How to Talk to your Child About their Food Allergy

It can be really hard to talk to your child about their food allergy. But there are tactics you can employ to make it an easier and more positive experience.

Through simple and clear communication, you can bring your child to a place where they understand their allergy. Having this understanding will help them to not be anxious or self-conscious about their condition.

1. Safety First

For young children, it is important to not overwhelm and to keep things really simple. The thing you should touch on first is safety.

– Give them simple terms to deem foods as either safe or unsafe. Explain to them that these ‘unsafe’ foods can make them very sick.
– The next step is to teach them the names of the foods and to point them out at the grocery store and in magazines.
– Then teach them to only eat foods given to them by their parents or by adults that their parents have approved of.
– The last first step is to tell your children that if they ever feel sick, they need to let and adult know. Also give them the run down on the emergency plan you have in case they have an allergic reaction.

2. Keep Calm

I know it is easier said than done, but try not to panic about your child’s food allergy in front of them. They will mirror your response. If you appear anxious, they will become anxious as well. It is important they know that their condition is serious, but they also need to know about there is no need to worry because there are plans in place to help them.

3. Get your Child Involved

It’s natural to want to care for your child behind the scenes, reading labels at the grocery store and what have you, but it is important that they join you in these activities. A helpful way to do this is to use “we” statements rather than “I” statements. For example, “Let’s make sure we have our epinephrine auto-injectors before we leave!”

4. Connect with Others

It’s important for kids to know that they are not alone in their food allergy. Tell them the facts about how many kids have food allergies and help them find friends who have food allergies. There are also support groups that you can join such as PAK (Parents of Allergic Kids). This will help you connect with other parents so you can get ideas on how to talk to your child.

With open and honest communication and consistency, your child will be prepared to face any situation. If you need any more advice on this topic, feel free to make an appointment with us. We have multiple locations in the greater Charlotte area.

occupational asthma

Occupational Asthma

I’m sure you can guess what occupational asthma is: asthma brought on by or made worse by certain work settings. But could you be at risk?

It’s important to discuss occupational asthma because it is the most common work-related lung disease in developed countries. It is hard to nail down the exact number or percentage of work related asthma cases, but in the US, up to 15% of asthma cases may be job-related.

Occupational asthma is caused by inhaling fumes, gases, dust or other potentially harmful substances while working. Often, symptoms are worse while working and improve when you have time off and start again when you go back to are away.

Individuals with a family history of allergies are more likely to develop occupational asthma, particularly to some substances such as flour, animals and latex. Also, smokers are at a greater risk for developing occupational asthma.

If you work in the petroleum or chemical industries, hydrochloric acid, sulfur dioxide or ammonia can induce occupational asthma. If you are exposed to any of these substances at high concentrations, you may begin wheezing and experiencing other asthma symptoms immediately after exposure.

Allergies play a role in many cases of occupational asthma. This type of asthma generally develops only after months or years of exposure to a work-related substance. Your body’s immune system needs time to develop allergic antibodies or other immune responses to a particular substance.

Some examples of this allergy-induced occupational asthma are workers in the washing powder industry, who may develop an allergy to the enzymes of the bacteria, Bacillus subtilis. Another profession that could be subject to this is bakers. They may develop an allergy and occupational asthma symptoms from exposure to various flours or baking enzymes.

Veterinarians, fishermen and animal handlers in laboratories can develop allergic reactions to animal proteins. Healthcare workers can develop asthma from breathing in powdered proteins from latex gloves or from mixing powdered medications. About 5% of people working with laboratory animals or with powdered natural rubber latex gloves have developed occupational asthma.

Some other professionals who are at risk for occupational asthma are those engaged in spray painting, insulation installation and in manufacturing plastics, rubber and foam. These chemicals can cause occupational asthma in up to 10% of exposed workers.

The length of time you are exposed to a substance before it triggers your asthma varies. It can be months or years before symptoms occur. On the other hand, exposure to a high concentration of irritants can cause asthma within 24 hours.

Those who practice agricultural work are also at risk. Substances in aerosol form can lead to a buildup of histamine or acetylcholine in your lungs, which can casue asthma. Also, insecticides can cause a buildup of acetylcholine, which causes your airway muscles to contract and tighten.

Be aware: many people with persistent asthma symptoms caused by substances at work are incorrectly diagnosed as having bronchitis. If occupational asthma is not correctly diagnosed early, and you aren’t protected or removed from the exposure, it can cause permanent changes to your lungs.

An allergist/immunologist, often referred to as an allergist, is the best qualified physician to determine if your symptoms are allergy or asthma-related. We can properly diagnose the problem and develop a treatment plan to help you feel better and live better.

In some cases, pre-treatment with specific medications can be an option. In other situations, particularly if you are very allergic to a substance in your workplace, you may want to consider a career change.

allergy vs intolerance

Allergy vs Intolerance

Do you get a stomach ache every time you eat some of your favorite foods like pizza or ice cream? If so, you’ve probably wondered if you have a milk allergy or intolerance. What is the difference between an allergy vs intolerance? Read on if you want to find out!

Some of the symptoms of food intolerance and food allergy are similar, but the differences between the two are very important. Eating a food you are intolerant to can leave you with an upset stomach. However, if you have a true food allergy, your body’s reaction to this food could be life-threatening.

The difference between the two are in the system they take place in. A food intolerance response takes place in the digestive system. It occurs when you are unable to breakdown the food properly. This could be due to enzyme deficiencies, sensitivity to food additives or reactions to naturally occurring chemicals in foods. Often, people can eat small amounts of the food without it causing problems.

A food allergic reaction involves the immune system. Your immune system controls how your body defends itself. For instance, if you have an allergy to cow’s milk, your immune system identifies cow’s milk as an invader or allergen. Your immune system overreacts by producing antibodies called Immunoglobulin E (IgE). These antibodies travel to cells that release chemicals, causing an allergic reaction. Each type of IgE has a specific “radar” for each type of allergen.

Unlike an intolerance to food, a food allergy can cause a serious or even life-threatening reaction by eating a microscopic amount, touching or inhaling the food.

Symptoms of allergic reactions to foods are generally seen on the skin (hives, itchiness, swelling of the skin). Respiratory symptoms may accompany skin and gastrointestinal symptoms, but don’t usually occur alone. Food intolerance, however, will show itself through gastrointestinal symptoms such as vomiting and diarrhea

Anaphylaxis is a life-threatening allergic reaction that happens very quickly and can be caused by a food allergy. Symptoms of anaphylaxis may include difficulty breathing, dizziness, abdominal pain or loss of consciousness. Without immediate treatment—an injection of epinephrine (adrenalin) and expert care—anaphylaxis can be fatal.

So this is why knowing the difference between allergy vs intolerance is so important. Food allergy can be fatal and needs to be taken very seriously. If you think you may have a food allergy, make an appointment with us today.

Charlotte Allergy Season (If There is One)

Charlotte, NC has been growing exponentially over the past few years and it’s no surprise to anyone. With the four seasons, beautiful trees and mild temperatures, it is clear to see why it is so desirable. Transplants are drawn in by these beautiful trees but don’t expect to be hit with allergies because of them. New arrivals wonder when the Charlotte allergy season will end, but does it ever?

One of our providers, Dr. Tom Humphries, suggests that newcomers manage their symptoms. He said that part of the problem for people relocating from the North is that the Charlotte allergy seasons starts earlier and lasts longer.

Dr. Humphries has some suggestions of how you can alleviate allergy symptoms in the long Charlotte allergy season. He said if you normally jog before work, consider not going outside to jog or doing it in the evening because most trees pollinate more in the early morning.

He also suggests over-the-counter antihistamines and nasal saltwater rinses, which help clear pollen out of the nose. For allergy control beyond the outdoors, Humphries suggests looking inside your house.

“Your body’s like a glass of water,” he said. “As you fill it up with different things you’re allergic to, the glass spills over and you begin having symptoms.”

So if you have a dog, be consistent about cleaning up its hair and make sure to keep the dust in your home under control. If symptoms persist or sinus infections become an issue, feel free to make an appointment with us.

Since winter is here and Charlotte winter allergies can be just as bad as spring and summer, here are some tips so you can prevent symptoms as much as possible:

• Winter allergy sufferers have the potential to suffer from dehydration, since people have to blow their noses so often. So be sure to drink lots of water and eat water-rich fruits and vegetables. Hot drinks are very helpful in reducing nasal congestion.
• If you have pets, wash your bedding and/or your child’s bedding frequently because they leave behind pet dander and dust mites. Wash bedding of allergy sufferers at least once per week and be sure to use hot water.
• Stay indoors when large gusts of wind send moist leaves in your front or backyard twirling around.
• Bathe often. This will wash allergy triggers from your face and hands. A nightly bath or shower goes a long way in keeping allergy symptoms under control.
• Consider adding a moisturizer to your heating system. Putting more moisture into your home during dry winter spells helps with allergies, just make sure you don’t overdo it!

Don’t let your allergies keep you from enjoying the holiday cheer! We hope these tips will help you so that you can embrace the gorgeous Charlotte outdoors this winter.

Allergic Skin Reaction: Is it Eczema?

Is your skin itchy, red or dry? Does it leak fluid that crusts over when scratched? 
If so, there’s a chance it’s Atopic dermatitis, more commonly known as Eczema.

Eczema is the most common skin condition, especially in children. It affects one in five infants but only around one in fifty adults. It arises from a “leakiness” of the skin barrier, which causes it to dry out and become prone to irritation and inflammation by many environmental factors.

In about half of patients with severe atopic dermatitis, the disease is due to inheritance of a faulty gene in their skin called filaggrin. Patients with the faulty filaggrin gene often have hand eczema with excessive little lines on their palms.

Unlike hives, the itch of eczema is not only caused by histamine so anti-histamines may not control the symptoms. Eczema is often an allergic skin reaction linked with asthma, allergic rhinitis (hay fever) or food allergy. This order of progression is called the atopic march.

The location of the rash depends on the age individual. In infants, eczema is often seen on the face. Children are prone to have the rash on the elbow, wrists, behind the knees and behind the ears. Adolescents and young adults typically have the rash in the same locations as children, but also have it on the hands and feet.

In many children, the exact cause of the eczema is not clear and treatment depends on regular use of moisturizer and topical medicines to dampen down the inflammation. One such treatment is topical steroids. In children where the skin is oozing, crusting and painful, an infection that needs treatment with antibiotics may be the primary trigger.

Some people with eczema have a food sensitivity which can make eczema symptoms worse. Infants and young children with more severe eczema should be evaluated for food allergy. If this is the case for your child, come in and see us for diagnosis and management. We also have our dietician in-house, who can be a great help in this.

Food allergies causing eczema are much less common in older children and adults. If you think your eczema is an allergic skin reaction caused by a food allergy, diagnosis begins with testing and a discussion with an allergist before starting any elimination diets.

Eczema is sometimes described as an “itch which rashes.” The rash is caused by scratching, so the more the patient scratches the more severe the rash will be. This is why it’s important to avoid scratching.

The best way to treat eczema is to use moisturizers and topical ointments that reduce the inflammation e.g. topical steroids or calcineurin inhibitors. The itch is not relieved by antihistamines although these are sometimes used at night to help people with eczema sleep.

Antibiotics may be prescribed if a skin bacterial infection is suspected as a trigger for your eczema flare-up. Symptoms of infection include crusting, oozing and pain. Oral steroids should be avoided, as although they are effective the eczema usually returns when the medicine is stopped. Oral steroids can also cause serious side-effects if taken for long periods of time.

Sometimes, wearing cotton undergarments and body suits can help protect the skin from irritants and scratching. We recommend you avoid using soap products that contain sodium laurel sulfate and any triggers that cause a reaction. If you come in and see us, will be able to help determine whether there is a trigger that can be avoided.

These skin allergy treatment and management strategies can relieve social challenges as well. People with eczema, especially children, are sometimes ignored or singled out by others who believe the rash is contagious.

Come in today to find out if you have eczema and to get the treatment you need. We can’t wait to meet you!

Rhinitis Symptoms & Treatment

Rhinitis Symptoms & Treatment

Rhinitis is more commonly referred to as Hay Fever. The name Hay Fever came about because symptoms would strike during hay harvesting season, when these pollens would be in the air. While a hay allergy is possible, usually people with hay fever are allergic to trees, grasses and ragweed – not hay. Hay Fever, has two types: allergic and non-allergic.

Allergic Rhinitis
If you have allergic rhinitis, your immune system mistakenly identifies a typically harmless substance as an intruder. This substance is called an allergen. The immune system responds to the allergen by releasing histamine and chemical mediators that typically cause symptoms in the nose, throat, eyes, ears, skin and roof of the mouth.

Seasonal allergic rhinitis (hay fever) is most often caused by pollen carried in the air during different times of the year in different parts of the country.

Allergic rhinitis can also be triggered by common indoor allergens such as the dried skin flakes, urine and saliva found on pet dander, mold, droppings from dust mites and cockroach particles. This is called perennial allergic rhinitis, as symptoms typically occur year-round.
In addition to allergen triggers, symptoms may also occur from irritants such as smoke and strong odors, or to changes in the temperature and humidity of the air. This happens because allergic rhinitis causes inflammation in the nasal lining, which increases sensitivity to inhalants.

Many people with allergic rhinitis are prone to allergic conjunctivitis (eye allergy). In addition, allergic rhinitis can make symptoms of asthma worse for people who suffer from both conditions.

Nonallergic Rhinitis
At least one out of three people with rhinitis symptoms do not have allergies. Nonallergic rhinitis usually afflicts adults and causes year-round symptoms, especially runny nose and nasal congestion. This condition differs from allergic rhinitis because the immune system is not involved.


Some typical symptoms of allergic rhinitis symptoms include itching in the nose, roof of the mouth, throat, eyes, sneezing, stuffy nose, runny nose, tearing eyes, and dark circles under the eyes.

You can expect to see these symptoms in the spring and fall, but sometimes they last all year long.

Thankfully, the physicians at Asthma & Allergy Specialists have specialized training and experience to diagnose specific allergens that trigger your illness, or to determine if your symptoms are non-allergic. Your allergist will take a thorough health history followed by allergy testing.


Once specific allergens are diagnosed, your immunologist will work with you to develop a plan to avoid allergens that trigger your symptoms. For example, if you are allergic to dust mites or indoor mold, you will want to take steps to reduce these allergens in your house as much as possible.

For outdoor allergies such as pollen, avoidance measures include limiting outdoor activities during times of high pollen counts. The National Allergy BureauTM (NAB) provides the most accurate and reliable pollen and mold levels from approximately 80 counting stations throughout the United States, two counting stations in Canada and two counting stations in Argentina.

Allergy shots can be used to provide long-term relief for many people suffering from allergic rhinitis.

Another form of allergy immunotherapy was recently approved in the United States called sublingual immunotherapy (SLIT) allergy tablets. Rather than shots, allergy tablets involve administering the allergens under the tongue generally on a daily basis.

Your allergist might prescribe medication to decrease allergic rhinitis symptoms. These medications may include nasal corticosteroid sprays, antihistamine pills, nasal antihistamine sprays or decongestant pills.

The treatment options for non-allergic rhinitis include nasal corticosteroids, nasal antihistamines and nasal saline formulations. If there is a lot of runny nose, ipratropium nasal spray can provide relief. If nasal congestion is a major problem, decongestant pills or sprays can be used, but the nasal decongestant sprays should not be used for more than four days unless they are used in conjunction with a nasal corticosteroid spray.

Be proactive. The majority of allergy medications for seasonal allergic rhinitis (hay fever) work best if started before tree pollen is in the air each spring and allergy symptoms develop. If you start taking allergy medications before you first come into contact with spring allergens, the medication can prevent the release of histamine and other chemicals. As a result, allergy symptoms are prevented from developing or are much less severe. In other words, come see us before spring!

Asthma and Pregnancy


When women are pregnant or thinking of becoming pregnant, they begin to strictly monitor what they eat and drink. One thing that’s easy the forget about is the relationship between asthma and pregnancy.

If you’re a mom-to-be, it is vital that you keep your asthma under control. It is important to avoid triggers and take your asthma medications as prescribed. These disciplines can all help ensure a healthy pregnancy for you and your little one.

If you struggle with asthma, it is encouraged that you monitor your asthma during prenatal visits. It is impossible to predict how your asthma will react to your pregnancy. One third of women experiences a worsening of symptoms, one third have a decrease in the severity and one third tend to stay the same. It is important to have these check-ins so your doctor can increase or decrease your medication if necessary.

Asthma attacks are most common during the later weeks of pregnancy, but are very rare during labor itself.

Managing Your Asthma During Pregnancy

What happens if you have an asthma flare-up during your pregnancy? An asthma flare-up causes decreased oxygen levels in the blood. This, in turn, can lead to less oxygen reaching the fetus. Low oxygen can impair healthy fetal growth and development.

If you were receiving allergy shots (immunotherapy) prior to becoming pregnant, it is safe for you to continue this treatment during pregnancy. Just be sure to let your allergist know that you are pregnant. If you are interested in starting allergy shots, it is best to wait until the baby is born.

What About Medications?

Make sure to continue taking your medications throughout your pregnancy. Many mothers-to-be are concerned about taking medications during pregnancy. Yet the risks posed by uncontrolled asthma are much greater than those from asthma treatments.

Inhaled corticosteroids are often the treatment of choice for persistent asthma. Studies have shown them to be effective and low-risk for pregnant women. The National Asthma Education and Prevention Program (NAEPP) recommends two specific drugs: budesonide (inhaled corticosteroid) and albuterol (short-acting Beta 2-agonist) as having good safety profiles when used during pregnancy.

Oral corticosteroids are not preferred for regular asthma treatment during pregnancy. However, they can be used to treat severe asthma attacks.

If you are pregnant and think you may have asthma, make sure to have your condition diagnosed to reduce the risks to your baby. Studies have linked asthma attacks in early pregnancy to birth defects.

If you want to learn more about asthma and pregnancy, make an appointment with one of the physicians at Asthma & Allergy Specialists today!

Acute Asthma Exacerbation

Have you experienced shortness of breath simultaneously with a tight pain in your chest? If so, you’ve probably experienced an acute asthma exacerbation. This is a fancy way to say ‘asthma attack.’

So what is happening in your body when you have an asthma attack? Well, your airways become swollen, your muscles contract and your bronchial tubes get narrow. This situation is not one to be taken lightly. Acute asthma exacerbation can be life-threatening, so we recommend you come see us.

The symptoms and severity of asthma attacks vary from person to person. An individual can experience wheezing, coughing, chest tightness, and/or shortness of breath. Acute asthma exacerbations also vary in length. Some attacks can last for one minute while others can last for hours.

There is a wide range of options that can cause an asthma attack. Some common triggers are upper respiratory infections, colds, pollen, mold, dust mites, pets, tobacco smoke, cold/dry air, exercise and gastroesophageal reflux disease. Sometimes it can be a combination of these factors.

If these symptoms sound familiar to you, we advise that you come in to get some tests done! It is important to learn how to treat an attack when it comes since it does have the potential to be life-threatening.

Understanding Pollen Counts

The term pollen count (or mold count) is very common and you’ve probably seen this on the news: “ pollen count today ”. But what exactly is a pollen count and how does it related to your allergies?

Pollen counts aren’t exactly ‘counts’. They are, more so, forecasts that give an estimate of how much pollen is in the air. The pollen is divided into categories of tree pollen, grass pollen and weed pollen. They are associated with specific numbers in addition to the levels high, medium and low.

Some reports go into more detail about which specific pollens are in the air, such as oak tree or ragweed.

Many people think that if a pollen count is high, they will experience a high level of allergy symptoms that day. But that is not always the case. There are too many variables to be able to say that for sure.

One of the first variables lies in the way the pollen counts are obtained. Most pollen counters are placed on tall buildings and they collect samples of pollen from the air. These samples are examined under a microscope and counted. The results are then extrapolated to make an estimate of how much pollen is in the air.

It is important to note that the levels of pollen (high, medium or low) are reported based on averages of pollen collected over the years. Also, these counts are not full-proof due to factors such as time of day collected, weather changes, and the area from which the pollen was collected.

Other factors that affect pollen counts include the types of local plants in the area where the pollen was collected and the fact that the types and amounts of pollen collected change over the course of a day and from day to day.

Lastly, what these counts mean to allergy sufferers can differ. For one person, a high pollen count of ragweed could cause severe allergy symptoms and for another person, it could cause only mild symptom. This just depends on how allergic a person is to the pollen in question.

Now when you see “ pollen count today ” on the news, you’ll know exactly what they’re talking about. Pollen counts can be helpful if you know what you’re allergic to and what reactions you have at the different levels. Find out today’s pollen count on our website or come in and find out what you’re allergic to!

How do Allergy Shots Work?

How do Allergy Shots Work?

Allergy shots, also known as Allergen immunotherapy, is a form of long-term treatment that decreases symptoms for many people with allergic rhinitis, allergic asthma, conjunctivitis (eye allergy) or stinging insect allergy.

Immunotherapy works by decreasing sensitivity to allergens. These shots often lead to lasting relief of allergy symptoms even after treatment is stopped. This potential for life-long treatment is what makes allergy shots a cost-effective, beneficial treatment approach for many people.


Who Can Benefit from Allergy Shots?

Both children and adults can receive allergy shots. When considering allergy shots for an older adult, medical conditions such as cardiac disease should be taken into consideration and discussed with us first.

We typically decide if allergy shots are right for you based on the following criteria:
•    Length of allergy season and severity of your symptoms
•    How well medications and/or environmental controls are helping your allergy symptoms
•    Your desire to avoid long-term medication use
•    Time available for treatment (allergy shots requires a significant commitment)
•    Cost, which may vary depending on region and insurance coverage

Unfortunately, allergy shots are not used to treat food allergies. The best option for people with food allergies is to strictly avoid that food.


How Do They Work?

Have you ever gotten a vaccine? Well allergy shots work the same way. Your body responds to injected amounts of a particular allergen, given in gradually increasing doses. Over time, you develop immunity or tolerance to the allergen.

There are two phases of allergy shots:
•    Build-up phase– Over the course of about 3-6 months, you receive shots with increasing amounts of allergens about one to two times per week.
•    Maintenance phase– This phase starts after the effective dose is reached. The effective maintenance dose depends on your level of allergen sensitivity and your response to the build-up phase. Over the course of this phase, there will be longer periods of time between treatments, ranging from two to four weeks. We will decide what range is best for you.

Do allergy shots work? Yes, but they do not work for everyone. Also, they require a lot of patience and consistency. It may take up to a year on the maintenance dose to notice an improvement. If the allergy shots are successful, maintenance treatment is generally continued for three to five years. Any decision to stop allergy shots should be discussed with us first.