Sneezing Up a Storm
Sneezing Up a Storm
For those people lucky enough to not have allergies, the misery allergies can inflict is something of a mystery. Yet, for those unfortunate individuals that suffer from allergies, the abiding mystery is how to live with them.
Allergies are an increasing health problem. According to the data provided by the American Academy of Allergy, Asthma & Immunology (AAAAI), allergies affect approximately 50 million people in the U.S. It is even more alarming that a study conducted by the Centers for Disease Control (CDC) established that, in the period between 1997 and 2011, prevalence of food allergies among children increased by 50%.
According to Dr. Sonia Kamboj, board-certified allergist and immunologist at West Jefferson Medical Center (WJMC), the reason for these increases is also something of an ongoing mystery.
“We are still learning about why people develop allergies,” said Dr. Kamboj. “We don’t have an exact answer, but there seems to be some kind of genetic predisposition. We see multiple possible causes, including genetics, our changing environment, global warming, even changes in the way that our food is processed. It is a complex issue.”
A graduate of Tulane University, Dr. Kamboj was displaced by Katrina during her residency, which she finished in Washington D.C., after which she worked in Atlanta before moving back to New Orleans. She specializes in adult and pediatric allergic diseases, with emphasis on asthma, sinus and nasal allergies, skin diseases, and food allergies. Dr. Kamboj said she was motivated to move back because she identified a real need here in the Crescent City.
Allergies are defined as a hypersensitive immune system response to essentially harmless substances. They occur when the body’s immune system mistakenly identifies a harmless foreign substance—such as pollen, a certain type of food, dust, pet dander, or even insect venom—as a dangerous pathogen.
Consequently, the immune system becomes sensitized, and essentially overreacts when exposed to that substance again, releasing large amounts of immunoglobulin E (IgE) to destroy the allergen to which it has become sensitized. This DEFCOM 1 immune response to what is essentially a non-threatening situation triggers what is known as an allergic response. The substances that cause this immune system response are known as allergens.
While allergens are not harmful, the allergic reaction they can provoke certainly can be. In addition, they can be difficult to avoid, as a dizzying number of things can provoke an allergic response.
The type of allergic response sufferers experience depends on the type of allergen, making allergy symptoms wide-ranging and difficult to predict. Symptoms of allergies caused by dust and pollen include itchy swollen and watery eyes, a runny or blocked nose, or a persistent cough. On the other hand, reactions to foods that produce allergic response might include nausea and vomiting, cramps, shortness of breath, swelling of the tongue, face, throat and lips, and even rectal bleeding. In rare cases, both food and insect sting allergies can cause anaphylaxis—a severe and possibly life-threatening allergic reaction that constricts vital airways.
Allergies can be classified by their source—such as insect venom or certain types of food—or by the part of the body they affect, e.g., skin, eyes, or nose. According to the CDC, food allergies are estimated to affect 4−6% of children in America. Similarly, Food Allergy Research & Education (FARE) data indicate that milk, eggs, tree nuts, soy, fish and shellfish, and peanuts account for more than 90% of food allergy reactions.
Some people grow out of allergies, while some develop them as they age. People can develop allergies after moving geographically or for no reason at all. Since, in theory, practically anything can cause an allergic response, treating allergies effectively is a complex problem. However, most scientists agree that all allergies begin with exposure.
Unique New Orleans
“New Orleans is a unique environment for allergies,” said Dr. Kamboj. “We have a lot of older homes, we have had a lot of water damage, and we still have a lot of humidity and storms. A lot of our buildings, including schools, have not been properly remediated since Hurricane Katrina, and so we have a lot of mold exposure.”
While it has been more than a decade since Katrina, according to Dr. Kamboj, one way that the storm’s effects are still felt in New Orleans is reflected in the rising number of individuals who have developed allergies since 2005. And she includes herself into this group.
“It is somewhat of a hot topic,” said Dr. Kamboj. “But I didn’t have any allergies when I was displaced by Katrina, and I didn’t have any allergies in the nine years I was away. But when I came back, I developed eye irritation, nasal congestion, post-nasal drip, and sinus issues. So, I am someone who shares the pain of my patients, because I developed year-round allergies when I moved back to New Orleans.”
However, according to Dr. Kamboj, the allergy treatment’s first line of defense is to correctly identify allergic “triggers.”
Skin testing is the most widely used method of identifying allergic triggers. It involves introducing small amounts of common allergens to the skin and observing the reaction.
“Skin prick testing is our gold standard,” said Dr. Kamboj. “Once the allergen is identified, we would first use medications—nasal sprays, eye-drops, anti-histamines—and based on how well the patient does, we might then think about a desensitization immunotherapy type of regimen.”
Immunotherapy is a preventative treatment for allergies that involves injecting sufferers with tiny doses of their particular allergen—doses small enough to stimulate the immune system, but not large enough to provoke a full-blown attack. The aim of immunotherapy is to build up a tolerance to the particular allergens, hopefully gradually diminishing and eventually eliminating sufferers’ symptoms.
This was the hope of Latter & Blum realtor Jo-Ann Fitzgerald Matherne. According to Matherne, as a child growing up in Ireland, she was allergy free. However, post-Katrina, she began to feel “constantly run down.”
“At first I thought it was just really bad hangovers,” joked Matherne. “But I had nasal congestion, I felt nauseous, I had headaches, red eyes and nose, and the roof of my mouth would get itchy. Then, I thought it was just emotional exhaustion after Katrina—but it just never went away.”
After recurrent sinus infections, she was diagnosed with multiple allergies and began immunotherapy. Three years into her treatment, Matherne also adopted an alternative diet-related approach. After removing processed food, potatoes, and dairy from her diet, she said, her allergies completely disappeared.
“I don’t know if my diet was making me more susceptible to allergies,” said Matherne. “But I do know that changing my diet worked, and is continuing to work, so I am not going to mess with it.”
Avoidance of allergens is one of the easiest—and most difficult—ways to avoid allergies. Avoidance works well with food-related allergies, but for those intolerant of universally present allergens, such as pollen, dust mites, or mold, it is a trickier proposition, said Dr. Kamboj.
Improved Quality of Life
For Rachel Mekdessie, allergies were just a part of life. Her husband Bryan is a K9 Police Officer, and his K9, a Belgian Malinois called Zen, is one of five dogs in the Mekdessie household. Highly allergic to pollen, grass, and dust, as well as dogs and cats, Mekdessie also suffered anaphylactic reactions to shellfish. However, it was when she began having anaphylactic reactions to other foods, such as nuts, that she began immunotherapy with Dr. Kamboj.
“And it has totally improved my everyday quality of life,” said Mekdessie. “I can spend more time outside. I don’t have to call in sick as often. I am just much happier now.”
Completely curing allergies might be tomorrow’s goal, said Dr. Kamboj, but improving the quality of life for allergy sufferers is something that can be achieved today.
“We don’t have a bubble to put patients in,” said Dr. Kamboj. “But what we do have are proven ways to diagnose allergies, and targeted medical ways to treat them. And that is very good news.”