF A PROBLEM. SO, WE’VE GOT — YOU KNOW, ANY OTHER SCENARIO, IF YOU’VE GOT ASTHMA, WOULD YOU DO AN EPIPEN? >>USUALLY NOT. IT’S FOR ANAPHYLAXIS.>>FOR PEOPLE WHO HAVE HAD PROBLEMS WITH IT. WE HAVE A CALLER FROM BROOKINGS. MY CHILD IS WHEEZING ON OCCASION. IS THIS ASTHMA? WHAT ABOUT ASTHMA? LET’S TALK ABOUT ASTHMA.>>ASTHMA IS ONE OF THOSE COMMON CHILDHOOD ILLNESSES THAT CAN GO ON INTO ADULTHOOD, THE REST OF YOUR LIFE. WE’VE GOT LITTLE PICTURES HERE WITH AIRWAYS. IT’S THE BRONCHIAL TUBES THAT ARE AN ISSUE. I DON’T KNOW IF THIS IS ON THERE YET.>>THERE WE GO.>> HERE WE GO. SO, ON THIS SIDE, WE’VE GOT THE BRONCHIAL –>>NORMAL.>> NORMALS. AND THE TUBES ARE WIDE OPEN. THE MUSCLES HERE ARE RELAXED. WHERE, ON THE OTHER SIDE, WE’VE GOT THE SQUEEZING THAT’S HAPPENING. IT’S LIKE SOMEONE’S GETTING SCRUNCHED. AND YOU GET RECURRENT EPISODES OF THAT. COUGHING, WHEEZE, TIGHT CHEST. INFECTIONS WITH VIRUSES ARE PROBABLY THE MOST COMMON THING FOR KIDS. IF YOU’VE GOT SOME NUMEROUS EPISODES WHERE YOU’LL HAVE WHEEZING, COUGHING GOING ON FOR A FEW DAYS, YOU DO THAT THREE, FOUR TIMES, A LOT OF THOSE KIDS HAVE ASTHMA. DEPENDING HOW FREQUENT IT IS, THERE’S GREAT PREVENTIVE STRATEGIES, ALBUTEROL TO TAKE IF YOU’VE GOT SYMPTOMS FOR QUICK RELF.>>NOW, THE SHOTS, LET’S SAY YOU’RE ALLERGIC TO SOMETHING, AND THAT BRINGS ON THE ALLERGY. DO THE SHOTS MAKE A DIFFERENCE FOR ASTHMA IN CHILDREN? >>IN LITTLE KIDS, THEY’RE LESS THAN 5, THE AMOUNT OF PROBLEM THAT THEY HAVE WITH VIRUSES IS SO ASTRONOMICAL THAT YOU CAN’T SEE AS MUCH HELP WITH ALLERGY SHOTS, EVEN THE REAL ALLERGIC ONES, THE STUDIES WERE INTERESTING BECAUSE YOU HAVE SOME GOOD NURSES ONCE OR TWICE A WEEK TEACHING THE PARENTS HOW TO TAKE CARE OF THEIR KID’S ASTHMA, THAT WAS PROBABLY THE BIGGEST THING THAT INTERVENTION HAD. >>DO YOU FIND THAT SHOTS HELP ANY GROUP? BECAUSE ADULTS, ASTHMA BECOMES LESS RESPONSIVE AS AN ALLERGIC PROCESS, AM I RIGHT ON THAT?>> WELL, IT DEPENDS. ABOUT 70% OF ASTHMATICS HAVE A HUGE ROLE OF ALLERGY AND IF YOU’RE LOOKING AT SOMEBODY THAT’S GOT CLEAR — THEIR ALLERGY TESTING CORRELATES WITH WHEN THEIR ASTHMA IS BAD, THOSE PEOPLE DO REALLY WELL, USE FAR LESS MEDICATION, THEY HAVE LESS FLARE-UPS, THEY’RE NOT GOING TO THE E.R. AND ALL THAT STUFF. ADJUNCTIVE CARE THAT YOU DO ALONG WITH OTHER THINGS.>>SO, ANYTHING ABOUT ASTHMA — YOU TALK ABOUT ALL OF THE ADJUNCTIVE CARE, IT IS MEDICATION?>>USUALLY IT’S MEDS. SOMETIMES YOU CAN DO SOME AVOIDANCES, BUT IT’S HARD. INHALED CORTICOSTEROIDS ARE THE MAIN THING THAT SAVES LIVES.>>RIGHT. WHAT ARE EXAMPLES OF THAT?>> FLOVENT, QVAR, ASMANEX. PULMICORT. >>A LOT OF MEDICINES COMBINED WITH BETA AGONIST, STEROIDS AND BETA AGONIST, I TEND TO GO TO THAT ONE BECAUSE THAT KEEPS THE PATIENT TAKING THE MEDICINE. WHAT’S YOUR TAKE ON THE COMBINATION DRUG?>>IF YOU WANT A DRUG THAT’S LIKELY TO WORK, YOU WOULD GO RIGHT TO THAT.>>RIGHT.>>THE PROBLEM IS, IT’S TWICE AS EXPENSIVE, 200, 300 BUCKS A CANISTER FOR ONE OF THOSE.>> ADVAIR. >>ADVAIR, DULERA, SYMBICORT, BRIO. THEY’LL WORK QUITE NICELY. IF YOU’VE GOT RATHER SIGNIFICANT ASTHMA, WHICH IS A QUARTER OF THE PATIENTS HAVE SEVERE ASTHMA, IT MAKES A HUGE LIFE-SAVING DIFFERENCE.>>I GENERALLY GET THEM STABLE ON THOSE AND THEN TRY TO MOVE TOWARD THE SINGLE STEROID.>> SINGLE INHALED STEROID. SO YOU STEP DOWN IS WHAT THAT IS. AND MOST PEOPLE ACTUALLY ONCE THEY GET UNDER CONTROL, THAT WILL HAPPEN — YOU’LL BE ABLE TO GET IT TO THEM. >>RIGHT. WE HAVE A QUESTION FROM ALLISTER, SOUTH DAKOTA. 31-YEAR-OLD MAN. WHAT IS THE EARLIEST AGE A CHILD CAN GET DIAGNOSED WITH ALLERGIES? >>I SUPPOSE EVEN BY A MONTH. ALLERGIES IN KIDS ARE GOING TO MOSTLY BE FOODS. SO IT WOULD BE LIKE MILK OR THE SOY THAT THEY MIGHT BE GETTING AS THEIR FORMULA. >>PEOPLE REALLY GET TRUE MILK ALLERGIES, THAT’S DIFFERENT THAN MILK INTOLERANCE AS AN ADULT. SO EXPLAIN THAT JUST A LITTLE BIT.>>SO, THE MILK IS ACTUALLY A FUN SUBSTANCE, YOU KNOW, IT’S DELICIOUS, ICE CREAM CONES, CHOCOLATE MILK AND THINGS. >>RIGHT.>>WHEN I SAY ALLERGY, YOU KNOW, YOU’RE GOING TO BREAK OUT IN HIVES, YOUR THROAT IS SWELLING UP, YOU’RE THROWING UP, YOU CAN’T BREATHE. SO THAT CAN HAPPEN REAL EARLY. WHAT’S REAL COMMON, TOO, IS YOU HAVE MILK INTOLERANCE OR MILK SOY INTOLERANCE AS A BABY AND YOU GET BLOODY DIARRHEA, TERRIBLE ABDOMINAL PAIN, BLOATING, AND THE KID HAS TO GO OFF OF IT. IT IS NOT AN ALLERGY WITH THAT I.G.E. ANTIBODY.>>RIGHT.>> AND THERE’S ALSO LACTOSE INTOLERANCE FROM MILK, IT’S THE SUGAR MOLECULE.>>WHICH MOST ADULTS KIND OF GET INTO. >>A LOT OF ADULTS. >>IF YOU’RE NOT NORWEGIAN.>> NORWEGIANS DO FINE.>> DESENSITIZING THERAPY MAY BE THE WAY TO GO. ESPECIALLY FOR YEAR-ROUND ALLERGIES.>>I FIRST FOUND OUT, I WAS PRETTY YOUNG, 5 OR 6, MY SISTER HAD A DOG AND I WAS PLAYING WITH HIM OUT IN THE GRASS. ORIGINALLY, WE THOUGHT THAT I WAS ALLERGIC TO GRASS, AFTER SOME FURTHER TESTING, FOUND OUT IT WAS ACTUALLY THE DOG THAT I WAS ALLERGIC TO. AT FIRST IT WAS A BLOOD TEST THAT MY FAMILY DOCTOR HAD DONE, RECOGNIZED SOME ALLERGIES. WE KIND OF WENT WITH THAT FOR A WHILE. EVENTUALLY WENT BACK TO DR. BUBAK AND WE DID SOME SKIN TESTING. ORIGINALLY I STARTED OUT WITH MEDICATIONS, BUT THAT WAS BEFORE I HAD A DOG, WHEN I KNEW I WAS GOING TO GET ONE, I STARTED ALLERGY SHOTS BEFORE THAT. EVEN WHEN I WAS JUST ON MEDICATION, MY SISTER HAS ALWAYS HAD DOGS, FAMILIES HAD DOGS, TOO, IT’S TOUGH TO BE AROUND THEM. THE WAY I UNDERSTAND IT, THERE’S A FEW DIFFERENT OPTION, I DID A LITTLE BIT QUICKER OPTION, I’D GO IN GET THREE SHOTS A DAY, COUPLE TIMES A WEEK FOR A WHILE UNTIL I GET BUILT UP CLOSER TO MY MAINTENANCE. NOW THAT I’M ON MY MAINTENANCE SCHEDULE, IT’S ONCE A MONTH I GO IN AND GET A SHOT, NOT NEARLY AS MUCH ANYMORE. SO KIND OF THE FURTHER YOU GET OUT FROM THE START, THE LESS YOU HAVE TO DO. NOW I DON’T NECESSARILY DO ANYTHING SPECIAL. YOU KNOW, IF I KNOW I’M GOING TO GO TO A PLACE THAT HAS MAYBE MORE CATS OR DOGS OR SOMETHING, I MIGHT TAKE A ZYRTEC BEFOREHAND, OTHER THAN THAT I DON’T HAVE TO DO MUCH FOR IT ANYMORE. AS PRIOR, I WOULD HAVE TRIED TO AVOID THEM COMPLETELY. AND IF NOT, I’D DEFINITELY BE ON ZYRTEC, BENADRYL, FLONASE, ANYTHING YOU CAN POSSIBLY DO AND HAVE UNCONTROLLED SYMPTOMS. EVER SINCE I STARTED THE ALLERGY SHOTS, THE ALLERGIES ARE MUCH IMPROVED WITH THE DOG, SOMETIMES I HAVE TO DO FLONASE, BUT OVERALL THE SHOTS HAVE DONE A GREAT JOB. IT’S WORKED GREAT FOR ME. I GET ASKED ALL THE TIME, HOW MUCH MY SYMPTOMS HAVE IMPROVED, MY GUESS WOULD BE 95% OR BETTER. SO, I RECOMMEND SHOTS TO WHOEVER CAN HAVE THEM. >>SO HE HAD DESENSITIZATION SHOTS, IN OTHER WORDS, HE’S ALLERGIC TO DOG, SO HE GOT A LITTLE DOG, A LITTLE HIGHER DOG, A LITTLE MORE DOG, DOG DANDER, SALIVA, WHAT IS IT IN THE DOG?>>A LITTLE BIT OF ALL OF THAT. FOR DOGS. MAINLY DANDER AND, YOU KNOW, WITH EACH ALLERGY THING THAT DOG OR CAT OR RAGWEED, THERE’S A CERTAIN DOSE YOU NEED TO GET PEOPLE TO AND, SO, WE BUILD THEM UP TO THAT. IT’S USUALLY ABOUT 10,000-FOLD STRONGER THAN WHEN WE START. BY GETTING TO THAT HIGH DOSE, YOU’RE ACTUALLY ABLE TO RETRAIN THE IMMUNE SYSTEM SO JUST TOLERATES IT A LOT MORE. YOU DON’T CURE THEM, YOU GET A MARKED DECREASE IN SYMPTOMS.>> SO THE ANTIBODY, I.G.E. ANTIBODY, GLOMS ON, BEFORE THE I.G.E., THAT WAS THE OLD THING THAT I LEARNED 30 YEARS AGO. IS THAT STILL THE CASE? >>YOU CAN ACTUALLY SEE THE I.G.G., LIKE, GOAT, ANTIBODY ELEVATING, WE’RE NOT SURE THAT IT’S REALLY BLOCKING, PROBABLY MORE WITH THE T CELLS.>>THEY SAY, HEY, WE’RE USED TO IT NOW.>>NOT A BIG DEAL. >>WE’VE GOT A CALLER FROM REDFLD WITH A RELATED QUESTION. I THINK MY 3-YEAR-OLD CHILD HAS ALLERGIES TO CATS AND WE OWN AND LOVE THREE HOUSE CATS. WHAT CAN WE DO?>>I THINK GRANDMA MIGHT NEED SOME CATS. >>GRANDMA NEEDS CATS. >>YEAH.>>GET RID OF THE CATS.>>THAT’S THE BEST THING, CLEAN EVERYTHING UP. THAT’S IN A PERFECT WORLD. I’LL BE HONEST WITH YOU. MOST PEOPLE WHO HAVE THREE CATS LOVE CATS. AND 3-YEAR-OLDS, YOU’RE GOING TO BE TREATING WITH MEDICATION FOR A WHILE. OCCASIONALLY WOULD CONTEMPLATE ALLERGY SHOTS, BUT MOST OF THE TIME YOU’RE GOING TO DO SHOTS WHEN THEY’RE OLDER. 8 OR SOMETHING LIKE THAT.>>SO YOU DON’T WANT TO START THE SHOTS BEFORE 8.>>WE CAN. YOU CAN. BUT LIKE 5 1/2 TO 7, MOST KIDS ARE SO NEEDLE PHOBIC YOU CAN’T DO IT. 3 OR 4-YEAR-OLD THAT CAN TALK AND TELL YOU IF THEY’RE REACTING, YOU CAN CONSIDER IT. >>GET RID OF THE CAT. GRANDMA NEEDS THE CAT. 21-YEAR-OLD — THAT’S A SAD ANSWER, BUT IT’S REALLY THE TRUTH, ISN’T IT? >>UM-HUM.>>21-YEAR-OLD FROM SERGEANT BLUFF, IOWA, ASKS, HELLO, SERGEANT BLUFF, WHAT ARE SOME PREVENTIVE MEASURES WE CAN TAKE TO HELP WITH SPRINGTIME ALLERGIES?>>SO, I MEAN, WE TALKED ABOUT IT, BUT JUST HIT IT AGAIN. IF I GET ALLERGIC, MIDDLE OF APRIL EVERY YEAR? >>NUMBER ONE, IT’S GETTING NICE OUT. DON’T OPEN YOUR WINDOWS. KEEP THE DOORS AND WINDOWS CLOSED. YOU WON’T GET AS MUCH OF THE POLLEN INSIDE. IF WE KNOW THAT YOU GOT THE TREE SEASON, SAY, MARCH 15th, ON YOUR SMARTPHONE, START MY RHINOCORT. AND DO IT FOR THE NEXT TWO MONTHS. THOSE ARE THE TWO BIG THINGS. >>SO CLOSE THE WINDOWS, TURN ON THE A.C. WHEN YOU NEED TO AND START YOURSELF ON STEROIDS –>>NASAL STEROID SPRAY TWO WEEKS BEFORE IT WOULD START UP.>>IT’S NOT HARD. >>JUST NEED TO KNOW.>>MY CHILD HAS TERRIBLE ECZEMA. IS HE MORE LIKELY TO HAVE PROBLEMS WITH AIR-BORN ALLERGIES?>>ECZEMA IS A COMPLICATED STORY. IT’S SORT OF LIKE CHRONIC URTICARIA, IS IT NOT?>>BOTH ARE ITCHY. SO, ECZEMA IS IN THE SAME TRIAD OF GENETIC PROBLEM AS ASTHMA, ALLERGY NOSE, AND THEN THE ECZEMA. AND, SO, IF YOU’VE GOT ECZEMA, YOU ARE MORE LIKELY TO GET HAY FEVER AND ASTHMA THAN OTHER PEOPLE ARE.>>AND ECZEMA, HOW WOULD I KNOW I HAVE ECZEMA?>> IT WOULD BE THICKENED SKIN THAT’S REAL SCRATCHY, IN A LITTLE KID IT’S GOING TO BE MORE ON THE HEAD AND THE LOWER LEGS, BUT THEN AS WE GET OLDER, IT STARTS DOING THE CREASES AND –>>CREASES HERE. >>ELBOWS, BACK OF THE KNEES IS CHARACTERISTIC DISTRIBUTION.>> AND, SO, THE TREATMENT, AGAIN, IS? TOPICAL STEROIDS?>>THE BIG THING IS, AFTER YOUR BATH OR SHOWER, YOU HAVE THREE MINUTES, AND YOU HAVE TO PUT A GOOD THICK MOISTURIZER ON. AND YOU PUT MOISTURIZER ON A SECOND TIME A DAY. AND THAT’S THE UNDERLYING, MOST IMPORTANT PART. >>BEFORE THREE OR FOUR MINUTES ARE DONE, AFTER YOU’VE DRIED OFF, PUT THE MOISTURIZER, PARTICULARLY THOSE AREAS LIKE CERAVE, FOR EXAMPLE, CERAVE CREAM IS EVEN BETTER THAN CERAVE LOTION, WHICH IS WONDERFUL STUFF.>> WHATEVER YOUR FAVORITE IS. TELL THE MOMS WITH LITTLE BOYS, JUST DON’T HAVE THEM SMELL LIKE A GIRL. >>YEAH. SO THE CERAMIDE, THERE’S A LOT OF OTHER AGENTS THAT HAVE THE CERAMIDE, THAT’S THE ACTIVE AGENT, YOU CAN SEE IT IN CERAVE, IT’S C-E-R-A-V-E, BUT THERE ARE OTHER VERSION THAT IS HAVE THE CERAMIDE. 40-YEAR-OLD WOMAN FROM MINERAL, SOUTH DAKOTA, ASKS IS ANGIOEDEMA AN ALLERGIC REACTION? WHAT IS ANGIOEDEMA, MARK?>>ANGIOEDEMA IS THE THICK SWELLING, SO IT’S GOING TO BE DEEPER IN THE SKIN THAN THE MOSQUITO BITE, HIVE TYPE OF THING. IT’S CAUSE THE BY BRADYKININ IS THE SUBSTANCE. AND OCCASIONALLY IT’S PART OF AN ALLERGIC REACTION. THOSE ANGIOEDEMA ARE GOING TO ITCH. THE OTHER ONES THAT ARE MORE COMMON ACTUALLY DON’T I HOPE. SO, BLOOD PRESSURE MEDICINE THAT’S AN ACE INHIBITOR, LISINOPRIL IS GOING TO BE THE MOST COMMON CAUSE THAT WE’LL EVER SEE. THERE’S SOME FAMILIAL DISORDERS WHERE PEOPLE DO THAT. >>HOW DO YOU DIFFERENTIATE ANGIOEDEMA FROM URTICARIA, FOR EXAMPLE? >>THE HIVE, WE LIKE TO SEE IT COME AND GO. IT’S REAL ITCHY, FOR SURE IT’S NOT GOING TO LAST 24 HOURS. >>RIGHT.>>ANGIOEDEMA, TYPICALLY WILL BE A LOT DEEPER, IT USUALLY FEELS WOODY, KIND OF LIKE YOU HAD YOUR NOVOCAINE AND IT OFTEN LASTS UP TO TWO DAYS.>>OKAY. >>IT’S NOT GOING TO LAST MORE THAN THREE DAYS, IF YOU GET — THAT WILL BE SOMETHING ELSE, IF THAT HAPPENS.>>BUT IT’S MOSTLY AN ALLERGIC REACTION?>> MOSTLY NOT. >>OH, IT’S NOT? SO WHAT DO YOU DO?>>IT’S OFTEN NOT. AND IT’S CAUSED BY OTHER MECHANISMS. IF IT’S ITCHY, THEN ALLERGY MAY PLAY A ROLE.>>AND SO WHAT DO YOU DO? YOU GO TO THE DOCTOR. >>YEAH. YOU TRY TO FIGURE OUT IF IT’S THE HEREDITARY ANGIOEDEMA AND THERE’S SOME MEDICATIONS THAT CAN BE GIVEN. BIG THING, SIDE EFFECT OF YOUR BLOOD PRESSURE MEDICINE.>>ACE INHIBITORS. >>BECAUSE THAT’S THE MOST COMMON.>>WE JUST GOT A QUESTION. HOW ABOUT LISINOPRIL LIKE YOU JUST TALKED ABOUT, OR AN ACE INHIBITOR ASSOCIATING WITH ESOPHAGITIS, WE JUST TALKED ABOUT THAT, TOO? YOU SEE THAT COMBINATION?>>I GUESS IT WOULD BE POTENTIAL, IT’S PRETTY UNLIKELY, THOUGH. THAT WOULD BE MORE JUST WITH A DRUG ALLERGY. >>OKAY. AND THE MOST COMMON CAUSE OF THE ESOPHAGITIS, ONCE AGAIN IS? >>MILK.>>OH, IT’S MILK? >>YUP. THAT’S THE NUMBER ONE. >>NO KIDDING. AND NEXT IS SHELL FISH?>>NO. IT WOULD BE EGG AND WHEAT.>> SO THEN AFTER THAT IS SHELL FISH? >>WE DON’T EAT A LOT OF SHELL FISH. SO IT WOULD BE SOY.>> OKAY.>>PEANUT BUTTER. >>OKAY.>>THIS IS SOUTH DAKOTA. WE WANT OUR BEEF AND PORK AND CHICKEN. >>AND THEN — SHE WILL FISH. >>AND IT CAN BE THE BEEF, PORK, CHICKEN. >>SO I HAD A GUY WHO I THOUGHT HAD ECZEMA. HE SAID, BUT, BOY, I DON’T HAVE THIS PROBLEM EXCEPT WHEN I’M PREPARING SHRIMP. AT THE PUB. THAT I’M WORKING AT. AND, SO, I TOLD HIM, HE CAN’T PREPARE SHRIMP ANYMORE. >>YUP. THAT FIXED IT, DIDN’T IT?>>IT SOLVED THE PROBLEM. 64-YEAR-OLD PERSON CURRENTLY LIVING IN SIOUX FALLS, GREW UP ON FARMS, LIVED IN LARGE CITIES AS WELL. ABOUT FIVE OR SO YEARS AGO, I STARTED EXPERIENCING ALLERGY SYMPTOMS IN THE SPRING AND THE FALL. WHY DID THEY START LATER IN LIFE? 64.>>ALLERGIES ARE SOMETHING THAT CAN START AT ANY AGE. AND FEEL LUCKY WHEN YOU DON’T HAVE THEM FOR MOST OF YOUR LIFE. >>OKAY. SO, IT’S JUST THE LUCK OF THE DRAW.>>YUP.>>I MEAN, SOMETHING SENSITIZED YOU. >>JUST THE WRONG EXPOSURES, INFECTIONS THAT THE WAY YOUR GENETICS INTERACTED WITH THE ENVIRONMENT. >>I HAVE SAMTER’S TRIAD. I DON’T KNOW WHAT THAT IS.>> THAT WOULD BE NASAL POLYPS, ASTHMA, AND WHEN YOU HAVE ASPIRIN, YOU HAVE A HORRIBLE ASTHMA ATTACK. AND IT CAUSES THE POLYPS TO GROW.>>I DIDN’T KNOW THAT WAS SAAPERS TRIAD. WANTED TO KNOW ABOUT PROCESS THAT CAUSED ASPIRIN ALLERGY THAT CAME ON WHEN HE WAS 62. >>SO PSYCHO OXYGENASE ISN’T WORKING WELL AND IT SHUNTS A BUNCH OF REACTIVE SUBSTANCES THE WRONG WAY, VOILA, YOU’RE SICK. IT’S NOT REALLY AN ALLERGY. IT’S A BIOCHEMICAL PROBLEM WITH ENZYMES. AND FOR SOME PEOPLE WHO ARE HAVING A LOT OF PROBLEMS, WE DESENSITIZE YOU TO THE ASPIRIN. YOU START A TEENY DOSE OF ASPIRIN TYPE OF STUFF THAT WE SQUIRT UP YOUR NOSE, SQUIRT SOME MORE, SOME MORE. IT’S A TWO-DAY PROCESS. IT CAN SLOW DOWN THE GROWTH OF YOUR POLYPS. AND IT CAN HELP OUT WITH SEVERITY OF YOUR ASTHMA.>>ALL THE PEOPLE WITH ASTHMA AND POLYPS HAVE THIS?>>NO.>> OKAY. SO POLYPS CAN OCCUR ANYWAY?>>AND NOT BE RELATED TO THE OTHER STUFF.>>NOT BE RELATED AT ALL. PLUGGED-UP EARS AN INDICATOR OF ALLERGIES? >>OCCASIONALLY. YOU’D HAVE TO HAVE ITCHY, SNEEZY NOSE, TOO, MOST OF THE TIME.>>OKAY. 30 SECONDS, 86-YEAR-OLD WOMAN FROM SIOUX FALLS, I’M ALLERGIC TO AN OPIUM-BASED DRUG. TELL ME WHAT THIS MEANS. ANY OPIUM-BASED.>>OPIUM, NARCOTIC DRUGS ARE DIRECT STIMULANTS TO FIRE OFF MASS CELLS, AND IF IT’S TO ALL THEM, THAT’S PROBABLY THE MECHANISM.>>ALL RIGHT. WELL, I THINK THAT’S IT FOR NOW. AND NOW FOR THE WINNER OF TONIGHT’S PRAIRIE DOC QUIZ QUESTION. ONE RAGWEED PLANT CAN PRODUCE HOW MANY POLLEN GRAINS IN A SEASON? A) 100 B) 5,000 C) ONE MILLION D) ONE BILLION THE CORRECT ANSWER IS D, ONE BILLION! IT WAS WAYNE FAUTH FROM BROOKINGS WHO ANSWERED THE QUESTION CORRECTLY. THANK YOU, WAYNE, FOR PARTICIPATING. AND A BOOK WILL BE IN THE MAIL TO YOU SOON. MARK, IF ONE PLANT MAKES A BILLION POLLEN GRAINS, HOW MANY POLLEN GRAINS DOES IT TAKE TO SCREW IN A LIGHT BULB? NO. [ Laughter ] HOW MANY GRAINS DOES IT TAKE TO CAUSE AN ALLERGIC REACTION? SO, I MEAN, ONE PLANT MAKES A BILLION. HOW MANY POLLEN GRAINS TO I NEED –>>JUST A FEW. YOU KNOW, WITH RAGWEED, WHAT’S AMAZING IS THEY’VE DONE STUDIES IN 400 MILES OUT TO SEA, YOU CAN STILL FIND RAGWEED POLLEN.>>400 MILES OUT TO SEA AND PEOPLE STILL HAVE AN ALLERGIC REACTION.>>YOU DON’T HAVE TO BE STANDING RIGHT NEXT TO THAT RAGWEED. >>IT’S REALLY — BUT IF I’M EXPOSED TO A TON OF THEM, IS IT GOING TO BE A WORSE ALLERGY? >>YEAH.>>SO, IT’S –>>DOSE DEPENDENT. LOWER DOSE, THAT’S WHY CLOSING YOUR HOUSE UP, RUN THE AIR CONDITIONER HELPS DECREASE YOUR SYMPTOMS SOME.>>SOME. >>YEAH.>>NOT COMPLETELY. ALL RIGHT. WE’LL BE RIGHT BACK AFTER THIS. >>AS YOUR BABY GROWS, THERE ARE NEW SURPRISES AND ADVENTURES EVERY DAY. WITH EACH NEW MILESTONE, REMEMBER, IMMUNIZATIONS ARE SAFE. AND ONE OF THE BEST WAYS TO PROTECT AGAINST SERIOUS DISEASES, ESPECIALLY BETWEEN BIRTH AND AGE 5.>>NOW THAT MY GRANDSON, HENRY, HAS REACHED HIS 1st BIRTHDAY AND OUR GRANDDAUGHTER, STELLA, HAS ARRIVED, WE’RE MAKING SURE THAT THEY STAY ON THEIR IMMUNIZATION SCHEDULES.>> SCHEDULE YOUR CHILDREN’S IMMUNIZATIONS TODAY, FOR BABY’S SAKE. >>HIS RASH WAS ITCHY, RAISED, RED, BLISTERY, AND DISTRIBUTED IN STREAKS ALONG BOTH FOREARMS. LIKELY THIS WAS FROM POISON IVY, ESPECIALLY SINCE HE HAD BEEN CAMPING AND HUNTING FOR FIREWOOD IN A WOODY AREA THAT WEEKEND. ALTHOUGH IT WAS TOO EARLY IN THE SPRING TO SEE THE GROUPS-OF-THREE GLOSSY-POINTED-LEAFED PLANTS, HE HAD BEEN PULLING ON FURRY-ROPE-LIKE WOODY VINES, PROBABLY THE WINTER-VINE FORM OF THE POISON PLANT. ALLERGISTS AND DERMATOLOGISTS CALL THE RASH FROM POISON IVY A FORM OF CONTACT DERMATITIS, WHICH IS AN ALLERGIC REACTION TO THE OIL OF THE PLANT. FIRST EXPOSURE TO THE POISONOUS OIL IS THE SENSITIZING DOSE AND GENERALLY DOESN’T CAUSE A RASH. THE NEXT EXPOSURE, HOWEVER, BRINGS ON THE ALLERGIC ERUPTION. 85% OF ADULTS HAVE BEEN SENSITIZED TO POISON IVY OIL, SOMETIME IN THE PAST. MANY OTHER AGENTS CAN ALSO CAUSE CONTACT DERMATITIS, BUT RARELY SO VIOLENT AS FROM OIL OF POISON IVY. ABOUT 15% OF US REACT TO NICKEL, WHICH IS CHARACTERIZED BY A DRY SCALY RASH, HIVES, OR BLISTERS DISTRIBUTED ON EAR LOBES, AROUND NECKLACES, OR UNDER WRIST WATCHES. OTHER ALLERGIC CONTACT CULPRITS INCLUDE LATEX OR RUBBER USED IN SHOES AND GLOVES; INGREDIENTS IN HAIR DYES AND SHELLFISH; PERFUMES BLENDED WITH COSMETICS,NAIL-POLISH, AND SKIN-CARE-PRODUCTS; STICKY ADHESIVES USED ON TAPE, FALSE-EéASHES, AND TOUPEES; AND ANTIBIOTICS FOUND IN NEOSPORIN, BACTROBAN, AND TRIPLE ANTIBIOTIC OINTMENTS. OTHER FORMS OF CONTACT DERMATITIS ARE NOT ALLERGY DRIVEN AND HAPPEN BECAUSE THE AGENT IS FRANKLY TOXIC, LIKE BLEACH, KEROSENE, BATTERY ACID, AND CEMENT. ALSO IRRITATING IS WHEN THERE IS EXCESSIVE WETNESS, WASHING, AND DETERGENTS. ANOTHER KIND OF CONTACT DERMATITIS FOLLOWS THE COMBINATION OF SUN EXPOSURE AND CERTAIN PERFUMES, INSECTICIDES AND OIL FROM THE SKIN OF A LIME. OF COURSE, TREATMENT DEPENDS SOMEWHAT ON THE SPECIFIC AGENT THAT CAUSES THE PROBLEM. CLEANSING THE ALLERGEN AWAY MIGHT BE IMPORTANT. PROTECTING WITH BARRIER CREAMS AND OINTMENTS LIKE ZINC OXIDE OR CERAVE MIGHT HELP. SOMETIMES ORAL, NOT TOPICAL, ANTIHISTAMINES HELP, LIKE ZYRTEC OR ALLEGRA TABLETS DAILY, BUT NOT BENADRYL LOTION. NORMALLY, HOWEVER, TOPICAL STEROIDS, LIKE CORTISONE OR TRIAMCINOLONE CREAM, ARE NEEDED TO TURN OFF INFLAMMATION. AND WHEN THE REACTION IS SEVERE ENOUGH, A TABLET OR INJECTABLE FORM OF STEROID MAY BE PRESCRIBED BY YOUR DOCTOR. THE MOST IMPORTANT LESSON SHOULD BE AVOIDING THE ALLERGIC OR TOXIC AGENT IN THE FIRST PLACE. MY POISON IVY PATIENT WAS CAREFUL WHEN HE WAS IN THE WOODS FROM THAT DAY FORWARD, ESPECIALLY WHEN ENCOUNTERING FURRY-ROPE-LIKE WOODY VINES. [MUSIC] >>A BIG THANK YOU TO OUR GUEST, DR. MARK BUBAK, IT IS ALWAYS A GOOD SHOW WHEN HE VOLUNTEERS TO COME TO THE STUDIO. AND ALSO HE’S ON OUR BOARD OF DIRECTORS AND WE APPRECIATE HIS TIME AND EFFORT.>>YOU’RE WELCOME. >>THANK YOU SO MUCH FOR ALL YOUR HELP THERE.>>>VIEWERS HAVE ASKED IF THERE IS A WAY TO GET A COPY OF OUR BOOK THE PICTURE OF HEALTH, BESIDES WINNING THE QUIZ QUESTION. GO TO OUR WEBSITE, PRAIRIEDOC.ORG AND CLICK ON THE “DONATE” BUTTON. THERE YOU MAY JOIN IN AND HELP BY UNDERWRITING OUR EFFORTS FOR HONEST-SCIENCE BASED, PUBLIC-HEALTH-EDUCATION. PLEASE FOLLOW THE DIRECTIONS THERE AND SEND YOUR DEDUCTIBLE GIFT TO HEALING WORDS FOUNDATION. FOR GIFTS OF $100 OR MORE, I WILL SEND YOU A PERSONALIZED AUTOGRAPHED COPY. THANK YOU IN ADVANCE FOR YOUR GENEROSITY AND SUPPORT OF THESE EFFORTS TO IMPROVE THE LIVES OF VIEWERS LIKE YOU. THIS WILL BE THE LAST “LIVE” SHOW THAT I WILL HOST THIS SEASON. NEXT WEEK, AN OLD FRIEND, LINDSEY MEYERS, WILL HOST AND THEN WE HAVE SEVERAL NEW SHOWS THAT WERE PREVIOUSLY RECORDED TO FINISH OUT OUR 14TH SEASON. WE HAVE ALREADY BEGUN PLANNING AND PREPARATION FOR NEXT SEASON. OUR TOPICS AND GUESTS ARE BEING LINED UP AND WE HOPE THAT YOU WILL INVITE US INTO YOUR HOMES AGAIN IN THE FALL. I HUMBLY THANK YOU, OUR VIEWER FRIENDS, FOR ALL OF YOUR SUPPORT OVER THE YEARS, IT MEANS A LOT TO KNOW THAT YOU ARE OUT THERE. THAT DOES IT FOR TONIGHT, FROM ALL OF US HERE AT “ON CALL WITH THE PRAIRIE DOC,” UNTIL NEXT TIME, STAY HEALTHY OUT THERE, PEOPLE. [MUSIC] >>WHEN YOU RECEIVE A DIAGNOSIS OF CANCER, YOU KNOW YOUR LIFE IS GOING TO CHANGE. SOME OF THOSE CHANGES AFFECT YOU PHYSICALLY AND EMOTIONALLY. BREAST CANCER, NEXT TIME “ON CALL WITH THE PRAIRIE DOC.”


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