Living with Allergies PDF
Preview Living with Allergies
LIVING with ALLERGIES Also in the Teen’s Guides series Living with Alcoholism and Addiction Living with Anxiety Disorders Living with Asthma Living with Cancer Living with Diabetes Living with Depression Living with Eating Disorders LIVING with ALLERGIES Paul M. Ehrlich, M.D. with Elizabeth Shimer Bowers Living with Allergies Copyright © 2009 by Paul M. Ehrlich, M.D. All rights reserved. No part of this book may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage or retrieval systems, without permission in writing from the publisher. For information contact: Facts On File, Inc. An imprint of Infobase Publishing, Inc. 132 West 31st Street New York NY 10001 Library of Congress Cataloging-in-Publication Data Ehrlich, Paul M. Living with allergies / by Paul M. Ehrich, with Elizabeth Shimer. p. cm — (Living with allergies) Includes bibliographical references and index. ISBN-13: 978-0-8160-7327-6 (alk. paper) ISBN-10: 0-8160-7327-9 (alk. paper) 1. Allergy. I. Bowers, Elizabeth Shimer. II. Title. RC584.E37 2007 616.97—dc22 2008034352 Facts On File books are available at special discounts when purchased in bulk quantities for businesses, associations, institutions, or sales promotions. Please call our Special Sales Department in New York at (212) 967-8800 or (800) 322-8755. You can find Facts On File on the World Wide Web at http://www.factsonfile.com Text design by Annie O’Donnell Cover design by Jooyoung An Printed in the United States of America Sheridan Hermitage 10 9 8 7 6 5 4 3 2 1 This book is printed on acid-free paper. CONTENTS ■ ■ 1 What Are Allergies? 1 ■ ■ 2 Is It Really an Allergy? Getting a Diagnosis 14 ■ ■ 3 Allergy Triggers 25 ■ ■ 4 Fighting Back: Allergy Medications 38 ■ ■ 5 Prevention: Staving Off an Allergy Attack 51 ■ ■ 6 Allergies at School 73 ■ ■ 7 Allergies and Your Social Life 90 ■ ■ 8 It’s in What You Eat: Food Allergies 102 ■ ■ 9 Managing Allergies into the Future 122 ■ ■ 10 Helping Friends and Family Cope with Allergies 132 ■ ■ 11 Paying for Care 142 Appendix: Associations and Resources 147 Glossary 150 Read More About It 158 Index 160 1 What Are Allergies? TT To Paul, 15, peanuts are like poison. When his mom fed him peanut butter for the fi rst time when he was fi ve, his throat closed, and he nearly died. At the hospital, doctors gave Paul an adrenaline shot and told his mother that he had a severe peanut allergy and would have to avoid contact with peanuts and nuts for the rest of his life. Even a tiny speck of food containing peanuts could be deadly to him. Since then, Paul has accidentally encountered peanuts on a few different occasions, and he was sent to the emergency room each time. When he is exposed to a nut, Paul immediately feels a tight, tingling sensation in his mouth and throat. He then develops hives on his skin, and his lips become hot and swollen. In sensitive people like Paul, peanut and nut allergies can trigger swelling of the mouth and throat, low blood pressure, spasms in their breathing tubes, and anaphylactic shock. The last time Paul had a reaction, he was in the cafeteria at school. Someone at his lunch table opened a bag of peanuts, and the dust from the nuts triggered an attack. Paul swelled up immediately, and an ambulance came for him. Once he arrived at the hospital, a shot of adrenaline saved Paul once again. Paul has been lucky: Each time he has been exposed to peanuts and suffered a reaction, he has gotten to the hospital in time, but other teenagers with similar allergies have not been so fortunate. Recent news stories have made the public more aware of how 1 2 Living with Allergies sensitive some patients with peanut and nut allergies really are. According to the Food Allergy and Anaphylaxis Network, teens with peanut and nut allergies are at the highest risk for a fatal reac- tion for a few reasons: They might not recognize early symptoms; they may not have the appropriate medication with them; and their friends may not realize the severity of the situation and therefore not call for help fast enough. They may also have asthma, which can exacerbate the problem. The good news is that there are some things Paul—and you, if you have allergies—can do to ease his mind and the worried minds of his parents and friends. For one, Paul can carry a Twinject or EpiPen. These are prescription-strength epinephrine auto-injectors that teenagers with severe allergies can carry with them in case they suffer an emergency attack. Paul knows what foods he can safely eat and which ones to avoid. He also makes sure to inform new friends about the issue. Because he is armed with knowledge about how to safely manage his allergy, Paul leads a pretty normal life as a teenager. Of course, relatively few people have a life-threatening reaction like Paul’s. It’s much more likely that you or your friends have a more common allergic reaction, like sneezing fi ts or a stuffy nose during “pollen season” in early spring. Both kinds of reactions—and many more—are symptoms of what doctors call allergies. WHAT IS AN ALLERGY? The word allergy comes from the Greek word allos, which means “an altered state.” An allergy is your immune system’s abnormal response to things that are harmless to other people. When you are allergic to something, your immune system thinks the substance—food, dust, pollen, medicines, and so on—is harmful to your body. In response, it sends off a false alarm in the form of an allergic reaction. More specifi cally, in an attempt to protect your body from the substance it thinks is harmful, your immune system produces what are known as IgE antibodies to that allergen. These antibodies cause certain cells in your body to release chemicals into your bloodstream, including cytokines, leukotrienes, and a chemical called histamine. This histamine is what causes the annoying reaction in your eyes, nose, throat, lungs, skin, or intestinal tract, which is why you take a medication called an antihistamine to make the allergic reaction stop. It works like this: When you are approached by a bacteria or some- thing foreign, you produce an antibody against it. Then the next time What Are Allergies? 3 your body encounters that substance, the antibodies attack it before it can produce any symptoms. In nonallergic people, DNA is not programmed to produce the IgE antibody. These people can smother themselves with peanut butter and not have a problem. If, however, you are programmed to produce IgE antibodies in response to that particular substance, you will have a reaction. The IgE antibodies have claws like lobsters. The dust, mold, or other allergen fi ts into those claws and forms a bridge that allows the allergens into your bloodstream where they can wreak havoc. An important part of the allergic reaction is a cell called a mast cell. Mast cells are like a combined command center and military base for your body. When you encounter a substance you are allergic to, the IgE antibodies hook on to mast cells—about 10,000 IgE molecules per mast cell—and the mast cells take on water, swell, and burst, releasing the histamine that causes hives, itching, sneezing, and other annoy- ing allergy symptoms. You have mast cells all over your body—in your skin, respiratory system, eyes, and gastrointestinal tract—which is why allergic reactions can occur in all these areas. You can think of an allergic reaction in your immune system like a guard dog; your immune system means well, but it becomes con- fused and reacts inappropriately. When it is properly trained and in its proper place, a guard dog offers protection against invaders (or, in the case of the immune system, bacteria and viruses). However, allergies are like guard dogs turned loose in a residential neighborhood—any innocent thing that comes across their path is in great danger. What’s more, your immune system has a memory. Each time your immune system comes across an allergen, it produces more antibod- ies faster than the time before. Different chain reactions occur in response to the dust, mold, pollen, food, or other thing to which you are allergic. Some of these chain reactions are merely annoying, and others are very dangerous. Milder allergic reactions come in the form of slightly itchy eyes, a runny nose, itchy throat, or other uncomfortable symptoms. Severe allergic reactions, on the other hand, can threaten your life and should be taken seriously. The most severe allergic reaction is called anaphylaxis, which involves diffi culty breathing, diffi culty swallow- ing, dizziness or passing out, and swelling of the lips, tongue, throat, or other parts of the body. Anaphylaxis, which is the reaction Paul and others with peanut allergies experience after eating nuts, usu- ally happens minutes after you’ve been exposed to an allergen, but it can also be delayed for as long as four hours. Luckily, these severe anaphylactic allergic reactions are rare, and they can be successfully treated if you follow the proper medical procedures.
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