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Allergen Immunotherapy

Purpose

Your individualized course of allergy shots (immunotherapy) is designed to decrease your allergic sensitivities. The vast majority of allergic patients (80-90%) will experience substantial reductions in their symptoms over time (months to years). Many also reduce or eliminate the need for other medications. Together with avoidance of offending allergens and medication allergy shots represent one of the recommended treatments for allergic rhinitis, allergic conjunctivitis, atopic dermatitis and asthma. Allergy shots are not useful for food/drug allergies or non-allergic conditions like infections.

Treatment Duration

The length of a treatment course varies on a case by case basis but in general a course requires 3 to 5 years of maintenance treatment for completion. Initially there is a build-up phase where the injections are given more frequently but as the High Dose, or maintenance dose, is reached the frequency of injections may be adjusted. The total duration of therapy can vary considerably from patient to patient. During your treatment you will be re-evaluated frequently by your physician. These visits will occur at least annually.

Schedule of Administration

Your series of injections begins at a low dose selected by your physician based on your skin test results and history. Over time the shots build gradually until you reach your High Dose. This High Dose is called the maintenance dose and you will stay on it for the duration of your treatment course unless it is changed by your physician. Maintenance therapy can be continued if you are pregnant BUT notify your OAAC physician when you become pregnant.

The build-up phase of the allergy shots can occur in different formats. Your physician will help you decide which is right for you. Most common is the weekly building schedule. Various accelerated schedules include: 2 or 3 time a week shots, clusters of several shots given on the same day and finally RUSH therapy where many injections are given on one day and then weekly shots follow until you are at your High Dose. RUSH therapy is associated with significantly more side effects (see below) and is not for every patient. However, it does bring you to the High Dose level in a month rather than slowly over many months. This is an advantage for some patients.

Safety

All allergy shots carry some risks for severe anaphylactic reactions. Therefore the injections need to be administered in a medical facility under medical supervision on a regular basis. Weekly or twice weekly shots from our clinic carry a risk of anaphylaxis of 0.015 to 0.02% of injections compared to nationally published risks of 0.1 to 0.3% of injections. RUSH therapy carries a nationally published risk of almost 40% of shots whereas our RUSH risk is closer to 10% of injections. This marked increase in risk however makes RUSH therapy unacceptable for many patients.

Recent News

Food Allergies and Theme Parks
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Food Allergies and Theme Parks

By Eve Chen, USA TODAY

There’s a lot more to theme park food than funnel cakes and turkey legs. Many parks pride themselves on their array of dining options for guests, but not just for flavor. More than 6% of Americans have a food allergy, according to the Centers for Disease Control and Prevention’s National Center for Health Statistics. The most common food allergens are milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat, soybeans and sesame, according to the U.S. Food and Drug Administration. With those, allergy-safe options can be a matter of life and death.

“I had my first reaction when I was a baby to nuts, and I’ve had serious reactions since that have brought me to the ER – thankfully not too many in recent years,” said Allie Bahn, who helps travelers with food allergies through her Miss Allergic Reactor website and Allergy Travels Facebook group. Bahn has four of the top nine food allergies and other specific allergens, like potatoes. “It can be certainly life-threatening, so it’s different than avoiding foods just because of something bothering your stomach.”

Here are seven ways travelers with food allergies can safely navigate theme parks and what parks are doing to help:

Do your research.

Some parks flag top allergens on their websites and apps.

“It’s listed by restaurant, by item, and it talks about each item what would be the allergen that could be present in that item … A lot of folks who have been living with allergies know what they can and can’t eat, and they’re just looking for a map of ‘Where can I get what I need?’ ” said Cedar Fair corporate chef Charles Walker, who helped roll out new dietary guides for guests earlier this year. As someone with food allergies himself and family members with food allergies, Walker added, “This was near and dear to my heart to really make sure this guest-facing platform was very user-friendly.”

For more personalized help, Cedar Fair’s parks and many others have phone lines and email addresses listed on their websites just for guests with special dietary needs.

“I’m a big fan of contacting places ahead of time,” Bahn said.

Don’t go hungry.

Bahn recommends eating a hearty meal before heading to the park. “So you already have something nice and warm in your stomach, hoping that you’ll be able to find something (else) when you’re there,” she said. She also recommends having plans for a meal after leaving the park, so at least those two meals are covered.

Pack snacks. Not all parks allow outside food, but when permitted, Bahn recommends packing snacks for backup. “Don’t make assumptions that you definitely can’t eat. I think there’s always the ability to try to do as much research ahead of time and then see how it goes once you get there, but having a plan in place is always really helpful,” she said.

Always carry medication or epinephrine. Bahn says she’s carried an epinephrine auto-injector with her for as long as she can remember. “Don’t lock it up in a locker where you can’t quickly access it in case of an emergency,” she said. “It should be on you at all times.”

Ask questions.

“Ask if they have ingredients that you can see,” Bahn said. Some park restaurants have binders of ingredients guests can look at, but it’s best to confirm everything is up to date with chefs, who are happy to speak with guests with food allergies. Sometimes, when creating menus, chefs will intentionally avoid using common allergens like peanuts to make foods more accessible. Chefs can also sometimes adjust dishes for allergies.

“Our festival chefs will go through (the menu) and make sure, based off of the dietary needs, if a dish is safe, if there’s anything (the guest) can have from those kiosks, or if there’s a way, we can make that dish for them safe,” said Kevin Downing, executive chef of EPCOT Festivals at Walt Disney World. Cedar Fair’s Walker echoed, “If you have a very, very specific allergy, we’ll do whatever we can to accommodate.”

Advocate for yourself.

“Explain your food allergies. Advocate for yourself,” Bahn said. She recommends carrying a Chef Card that can be given to chefs, stating each allergy, its severity, and the need for clean utensils and surfaces to be used in food preparation to avoid possible cross-contamination. “It makes everybody’s life, I think, a lot easier and really gets the point across that this is a severe food allergy and not just dietary preference,” she said.

When an allergy-related order comes into Connections Eatery kitchen at EPCOT, Chef Scott Tosh said. “It prints up special, so the special diets-trained cast member will prepare that food. We put an allergy pick in it. If there’s two items – one’s allergy, one’s not – we serve them with separate trays.” Bahn said Disney parks have always been great with her needs, even when she was a kid and people were generally less aware of food allergies.

Trust your gut.

Bahn recommends double-checking all food before digging in.

“I think I have been able to sort of save myself from some potential reactions because of advocating and double checking, trusting my gut,” Bahn said of no place in particular. “There’s plenty of times where I’ve decided not to eat, even if I’ve ordered something because I just felt like I didn’t get all my questions answered in a way that I felt was safe. And that’s OK too. Being able to politely and kindly decide not to eat and walk away and make a different plan is OK, as well. It’s your safety. It’s your health.”

https://www.usatoday.com/story/travel/experience/theme-parks/2023/12/14/food-allergies-theme-park-tips/70911517007/

The post Food Allergies and Theme Parks appeared first on Oklahoma Allergy and Asthma Clinic.

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